Factors associated with dengue fever IgG sero-prevalence in south Kordofan state, Sudan, in 2012: Reporting prevalence ratios

Dengue fever [DF] is a vector-borne virus transmitted to humans by infected Aedes mosquitoes. In this study, we identified the most important factors associated with the prevalence of IgG antibodies in a border state between Sudan and the new republic of South Sudan. To quantify the association of specific factors with the prevalence of DF IgG antibodies in Lagawa among subjects aged 16-60 years in 2012. Analytical cross-sectional community-based study conducted in Lagawa in 2012. Indoor mosquito breeding was the most significant predictor affecting DF IgG serology. Household water storage was also strongly associated with the presence of IgG antibodies. Residence in urban areas, younger age and a history of travel to the Red Sea State were significant predictors of DF IgG seroprevalence in South Kordofan state. Indoor [household] behaviors associated with DF infection should be modified to mitigate the infection risk in the study area. Awareness should be raised regarding DF in Lagawa to ensure community participation in all control measures, and the surveillance system at the border between Sudan and the republic of South Sudan should be strengthened

Health disparities between Muslim and non-Muslim countries

We examined differences in health indicators and associated factors across countries according to the proportion of the population who are Muslim. Of 190 UN countries, 48 were classified as Muslim-majority countries [MMC] and 142 as non-MMC. Data on 41 potential determinants of health were obtained from 10 different data sources, and 4 primary outcome measures [male and female life expectancy, maternal mortality ratio and infant mortality rate] were analysed. Annual per capita expenditure on health in MMC was one-fifth that of non-MMC. Maternal mortality and infant mortality rates were twice as high in MMC as non-MMC. Adult literacy rate was significantly higher for non-MMC. Four significant predictors explained 52%-72% of the differences in health outcomes between the 2 groups: gross national income, literacy rate, access to clean water and level of corruption

Quantitative and qualitative analysis of pubmed-indexed biomedical publications in Oman from years 2005-2009

Research activities are promoted at the government and the institutional levels in Oman. However, the quantity and quality of research conducted in various institutes of Oman has not been measured. Therefore, this study was conducted to analyze the quantity and quality of biomedical publications emanating from Oman over the last five years [2005-2009]. Data regarding the biomedical publications of Omani origin published from January 2005 to December 2009 were retrieved from Pubmed. All abstracts were manually checked to exclude false retrievals. The journal impact factor [IF] for 2008 was applied for every publication. Full-length original articles, review articles and publications mentioning new research methods/new technique were assigned full IF of the journal. However, half of the journal IF were assigned to correspondences/commentaries, case reports/series and short communications. Of biomedical publications, 752 were retrieved from Pubmed and 519 publications were included for final analysis after excluding false positives. The number of biomedical publications steadily increased over the last five years, but it was not statistically significant. Original research articles constituted more than half [54.3%] of all the publications, followed by case reports/series [30.1%]. Sultan Qaboos University [SQU] contributed more than half of the biomedical publications [51.5%], followed by the Ministry of Health [MoH], which contributed 38% of the publications. Interestingly, the mean IF of the publications was not significantly different throughout the years. The number of publications emanating from Oman increased over the last five years; however, the quality of research has not improved. Furthermore, the research in Oman is mainly conducted by the government-run institutions and there is hardly any contribution from the private institutions

Using SERVQUAL for assessing and improving patient satisfaction at a rural health facility in Pakistan

A cross-sectional study of patient satisfaction with care was conducted over a period of 1 year from March 2004 to March 2005 in a secondary-level hospital in a peri-urban area of Karachi, Pakistan. Using the SERVQUAL tool and exit interviews, data were collected quarterly from a total of 1533 patients. Results sharing and capacity-building workshops were arranged during the 4 phases of the survey to sensitize the staff of the hospital to work towards improving patient satisfaction. The level of satisfaction of the patients with the outpatient health services provided showed a gradual increase from 34.4% to 82.0% over the 1-year period

Diabetes knowledge, beliefs and practices among people with diabetes attending a university hospital in Karachi, Pakistan

A structured questionnaire on knowledge, beliefs and practices regarding diabetes was administered to 199 persons with diabetes [92.5% type 2] attending the Aga Khan University Hospital, Karachi. Mean age [standard deviation [SD]] was 53 [11] years. Mean duration of diabetes [SD] was 8 [7] years in men and 9 [6] years in women. Men had a significantly better knowledge score than women [P = 0.02]; there was no significant difference in the beliefs and practices scores. Scores were classed as good [> 60%] in only 13.6% of participants for knowledge, 17.6% for beliefs and 11.2% for practices.About 38% of the participants had received education on diabetes care

Hypertriglyceridemia and low HDL-cholesterol are the major lipid abnormalities in normal Pakistani adults: are these contributing to the high rates of coronary artery disease in this population?

Objective: Lipid abnormalities are related to enhanced risk of developing cardiovascular disease. The objective of the study was to investigate variability in lipid profile in Pakistani normal adults [from the personnel of 4 tertiary care hospitals] by age, gender, body mass index [BMI] and smoking, and to determine the prevalence of hypertriglyceridemia, hypercholesterolemia, low HDL-cholesterol and isolated low HDL-cholesterol in this population

Method: Serum samples from 323 normal healthy subjects [236 males and 87 females, age 30-70 years] from the personnel of the Aga Khan University, Civil Hospital, Karachi, Armed Forces Institute of Cardiology and Military Hospital, Rawalpindi were analyzed for total cholesterol, HDL-cholesterol and triglycerides using kit methods. LDL-cholesterol was determined using the Friedewald formula

Results: Mean +/- SD concentrations of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides were found to be 165+/-37 mg/dl, 37+/-11.5 mg/dl, 98+/-34 mg/dl and 155 +/- 88 mg/dl, respectively. Mean levels of total cholesterol were found to be significantly higher in hypertriglyceridemia [>200mg/dl] than normotriglyceridemia [181+/-30 mg/dl vs 160+/-38 mg/dl; p=0.001]. Mean concentration of HDL-cholesterol in the younger age group [50 years] group [39.6+/-11.7 mg/dl vs 33.4+/-9.7 mg/dl; p=0.001]. Similarly, mean concentration of HDL-cholesterol in females was significantly higher compared to males [44.3+/-14 mg/dl vs 34.9+/-9.1 mg/dl; p=0.001]. In hypertriglyceridemia [>200 mg/dl], mean HDL-concentration was significantly lower compared to normotriglyceridemia [33.4+/-8.3 mg/dl vs 38.9+/-12 mg/dl; p=0.001]. The combined effect of age, gender and triglyceridemia was found to be significantly associated with HDL-cholesterol concentration [p25], triglyceride levels were significantly higher compared to those with BMI<25 [180+/-107 mg/dl vs 144+/-71 mg/dl; p=0.001]. Levels of triglycerides were, therefore, significantly associated with gender and BMI [p<0.001; R2 =0.076]. LDL-cholesterol levels were not found to be significant by age, gender, smoking, BMI and triglyceridemia. Smoking had no significant effect on lipid levels of male healthy subjects. Frequencies of hypercholesterolemia, hypertriglyceridemia, low HDL-cholesterol and isolated low HDL-cholesterol were found to be 17.6%, 26.9%, 45.8% and 29.4%, respectively. High prevalence values of low HDL-cholesterol and isolated low HDL-cholesterol are reported for the first time in Pakistani normal adults and require further studies at the community level

Conclusion: High levels of triglycerides and low levels of HDL-cholesterol are the most prominent abnormalities in Pakistani adults working in tertiary health care centers

Prevalence and fators associated with anxiety and depression among family practitioners in Karachi, Pakistan

We aimed to assess anxiety and depression and to identify the factors associated with these conditions among family practitioners in Karachi, Pakistan. A self-reported postal survey was conducted among 540 family practitioners in Karachi during the months of July -August 2003. Aga Khan University Anxiety and Depression Scale [AKUADS] was used to assess anxiety and depression. Additional questions were also inquired to get information about socio- demographic, professional and lifestyle characters. Using AKUADS, 155 [39%] family practitioners had anxiety and depression. Mutlivariate analysis disclosed five factors to be significantly associated with anxiety and depression; these were female sex [AOR = 6.4,95% CI 3.2-12.6]; age group of < 35 years [AOR = 23.3,95% CI 9.0-60.3]; lack of regular exercise [AOR = 4.9,95% CI2.4-10.2] and working for more than 48 hours per week [AOR = 12.7, 95% CI6.2-26.2]. This study reveals that prevalence of anxiety and depression among family practitioners in Karachi is high and higher than general population in Karachi. Further research and intervention studies are required to identify preventive measures in this regard and also to assess the impact of these interventions

Macrovascular complications and their associated factors among persons with type 2 diabetes in Karachi, Pakistan - a multicenter study

To assess the prevalence of macrovascular complications and factors associated with these complications among persons with Type 2 diabetes. A multi-center, cross-sectional survey was conducted in three diabetes clinics of Karachi from November 2000 to April 2001. Six hundred and seventy-two persons were interviewed to determine the prevalence of ischemic heart disease [IHD], cerebrovascular disease [CVA] and diabetic foot [DF]. Demographic data and co-variables obtained include age, sex, duration of diabetes, body mass index [BMI], smoking status, exercise habits and history of hypertension [HTN]. Overall, 26.4%, 6.8% and 3.9% of individuals had IHD, CVA and DF respectively. Multiple logistic regression analysis showed that subjects having IHD were more likely to have HTN [AOR=1.88, 95% CI 1.31- 2.69], not performing regular exercise [AOR=2.09, 95% CI 1.39-3.17] and be current smokers [AOR=1.85, 95% CI 1.10-3.10]. Subjects having CVA were more likely to have diabetes for more than 5 years [AOR=1.94, 95% CI 0.97-3.87]. Males were more prone than females to have DF [AOR=3.48, 95% CI1.46-8.31]. Those who had DF were more likely to have diabetes for more than 5 years [AOR=3.29, 95% CI 1.09-9.89] and of reporting current smoking [AOR=4.01, 95% CI1.49-10.71]. Large proportions of persons with Type 2 diabetes were suffering from preventable macrovascular complications in Karachi, Pakistan. There is a need to develop risk factor modification interventions to reduce the impact of long-term complications