The Effect of Self-Care Training on Blood Sugar Control, HbA1C Level, and Life Quality of Diabetic Patients in Birjand, East of Iran: A Randomized Clinical Trial StudyRead the full article
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Assessing Level of Knowledge and Uptake of Hepatitis B Vaccination among Health Care Workers at Juba Teaching Hospital, Juba City, South Sudan
Background. Chronic hepatitis B (CHB) virus (HBV) infection remains a severe problem worldwide. An estimated 240–400 million persons are reported to have chronic HBV infection, and the annual mortality from HBV-related complications including cirrhosis and hepatocellular carcinoma was 600,000 persons. In Sub-Saharan Africa, the prevalence of HBV chronic infection is particularly high while in South Sudan, hepatitis B remains a serious problem of public health importance with health care workers being more at greater risk. Vaccination coverage against HBV is low among all age groups, yet vaccination status among health care workers is not even known in South Sudan. This study aimed at assessing viral hepatitis B vaccination uptake among health care workers at Juba Teaching Hospital, Juba City, South Sudan. Objective. To assess the uptake of viral hepatitis B vaccination among health care workers in Juba Teaching Hospital, Juba City, South Sudan. Methods. An analytical cross-sectional study design was conducted targeting 154 health workers. A convenient sampling procedure was used to recruit study participants. Questionnaires were used to collect data. SPSS version 20.0 was used for data analysis. Chi-square tests were used to determine the association between the uptake of hepatitis B vaccination and individual and health facility factors. Multivariable analysis was conducted. Adjusted OR was used to interpret the findings. Results. Uptake of hepatitis B vaccination was found to be low at 44.20%, only 48.8% had received one dose, 29.1% received two doses, and 22.1% had received all three doses. Being married (), knowing that hepatitis B can be prevented by vaccination (), knowing that HBV can be got through unprotected sexual intercourse (), awareness of where to get hepatitis B vaccination from (), availability of vaccines in the health facility (), and availability of guidelines followed by all health workers in this facility () were the factors independently associated with the uptake of hepatitis B vaccination. Conclusion. The uptake of hepatitis B vaccination among health workers at Juba Teaching Hospital was low (22.1%), putting health workers at great risk of HBV infection. Having knowledge about hepatitis B vaccination and unprotected sexual intercourse were individual factors associated with hepatitis B vaccination. Availability of the vaccine and vaccination guidelines were the health-related factors associated with hepatitis B vaccination. The government of South Sudan through the Ministry of Health should first track approval of the viral hepatitis B vaccination policy and ensure that it is adopted and implemented by all hospitals. Health care workers must be prioritized and mandatorily vaccinated against viral hepatitis B.
Role of Statins in the Primary Prevention of Atherosclerotic Cardiovascular Disease and Mortality in the Population with Mean Cholesterol in the Near-Optimal to Borderline High Range: A Systematic Review and Meta-Analysis
Objective. The objective of this meta-analysis was to analyze the benefits and harms of treating the population with statins in those having mean low-density lipoprotein cholesterol (LDL-C) in the near-optimal (100 to 129 mg/dl) to borderline high (130 to 159 mg/dl) range and free of cardiovascular disease (CVD). Methods. We searched PubMed, PubMed Central, Cochrane Library, and Google Scholar databases for randomized controlled trials (RCTs) published between 1994 and July 2020. We included RCTs with greater than 90% of participants free of CVD. Two reviewers independently screened the articles using the Covidence software, assessed the methodological quality using the risk of bias 2 tool, and analyzed the data using the RevMan 5.4 software. Results. Eleven trials were included. Statin therapy was associated with a decreased risk of myocardial infarction (RR = 0.56, 95% CI: 0.47 to 0.67), major cerebrovascular events (RR = 0.78, 95% CI: 0.63 to 0.96), major coronary events (RR = 0.67, 95% CI: 0.57 to 0.80), composite cardiovascular outcome (RR = 0.71, 95% CI: 0.62 to 0.82), revascularizations (RR = 0.65, 95% CI: 0.57 to 0.74), angina (RR = 0.76, 95% CI: 0.63 to 0.92), and hospitalization for cardiovascular causes (RR = 0.74, 95% CI: 0.64 to 0.86). There was no benefit associated with statin therapy for cardiovascular mortality and coronary heart disease mortality. All-cause mortality benefit with statin therapy was seen in the population with diabetes and increased risk of CVD. Statin therapy was associated with no significant increased risk of myalgia, creatine kinase elevation, rhabdomyolysis, myopathy, incidence of any cancer, incidence of diabetes, withdrawal of the drug due to adverse events, serious adverse events, fatal cancer, and liver enzyme abnormalities. Conclusion. Statin therapy was associated with a reduced risk of cardiovascular disease and procedures without increased risk of harm in populations with mean LDL-C in the near-optimal to the borderline high range and without prior atherosclerotic cardiovascular disease.
A Survey on Prevalence and Knowledge of Family Planning among Women of Childbearing Age in the Provincial Settings of the Gambia: A Descriptive Cross-Sectional Study
Background. Family planning (FP) is one of the fundamental pillars of safe motherhood and reproductive health rights. In developing countries, women with unmet need for FP constitute a significant proportion of all women of reproductive age and it is an ongoing public health challenge in the Gambia. The study aimed to determine the women’s proportion of contraceptive uptake and knowledge of FP methods. Methods. The study employed a community-based descriptive cross-sectional study conducted for 643 women of reproductive age (15–49 years) from the selected clusters in rural Gambia through a multistage sampling technique. A pretested structured interview questionnaire was used to collect data. Univariate analysis using frequencies and percentages were used to present results in this study. Data entry and analysis were done using IBM SPSS version 24. Results. The overall contraceptive prevalence rate was 30.4%, while the CPR for married or in the union was 34.2%. About 86% of women reported child spacing as the major benefits of FP, while 49.5% reported amenorrhea as the most common side effect of contraceptives. Injectable (Depo-Provera, Noristerat, and ) and pills (progesterone and combined) were the two most common FP methods used at 58.5% and 44.0%, respectively. Conclusion. The present study showed a moderately low contraceptive uptake. Thus, there is a need to focus FP services for women in rural areas, emphasizing the quality of services and gender equality. The study further recommends strengthening and mainstreaming of male involvement and religious leaders participation in FP interventions and the initiation of a communication program that explicitly promotes interspousal communication.
Knowledge, Attitude, and Associated Factors towards Safe Abortion among Private College Female Students in Gondar City, Northwest Ethiopia: A Cross-Sectional Study
Background. Women die from complications of unsafe abortion in developing countries because most have little knowledge about how to safely access to abortion care. Studies on knowledge, attitude, and associated factors towards safe abortion are limited in general and particularly among private college students. Therefore, the aim of this study was to assess knowledge, attitude, and associated factors towards safe abortion among private college female students in Gondar City, Northwest Ethiopia. Methods. An institution-based cross-sectional study was conducted from April 30, 2019, to May 30, 2019, among private college students in the Gondar town. Data were collected from 633 female students using self-administered questionnaires by a simple random sampling technique. Bivariable and multivariable logistic regression analyses were performed to identify association of dependent and independent variables using SPSS, version 20. Results. A total of 633 respondents participated in this study with the response rate of 97.7%. The majority (433 (68.4%)) of students had good knowledge about safe abortion. Older age (AOR = 2.79, 95% CI: 1.16, 7.29), urban residence (AOR = 2.42, 95% CI: 1.26, 4.35), family education (AOR = 3.18, 95% CI: 1.32, 7.06), and ever having heard about safe abortion (AOR = 4.36, 95% CI: 1.89, 10.83) were factors associated with knowledge of students on safe abortion. Regarding attitude, 361 (57%) of students had favorable attitude towards safe abortion. Age (AOR = 6.58, 95% CI: 2.71, 11.21) and urban residence (AOR = 1.51, 95% CI: 1.09, 2.21) were factors significantly associated with attitude towards safe abortion. Conclusion. More than half of the participants have good knowledge and attitude towards safe abortion, but still a significant proportion of students have poor knowledge and unfavorable attitude. Information, education, and communication programs on youth reproductive health should be provided to address topics on safe abortion for students. Forums and panel discussions on safe abortion need to be undertaken especially, among youths and students who come from rural area.
Vaccines Attitudes, Concerns, and Information Sources Reported by Parents of Young Children among North Palestinian Parents
Parental acceptance of routine childhood immunization is critical to protecting children’s health, as high vaccination-coverage rates lead to decreased rates of vaccine-preventable diseases. However, to communicate effectively with parents about vaccines and vaccine-preventable diseases, it is necessary to assess their vaccine-related attitudes and concerns continually. Recently the Palestine Ministry of Health has recorded epidemics of measles and mumps. Poor compliance with vaccination has been attributed to multiple factors including physician inadequacy advocating for vaccination and public mistrust of vaccinations. As a result, this study was conducted to describe the vaccine-related attitudes, concerns, and information sources of North Palestinian parents of young children. A cross-sectional survey was conducted involving parents visiting emergency departments and primary health care centers from different North Palestinian hospitals and centers. 480 surveys were eligible and analyzed. The surveys revealed that although parental confidence in vaccine safety is high, several vaccine-related concerns, such as pain from vaccine administration and the number of vaccines given at once, were common among parents of young children. To maintain and improve the success of childhood vaccines in preventing disease, a holistic approach is needed to address parents’ concerns in an ongoing manner. Listening and responding in ways and with resources that address specific questions and concerns could help parents make more informed vaccination decisions.
Level and Associated Factors of Knowledge regarding Menstrual Hygiene among School-Going Adolescent Girls in Dang District, Nepal
Background. Adolescent girls in developing countries do not have proper information, and proper information is covered up by sociocultural boundaries resulting in various morbidities. This study aimed to determine level of knowledge and its associated factors regarding menstrual hygiene amongst adolescent school girls in Dang district, Nepal. Methods. Institution-based cross-sectional study was conducted between April and October 2019 among 406 adolescent girls studying in grades 8–10 between ages of 10–19 years in Dang district, Nepal. From a total of 10 local units, 5 were selected randomly. Out of the selected 5 units, 10 schools consisting of 5 government and 5 private schools were selected through disproportionate stratified random sampling. A further 406 students were then selected randomly from the 10 selected schools. Bivariate analysis was used primarily to assess the association between dependent and independent variables. Variables which were associated with bivariate analysis were entered into a multivariable logistic regression model to identify associated factors of menstrual hygiene practice. Results. The mean age and family size were 15.13 ± 1.19 and 5.58 ± 1.81, respectively. A total of 87.7% of adolescents had good knowledge regarding menstrual hygiene. Adolescents living in rural area (AOR = 0.27, CI: 0.12–0.61, ), private schools (AOR = 6.10, CI: 1.58–23.46, ), mothers who can read and write (AOR = 0.22, CI: 0.07–0.64, ), fathers who have up-to-grade-10 education (AOR = 5.15, CI: 1.84–14.39, ), and living only with mothers (AOR = 0.29, CI: 0.12–0.69, ) were significantly associated with level of knowledge of menstrual hygiene. Conclusions. Though the majority of respondents had a good level of knowledge regarding menstrual hygiene, there was a knowledge gap in specific areas. The level of knowledge was significantly poor among adolescents in rural areas and those living only with mothers. Thus, this study concerns the need for policy makers to focus on specific education regarding menstrual hygiene in rural areas including both parents.