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1.
BMC Genomics ; 24(1): 22, 2023 Jan 16.
Artículo en Inglés | MEDLINE | ID: mdl-36646998

RESUMEN

BACKGROUND: The fall armyworm (FAW), Spodoptera frugiperda; J.E. Smith (Lepidoptera: Noctuidae), is now an economically important pest that causes huge losses to maize productivity in sub-Saharan Africa. Variations in sub-population genetics and the processes of rapid adaptation underpinning the invasion remain unclear. For this, the genetic identity and diversity of FAW populations in Uganda were revealed by sequencing 87 samples (collected across the country). Based on the partial mitochondrial cytochrome oxidase I (COI) gene polymorphisms, we further examined the mitochondrial haplotype configuration and compared the FAW in Uganda with sequences from other parts of the world. The molecular target for organophosphate and carbamate resistance, acetylcholinesterase, was also investigated. RESULTS: Analysis of the partial COI gene sequences showed the presence of both rice (predominant) and corn strain haplotypes, with a haplotype diversity of 0.382. Based on the COI marker, pairwise difference distribution analyses, and neutrality tests, showed that the FAW populations in Uganda and the rest of Africa are evolving neutrally, but those in America and Asia are undergoing expansion. Our findings support observations that invasive FAW populations throughout the rest of Africa and Asia share a common origin. Sequencing of the S. frugiperda ace-1 gene revealed four amino acid substitutions, two of which (A201S and F290V) were previously shown to confer organophosphate resistance in both S. frugiperda and several other insect species. The other two previously reported new variations in positions g-396 and g-768, are presumed to be related to the development of insecticide resistance. CONCLUSIONS: This research has increased our knowledge of the genetics of FAW in Uganda, which is critical for pest surveillance and the detection of resistance. However, due to the low gene polymorphism of COI, more evolutionary studies incorporating the Spodoptera frugiperda whole-genome sequence are required to precisely understand the FAW population dynamics, introduction paths, origin, and subsequent spread.


Asunto(s)
Acetilcolinesterasa , Insecticidas , Animales , Spodoptera/genética , Acetilcolinesterasa/genética , Mutación Puntual , Organofosfatos/farmacología , Uganda , Resistencia a los Insecticidas/genética , Insecticidas/farmacología , Zea mays/genética , Larva
2.
BMC Health Serv Res ; 23(1): 252, 2023 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-36918937

RESUMEN

BACKGROUND: The Coronavirus disease (a highly infectious viral disease) quickly swept across the globe in 2020, causing mortality and severe respiratory illnesses. It quickly affected businesses and publicly provided services in United Arab Emirates (UAE), imposing significant costs to society. The general population of UAE was jittery and unsure how to address the problem. The focus turned on government and Health Care Workers (HCW) to handle the pandemic. Thus, knowledge, attitudes and practices (KAP) of HCW became critical for the treatment and isolation of COVID-19 patients. Thus, the KAP of the HCW came under scrutiny. This is study set out to answer the research question, by investigating the KAP of HCW related to COVID-19 in the UAE. METHODS: This was a cross-sectional study undertaken in UAE. The focus of was on HCWs as a population. Using convenience sampling with the help of Creative Research Software, the participants were identified, and an online questionnaire (Google Forms) distributed by the author. The questionnaire was adapted from the instrument developed by Bruce and Frey. It contained questions on demographic variables, knowledge, attitudes, and practice of HCW related to COVID-19. That instrument was contextualized to the UAE society and validated. RESULTS: Among the participants in the study, the majority, 90.7% (97) knew that the absence of fever did not mean there was no chance of transmission from an infected person. Further, 84.1% (90) agreed that wearing general medical face masks helps prevent one from contracting COVID-19. However, only 36.4% (39) strongly believed that wearing a well-fitting face mask was effective. In addition, only 15.9% (17) reported confidently managing patients with symptoms of COVID-19, while 54.2% (58) indicated they were afraid of contracting the virus from patients. Almost 50% of the participants noted that they avoided patients who had symptoms of the COVID-19. CONCLUSION: This study revealed that the KAP for healthcare workers from UAE healthcare facilities related to COVID-19 was high. The healthcare workers were trained well and that positively affected awareness and the practice of HCW regarding the spread of the virus.


Asunto(s)
COVID-19 , Humanos , COVID-19/epidemiología , Estudios Transversales , Emiratos Árabes Unidos/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud , Encuestas y Cuestionarios
3.
Crop Prot ; 156: 105945, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35662834

RESUMEN

Stem borers are major insect pests of maize in Uganda. A study was conducted in 2014-2016 to assess the performance of Bt hybrids expressing Cry1Ab (event MON810) against the two major stem borer species in Uganda - the African stem borer (Busseola fusca) and the spotted stem borer (Chilo partellus) - under artificial infestation. The study comprised 14 non-commercialized hybrids, including seven pairs of Bt and non-Bt hybrids (isolines), three non-Bt commercial hybrids and a conventional stem borer resistant check. All stem borer damage parameters (leaf damage, number of internodes tunneled and tunnel length) were generally significantly lower in Bt hybrids than in their isolines, the conventionally resistant hybrid, and local commercial hybrids. Mean yields were significantly higher by 29.4-80.5% in the Bt hybrids than in the other three categories of non-Bt hybrids. This study demonstrated that Bt maize expressing Cry1Ab protects against leaf damage and can limit entry of stem borers into the stems of maize plants, resulting in higher yield than in the non-transgenic hybrids. Thus, Bt maize has potential to contribute to the overall management package of stem borers in Uganda.

4.
Environ Monit Assess ; 194(5): 339, 2022 Apr 07.
Artículo en Inglés | MEDLINE | ID: mdl-35389105

RESUMEN

There have been many global studies on the occurrence and distribution of pharmaceuticals and personal care products (PPCPs) in the aquatic resources, but reports on the effects of physicochemical properties of water on their concentrations are very scarce. The amounts and removal of these contaminants in various environmental media are dependent on these physicochemical properties, which include pH, temperature, electrical conductivity, salinity, turbidity, and dissolved oxygen. Here, we reviewed the influence of these properties on determination of PPCPs. Reports showed that increase in turbidity, electrical conductivity, and salinity gives increase in concentrations of PPCPs. Also, neutral pH gives higher PPCP concentrations, while decrease in temperature and dissolved oxygen gives low concentration of PPCPs. Nevertheless, it is quite challenging to ascertain the influence of water quality parameters on the PPCP concentration, as other factors like climate change, type of water, source of pollution, persistence, and dilution factor may have great influence on the concentration of PPCPs. Therefore, routine monitoring is suggested as most water quality parameters vary because of effects of climate change.


Asunto(s)
Cosméticos , Contaminantes Químicos del Agua , Cosméticos/análisis , Monitoreo del Ambiente , Oxígeno , Preparaciones Farmacéuticas , Contaminantes Químicos del Agua/análisis , Humedales
5.
Crop Prot ; 139: 105384, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33390639

RESUMEN

Smallholder maize farmers in Africa experience pre- and post-harvest production stresses either individually or in combination at different stages of the crop cycle. The maize weevil is among the major post-harvest storage pests. A strategy to address this problem is to develop and promote high yielding maize germplasm with resistance to multiple stresses. A study was conducted to: 1) assess yield and agronomic performance of testcross hybrids developed from early generation lines; and 2) assess the response of the testcross hybrids to infestation with Sitophilus zeamais. Fifty-eight drought-tolerant testcross hybrids were evaluated for agronomic performance and weevil resistance at four environments in Uganda in 2016. Hybrid G39 (L2/T2) had the best grain yield performance; it significantly out-performed the best check by 11.4% in all environments. Hybrid grain from field trials was subjected to Sitophilus zeamais infestation in a choice and no choice test under laboratory conditions. Hybrids G56 (L49/T2) and G58 (L51/T2) had the least weevil damage and were rated as resistant to Sitophilus zeamais. The numbers of damaged kernels, number of exit holes and ear aspect were positively correlated with the grain weight loss. The results suggest possibilities for simultaneous selection for high grain yield and storage insect pest resistance among drought-tolerant genotypes. Use of high-yielding and resistant maize hybrids to storage insect pest should be promoted for increased maize production and managing post-harvest losses due to the maize weevil in smallholder farming communities in Africa.

6.
Qual Life Res ; 27(4): 891-903, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29357027

RESUMEN

PURPOSE: Acute respiratory infections (ARIs), and associated symptoms such as cough, are frequently experienced among children and impose a burden on families (e.g., use of medical resources and time off work/school). However, there are little data on changes in, and predictors of, quality of life (QoL) over the duration of an ARI with cough (ARIwC) episode. We therefore aimed to determine cough-specific QoL and identify its influencing factors among children with ARIwC, at the time of presentation to a pediatric emergency department (ED), and over the following 4 weeks. METHODS: Data from 283 children aged < 15 years were included in our analyses. We used the validated parent-proxy children's acute cough-specific QoL questionnaire (PAC-QoL) at each time-point. Linear regression and mixed effect modeling were used to identify factors influencing QoL at baseline and over the follow-up period. RESULTS: Median PAC-QoL at baseline was 2.7 (IQR 2.1-3.6) and significantly improved by Day-7 (4.9, IQR 3.8-6.1) and Day-14 (6.59, IQR 5.1-7.0), both p < 0.001. The improvements in median PAC-QoL between Days-14, -21, and -28 were not significant. Regression modeling identified that day-cough severity, night-cough severity, and financial concerns had the highest impact on both baseline, and follow-up, PAC-QoL scores. There were five additional independent significant factors at baseline and six at follow-up. CONCLUSIONS: Quality of life is considerably impaired at presentation to ED, but improves significantly by Days-7 and -14. As cough severity and financial concerns had the highest impact on QoL, effectively managing cough to reduce the clinical and financial burden on children and families is important.


Asunto(s)
Enfermedad Aguda/psicología , Tos/psicología , Calidad de Vida/psicología , Infecciones del Sistema Respiratorio/psicología , Adulto , Estudios de Cohortes , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Encuestas y Cuestionarios
7.
J Paediatr Child Health ; 54(6): 671-676, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29341387

RESUMEN

AIM: The majority of Australia's Aboriginal and/or Torres Strait Islander children live in urban areas; however, little is known about their health service use. We aimed to describe health service utilisation amongst a cohort of urban Aboriginal and/or Torres Strait Islander children aged <5 years. METHODS: We analysed health service utilisation data collected in an ongoing prospective cohort study of children aged <5 years registered with an Aboriginal-owned and operated primary health-care service. Enrolled children were followed monthly for 12 months, with data on health service utilisation collected at baseline and at each monthly follow-up. Health service utilisation rates, overall and by service provider and reason for presentation, were calculated and reported as incidence rates per 100 child-months with the corresponding 95% confidence intervals (CIs). RESULTS: Between February 2013 and November 2015, 180 children were enrolled, and 1541 child-months of observation were available for analysis. The overall incidence of health service utilisation was 52.5 per 100 child-months (95% CI 48.7-56.5); 81% of encounters were with general practitioners. Presentation rates were the highest for acute respiratory illnesses (30.7/100 child-months, 95% CI 27.8-33.9). CONCLUSIONS: In this community, acute respiratory illnesses are predominant causes of health service utilisation in young children. The health-care utilisation profile of these children presents important opportunities for health promotion and intervention.


Asunto(s)
Servicios de Salud , Nativos de Hawái y Otras Islas del Pacífico , Población Urbana , Preescolar , Estudios de Cohortes , Femenino , Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Queensland , Sistema de Registros , Encuestas y Cuestionarios
8.
BMC Health Serv Res ; 17(1): 108, 2017 02 02.
Artículo en Inglés | MEDLINE | ID: mdl-28153014

RESUMEN

BACKGROUND: Stroke and other non-communicable diseases are important emerging public health concerns in sub-Saharan Africa where stroke-related mortality and morbidity are higher compared to other parts of the world. Despite the availability of evidence-based acute stroke interventions globally, uptake in low-middle income countries (LMIC) such as Ghana is uncertain. This study aimed to identify and evaluate available acute stroke services in Ghana and the extent to which these services align with global best practice. METHODS: A multi-site, hospital-based survey was conducted in 11 major referral hospitals (regional and tertiary - teaching hospitals) in Ghana from November 2015 to April 2016. Respondents included neurologists, physician specialists and medical officers (general physicians). A pre-tested, structured questionnaire was used to gather data on available hospital-based acute stroke services in the study sites, using The World Stroke Organisation Global Stroke Services Guideline as a reference for global standards. RESULTS: Availability of evidence-based services for acute stroke care in the study hospitals were varied and limited. The results showed one tertiary-teaching hospital had a stroke unit. However, thrombolytic therapy (thrombolysis) using recombinant tissue plasminogen activator for acute ischemic stroke care was not available in any of the study hospitals. Aspirin therapy was administered in all the 11 study hospitals. Although eight study sites reported having a brain computed tomographic (CT) scan, only 7 (63.6%) were functional at the time of the study. Magnetic resonance imaging (MRI scan) services were also limited to only 4 (36.4%) hospitals (only functional in three). Acute stroke care by specialists, especially neurologists, was found in 36.4% (4) of the study hospitals whilst none of the study hospitals had an occupational or a speech pathologist to support in the provision of acute stroke care. CONCLUSION: This study confirms previous reports of limited and variable provision of evidence based stroke services and the low priority for stroke care in resource poor settings. Health policy initiatives to enhance uptake of evidence-based acute stroke services is required to reduce stroke-related mortality and morbidity in countries such as Ghana.


Asunto(s)
Hospitalización/estadística & datos numéricos , Accidente Cerebrovascular/terapia , Enfermedad Aguda , Aspirina/uso terapéutico , Femenino , Fibrinolíticos/uso terapéutico , Ghana , Política de Salud , Accesibilidad a los Servicios de Salud/normas , Fuerza Laboral en Salud , Hospitales/estadística & datos numéricos , Humanos , Angiografía por Resonancia Magnética/estadística & datos numéricos , Masculino , Guías de Práctica Clínica como Asunto , Derivación y Consulta/estadística & datos numéricos , Encuestas y Cuestionarios , Terapia Trombolítica/normas , Activador de Tejido Plasminógeno/uso terapéutico , Tomografía Computarizada por Rayos X/estadística & datos numéricos
9.
Int J Health Plann Manage ; 31(3): 277-95, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25758840

RESUMEN

OBJECTIVE: This study aimed to examine the acceptability of programme budgeting and marginal analysis (PBMA) as a tool for priority setting in the Indigenous health sector. METHODS: The study uses a mix of quantitative and qualitative methods. A survey of key decision makers in Indigenous health in Victoria was conducted to assess the acceptability of PBMA as a potential tool for priority setting. Respondents comprised 24 bureaucrats from the Victorian Department of Human Services (DHS) and 26 senior executives from the aboriginal community controlled health sector (ACCHS) in Victoria. The survey instrument included both closed-ended and open-ended questions and was administered face-to-face by a trained researcher in 2007-2008. Closed-ended questions were analysed using descriptive statistics, and content analysis was used for the open-ended ones. RESULTS: The PBMA was well received as having the potential to improve priority setting processes in Indigenous health. Sixty-nine percent of the DHS respondents felt that PBMA was acceptable as a routine decision-making tool, and nearly 80% of ACCHS respondents thought that PBMA was intuitively appealing and would most probably be an acceptable priority setting approach in their organisations. The challenges of using PBMA were related to resource constraints and data intensity. CONCLUSION: Programme budgeting and marginal analysis is potentially acceptable within the ACCHS and was perceived as useful in terms of assisting the decision maker to maximise health outcomes, but data systems need to be re-oriented to address its significant data needs. IMPLICATION: Proper guidelines need to be developed to facilitate PBMA application within the Indigenous-controlled community health sector. Copyright © 2015 John Wiley & Sons, Ltd.


Asunto(s)
Presupuestos/organización & administración , Análisis Costo-Beneficio , Prioridades en Salud/organización & administración , Servicios de Salud del Indígena/organización & administración , Análisis Costo-Beneficio/métodos , Análisis Costo-Beneficio/organización & administración , Prioridades en Salud/economía , Humanos , Nativos de Hawái y Otras Islas del Pacífico , Victoria
10.
Hum Resour Health ; 13: 58, 2015 Jul 14.
Artículo en Inglés | MEDLINE | ID: mdl-26169179

RESUMEN

INTRODUCTION: Community health workers (CHWs) have been proposed as a means for bridging gaps in healthcare delivery in rural communities. Recent CHW programmes have been shown to improve child and neonatal health outcomes, and it is increasingly being suggested that paid CHWs become an integral part of health systems. Remuneration of CHWs can potentially effect their motivation and focus. Broadly, programmes follow a social, monetary or mixed market approach to remuneration. Conscious understanding of the differences, and of what each has to offer, is important in selecting the most appropriate approach according to the context. CASE DESCRIPTIONS: The objective of this review is to identify and examine different remuneration models of CHWs that have been utilized in large-scale sustained programmes to gain insight into the effect that remuneration has on the motivation and focus of CHWs. A MEDLINE search using Ovid SP was undertaken and data collected from secondary sources about CHW programmes in Iran, Ethiopia, India, Bangladesh and Nepal. Five main approaches were identified: part-time volunteer CHWs without regular financial incentives, volunteers that sell health-related merchandise, volunteers with financial incentives, paid full-time CHWs and a mixed model of paid and volunteer CHWs. DISCUSSION AND EVALUATION: Both volunteer and remunerated CHWs are potentially effective and can bring something to the health arena that the other may not. For example, well-trained, supervised volunteers and full-time CHWs who receive regular payment, or a combination of both, are more likely to engage the community in grass-roots health-related empowerment. Programmes that utilize minimal economic incentives to part-time CHWs tend to limit their focus, with financially incentivized activities becoming central. They can, however, improve outcomes in well-circumscribed areas. In order to maintain benefits from different approaches, there is a need to distinguish between CHWs that are trained and remunerated to be a part of an existing health system and those who, with little training, take on roles and are motivated by a range of contextual factors. Governments and planners can benefit from understanding the programme that can best be supported in their communities, thereby maximizing motivation and effectiveness.


Asunto(s)
Agentes Comunitarios de Salud , Países en Desarrollo , Motivación , Remuneración , Población Rural , Salarios y Beneficios , Trabajo , Bangladesh , Niño , Atención a la Salud , Empleo , Etiopía , Humanos , India , Recién Nacido , Irán , Nepal , Características de la Residencia , Voluntarios
11.
BMC Pediatr ; 15: 56, 2015 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-25971445

RESUMEN

BACKGROUND: Despite the burden of acute respiratory illnesses (ARI) among Aboriginal and Torres Strait Islander children being a substantial cause of childhood morbidity and associated costs to families, communities and the health system, data on disease burden in urban children are lacking. Consequently evidence-based decision-making, data management guidelines, health resourcing for primary health care services and prevention strategies are lacking. This study aims to comprehensively describe the epidemiology, impact and outcomes of ARI in urban Aboriginal and Torres Strait Islander children (hereafter referred to as Indigenous) in the greater Brisbane area. METHODS/DESIGN: An ongoing prospective cohort study of Indigenous children aged less than five years registered with a primary health care service in Northern Brisbane, Queensland, Australia. Children are recruited at time of presentation to the service for any reason. Demographic, epidemiological, risk factor, microbiological, economic and clinical data are collected at enrolment. Enrolled children are followed for 12 months during which time ARI events, changes in child characteristics over time and monthly nasal swabs are collected. Children who develop an ARI with cough as a symptom during the study period are more intensely followed-up for 28 (±3) days including weekly nasal swabs and parent completed cough diary cards. Children with persistent cough at day 28 post-ARI are reviewed by a paediatrician. DISCUSSION: Our study will be one of the first to comprehensively evaluate the natural history, epidemiology, aetiology, economic impact and outcomes of ARIs in this population. The results will inform studies for the development of evidence-based guidelines to improve the early detection, prevention and management of chronic cough and setting of priorities in children during and after ARI. TRIAL REGISTRATION: Australia New Zealand Clinical Trial Registry Registration Number: 12614001214628 . Registered 18 November 2014.


Asunto(s)
Nativos de Hawái y Otras Islas del Pacífico , Enfermedades Respiratorias/etnología , Salud Urbana/etnología , Preescolar , Enfermedad Crónica , Costo de Enfermedad , Tos/economía , Tos/etnología , Tos/microbiología , Femenino , Humanos , Incidencia , Estudios Longitudinales , Masculino , Mucosa Nasal/microbiología , Prevalencia , Atención Primaria de Salud , Estudios Prospectivos , Queensland/epidemiología , Enfermedades Respiratorias/economía , Enfermedades Respiratorias/microbiología , Salud Urbana/economía
12.
Aust J Prim Health ; 21(4): 438-43, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25230153

RESUMEN

Asthma is the most common chronic illness among adolescents in Australia. Aboriginal and Torres Strait Islander adolescents, in particular, face substantial inequalities in asthma-related outcomes. Triple A (Adolescent Asthma Action) is a peer-led education intervention, which aims to improve asthma self-management and reduce the uptake of smoking among adolescents. The aim of this study was to determine the cost of implementing the Triple A program in Australia. Standard economic costing methods were used. It involved identifying the resources that were utilised (such as personnel and program materials), measuring them and then valuing them. We later performed sensitivity analysis so as to identify the cost drivers and a stress test to test how the intervention can perform when some inputs are lacking. Results indicate that the estimated cost of implementing the Triple A program in five schools was $41060, assuming that the opportunity cost of all the participants and venues was accounted for. This translated to $8212 per school or $50 per target student. From sensitivity analysis and a stress test, it was identified that the cost of the intervention (in practice) was $14 per student. This appears to be a modest cost, given the burden of asthma. In conclusion, the Triple A program is an affordable intervention to implement in high schools. The potential asthma cost savings due to the program are significant. If the Triple A program is implemented nation-wide, the benefits would be substantial.


Asunto(s)
Asma/economía , Asma/terapia , Grupo Paritario , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Autocuidado/economía , Autocuidado/estadística & datos numéricos , Adolescente , Australia , Femenino , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud/economía , Autocuidado/métodos
13.
Bull World Health Organ ; 92(4): 277-82, 2014 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-24700995

RESUMEN

Timor-Leste is in the process of addressing a key issue for the country's health sector: a medical workforce that is too small to provide adequate care. In theory, a bilateral programme of medical cooperation with Cuba created in 2003 could solve this problem. By the end of 2013, nearly 700 new doctors trained in Cuba had been added to Timor-Leste's medical workforce and by 2017 a further 328 doctors should have been trained in the country by Cuban and local health professionals. A few more doctors who have been trained in Indonesia and elsewhere will also soon enter the workforce. It is expected that the number of physicians in Timor-Leste in 2017 will be more than three times the number present in the country in 2003. Most of the new physicians are expected to work in rural communities and support the national government's goal of improving health outcomes for the rural majority. Although the massive growth in the medical workforce could change the way health care is delivered and substantially improve health outcomes throughout the country, there are challenges that must be overcome if Timor-Leste is to derive the maximum benefit from such growth. It appears crucial that most of the new doctors be deployed in rural communities and managed carefully to optimize their rural retention.


Le Timor-Leste s'occupe actuellement d'un problème essentiel du secteur de la santé du pays: l'effectif médical est trop restreint pour pouvoir dispenser des soins adéquats. En théorie, un programme bilatéral de coopération médicale avec Cuba créé en 2003 pourrait résoudre ce problème. À la fin de 2013, près de 700 nouveaux médecins formés à Cuba ont rejoint l'effectif médical du Timor-Leste et d'ici 2017, 328 médecins supplémentaires devraient avoir été formés dans le pays par des professionnels de la santé locaux et cubains. Quelques autres médecins, formés en Indonésie et ailleurs, intégreront bientôt cet effectif médical. On s'attend à ce que le nombre de médecins exerçant dans le Timor-Leste en 2017 soit trois fois supérieur au nombre de médecins présents dans le pays en 2003. La plupart des nouveaux médecins devraient travailler dans les communautés rurales et soutenir l'objectif du gouvernement national d'améliorer l'état de santé de la majorité rurale. Bien que l'augmentation importante de l'effectif médical puisse changer la manière de dispenser les soins de santé et améliorer considérablement la santé dans l'ensemble du pays, des défis doivent être surmontés pour que le Timor-Leste puisse tirer le bénéfice maximal de cette augmentation. Il semble crucial que la majorité des nouveaux médecins soient déployés dans les communautés rurales et gérés soigneusement pour qu'ils restent le plus possible dans les zones rurales.


Timor-Leste se encuentra en proceso de abordar una cuestión clave para el sector sanitario del país: un personal médico demasiado escaso para proporcionar una atención adecuada. En teoría, un programa bilateral de cooperación médica con Cuba, creado en el año 2003, podría solucionar este problema. A finales de 2013, casi 700 médicos nuevos formados en Cuba se unieron al personal médico de Timor-Leste, y se espera que profesionales de la salud nacionales y cubanos formen a otros 328 médicos en el país hasta 2017. En Indonesia y otros lugares han recibido formación algunos médicos más, que se sumarán pronto a este personal. Se espera que el número de médicos en Timor-Leste triplique en el año 2017 el número de médicos existentes en el país en 2003. La mayoría de estos médicos nuevos trabajarán en comunidades rurales y respaldarán el objetivo del gobierno nacional de mejorar los resultados sanitarios de la mayoría rural. Aunque el incremento masivo del personal médico podría cambiar el modo de proporcionar la atención sanitaria y mejorar notablemente los resultados sanitarios en todo el país, hay desafíos que es necesario superar si Timor-Leste pretende obtener el máximo beneficio de dicho crecimiento. Parece fundamental que la mayor parte de los nuevos médicos se despliegue en comunidades rurales y se gestione con gran atención para optimizar su permanencia en dichas zonas.


Asunto(s)
Reorganización del Personal , Médicos/provisión & distribución , Servicios de Salud Rural/provisión & distribución , Movilidad Laboral , Conducta Cooperativa , Cuba , Educación Médica , Política de Salud , Humanos , Indonesia , Cooperación Internacional , Medicina , Evaluación de Necesidades , Reorganización del Personal/estadística & datos numéricos , Médicos/estadística & datos numéricos , Timor Oriental
14.
Int J Equity Health ; 13: 45, 2014 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-24906391

RESUMEN

INTRODUCTION: The health of Indigenous Australians is worse than that of other Australians. Most of the determinants of health are preventable and the poor health outcomes are inequitable. The Australian Government recently pledged to close that health gap. One possible way is to improve the priority setting process to ensure transparency and the use of evidence such as epidemiology, equity and economic evaluation.The purpose of this research was to elicit the perceptions of Indigenous and non-Indigenous decision-makers on several issues related to priority setting in Indigenous-specific health care services. Specifically, we aimed to:1. identify the criteria used to set priorities in Indigenous-specific health care services;2. determine the level of uptake of economic evaluation evidence by decision-makers and how to improve its uptake; and 3. identify how the priority setting process can be improved from the perspective of decision-makers. METHODS: We used a paper survey instrument, adapted from Mitton and colleagues' work, and a face-to-face interview approach to elicit decision-makers' perceptions in Indigenous-specific health care in Victoria, Australia. We used mixed methods to analyse data from the survey. Responses were summarised using descriptive statistics and content analysis. Results were reported as numbers and percentages. RESULTS: The size of the health burden; sustainability and acceptability of interventions; historical trends/patterns; and efficiency are key criteria for making choices in Indigenous health in Victoria. There is a need for an explicit priority setting approach, which is systematic, and is able to use available data/evidence, such as economic evaluation evidence. The involvement of Indigenous Australians in the process would potentially make the process acceptable. CONCLUSIONS: An economic approach to priority setting is a potentially acceptable and useful tool for Aboriginal Community Controlled Health Services (ACCHS). It has the ability to use evidence and ensure due process at the same time. The use of evidence can ensure that health outcomes for Indigenous peoples can be maximised - hence, increase the potential for 'closing the gap' between Indigenous and other Australians.


Asunto(s)
Servicios de Salud Comunitaria , Atención a la Salud , Política de Salud , Servicios de Salud del Indígena , Disparidades en el Estado de Salud , Nativos de Hawái y Otras Islas del Pacífico , Actitud , Australia , Participación de la Comunidad , Encuestas de Atención de la Salud , Humanos , Entrevistas como Asunto , Percepción
15.
Insects ; 15(5)2024 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-38786857

RESUMEN

Spodoptera frugiperda (Lepidoptera: Noctuidae), commonly known as fall armyworm, was first detected in Uganda in 2016 and has spread to all the maize-growing districts. Different methods have been deployed to control this pest. However, there is a limited understanding of the role of the environment and farmers' practices on the abundance of and damage by S. frugiperda in Uganda. This study, therefore, assessed the abundance of S. frugiperda and leaf damage levels in three different districts and explored the association between agronomic practices, crop phenology, and weather parameters on S. frugiperda damage and abundance in smallholder farmers' maize fields using a longitudinal monitoring survey in 69 farmers' fields of Kole, Kiryandongo, and Nakaseke for three seasons. The numbers of egg masses and adults were generally low. The highest numbers of adults were trapped in Kiryandongo, followed by Nakaseke, and the lowest numbers were trapped in Kole. Leaf damage and incidence of damaged plants differed significantly between districts and seasons. Leaf damage and abundance of larvae varied significantly in the districts and at different growth stages. Conservation tillage, reduced weeding frequency, increased rainfall and high maximum temperatures were associated with reduced S. frugiperda damage. No significant relationship was observed between pesticide or cropping systems with S. frugiperda leaf damage. However, the influence of fertilizer use on leaf damage was contradictory across seasons and districts. Timely and vigilant scouting, proper timing of control measures, and minimum tillage practices should be included in an IPM strategy for S. frugiperda.

16.
Insects ; 15(7)2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-39057249

RESUMEN

The bean leaf beetle (BLB) (Ootheca spp.) is a polyphagous pest causing significant yield losses in Uganda, particularly in the Northern and Eastern regions on various hosts plants. Despite its polyphagous behaviour, the BLB exhibits preferential feeding, offering an opportunity for targeted pest management. This study explored its feeding preferences across seven crops: common bean, cowpea, greengram, okra, roselle (malakwang), groundnuts, and soybean. This study was conducted in Arua and Lira districts using a randomized complete block design for two rainy seasons (2018A and 2018B). The results showed significant differences in BLB abundance and foliar damage among host crops, locations, days after planting and seasons. Cowpea was the most preferred crop while groundnuts was the least preferred. Therefore, cowpea can be recommended for use as a trap for managing Ootheca spp. in gardens where it is not the main crop. There was a higher pest abundance in Arua than in Lira. There was also a higher pest abundance in 2018A than in 2018B. These findings highlight the importance of understanding BLB's feeding preferences for implementing effective IPM strategies, emphasizing the potential role of trap cropping, especially with cowpea, to minimize BLB damage in resource-constrained agricultural settings.

17.
Res Sq ; 2024 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-38496471

RESUMEN

Background: Chronic kidney disease (CKD) is one of the most common complications of Diabetes Mellitus (DM). DM contributes to about 66% of CKD cases globally. CKiiiD results in increased morbidity and mortality and advanced stages often require renal replacement therapy that is unaffordable for the majority of the patients. Developing countries have scanty data regarding CKD burden in diabetic patients. OBJECTIVES: This study aimed at determining the prevalence of biomarkers for CKD and associated factors among diabetic patients attending the adult diabetic clinic of Mbale Regional Referral Hospital (MRRH). Methods: A cross-sectional study was conducted at the adult diabetic clinic of Mbale Regional Referral Hospital in Eastern Uganda. 374 adult diabetic patients who consented, were recruited and interviewed. A urine sample for Urine Albumin Creatinine Ratio (UACR) determination and a venous blood sample for measurement of serum creatinine were obtained from each participant. The estimated glomerular filtration rate (eGFR) was determined using the CKD-EPI equation and CKD was staged according to the Kidney Disease Improving Global Outcomes (KDIGO) systems. Results: A total of 318 (85%) participants had an eGFR of ≤ 60mls/min/1.72m2, significant proteinuria, or both. 6.1% were aware. Age, Duration of DM, Hypertension, and Dyslipidemia were associated with CKD biomarkers. Conclusion: There is a high prevalence of biomarkers for CKD among DM patients, the majority of them being undiagnosed. Over half of the DM patients had an eGFR consistent with advanced CKD. Strengthening routine screening for CKD biomarkers and enhancing the DM clinics with more diagnostic resources is recommended.

18.
Front Med (Lausanne) ; 11: 1399381, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39234035

RESUMEN

Mycobacterium riyadhense is an emerging slowly growing species that belongs to the group of nontuberculous mycobacteria (NTM) with approximately 20 cases reported worldwide. We highlight the first case of pulmonary infection by Mycobacterium riyadhense in United Arab Emirates (UAE). A 44-year-old female presented with chronic productive cough; a bronchial breathing pattern was appreciated on auscultation of her right upper lung. She was treated multiple times with allergic medications and antibiotics. Thorough investigations revealed Mycobacterium riyadhense and antitubercular drugs were started, eventually she was cured, however she had multiple relapses later. This case report holds a significant potential to make considerable contribution to the diagnosis of NTM, primarily because it presents the first documented case in UAE, as well as insights on how to address possible similar cases in the future.

19.
Front Insect Sci ; 4: 1345139, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38828261

RESUMEN

Spodoptera frugiperda (J.E. Smith), fall armyworm (FAW), a polyphagous Noctuid pest, was first reported in Uganda in 2016. Farmers were trained to identify and manage the pest, but there was a lack of information on farmer knowledge, perceptions and practices deployed to control it. Therefore, we conducted a survey to assess maize farmers' knowledge, perceptions and management of the pest during the invasion. We interviewed 1,289 maize farmers from 10 maize-growing agro-ecological zones (AEZ) of Uganda using well-structured questionnaires. The data were analyzed using R version 4.2.3. The respondents faced many constraints, including pests, drought, poor soils and labor constraints. Among the pests, FAW was ranked by most (85%) of the respondents as the number one pest problem in maize, and some farmers reported having noticed it way back in 2014. By 2018, more than 90% of the farmers had seen or heard about FAW, and about 80% saw FAW in their fields. The most common FAW symptoms reported by maize farmers were windowing, near tunnel damage, and holes on the cobs. The developmental stages of FAW identified by farmers included eggs (10%), young larvae (78.7%), mature larvae (73.5%) and adult moths (6.7%). Insecticides were the major control tactic, although some farmers used plant extracts, hand-picking, sand, and ash. Farmers sourced information on FAW from various sources, including fellow farmers, radio/TV, extension agents, input dealers, print media, research and NGO extension. There is a need to package clear and uniform information for the farmers and to develop and promote a sustainable solution for FAW management, including harnessing biological control and cultural practices.

20.
Insects ; 14(10)2023 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-37887798

RESUMEN

Surveys were conducted during 2020 and 2021 to study the emerging lepidopteran pests inflicting cereals in Tunisia, with specific emphasis on maize and sorghum crops. A species was collected from traps placed in the Jendouba, Bizerte, Nabeul and Gabes regions. Thus, this study carried out first report on its identification, distribution, population density and damage. Results showed that M. loreyi was abundant in all prospected areas, with total adult captures reaching 4779 and 9499 moths on sorghum and maize, respectively, during 2020. Moreover, the mean infestation percentage reached its maximum during August at 31.05% and 20.69% for the Jendouba and Bizerte regions, respectively, while the highest infestations were observed in the Gabes and Nabeul regions during July, with respective mean values of 13.54% and 21.35%. In addition, results revealed that the highest pest incidence occurred in the Gabes region, with values of 11.1 ± 0.47 and 5.7 ± 0.48 during 2020 and 2021, respectively. Additionally, results pointed out that M. loreyi achieved two summer generations in the different localities of Tunisia. Overall, this study provides basic insights into the ecology and population biology of M. loreyi, which are required to establish an effective pest control program.

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