Health concerns of Micronesian peoples.

Several states in the United States have been experiencing an influx of migrants from an area of the world that most people have only heard of when learning about the atomic bomb and World War II. This area is the former U.S. Trust Territory of Pacific Islands now called the Freely Associated States. At the end of World War II, the United States took possession of many of these islands and in 1948, the United States formally took over administration of the Marshalls, the Carolines, Palau, and the Northern Marianas islands. Collectively this area is known as Micronesia. Micronesians come from areas that have high prevalence of several communicable diseases and there is growing concern that Micronesian immigrants may enable the spread of infectious disease to the United States from Asia. Data concerning Hansen's disease and tuberculosis support this claim. According to data from the Hawai'i State Department of Health, a 5-year trend examining new cases of tuberculosis in Hawai'i identified that 65 out of 77 new cases came from the Freely Associated States of Micronesia. Presented is an overview of the health concerns and health status of the people from the Federated States of Micronesia.

Quality of tuberculosis care in six health facilities of Afar Region, Ethiopia.

BACKGROUND: Quality tuberculosis care plays an important role in the status of tuberculosis (TB) control, treatment completion and adherence. Nonetheless, very little is known about the quality of TB care in public health facilities in Ethiopia. In this study we assessed the quality of TB care delivery in Afar Region of Ethiopia. METHODS: A descriptive cross sectional health institution based survey with both semi-structured and structured questionnaires was employed. A mix of complementary techniques was administered Data were collected between 5th February and 10th March 2007 from six health institutions. Records were reviewed for 270 patients, exit interviews were made for 209 patients, six providers were interviewed & 49 patients were observed Data was collected by trained nurses and analyzed using SPSS 11.0 statistical software. RESULTS: The study had showed that delivery of materials, drugs and supplies for tuberculosis control activities were fairly good. Staffing qualities were poor and patterns of supervision were weak. A relatively higher proportion of patients were dissatisfied with the appropriateness and adequacy of working hours (63.6%) and waiting time (70.3%). Statistically significant correlation was observed between process quality and output quality (clients' satisfaction) parameters (p < 0.001). CONCLUSION: Continues quality improvement mechanisms to improve the different aspects of the programme and adherence to the National Tuberculosis and Leprosy Control Program guideline could be important interventions to enhance the quality of care delivery. An expanded community-based study to better guide quality DOTS program in pastoralist communities is crucial.