Factors associated with pentavalent vaccine coverage among 12-23-month-old children in Afghanistan: A cross-sectional study.

INTRODUCTION: This study aimed to identify the factors associated with the coverage of the third dose of pentavalent vaccine (Penta3) among children aged 12-23 months in Afghanistan. METHODS: The data of 3,040 children aged 12-23 months were taken from the Afghanistan Health Survey 2018, including characteristics of the children and their households, household heads, and mothers/primary care givers. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using a logistic model. Multivariable stepwise logistic regression analysis with forward-selection (Model 1) and backward-selection (Model 2) was performed using variables that showed significant differences by bivariate analysis. RESULTS: The coverage of Penta3 among 12-23-month-old children was 82.3%. Factors associated with Penta3 coverage in the two models of multivariable analysis were 18-23 months old compared to 12-17 months old; having no diarrhea in the last two weeks compared to having diarrhea; no bipedal edema compared to having edema; taking vitamin A supplement; 1-2 children under five years in a household compared to three or more; distance from residence to the nearest health facility ≤2 hours on foot; having a radio; having a TV; educated heads of households; non-smoking of heads of households; and literacy of mothers/primary caregivers. CONCLUSIONS: Penta3 coverage among 12-23-month-old children improved but was still lower than the target. Primary education should be provided to all children throughout the country. TV and radio are useful tools for providing health information. Mobile outreach programs and the establishment of new health facilities should be promoted to improve access to health service for all people in Afghanistan.

Reporting system on mortality statistics in Lao People's Democratic Republic.

The system to collect information on mortality statistics in Lao PDR is not well established, accurate and timely death information is therefore not available. This article reports the system and process to make the mortality statistical data of Lao PDR. The country has a paper-based resident registration system, using a death notification document, a death certificate, and a family census book. The death notification document is important as it provides the cause of death, which is issued from a health facility and the village office. In the event of a death occurring at home, the family representative needs to report to the village office verbally to obtain a death notification document. On the other hand, if the death occurred in a medical facility, a death notification document from a health facility is provided. The family representative should bring the death notification document to the district Home Affairs office to register the death and obtain a death certificate. After that, the family representative needs to bring the death certificate to the district Public Security office for an amendment in the family census book. ICD-10 is under development regarding death notification from health facilities under the Ministry of Health. However, it is unclear how death notification from village offices can adopt ICD-10 as the majority of deaths occur outside health facilities. A comprehensive and integrated mortality reporting system is necessary in order to create a holistic health policy and welfare for the country.

Mass media exposure and childhood diarrhea: a secondary analysis of the 2011 Bangladesh Demographic and Health Survey.

In order to reduce child mortality, recommendations for diarrhea management practices have been widely promoted by various methods, including mass media. This study examined whether mother's exposure to mass media was associated with child's diarrhea, and with the diarrhea management practiced by their mothers. Data on 7,068 women, whose youngest child was under five years old, were extracted from the Bangladesh Demographic and Health Survey, 2011, together with information on the child. The outcome variables were an episode of diarrhea in the two weeks prior to the survey and diarrhea management practices; exposure to mass media was used as the major explanatory variable. They were descriptively summarized, and logistic regression analyses were performed. Television was found to be the most common form of media. Among 346 children who had experienced an episode of diarrhea in the previous 2 weeks, less than 42.5% were given zinc and only 26.3% of the mothers provided sufficient fluids. No significant associations between mother's mass media exposure and child's diarrhea were observed. Women who read newspapers/magazines were more likely to provide sufficient fluids and food, and those exposed to the radio were more likely to provide zinc supplementation. Since mother's exposure to newspaper/magazines and radio showed associations with some recommended practices for the treatment of childhood diarrhea, mass media clearly has the potential to improve diarrhea management practices. More effective use of mass media is anticipated; in particular, promotion of zinc supplementation and increasing fluid intake during diarrhea, neither of which were currently well practiced.

Patient satisfaction on the utilization of traditional and complementary medicine services at public hospitals in Malaysia.

BACKGROUND: Traditional and complementary medicine (T&CM) has been integrated into the Malaysian public healthcare system since the establishment of the first T&CM unit at a public hospital in 2007. Assessing patient satisfaction is a vital component of health service evaluation. The main objective of this study is to determine the level of patient satisfaction with the utilization of T&CM services at public hospitals in Malaysia and assess the sociodemographic influence on the overall reporting of satisfaction. This study also aims to analyze the response of the patients towards expansion of T&CM services in the public sector in Malaysia. MATERIALS AND METHODS: A study was conducted to analyze data on the utilization of T&CM services within public hospitals. Secondary data on 822 patients' satisfaction with services offered at 15 T&CM units was analyzed to examine the overall levels of satisfaction with T&CM services in public hospitals in Malaysia. RESULTS: Overall, 99.4% of patients were satisfied with T&CM services and most patients (91.8%) felt that T&CM treatment positively impacted their health. Overall satisfaction was not affected by lower levels of satisfaction with subcategories of service, such as the number of treatment sessions received (90.7% satisfied), date to the next appointment (90.7% satisfied), and the absence of adverse effects of treatment received (87.1% satisfied). There were no significant associations between the socioeconomic status of the respondents and the level of satisfaction reported; however, respondents with a monthly salary of Ringgit Malaysia (RM) 1000 to RM 3000 were more than twice as likely to be strongly satisfied with services received (adjusted odds ratios [AOR]: 2.12, 95% CI: 1.19-3.78). CONCLUSION: This study revealed a high level of satisfaction among patients who had received T&CM treatment at public hospitals in Malaysia. High satisfaction with T&CM treatment validates the integrative management approach adopted in patient care within the public hospitals in Malaysia.

Macronutrient intakes and serum oestrogen, and interaction with polymorphisms in CYP19A1 and HSD17B1 genes: a cross-sectional study in postmenopausal Japanese women.

Although higher circulating levels of oestrogen are related to postmenopausal breast cancer risk, limited information is available regarding effects of diet on endogenous oestrogen. Thus, we examined associations between macronutrient intakes and serum oestrogen with consideration of polymorphisms in oestrogen-metabolising genes. In this cross-sectional study, 784 naturally menopaused Japanese women aged 47-69 years were selected from participants of the Japan Multi-Institutional Collaborative Cohort Study. We documented dietary intakes, measured serum concentrations of oestrone (E1) and oestradiol (E2) and genotyped polymorphisms in oestrogen-metabolising CYP19A1 (rs4441215 and rs936306) and HSD17B1 (rs605059) genes. Trends and interactions were examined using linear regression models. In addition, we calculated the ratios of the oestrogen concentrations of the second to the highest quartiles (Q2-Q4) of dietary intake to those of the lowest quartiles (Q1). After adjustment for potential confounders, E2 was significantly associated with intake of carbohydrate and noodles; ratios of Q4 v. Q1 were 1·15 (95 % CI 1·04, 1·28) and 1·15 (95 % CI 1·04, 1·26), respectively. In contrast, E2 levels were inversely associated with intake of total energy, SFA and n-3 highly unsaturated fatty acids (n-3 HUFA); ratios of Q4 v. Q1 were 0·90 (95 % CI 0·82, 0·99), 0·89 (95 % CI 0·81, 0·98) and 0·91 (95 % CI 0·83, 1·00), respectively. In stratified analysis by polymorphisms, the rs605059 genotype of HSD17B1 significantly modified associations of E2 with intake of n-3 HUFA and fish; the associations were limited to those with the CC genotype. Macronutrient intakes were associated with serum E2 level, and these associations may be modified by HSD17B1 polymorphism in postmenopausal women.

Uranium in well drinking water of Kabul, Afghanistan and its effective, low-cost depuration using Mg-Fe based hydrotalcite-like compounds.

Toxic elements in drinking water have great effects on human health. However, there is very limited information about toxic elements in drinking water in Afghanistan. In this study, levels of 10 elements (chromium, nickel, copper, arsenic, cadmium, antimony, barium, mercury, lead and uranium) in 227 well drinking water samples in Kabul, Afghanistan were examined for the first time. Chromium (in 0.9% of the 227 samples), arsenic (7.0%) and uranium (19.4%) exceeded the values in WHO health-based guidelines for drinking-water quality. Maximum chromium, arsenic and uranium levels in the water samples were 1.3-, 10.4- and 17.2-fold higher than the values in the guidelines, respectively. We next focused on uranium, which is the most seriously polluted element among the 10 elements. Mean ± SD (138.0 ± 1.4) of the 238U/235U isotopic ratio in the water samples was in the range of previously reported ratios for natural source uranium. We then examined the effect of our originally developed magnesium (Mg)-iron (Fe)-based hydrotalcite-like compounds (MF-HT) on adsorption for uranium. All of the uranium-polluted well water samples from Kabul (mean ± SD = 190.4 ± 113.9 µg/L; n = 11) could be remediated up to 1.2 ± 1.7 µg/L by 1% weight of our MF-HT within 60 s at very low cost (<0.001 cents/day/family) in theory. Thus, we demonstrated not only elevated levels of some toxic elements including natural source uranium but also an effective depurative for uranium in well drinking water from Kabul. Since our depurative is effective for remediation of arsenic as shown in our previous studies, its practical use in Kabul may be encouraged.

Contribution of specific foods to fat, fatty acids, and cholesterol in the development of a food frequency questionnaire in Koreans.

The present study identified dietary sources of fat, fatty acids, and cholesterol in Koreans residing in and near Seoul. The study also identified foods to be included in a food frequency questionnaire (FFQ) by both contribution analysis (CA) and multiple regression analysis (MRA). Three-day dietary records were collected from 224 subjects (107 men and 117 women) aged 30 to 85 years. Pork was the main source of total fat and the largest contributor to saturated fatty acids (SFA) was beef. MRA identified animal food as the primary source of between-person variance for SFA. Arachidonic acid, eicosapentaenoic acid, and docosahexaenoic acid originated primarily from marine products. About a fourth of the total cholesterol intake was derived from chickens' eggs by CA, while chickens' eggs accounted for 46% of the cholesterol intake for between-person variance by MRA. With 10 food items, the FFQ could explain more than half of total intakes except for total fat and n-3 polyunsaturated fatty acids (PUFA), and at least 65% of between-person variances. The percentage coverage in the FFQ ranged from 61% for n-6 PUFA and linoleic acid and to 90% for arachidonic acid. The value of this FFQ is that it can estimate usual dietary food patterns and nutrient intake in Koreans for epidemiological studies. It can also potentially be used to study the relationship between specific diseases and nutrient intakes of interest.