Determining the risk factors associated with delayed sputum conversion at the end of the intensive phase among tuberculosis patients

Background: In pulmonary tuberculosis (PTB), the sputum conversion rate at 2 months is frequently used to evaluate treatment outcomes and effectiveness of a TB control programme. Aims: The study aimed to estimate the rate of delayed sputum conversion and explore its predicting factors at the end of the intensive phase among smear-positive PTB (PTB +ve) patients. Methods: A 3-year retrospective study was conducted in the government hospital in Pulau Pinang from 2016 to 2018. During the study, a standardized, data collection form was used to collect data from the patient record. Patients aged over 18 years were recruited. Multivariable logistic regression analysis was used to identify significant independent variables associated with delayed sputum conversion. Results: A total 1128 of PTB patients were recorded visiting the TB clinic, 736 (65.2%) were diagnosed as PTB +ve; of these, 606 (82.3%) PTB +ve had a record of sputum conversion at the end of the intensive phase. Age ≥ 50 years, blue-collar jobs, smoking, heavy bacillary load, relapsed and treatment interrupted were significantly (P < 0.05) associated with delayed sputum conversion. Delayed sputum conversion rate at the end of the intensive phase was 30.5%. Conclusion: The rate of sputum smear conversion in the intensive phase of treatment was independently associated with high sputum smear grading at diagnosis, relapsed and treatment interrupted categories, old age and blue-collar occupations.

Climate conditions, workplace heat and occupational health in South-East Asia in the context of climate change

Occupational health is particularly affected by high heat exposures in workplaces, which will be an increasingproblem as climate change progresses. People working in jobs of moderate or heavy work intensity inhot environments are at particular risk, owing to exposure to high environmental heat and internal heatproduction. This heat needs to be released to protect health, and such release is difficult or impossible at hightemperatures and high air humidity. A range of clinical health effects can occur, and the heat-related physicalexhaustion leads to a reduction of work capacity and labour productivity, which may cause substantialeconomic losses. Current trends in countries of the World Health Organization South-East Asia Region aretowards higher ambient heat levels during large parts of each year, and modelling indicates continuing trends,which will particularly affect low-income individuals and communities. Prevention activities need to addressthe climate policies of each country, and to apply currently available heat-reducing technologies in workplaceswhenever possible. Work activities can be adjusted to reduce exposure to daily heat peaks or seasonal heatconcerns. Application of basic occupational health principles, such as supply of drinking water, enforcementof rest periods and training of workers and supervisors, is essential.

Value systems and locus of control of people undergoing aesthetic surgery and their application in the work environment: a case study in Cyprus

With the growth in elective aesthetic plastic surgery in recent years researchers are becoming increasingly interested in the psychological aspects of the procedure. The aim of this research in Cyprus was to describe the value systems and the locus of control of employees who have undergone aesthetic plastic surgery. A questionnaire comprising the Schwartz human value scale, the Rotter scale for locus of control and questions about the reason for surgery was completed by 75 employees in a range of occupations. The values rated as very/supremely important by > 80% of respondents were: preserving public image [power domain], being capable [achievement], pleasure and self-indulgence [hedonism], freedom and independence [self-direction] and being honest, helpful and responsible [benevolence]. They also scored highly on politeness and honouring parents and elders [conformity domain] and family security and being clean [security]. A small majority [54.7%] was classified as internal or extreme internal locus of control

Study on child labour in automobile workshops of Peshawar, Pakistan

To determine the characteristics of children working in car workshops in Peshawar, a descriptive survey was conducted from June to November 2005 of 200 boys [6-15 years] randomly selected from 32 workshops. A questionnaire was used to collect socioeconomic and work-related data. The majority of the boys had no or little education, had started work before the age of 10 years and earned < 700 rupees/month. Most of their fathers had little education and were in poorly paid jobs, unemployed or deceased. About 40% of the boys were engaged in mechanical work. Watery eyes [31%], chronic cough [29%] and diarrhoea [22%] were the commonest symptoms reported by the boys and 38% had had a major injury

Women’s Health: a Strategy for the African Region: Report of the Regional Director

1. Women’s health is a state of complete physical, mental and social well-being of womenthroughout their lifespan and not only their reproductive health. Women’s health is a result of theinteraction of different factors: biological, psychological and sociocultural influences;environmental and occupational conditions; and economic development. The various stages inthe life of a woman range from infancy, childhood, adolescence and adulthood to the postreproductiveyears. Each stage has specific health problems that influence outcomes insubsequent years.2. Women’s biological vulnerability, low social status, limited access to health services, lowlevel of literacy and lack of decision-making powers are major determinants of ill-health.Difficult geographical and financial access, poor quality of care, attitude of health care workersand long waiting hours in health facilities have limited women’s utilization of services. All thesefactors require detailed studies in order to inform policies and promote effective planning andinterventions.3. The creation of an enabling environment for women at all levels is critical to the attainmentby them of the highest possible level of health as reflected in the Health-for-All Policy for the21st Century in the African Region: Agenda 2020. This consists of health system responsivenessto the needs of women, education of the girl-child, quality health care, elimination of genderdiscrimination and harmful traditional practices, and an appreciation of the role of women insustaining human life.

Current and never smokers: differentials in characteristics, knowledge and perceptions

A cross-sectional interview survey of tobacco use was conducted in Alexandria, Egypt, comparing current smokers with never smokers. Among men, the risk of current tobacco use was significantly higher among married participants [OR = 1.74], especially those with low educational or occupational status. In contrast, although few women smoked, tobacco use was significantly higher among those holding a university degree [OR = 15.33]. Never smokers were significantly more knowledgeable than current smokers about tobacco-related health hazards. Never smokers had significantly better perceptions of the danger of tobacco use, susceptibility to health-related hazards and the benefits of being tobacco-free. Multivariate analysis revealed that tobacco use is independently predicted by participants' sex, age and educational attainment as well as their perceptions

Gender differences and tuberculosis in the Syrian Arab Republic: patients' attitudes, compliance and outcomes

In a prospective study of gender and TB outcomes, 552 newly diagnosed smear-positive patients throughout the Syrian Arab Republic were interviewed at recruitment [from January 2002 to July 2002] and followed until the end of treatment. Delay in diagnosis was significantly longer among males. Significant differences between males and females were noted in relation to the place they usually use to seek care. Gender did not seem to affect knowledge and attitudes of TB patients. Although the women reported more barriers to seeking care, compliance with treatment tended to be higher and the treatment success rate was significantly higher among females than males. Multivariate analysis showed that male sex was a significant predictor of a negative treatment outcome, after controlling for other significant sociodemographic and health care related variables

Knowledge, attitudes and practices survey among health care workers and tuberculosis patients in Iraq

A cross-sectional study was made of 500 patients and 500 health care workers randomly selected from 250 primary health care centers throughout Iraq to evaluate knowledge, attitudes and practices towards tuberculosis [TB]. Using structured questionnaire interviews, the study showed 64.4% of patients had good knowledge, while 54.8% had negative attitudes and practices towards TB. The 2 most important sources of patient information about TB were physicians and television. Of health care workers, 95.5% had good knowledge about TB and this was significantly associated with age and job duration. By contrast, health care workers' practice was poor: only 38.2% handled suspected TB cases correctly. The national TB programme in Iraq has had a good impact on knowledge of TB patients and health care workers

Prevalence of pulmonary tuberculosis in Karachi juvenile jail, Pakistan

Jail inmates may be at increased risk of contracting tuberculosis [TB]. We studied 386 detainees [mean age 17.7 years] in Karachi juvenile jail to determine the prevalence of TB and possible risk factors for contracting TB. We found a 3.9% prevalence of TB among the inmates, significantly higher than the estimated 1.1% prevalence in the general population of Pakistan. Positive family history of TB was a significant risk factor for TB. Poor adherence of previously diagnosed patients to anti-TB treatment was found. Our study highlights the vulnerability of inmates to TB owing to the presence of highly infectious cases, along with environmental conditions such as overcrowding and poor ventilation. This study strongly indicates the need for an effective treatment programme in the jails as well in the general community

Smoking among secondary-school boys in Bahrain: prevalence and risk factors

To determine the prevalence of smoking among male secondary school students in Bahrain and to identify their risk factors for smoking, we surveyed a random sample of students by questionnaire. The prevalence of smoking was 26.6%, 25.5% and 25.4% among first-year, second-year and third-year students respectively. Cigarettes [21.0%], water-pipes [13.0%] and cigars [1.6%] were popular. Smokers and non-smokers had similar socioeconomic profiles, but differed in degree of disapproval of smoking shown by close contacts and whether close contacts were smokers. The prevalence of smoking among male secondary-school students in Bahrain did not decline despite intense anti-smoking efforts in the last decade, perhaps indicating the effectiveness of tobacco advertising and promotions that target youth

Knowledge and attitudes towards AIDS among Saudi and non-Saudi bus drivers

We explored the AIDS knowledge and attitudes of long-distance [non-Saudi] and in-city [Saudi] bus drivers in Saudi Arabia. The 69 non-Saudi drivers tended to score higher on knowledge than the 40 Saudi drivers although there were several gaps in their knowledge. As regards attitude, more Saudis knew that chastity could protect against AIDS and both groups tended to think that they were not the kind of people to get AIDS. Intensive health education and follow up is highly recommended for this sector of workers

[Prevalence of contraceptive use in a periurban area of Sousse, Tunisia]

A contraceptive prevalence survey was conducted among 1277 women of reproductive age, to explore knowledge of and attitudes to contraceptive use and study factors influencing contraceptive use. We found that family planning methods were generally well known. The prevalence of modern contraceptive use was 53.6%, IUDs being the most commonly used followed by sterilization and pills. The public sector was the main source for obtaining contraceptives although pills and condoms tended to be obtained from the private sector. There was a significant correlation between contraceptive use and urban residence