ABSTRACT
@#Postpartum depression is a depressive episode that can start at any point during the first year after childbirth. There are several tools that can be used for PPD screening. The need to define a predictive tool that is clinically useful and has acceptable sensitivity and sensitivity is important especially to be used in the primary care setting. This systematic review investigates the evidence of the sensitivity and specificity of screening tools used for PPD screening. The Standard for Reporting of Diagnostic Accuracies (STARD) guidelines were used to conduct the review as a basis for our methodology. PubMed, ScienceDirect and Springerlink databases between 2007 until 2017 were comprehensively searched EPDS and BDI instrument has sensitivity of more than 80% but findings for specificity was inconclusive. The heterogeneity across studies could be the result of methodological differences in validation of the instruments. In addition, these studies were conducted across continents and settings with different cultures, languages and resources. We have identified 5 different instruments used to screen for postpartum depression. The EPDS was the most validated instrument in the review and we found that EPDS and BDI have higher accuracy to screen postpartum depression because the sensitivity reported were more than 80%.
ABSTRACT
Vaccine hesitancy among parents has led to re-emergence of vaccine preventable diseases. In Malaysia, measles cases had increased by three times in 2015 compared to previous year. Immunization coverage has always been above 95% since 2009. However, in 2014, Mumps-Measles-Rubella (MMR) coverage has a significant drop to 93.4%. The aim of the study was to identify predictors for inadequate knowledge and negative attitude towards childhood immunization among parents in Hulu Langat, Selangor. A cross sectional study design was conducted from January to July 2016 with760 respondents. Respondents were selected by cluster random sampling and a validatedself-administered questionnaire was used. The majority of respondents were female (70%), Malay (87%), employed (92%) and parents with tertiary education (99.7%). In this study, 12.8% parents have an inadequate knowledge on childhood immunization and 47.6% parents have a negative attitude towards childhood immunization. The predictors for inadequate knowledge on childhood immunizations were last child’s age of 2 years old or more (AOR=1.413 95% CI 0.28-0.69); parents without tertiary education (AOR=2.02 95% CI 1.15-3.54); parents withouteducational exposure on childhood immunization (AOR=2.87 95% CI 1.59-5.18) and parents who obtained information on childhood immunization from non-healthcare provider (AOR=2.66 95% CI 1.50-4.70). Predictors for negative attitude on childhood immunizations were being male (AOR=1.44 95% CI 1.04-2.01); parents without tertiary education (AOR=1.67 95% CI 1.04-2.68); household income of less than RM5000 (AOR=1.85 95% CI 1.28-2.67) and unsatisfactory religious belief (AOR=2.76 95% CI 2.03-3.75). Therefore, these predictors should be considered in any health intervention on childhood immunizations for parents in Malaysia.