Seroprevalence of Canine Toxocariasis in Three Rural Areas of Fars Province, Southern Iran.

Background: Toxocara canis is one of the most important causes of animal toxocariasis with global distribution. We aimed to find out the seroprevalence of toxocariasis in dogs in a rural area in Fars Province, south of Iran. Methods: Dogs blood samples were collected from 60 dogs in three rural areas in the Sar Mashhad region, Fars Province. Dog sera were evaluated for anti-Toxocara antibodies by an indirect ELISA method. The association between the seropositivity and age, gender, and the sampling location were statistically evaluated. Results: Serological assay detected anti-Toxocara antibodies in sera of 32 out of 60 dogs, corresponding to a seroprevalence of 53.3%. The rate of seropositivity was higher in the male dogs. The rate of seropositivity was higher in old dogs. This rate increased with increasing age, however, the association between age and Toxocara seropositivity was not statistically significant. Conclusion: The high prevalence of Toxocara infection in dogs in the current study area confirms that infected dogs are an important source of Toxocara infection for their owners and people who are in close contact with these animals, especially children.

COVID-19 Imposed Closure of Rural Co-Housing and Loneliness in Older Adults Living Alone: Longitudinal Evidence From South Korea.

This study aimed to examine the impact of COVID-19 on loneliness among rural older women in senior cohousing in Korea. Using a natural experimental study design, we investigated how the pandemic-induced closure of cohousing affected the former residents' loneliness. The sample comprised 84 cohousing residents and 51 individuals in conventional homes. The dependent variable is loneliness, and the independent variables include housing transition, social contact, and support from neighbors and friends. Our findings from fixed effect regression models showed former cohousing residents were less likely to experience loneliness when they had more contact with their friends and neighbors, while negative relationships exacerbated feelings of loneliness. Sharing meals and participating in activities with friends and neighbors in cohousing helped the residents develop effective coping strategies. Senior cohousing in rural areas has the potential to strengthen social ties and protect the most vulnerable subgroup of older adults from social isolation and loneliness.

Strengths within the Community Perceived by Older Adults Living Alone in a Semi-Mountainous Rural Region: A Qualitative Study.

It is recommended that health promotion activities in the community focus on residents' strengths. Hence, this study explored the community strengths perceived by older adults living alone in a semi-mountainous rural region of Japan. A qualitative, descriptive approach was used. Content analysis was performed using data obtained through face-to-face interviews. Interview data were coded; codes were classified based on similarity to create subcategories and categories. The strengths within the community, as perceived by older adults living alone in a semi-mountainous rural region, were revealed in four categories related to ten subcategories: "loose connections with others", "active community participation", "close relationships with community professionals", and "familiarity with the living environment". Strengths within the community perceived by older adults living alone in a semi-mountainous rural region were cultivated in an environment formed by their past lives. Utilizing these resources may help support community-based societies in semi-mountainous rural regions where depopulation and aging are expected to continue in the future. This study was not registered.

Innovative DIY drinking water disinfection for underserved communities.

Waterborne pathogens threaten 2.2 billion people lacking access to safely managed drinking water services, causing over a million annual diarrheal deaths. Individuals without access to chlorine reagents or filtration devices often resort to do-it-yourself (DIY) methods, such as boiling or solar disinfection (SODIS). However, these methods are not simple to implement. In this study, we introduced an innovative and easily implemented disinfection approach. We discovered that immersing aluminum foil in various alkaline solutions produces alkali-treated aluminum foil (ATA foil) that effectively adsorbs Escherichia coli (E. coli), Salmonella, and Acinetobacter through the generated surface aluminum hydroxide. For example, a 25 cm2 ATA foil efficiently captures all 104E. coli DH5α strains in 100 mL water within 30 min. Using a saturated suspension of magnesium hydroxide, a type of fertilizer, as the alkaline solution, the properties of the saturated suspension eliminate the need for measuring reagents or changing solutions, making it easy for anyone to create ATA foil. ATA foils can be conveniently produced within mesh bags and placed in household water containers, reducing the risk of recontamination. Replacing the ATA foil with a foil improves the adsorption efficiency, and re-immersing the used foil in the production suspension restores its adsorption capacity. Consequently, ATA foil is an accessible and user-friendly alternative DIY method for underserved communities. Verification experiments covering variations in the water quality and climate are crucial for validating the efficacy of the foil. Fortunately, the ATA foil, with DIY characteristics similar to those of boiling and SODIS, is well-suited for testing under diverse global conditions, offering a promising solution for addressing waterborne pathogens worldwide.

Preference-Based Implementation of Video Consultations in Urban and Rural Regions in Outpatient Care in Germany: Protocol for a Mixed Methods Study.

BACKGROUND: Particularly in rural regions, factors such as lower physician density and long travel distances complicate adequate outpatient care. However, urban regions can also be affected by deficits in care, for example, long waiting times. One model of care intending to improve the situation is the implementation of video consultations. The study protocol presents the methodology of the research project titled "Preference-based implementation of the video consultation in urban and rural regions" funded by the German Federal Joint Committee (funding number 01VSF20011). OBJECTIVE: This study aims to identify existing barriers to the use of video consultation and the preferences of insured individuals and physicians as well as psychotherapists in order to optimize its design and thus increase acceptance and use of video consultations in urban and rural regions. METHODS: Built on a mixed methods approach, this study first assesses the status quo of video consultation use through claims data analysis and carries out a systematic literature review on barriers and promoting factors for the use of video consultations. Based on this preliminary work, focus groups are conducted in order to prepare surveys with insureds as well as physicians and psychotherapists in the second study phase. The central element of the survey is the implementation of discrete choice experiments to elicit relevant preferences of (potential) user groups and service providers. The summarized findings are discussed in a stakeholder workshop and translated into health policy recommendations. RESULTS: The methodological approach used in this study is the focus of this paper. The study is still ongoing and will continue until March 2024. The first study phase has already been completed, in which preliminary work has been done on potential applications and hurdles for the use of video consultations. Currently, the survey is being conducted and analyses are being prepared. CONCLUSIONS: This study is intended to develop a targeted strategy for health policy makers based on actual preferences and perceived obstacles to the use of video consultations. The results of this study will contribute to further user-oriented development of the implementation of video consultations in German statutory health insurance. Furthermore, the iterative and mixed methods approach used in this study protocol is also suitable for a variety of other research projects. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50932.

Cardiovascular admission risk attributable to hot apparent temperature: a study in a rural area of northwest China.

Cardiovascular disease (CVD) is the leading cause of mortality worldwide, posing a significant threat to public health. Research on the relationship between CVD and temperature has primarily focused on developed urban settings, with limited studies conducted in rural regions with lower levels of development. Additionally, compared to relative risks, attributable risks can provide more information when assessing the risk of CVD hospitalizations associated with exposure to apparent temperature (AT). Apparent temperature is a composite temperature index that takes into account both meteorological factors and temperature, providing an objective reflection of human thermal sensation. Therefore, this study investigates the impact of AT on CVD hospitalization and quantifies the burden of CVD admission in the rural areas of China. We employed the distributed lag non-linear model (DLNM) to estimate the relationship between AT and the relative risk (RR) of CVD hospitalization. Finally, we used attributable risk methods to quantify this relationship further.

Food Habits of Raccoon Dogs at An Agricultural Area in Shikoku, Western Japan.

The diet of raccoon dogs, which live in close proximity to agricultural fields in Matsuyama, western Japan, was studied throughout the year by the fecal analysis method (n = 114). Fruits were most important, accounting for 30-40% of the diet except in winter. Crops were next in importance, accounting for 10-30%. It was characteristic that the proportion of crops was greater and more stable than in other "satoyama" or rural areas in Japan. Crops included rice (Oryza sativa), wheat, sesame (Sesamum indicum), strawberries (Fragaria × ananassa), kiwi fruit (Actinidia chinensis var. deliciosa), ginkgo nuts (Ginkgo biloba), and persimmon (Diospyros kaki). Crops were important as the food for the raccoon dogs, but the use was not regarded as causing serious damage. Although wild boars (Sus scrofa), sika deer (Cervus nippon), and Japanese macaques (Macaca fuscata) were culled for pest control in the area, raccoon dogs were not culled. This may be a reason why the raccoon dog has coexisted with people in Japan.

Cultural practices supporting early motherhood in a Ghanaian community.

Cultural practices help constitute a 'normal' way of life within a specific community and set the standard that members of the community are expected to adhere to. Some of these practices may have a short- and long-term influence on young people in ways supportive of teenage motherhood. This study explored cultural practices and beliefs in a study area in Ghana that encourage teenage girls into motherhood unintendedly. An exploratory design was used. Thirty teenage mothers and twenty-two opinion leaders participated in fieldwork conducted between October 2018 and February 2019. Data were analysed using an inductive approach. Four themes became apparent: fear of being cursed for having an abortion; sleeping arrangements; funerals and wakes; and practices of cohabitation in the study area. Cultural practices contribute to teenage motherhood in the Adaklu District of Ghana. Programmes, interventions and policies should be designed to take into consideration the needs, contexts, and backgrounds of teenagers. Future programmes to enhance teenagers ability to avoid teenage pregnancy and motherhood should consider factors such as the family, the person, the community, institutions, and national and international influences.

Home Environmental Factors Associated with Falls Among Elderly in Ubon Ratchathani, Thailand.

Purpose: The demographics of the world's population have changed over time. Previous research demonstrated the high rate of falls among elderly people living in rural areas in their own houses. This study aimed to use the Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT) to look into the environmental factors inside and outside of residential homes connected to falls among elderly living in rural Thailand. Methods: Data was gathered between August and October 2023 using a questionnaire to obtain demographic data and the 44-question Thai-HFHAT survey. The survey was divided into seven sections covering the areas inside and outside the elderly home facility. Descriptive statistics were used in the data analysis, and statistical tests, including Fisher's exact test and the Chi-square test, were used to examine the relationship between environmental factors and falls in elderly people. Results: The study found that issues with an elderly rural home included split-level flooring in the living room, bathroom, and bedroom, an insecurely attached carpet in the kitchen and bedroom, and a shower area not separated from the toilet. The environmental factors linked to falls among the elderly encompass insufficient lighting in the living room, bathroom, bedroom, and parking garage, debris and obstacles such as wires along the path in the living room and parking garage, and the poor condition of the staircase, characterized by inconsistent step heights or a slippery surface. Conclusion: Community agencies should consider the living conditions of elderly people in rural areas to effectively reduce the occurrence of falls among this population.

[Need for livelihood support and relationship with community residents: A cross-sectional survey among older adults who do not use livelihood support in a rural area].

Objectives　In recent years, the Japanese government has promoted a livelihood support system based on residents-based mutual help in the community. This study aimed to examine the associations between the need for livelihood support and the relationship with community residents among older adults who do not use livelihood support in a rural area. We operationally defined livelihood support as helping older adults with daily problems so that they can continue to live in familiar neighborhoods.Methods　A self-administered questionnaire survey was conducted in Gejo Area of Tokamachi City, Niigata Prefecture in October 2018. The questionnaires were distributed to all 1,033 residents aged 65 years or over, excluding those certified with care levels 3-5 in the long-term care insurance system. The survey items included basic characteristics, health status, relationship with community residents, and need for 33 livelihood support items.Results　A total of 802 questionnaires were returned (response rate of 77.6%), and 653 community-dwelling individuals who had not used livelihood support were included in the analysis. Factor analysis grouped the 33 livelihood support items into four factors: temporary problems and troubles (53.4%), participation in events and gatherings (38.0%), daily household chores (31.7%), and small problems in daily life (27.7%). Logistic regression analysis showed that the need for assistance with temporary problems and troubles was related to "low trust in community residents," "willing to help community residents but have not yet done so," and "willing to help community residents and have already done so." The need for assistance with participation in events and gatherings was related to "willing to help community residents but have not yet done so," "willing to help community residents and have already done so," and "higher levels of sekentei." The need for assistance with daily household chores was related to "low trust in community residents" and "willing to help community residents and have already done so." Finally, the need for assistance with small problems in daily life was related to "willing to help community residents and have already done so."Conclusion　The need for livelihood support was related to relationships with community residents. To promote the livelihood support system in communities, the relationships between older adults and community residents should be considered.

Reduction in all-cause medical and caregiving costs through innovative health awareness projects in a rural area in Japan: a retrospective cohort study.

BACKGROUND: This study evaluates cost reduction in participants of a health awareness program (the Center of Healthy Aging Program, CHAP) in a Japanese rural area, characterized by an annual check-up and personalized interview on health issues and related risks immediately after the check-up. METHODS: This is a cross-sectional study using medical and caregiving costs and Japan-specific health check-up results in Hirosaki residents stored by the local government, which were individually-based linked to the CHAP information collected by Hirosaki University. This is the first study that used anonymized data with individually-based linkages to both a research institute and a local government in Japan under a strict limitation regarding linking to third-party data. We included residents who had been continuously enrolled for > 6 months as of 1 July 2015. We compared 5-year all-cause costs between three groups (with CHAP, with Japan-specific health check-up, and no check-up) using a multivariate negative binomial regression model considering risk factors including lifestyle habits and an inverse probability weight to adjust for baseline characteristics: age, sex, Charlson comorbidity index, baseline care level, and risk score of coronary heart diseases. RESULTS: A total of 384, 9805, and 32,630 residents aged 40-74 years were included for the CHAP, Japan-specific health check-up, and no check-up groups, respectively. The Japan-specific health check-up group showed older and higher Charlson comorbidity index than the others. After inverse probability weight adjusting, the amount of all-cause medical costs was significantly lower only in the CHAP group. Faster walking speed and exercise habits were independently associated with lower all-cause medical and caregiving costs. CONCLUSIONS: We demonstrated a 5-year all-cause cost reduction in residents who participated in the CHAP and also suggested the effect of exercise habits in Hirosaki, which indicated the significance of individually-based data linkages to external third-party data for all local governments to improve the health condition of residents.

[Develop the rural ecology in the New Era]. / 发展新时代的乡村生态学.

Rural ecology is a comprehensive field of study that takes the rural social-ecological-economic systems as the objective object and emphasizes spatial carrier governance. The development of rural ecology in the New Era embodies and implements comprehensively the core concepts of Xi Jinping Thought on Socialism with Chinese Cha-racteristics for a New Era, including harmonious coexistence between humans and nature, rural revitalization, green development, and the comprehensive construction of a socialist modernized nation. Under the goal of Chinese-style modernization, rural ecology exhibits characteristics distinct from the past, such as the integration of research objects, the intersectionality of basic theories, the computational feature of technical methods, and the orientation of exporting outcomes. To provide disciplinary support for modernization-oriented science to meet the new demands of country's rural development, effectively narrating the story of sustainable rural development in China and providing fundamental guarantees for the safety of rural systems, a number of issues such as paradigm innovation in research, improvement of data quality, and integration of comprehensive technologies, should be fully considered.

Gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural western China: A decomposition analysis.

Understanding the ethnic gap in protective behavior and its explanatory factors is a promising step for reducing pandemic-induced disparities. However, no studies have endeavored to identify the factors contributing to a gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural China. We aimed to analyze the gap in protective behaviors between Han and minority residents in rural China. We conducted cross-sectional studies in multi-ethnic rural China in 2020. A total of 1640 participants from Han and minority groups were invited to participate. The decomposition method was applied to analyze the gap in protective behaviors and its associated factors between the Han and minority groups. Participants in the Han group had a higher protective behavioral score (9.26 ± 1.20) than the minority group (8.97 ± 1.50), yielding a significant gap in protective behaviors between Han and minority ethnicities of 0.29. Socio-demographic characteristics, health status, the degree of knowledge held about COVID-19, and psychological responses to COVID-19 explained 79.3 % (0.23/0.29) of the behavioral gap between the Han and minority groups. The difference in household asset levels was the largest explained contributor to the behavioral gap (52.17 %) (0.12/0.23), followed by fear felt for COVID-19 (-21.74 %) (-0.05/0.23). Differences in educational attainment, degree of knowledge held about COVID-19, and self-efficacy in response to COVID-19 each explained 17.4 % (0.04/0.23) of the behavioral gap. In conclusion, Han group show greater protective behaviors than minority ethnic groups. To drive better protective behavior in the most vulnerable communities, targeted, group-specific COVID-19 preventative messages deployed in public health communication strategies is suggested to enhance individual confidence in coping with the pandemic while creating a healthy amount of fear for public health crisis.

Prevalence and determinants of anaemia among pregnant women in a high malaria transmission setting: a cross-sectional study in rural Burkina Faso.

Introduction: anemia, the commonest nutritional deficiency disorder among pregnant women in sub-Saharan Africa, is associated with severe peripartum complications. Its regular monitoring is necessary to timely inform clinical and preventive decision-making. The aim of this study was to assess the prevalence and determinants of anemia among pregnant women in rural areas of Burkina Faso. Methods: between August 2019 and March 2020, a cross-sectional study was conducted to collect maternal sociodemographic, gynaeco-obstetric, and medical characteristics by face-to-face interview or by review of antenatal care books. In addition, maternal malaria was diagnosed by standard microscopy and the hemoglobin levels (Hb) measured by spectrophotometry. The proportion of anaemia (Hb<11.0 g/dL), moderate (7.0

[Interest of a short educational intervention coordinated by community pharmacists for elderly type 2 diabetes patients in a rural area]. / Intérêt d'une séance éducative « flash ¼ coordonnée par des pharmaciens d'officine pour des patients âgés diabétiques de type 2 en milieu rural.

The number of elderly people with type 2 diabetes (T2D) is increasing worldwide. Community pharmacies, thanks to their proximity, provide more easy access to therapeutic education for rural patients. Populations living in isolated areas require specific educational resources related to their condition. The aim of this project was to perform a short (FLASH) educational intervention, coordinated by community pharmacists, and then evaluate the impact of this intervention on patient knowledge of their disease. The study was performed in Issoudun, a rural French town of approximately 10,000 inhabitants. Educational priorities were defined and the project was presented to health authorities and local health professionals. Pharmacies in Issoudun recruited patients, either alone or accompanied by their caregivers. The educational intervention lasted 2h and focused on 4 teaching objectives: knowledge concerning diabetes, diabetic complications and how to monitor them; how to react to hypoglycemia; understanding treatments; and understanding glycated hemoglobin. The impact of this educational intervention was assessed using a questionnaire delivered before the intervention, immediately after, and after 6months. Forty-five patients aged 71±6years with T2D duration of 14±6years were recruited over 6months. Some false beliefs were identified before the intervention. The educational session led to a significant improvement in the percentage of correct answers (before: 60.3%±7.5, after: 99%±0.4, P=0.0002) and at 6months (99.5%±0.3, P=0.0002) compared with the patients' initial knowledge. Almost all false beliefs were corrected by the intervention and patients were able to recall the mechanism of action of their drugs, with the help of a "key and lock" schematic. This short FLASH educational intervention, coordinated by community pharmacists, showed that the model was both interesting to patients and effective. This method could be expanded to other rural communities and medical deserts.

Prevalence of Vitamin A Deficiency in Children Aged 6 to 17 Years - Western and Central Rural Areas, China, 2012-2021.

What is already known about this topic?: Vitamin A deficiency (VAD) is a leading global nutritional concern, ranking among the top four major nutritional deficiencies worldwide. The prevalence of VAD is unevenly distributed across various regions, both within China and globally. What is added by this report?: The report adds valuable insights into the vitamin A nutritional status of rural students aged 6-17 years who participated in the Nutrition Improvement Programme for Rural Compulsory Education Students (NIPRCES). Over the decade from 2012 to 2021, there was a modest improvement in vitamin A status. The prevalence of VAD and sub-clinical VAD (SVAD) declined as the students aged. Throughout the majority of the survey years, the incidence of VAD was higher among males and western regions compared to females and central regions, respectively. What are the implications for public health practice?: A comprehensive approach, incorporating dietary diversification, nutrition education, and food fortification, should be implemented to prevent VAD and SVAD especially in males, younger children and children in western areas.

Conocimientos, actitudes y prácticas sobre el autoexamen de mamas en mujeres de una zona rural / Knowledge, Attitudes and Practices of breast self- examination in rural area women

Objetivo principal: Describir los conocimientos, actitudes y prácticas sobre el autoexamen de mamas en mujeres de una zona rural. Metodología: Estudio cuantitativo de diseño no experimental, descriptivo, transversal. La muestra fue de 139 mujeres que viven en una zona rural en Lambayeque-Perú. Para la recolección de datos se empleó un cuestionario adaptado, validado por juicio de expertos y con α de Cronbach 0,88. Los datos fueron procesados y analizados mediante el uso del programa SPSS versión 25. Resultados principales: Se encontró que el 94,96% desconocen sobre el autoexamen de mamas, 93,6% de las participantes tienen actitud positiva para realizarlo, sin embargo, el 64,7% nunca se lo ha realizado. Conclusión principal: Las mujeres del estudio presentan conocimientos incorrectos sobre el autoexamen de mamas, una actitud positiva hacia esta técnica, pero una práctica inadecuada. Es necesario ampliar las coberturas y estrategias educativas en salud para que esta población conozca y practique el autoexamen de mama.(AU)

Objective: To describe the knowledge, attitudes and practices about breast self-examination in women from a rural area. Methods: Quantitative study of non-experimental, descriptive, cross-sectional design. The sample consisted of 139 women living in a rural area in Lambayeque-Peru. For data collection, an adapted questionnaire was used, validated by expert judgment and with Cronbach's alpha 0.88. The data was processed and analyzed using the SPSS version 25 program. Results: It was found that 94.96% are unaware of breast self-examination, 93.6% of the participants have a positive attitude to perform it, however, 64.7% never know about it. Conclusions: The women in the study present incorrect knowledge about breast self-examination, a positive attitude towards this technique, but an inadequate practice. It is necessary to expand health educational coverage and strategies so that this population knows and practices breast self-examination.(AU)

Prevalence of Metabolic Syndrome and its Risk Factors among Adults in a Rural Area of Dakshina Kannada District.

Background: Metabolic syndrome (MS) consists of interconnected factors responsible for increased risk of cardiovascular diseases and development of type 2 diabetes mellitus. Early identification and treatment of components of MS leads to improved cardiovascular outcomes. Aims: To determine the prevalence of metabolic syndrome among adults >18 years of age and to study the various socio-demographic and behavioral factors associated with MS. Methods and Material: This was a cross-sectional study conducted among 280 adults of >18 years in a rural area of Dakshina Kannada district. Probability proportional to size and random sampling was used to select the study participants. Data was collected by interviews, anthropometry, blood investigations. Results: Prevalence of MS was 33.9% and majority were females (71.8%). The mean age was 49.35 (±15.22) years. The prevalence (raised levels/on treatment) of hypertension, hyperlipidemia and hyperglycemia were 56.79% (systolic), 38.93% (diastolic), 38.57% (raised triglycerides), and 45% respectively. Majority of the subjects were obese (52.9%). Participants of 18-49 years age group had 2.30 times higher odds of having MS than ≥50 years age group (P value < 0.001). Female gender and low socio-economic status had 1.49- and 1.31-times higher odds of having MS respectively. Family history of diabetes and presence of co-morbidities had 1.20- and 1.02-times higher odds of developing MS. Conclusion: There is a high prevalence of MS in rural areas. Intervention based on lifestyle modifications needs to be developed.

High organic aerosol in the low layer over a rural site in the North China Plain (NCP): Observations based on large tethered balloon.

High mass concentration of organic aerosol (OA) and its fraction in PM2.5 (particle matter with radius <2.5 µm) were observed in the low layer over a rural site of the North China Plain (NCP) in winter 2018. The mass fraction of OA in PM2.5 was 65.5 % at ground level (5 m above ground), and decreased to 37.1 % in layer of 200-1000 m. In addition, there was a sharp decrease of OA at around the top of planetary boundary layer (PBL), which was distinctly different from the vertical distributions of secondary inorganic aerosols (SIA, e.g., nitrate (NO3-), ammonium (NH4+), and sulfate (SO42-)). The altitude with sharp decrease of OA was very low in the morning and evening, e.g., the sharp decrease of OA occurred at a height <50 m at nighttime on Dec. 19, while was elevated in the noon with the PBL development. Furthermore, OA at ground level exhibited a distinct diurnal variation with a night-to-day ratio of 2.3, which was much larger than those of SIA and inactive CO. All the above results indicated the extremely high OA concentration at the rural site was mainly attributed to direct emission from local sources, such as the combustion of coal and biomass for heating. The extremely high OA could be expected in vest rural areas of the NCP in winter because the farmer activities are very similar to the investigated rural site, underscoring the urgency to mitigate OA emission in rural area for improving the local as well as the regional air quality.

Honey dressing for penile skin avulsion caused by traditional circumcision: a case report.

OBJECTIVE: Penile skin avulsion is a rare complication of circumcision but commonly encountered as the result of traditional practice. We aimed to present the use of honey dressing and the benefit of its wound healing properties for management of such a complex wound. CASE: A 24-year-old male patient with penile bleeding presented to the emergency department after undergoing traditional circumcision. Complete degloving of the penis with active bleeding and foul odour, along with heavy contamination of chewed betel leaves and powdered amoxicillin was found. Honey (Madu Nusantara, PT. Madu Nusantara, Indonesia) was used as dressing after copious irrigation using saline and povidone-iodine with bleeding control. RESULTS: Honey dressing was shown to be effective for secondary wound healing of such a complicated and contaminated wound-in this case due to its antimicrobial, anti-inflammatory, immunostimulatory and autolytic debridement properties. A complete re-epithelialisation of the wound was achieved without progression to the hard-to-heal state by day 43. Suboptimal sexual function and aesthetic result due to wound contracture were observed as surgical reconstruction via split-thickness skin graft was refused due to cost. CONCLUSION: In this case report, honey dressing was shown to be effective for wound healing, even in a penile avulsion with complete skin loss and heavy contamination. In rural settings, where penile avulsion due to traditional circumcision is common, honey should be considered as one of the dressing choices.