Seroprevalence of human leptospirosis in a rural community from Tandil, Argentina. Assessment of risk factors and spatial analysis / Seroprevalencia de leptospirosis humana en una comunidad rural del partido de Tandil (Argentina). Identificación de los factores de riesgo y del análisis espacial

Abstract Leptospirosis is a neglected zoonosis that is widely distributed in the world. Although it is endemic in Argentina, prevalence remains unknown. The aims of the study were: (i) to determine the prevalence of leptospirosis in humans from a rural community in Tandil Argentina, (ii) to identify infecting Leptospira spp. serogroups, (iii) to identify factors associated with the infection, (iv) to estimate the population attributable fraction (PAF) of the risk factors and (v) to determine the spatial patterns of disease presentation and related risk factors. Blood samples from 202 participants were collected. A survey was conducted to obtain clinical and epidemiological data. Serological testing was performed by the microscopic agglutination test (MAT). Univariate and multivariate methods were applied to evaluate associations. Spatial clusters were investigated for seroprevalence and risk factors. Antibodies were found in 32.2% of participants (95% CI: 25.8-39.1). The most prevalent serogroup was Hebdomadis followed by Sejroe; Icterohaemorrhagiae; Tarassovi and Canicola. Living at lower altitudes (OR: 13.04; 95% CI: 2.60-65.32); not having access to water supply network (OR: 2.95; 95% CI: 1.30-6.69); living close to flooded streets (OR: 2.94; 95% CI: 1.14-7.69) and practicing water sports (OR: 3.12; 95% CI: 1.12-8.33) were associated with seropositivity. Factors related with housing characteristics, services and infrastructure had the higher PAF (from 17% to 81%). A spatial cluster with higher rates of positivity and of the main risk factors was determined. This work contributes useful data for specific preventive measures that should be implemented for the control of the disease.

Resumen La leptospirosis es una enfermedad desatendida, ampliamente distribuida a nivel mundial. Aunque es endémica en Argentina, su prevalencia es desconocida. Los objetivos de este estudio fueron los siguientes: (i) determinar la prevalencia de leptospirosis humana en comunidades rurales del partido de Tandil (Argentina), (ii) identificar serogrupos infectantes de Leptospira spp., (iii) identificar factores de riesgo asociados, (iv) estimar la fracción atribuible poblacional (FAP) de los factores de riesgo y (v) determinar los patrones espaciales de la enfermedad y de los factores de riesgo. Se tomaron muestras de sangre a 202 personas, y se registró información clínica y epidemiológica. El diagnóstico se realizó por microaglutinación (MAT). Para evaluar asociaciones, se utilizaron métodos univariados y multivariados. Se estudiaron clusters espaciales de la seroprevalencia y de los factores de riesgo. El 32,2% de los participantes (IC 95%: 25,8-39,1) presentaron anticuerpos. Los serogrupos más prevalentes fueron Hebdomadis, Sejroe, Icterohaemorrhagiae, Tarassovi y Canicola. Vivir a menores altitudes (OR: 13,04; IC 95%: 2,60-65,32) y cerca de calles inundables (OR: 2,94; IC 95%: 1,14-7,69), la falta de acceso a agua de red (OR: 2,95; IC 95%: 1,30-6,69) y la práctica de deportes acuáticos (OR: 3,12; IC 95%: 1,12-8,33) estuvieron asociados con la seropositividad. Factores relacionados con las características de las viviendas, los servicios y la infraestructura tuvieron mayor proporción de FAP (17 al 81%). Se encontró un área de mayor riesgo de presentación de individuos seropositivos y de los principales factores de riesgo. Este trabajo provee información útil para generar medidas preventivas específicas que podrían ser aplicadas para controlar esta enfermedad.

Cohort profile of the largest health & demographic surveillance system (Dibrugarh-HDSS) from North-East India

Dibrugarh Health and Demographic Surveillance System (Dibrugarh-HDSS), was started in the year 2019 with the objective to create the health and demographic database of a population from a defined geographical area and a surveillance system for providing technical assistance for the implementation of programmes and formulating intervention strategies for reducing disease morbidities and mortalities in the population. Dibrugarh-HDSS adopted a panel design and covered 60 contiguous villages and 20 tea gardens. Line listing of all the households was conducted and a unique identification number detailing State, district, village/tea garden and serial number was provided along with geotagging. Detailed sociodemographic variables, anthropometric measurements (subjects ?five years) and blood pressure data (subjects ?18 yr), disease morbidity and mortality were collected. All data were collected in pre-designed and pre-tested questionnaires using a mobile application package developed for this purpose. Dibrugarh-HDSS included a total of 106,769 individuals (rural: 46,762, tea garden: 60,007) with 52,934 males (49.6%) and 53,835 females (50.4%). The number of females per thousand males were significantly higher (1042 in tea garden vs. 985 in rural populations) in the tea-garden community as compared to the village population. More than one-third (35.1%) of tea populations were illiterate compared to the rural population (17.1%). Villagers had significantly higher body mass index than the tea-garden community. The overall prevalence of hypertension (adjusted for age) was 29.4 vs. 28.2 per cent, respectively, for the village and tea-garden population. For both these communities, males (village=30.8%, tea garden=31.1%) showed a higher prevalence of hypertension (adjusted for age) than females (village=28.2%, tea garden=25.8%). The findings of the present study give an insight into the profile of the native rural and tea-garden populations that will help to identify risk factors of different health problems, review the effectiveness of different ongoing programmes, implement intervention strategies for reducing morbidity and mortality and assist the State health authorities in prioritizing their resource allocation and implementation strategies.

Glycosylated hemoglobin control and its influencing factors amongpatients with type 2 diabetes mellitus in rural communities of Zhejiang Province / 预防医学

Objective@#To investigate the degree and influencing factors of glycosylated hemoglobin ( HbA1c ) control among patients with type 2 diabetes ( T2DM ) living in rural communities of Zhejiang Province, so as to provide the reference for optimizing the management of diabetes patients in rural communities.@*Methods@#Permanent adult patients with T2DM that were registered and received standardized management in all communities of Jiashan County and Suichang County, and 6 communities of Yongkang City, Zhejiang Province in 2016 were recruited, and their demographic characteristics were captured from the health record system and chronic disease management system. The height, body weight, waist circumstance and blood pressure were measured, and HbA1c and blood lipid parameters were detected. The degree of HbA1c control ( <7% ) was analyzed, and its influencing factors were identified using a multivariable logistic regression model.@*Results@#A total of 10 339 patients with T2DM were enrolled, including 4 520 men ( 43.72% ) and 5 819 women ( 56.28% ), with a mean age of ( 63.54±9.78 ) years and the mean course of diabetes of ( 6.36±4.73 ) years. The rate of HbA1c control was 47.89%. Multivariable logistic regression analysis showed that males ( OR=1.123, 95%CI: 1.024-1.233 ), region ( Suichang, OR=2.413, 95%CI: 2.106-2.765; Yongkang, OR=2.460, 95%CI: 2.188-2.767 ), course of disease ( 5-9 years, OR=1.724, 95%CI: 1.504-1.977; 10 years and longer, OR=2.881, 95%CI: 2.477-3.351 ), use of hypoglycemic drugs ( OR=1.203, 95%CI: 1.089-1.329 ), development of chronic complications ( OR=1.190, 95%CI: 1.027-1.379 ), uncontrolled blood pressure ( OR=1.140, 95%CI: 1.030-1.261 ), uncontrolled blood lipid ( OR=1.258, 95%CI: 1.104-1.433 ), and smoking ( OR=1.318, 95%CI: 1.165-1.491 ) were statistically associated with HbA1c control among T2DM patients.@*Conclusion@#The rate of HbA1c control was 47.89% among T2DM patients in rural communities of Zhejiang Province. HbA1c control should be given a high priority among men living in low-economic-level regions with long course of disease, use of hypoglycemic drugs, chronic complications, smoking, uncontrolled blood pressure and lipid.

Prevalence and distribution of cervical high-risk human papillomavirus infection in a rural community of Edo State, Nigeria

Background: Human papillomaviruses (HPVs) are non-enveloped, double-stranded DNA viruses and most women in the world are probably infected with at least one type of the virus during their sexual life. Oncogenic HPVs are predominantly sexually-transmitted pathogens and several high-risk types are associated with nearly all cases of cervical cancer worldwide. In view of paucity of data on the prevalence and distribution of various high risk HPV subtypes, this study was carried out to provide evidence based local data for cervical cancer preventive programs within this region. Methodology: This was a descriptive cross-sectional study involving 145 consenting women living in Ugbegun rural community of Edo central senatorial district, Edo State, Nigeria. Informed consent of each participant was obtained and socio-demographic information collected through interviewer-administered collection tool. Cervical swab sample was collected using the female cervical cell collection kit for HPV DNA testing. HPV DNA was detected by the Hybribio 21 HPV Geno array test kit which uses polymerase chain reaction (PCR) amplification and flow through hybridization assay. Summary statistics were presented as mean, standard deviation, median, frequency and proportions as appropriate using the Statistical Package for the Social Sciences (SPSS) version 22.0. Association of sociodemographic characteristics of the women with HPV prevalence was done using the 't' test, with p value less than 0.5 considered statistical significance. Results: Twenty four of the 145 women tested positive, giving HPV prevalence of 16.6%. Six HPV serotypes were detected; types 16, 18, 35, 45, 52 and 58. HPV types 16 and 18 were most frequent, contributing 54.2%, and coinfection occurred in 29.2%. HPV-positive women had significantly higher mean number of life time sexual partners (p=0.046) and mean parity (p=0.0001) compared to HPV-negative women. The mean age of the women (p=0.710), mean age at menarche (p=0.570) and mean age at coitarche (p=0.940) were not significantly associated with prevalence of HPV Conclusion: This study showed predominance of oncogenic cervical HPV types 16 and 18 within this sub region of rural Nigeria. Strengthening reproductive and sexual education in both males and females with focus on HPV vaccination, delaying sexual activities and reduction in number of child birth are strategies which could prevent high risk HPV infection and cervical cancer in rural communities

Strategies employed in coping with physical disabilities acquired during adulthood in rural South Africa

Society places people with physical disabilities acquired during adulthood in disadvantaged positions, especially when they cannot participate in activities like their non-disabled counterparts. The situation can be worse for individuals who acquire disabilities during adulthood, where they have to learn to cope with the adulthood-acquired physical disabilities. Objectives: This study aimed to identify the types of physical disabilities acquired during adulthood and their causes and explore how participants defined their disabilities and the coping strategies they used. Methods: The study used a phenomenological research design. Five adults (three women, two men) with adulthood-acquired disabilities were purposefully selected from a rural area in Limpopo, South Africa. Data were collected using semi-structured interviews. Thematic analysis was used to generate themes about coping strategies study participants used. Results: The results show four types of adulthood-acquired disabilities amongst the participants: visual impairment, paraplegia, weakened muscles which led to bilateral amputation, loss of function on both hands and legs. Participants' meanings of their physical adulthood-acquired disabilities ranged from a punishment, pain, not a bother, black magic, to results of doing wrong things to someone. In coming to terms with their adulthood-acquired disabilities, participants used problem- and emotion-focused strategies. Four themes from the participants' responses were spiritual support, social support, substance dependency, access to health and rehabilitation services. Conclusion: The study contributes to understanding the experiences of individuals who acquired disabilities in adulthood, how they define their disabilities and the divergent coping strategies they use. This study established that participants used problem-focused, positive emotion-focused and negative emotion-focused coping strategies.

Experiences of Living with HIV: Social Stigma and Discrimination among HIV-Positive Mothers in Southern Thailand

@#Introduction: This paper discusses the lived experience of mothers living with HIV/AIDS in the southern region of Thailand. Methods: We employed semi-structured interviewing and drawing method with 30 HIV-positive mothers. Thematic analysis method was used to analyse the data. Results: Most mothers living with HIV found their HIV status through a blood test service at the Antenatal Care Clinic of local hospitals while some visited the doctors because their partner showed severe symptoms of illness. When they learnt about the infection, they experienced a great shock and feared that illness would be disclosed to others in the community. The women were concerned about keeping HIV secret because they would be blamed by people in locality, labeled as “disgusting” people, and excluded from social networks. Nevertheless, we found that social support played a crucial role in assisting these mothers to cope with their HIV status. Religious beliefs and living positively also helped them to deal with their health conditions. Conclusion: Health care providers should design sensitive programs to promote self-confidence for HIV-positive mothers as this could increase their quality of life. The findings revealed that tangible and emotional support from family members and religious sources, as well as positive thinking, played a significant role in supporting these women to deal with their health and well-being, and negative effect associated with their HIV condition. These can be incorporated into the provision of health care, which would enhance their well-being and reduce the feeling of isolation and discrimination among these vulnerable women.

Knowledge of pregnant women on the factors that influence anaemia in pregnancy in a rural farming district of the Western Region of Ghana

Background: The presence of anaemia in pregnancy is one of the serious public health concerns across the globe especially in developing countries like Ghana. This study assessed pregnant women's knowledge on factors influencing aneamia in pregnancy in a low-income district of Ghana.Methods: A quantitative descriptive cross-sectional study. Data was collected using a pretested questionnaire. 112 pregnant women seeking antenatal care were recruited using systematic sampling technique in the Wassa East district of Ghana. Data were cleaned and entered into SPSS version 22 and analysed into descriptive statistics.Results: Majority of participants; 72.3% did not know the causes of anaemia in pregnancy. Pregnant women (27.7%) indicated nutritional deficiency as a common cause of anaemia; 18.7% of them could identify appropriately at least one sign of anaemia in pregnancy with 28% asserting that pregnancy-related anaemia can affect labour, despite 72% indicating that anaemia could cause maternal mortality. The reasons for irregular ANC attendance included; perceived non importance of ANC (18.8%), financial difficulties (17.9%), health facility inaccessibility (18.8%) and time constraints (44.5%). There was a strong association between knowledge level on the cause of anaemia in pregnancy and the educational level of pregnant women (p=0.005 chi square = 50.289).Conclusions: Lack of knowledge on the importance of antenatal care and financial constraints were among the reasons leading to a surge in anaemia amongst pregnant women in the district. Health providers should incorporate services which enable pregnant women to access valuable information on anaemia prevention in pregnancy.

Proceso de co-creación de una cartilla tipo cómic para conocer problemas sentidos por niños(as) campesinos / Process of co-creation of a comic type primer to know problems felt by peasant children

RESUMEN Introducción: El texto deriva del proyecto de extensión solidaria Participación Comunitaria y calidad de vida: un ejercicio de empoderamiento en una población campesina de la Inspección de La Virgen, en Quipile, Colombia. Su objetivo: describir el proceso de co-creación de una cartilla infantil tipo cómic entre niños de ambos sexos de la Inspección de La Virgen (Quipile, Cundinamarca) y el equipo de trabajo de la Universidad Nacional de Colombia Métodos: Se utilizó el diseño participativo para identificar los problemas desde la mirada de los niños. Los participantes pertenecían a la Inspección de La Virgen y a las veredas Galilea, San Nicolás, San Isidro y Estambul. Resultados: Los dibujos hechos por los niños/as inspiraron los títeres de los superhéroes de la obra. Las representaciones en la cartilla simbolizaron los problemas: Contaminación en la quebrada, Discusiones, La contaminación del aire, Las peleas familiares; títulos de las historias de la cartilla Las grandes aventuras de Tony y la Súper Ardilla en La Virgen. Discusión: El uso de la cartilla, en conjunto con los títeres, ayuda a reflexionar con los niños sobre sus realidades. La experiencia puede contextualizarse a comunidades campesinas con características similares. La cartilla constituye una herramienta útil en el proceso de formación de la concientización de problemas sociales en la población infantil.

ABSTRACT Introduction: The text derives from the project of united extension Community participation and quality of life: an empowerment exercise in a rural population of the Inspección de La Virgen, in Quipile, Colombia. Its objective: to value the results of the process of co-creation of an infantile comic type primer prepared by children on their main problems and their possible solutions. Methods: it was used a participative design to identify the problems from the children´s point of view. The participants belonged to the Inspección de La Virgen and to the paths Galilee, San Nicolás, San Isidro and Istanbul. Results: The drawings inspired the marionettes of the superheroes of the work. The representations symbolized the problems Contamination in the gorge, Discussions, The contamination of the air, The familiar fights; titles of the stories of the primer Tony's big adventures and the Super Squirrel in The Virgin. Discussion: The use of the primer, as a whole with the marionettes, helps to reflect with the children on their realities. The experience can contextualize to rural communities with similar characteristics. The primer constitutes a useful tool in the process of formation of the campaign to raise public awareness of social problems in the infantile population.

A cross-sectional study to assess the knowledge, attitude, and practice toward road safety rules and regulations among higher secondary school students in rural field practice area of a medical college

Background: India being a developing country faces a double burden of communicable disease and increasing burden of non-communicable disease like road traffic accidents. The year 2000–2011 was declared “Decade of action for road safety” by the UN General Assembly with a goal to reduce and stabilize road traffic accidents. Age groups from 15 to 19 years and second 5 to 14 years are more commonly exposed to road traffic accidents (RTAs), with this background, the study was focused on school-children. Objectives: The objectives of the study were as follows: (i) To study the sociodemographic profile of the study population and (ii) to study the knowledge, attitude, and practices of road safety rules and regulations among higher secondary school students. Materials and Methods: A cross-sectional study was conducted among 266 higher secondary school students in Lokikere, field practice area of S. S. Institute of Medical Sciences, Davangere. Data were collected using pre-tested questionnaire for a period of 2 months from October 2019 to November 2019. Results: Among 266 students, 97.7% of students have received knowledge from their teacher and 61.2% of higher secondary school students have adequate knowledge and positive attitude regarding road safety rules and regulations, even after 95.5% of students having adequate knowledge of age to attain driving license still 23.4% of them drive vehicle without obtaining license, of which 48.3% drive vehicle without parent’s knowledge and 29% of them have been exposed to RTA. Conclusion: Majority of the students have good knowledge of road safety. Around 95% of the students have adequate knowledge, 61.2% of students have positive attitude regarding road safety rules. About 23% of the students drove vehicles without license, among whom 48.3% drove vehicles without parents knowledge and 29% of them have been exposed to RTA.

Perceptions of Physical Activity among Older Adults in Rural Communities Southern Thailand

@#Thailand promotes the regular engagement of physical activity (PA) among its older population to gain health benefits. However, the majority of this group does not achieve sufficient levels of PA to meet the minimum guidelines recommended by Thailand’s National Health Policy. This study explores how older Thai adults living in rural community context, southern Thailand perceive participation in PA along with the barriers that enable them to participate regularly in PA. Methods: Five focus group discussions were investigated consisting of older members living in Muslim and Buddhist communities in southern Thailand. Thematic analysis was used to analyse the data. Results: All older participants were aware of the health benefits of PA. Forty - three considered themselves to be active as part of their daily activities. The kinds of PA they practised were based on local lifestyles and individual convenience. Biological, psychological, social and environmental factors were revealed as motivations and barriers regarding consistent PA. Conclusion: This paper provides a conceptual understanding about the perceptions of PA among older people living in rural communities of southern Thailand. The findings have implications for health care professional who care for older groups. The provision of needs and supports related to their backgrounds and lifestyles could reduce barriers and increase accessible resources to achieve effective levels. The information should be valuable to those interested in designing suitable interventions to increase participation in PA.

Relações entre pobreza e bem estar em comunidades rurais do Brasil / Relaciones entre pobreza y bienestar en comunidades rurales de Brazil / Relation between poverty and wellbeing in rural communities in Brazil

Resumo: A pobreza é um fenômeno complexo e multidimensional. As relações da pobreza com o bem estar, no geral, estão presentes na incompatibilidade entre esses dois aspectos. Objetiva-se analisar os impactos da pobreza e suas repercussões no bem estar da população das comunidades rurais do Brasil. A metodologia quantitativa com a aplicação de um questionário com Índice de Pobreza Multidimensional (IPM) e a Escala de Bem Estar Pessoal (Personal Wellbeing Index - PWI) nas comunidades Pentecoste (Ceará), Cascavel (Paraná) e Humaitá (Amazonas). Participaram 1.156 indivíduos, tendo 1.113 questionários válidos com 328 (29,7%) questionários respondidos por homens e 777 (70,3%) por mulheres. Ao comparar a média do IPM por município, Pentecoste foi o município com maior pobreza multidimensional (IPM=0,32, DP=0,11), seguido de Humaitá (IPM=0,31, DP=0,11) e Cascavel, município que apresentou menor pobreza multidimensional (IPM=0,28, DP=0,11). Pentecoste apresentou a média de bem estar mais alta (M= 7,78), seguida de Cascavel (M= 7,42) e de Humaitá (M= 7,13). As relações entre pobreza multidimensional e o bem estar apresentaram as contradições entre maior quantidade de renda e maior bem estar, tendo em vista que o nível de bem estar dos pesquisados foi alto, mesmo vivendo em contextos de pobreza. Então surge a proposta de discutir o bem estar a partir da perspectiva do buen vivir que exige um processo amplo de reflexões e discussões que aponta para necessidade de incorporar valores coletivistas e a ética da suficiência para toda a comunidade, quando se analisa principalmente os contextos rurais.

Resumen: La pobreza es un fenómeno complejo y multidimensional. Las relaciones de la pobreza con el bienestar, en general, están presentes en la incompatibilidad entre estos dos aspectos. En el presente estúdio son analizados los impactos de la pobreza y sus repercusiones en el bienestar de la población de comunidades rurales de Brasil. La metodología cuantitativa con la aplicación de uma encuesta con Índice de Pobreza Multidimensional (IPM) y la Escala de Bienestar Personal (Personal Wellbeing Index (PWI) en Pentecoste (Ceará), Cascavel (Paraná) y Humaitá (Amazonas). Participaron 1.156 individuos, con 1.113 cuestionarios válidos, con 328 (29,7%) contestados por hombres y 777 (70,3%) por mujeres. Al comparar la média del IPM, la comunidade de Pentecoste tuvo valores más elevados de pobreza multidimensional (IPM = 0,32, DT = 0,11), seguido de Humaitá (IPM = 0,31, DT = 0,11) y Cascavel que presento la menor pobreza multidimensional (IPM = 0,28, DT = 0,11). Pentecoste presentó la media de bienestar más alta (M = 7,78), seguida de Cascavel (M = 7,42) y de Humaitá (M = 7,13). Las relaciones entre pobreza multidimensional y el bienestar presentaron las contradicciones entre mayor cantidad de ingresos y mayor bienestar, teniendo en vista que el nivel de bienestar de los encuestados fue alto, todavía viviendo en contextos de pobreza. Entonces surge la propuesta de discutir el bienestar desde la perspectiva del buen vivir que exige un proceso amplio de reflexiones y discusiones que apunta a la necesidad de incorporar valores colectivistas y la ética de la suficiencia para toda la comunidad cuando se analizan principalmente los contextos rurales.

Abstract: Poverty is a complex multidimensional phenomenon. The relation of poverty with wellbeing, in general, are present in the incompatibility between these two aspects. The objective is to analyze the impacts of poverty and its repercussions on the wellbeing of the population of rural communities in Brazil. The quantitative methodology with the application of a questionnaire with Multidimensional Poverty Index (MPI) and the Personal Wellbeing Index (PWI) in Pentecoste (Ceará), Cascavel (Paraná) and Humaitá (Amazonas) communities. A total of 1,156 individuals participated, with 1,113 valid questionnaires with 328 (29.7%) questionnaires answered by men and 777 (70.3%) by women. In Humaitá and Pentecoste, 376 people participated and in Cascavel, there were 361 people. Pentecoste was the community with the highest multidimensional poverty (MPI = 0.32, SD = 0.11), followed by Humaitá (MPI = 0.31, SD = 0.11) and Cascavel, community with lower multidimensional poverty (MPI = 0.28, SD = 0.11). Pentecost showed the highest average of wellbeing (M = 7.78), followed by Cascavel (M = 7.42) and Humaitá (M = 7,13). The relation between multidimensional poverty and well-being presented the contradictions among higher income and greater well-being, considering that the level of well-being of the respondents was high, even living in contexts of poverty. Then the proposal of discussing well-being from the perspective of buen vivir demands a broad process of reflections and discussions that points to the need to incorporate collectivist values and the ethics of sufficiency for the whole community when analyzing mainly the rural contexts.

Rural Communities’ Perceptions of Climate Change and Its Impacts on Their Livelihood in Southeastern Niger

Climate change exacerbates ecosystem degradation in Sahel where rural communities are highly dependent on natural resources and ecosystem services for their livelihoods. In order cope with the adverse effects of climate change by developing climate adaptation strategies, there has been a need to understand how communities perceive the change or variability in their local climate and how this change could affect their livelihood. This paper aims to examined rural communities’ perceptions about climate change in the commune of Chetimari located in the region of Diffa, southeastern Niger. It investigated particularly: 1) how communities’ perceptions of climate change? 2) What are the impacts of climate change on the livelihood of communities? And 3) What do elements and options to detect abrupt change points in annual precipitations and both annual maximum and minimum temperature? Survey data were collected from October to November 2018 from 101 households (15% of the total households in the study area) in three villages. Multiple correspondence Analysis (MCA) and Factorial Correspondence Analysis (FCA) were performed with XLSTAT to analyzed data from survey. Meteorological data including Monthly precipitation from 1981 to 2017, and Monthly temperatures (maximum, minimum) from 1986 to 2017 of the Diffa meteorological station were analyzed using R to perform the Man Kendal trend test and the Pettit test for detection of abrupt changes in the series. Results showed that community perceptions on temperature increase (not for precipitation) trends as indicators of climate change are in agreement with meteorologically observed trends. The findings showed that people in this zone are aware of climate change that they see as increase in maximum and minimum temperature, decrease in rainfall, frequency of extreme events (drought and flood), dry spells, decrease in number of rainy days, strong winds etc…Results revealed the most significant impacts of climate change affecting the livelihood of rural communities in this area. These are higher risk of crop damage from drought, farmer and herder conflict frequency, drying up of wells, food shortage/insecurity, silting pools, decline in soil fertility and livestock production, silting pasture areas, frequency of livestock diseases, increased weed and invasive species, livestock mortality. The perception of the climate change and its impacts on the main socioeconomic activities vary from a village to another, according the sexes and age ranges. We conclude that communities are relatively aware about the climate change issue. For a better management of climate-induced risks in the study area we stress the need to improve the awareness of climate change within the rural community by improving the availability and the quality of relevant climate information.

Blood Cell Profiling of Malaria Patients Attending Gaya General Hospital, Kano State, Northern Nigeria

Background:Changes in blood cell profile were common findings in malaria. In the rural community of Kano State, Nigeria, information on haematological changes in human malaria was scanty in spite of their role in the pathophysiology of malaria. This cross-sectional study was undertaken to determine blood cell profiles in malaria patients attending a rural hospital in malaria-endemic region.Methods:Blood samples (3ml each) were collected in EDTA-containers from 150 randomly selected outpatients attending Gaya General Hospital, screened for malaria using RDT kit (CareStart Malaria HRP 2, Access Bio Inc., USA) based on Histidine-rich protein 2 (PfHRP-2), and blood cell profiles determined using automated Sysmex haematologic analyser. Data on socio-demographics and medical history related to the study objectives, such as taking antimalarial regimen and/or haematinic, and direct involvement in blood transfusion, were obtained by questionnaire administration supplemented with oral interview Findings:The study revealed amalaria prevalence of 67.33%, with highest in 11-20years (80.95%) and lowest (55.00%) in 1-10years age-groups; slightly higher in females (68.25%) than in males (66.67%) without significant difference (P<0.05). For blood parameters, malaria positive patients have a significantly lower mean PCV of 32.2% as compared to 38.18% obtained for malaria negative patients (P<0.05). The mean Hb was 10.76±2.27g/dL and 12.65±2.38g/dL (P<0.05), while WBC revealed 6.91×109/L and 6.56×109/L in malaria positive and negative patients, respectively. Platelet counts recorded 179.24×109/L and 230.47×109/L (P<0.05). Socio-demographic factors such as level of education, occupation and marital status did not significantly influence malaria prevalence. Interpretation:Low PCV and Hb in malaria patients indicate mild anaemia due to malaria-related haemolysis. The occurrence of thrombocytopenia may be due to other underlying pathology as further studies with larger sample size are needed to ascertain the cause of low platelet counts in malaria patients in the study area

Preferred parenting style in rural community and its association with socio-demographic variables: a cross sectional study

Background: Parenting styles are the methods used by parents when dealing with their children. Some theorists in counseling and psychotherapy have shown the importance of parenting styles in forming children personalities. Baumrind recommended three prototypes of parenting styles: authoritative, authoritarian, and permissive. Parenting styles are associated with different levels of social and cognitive competence in children and adolescents. Hence with this background the following study was undertaken to understand the preferred parenting style practiced in the rural community of southern part of India. The objective of this study is to assess the parenting style practiced in the rural community and to assess the association of socio-demographic variables with the type of parenting styles practiced in rural community.Methods: It is a cross-sectional study, conducted in Basavanapura village of Hunasuru taluk of Mysuru district. 141 parents were selected by simple random sampling. Data was collected using parenting style questionnaire (PSQ). The questionnaire also included information on socio demographic variables. Data was analyzed using SPSS V.24. Analysis is done using descriptive statistics like percentage and inferential statistics like chi square analysis to find the association between socio demographic variables and preferred parenting styles.Results: The most preferred parenting style reported was authoritative (63.2%) followed by authoritarian (26.2%) and permissive (10.6%) types. Years of marriage was found to be significantly associated with preferred parenting styles.Conclusions: Nearly three fourth of the parents practiced authoritative parenting style with this type of parenting style adopted by parents having children less than twenty years.

Intervention for the comprehension of menstrual cycle, body function and pregnancy in adolescents from rural context / Intervención para comprender el ciclo menstrual, funcionamiento del cuerpo y embarazo en adolescentes de contexto rural

Abstract: Objective: To measure the impact of an intervention on adolescents' knowledge of the phase of the menstrual cycle with more likelihood of pregnancy and identify its associated factors. Materials and methods: A quasi-experimental study in two rural communities. Difference-in-differences analyses was performed. Results: There was a 22.1% average reduction in wrong answers on the phase of the menstrual cycle with more likelihood of pregnancy in the intervention group versus the control group (p<0.001). We founded six factors associated with this knowledge: marry and have children, right to receive education and information on sexual and reproductive health; gender equity; use of the condom; condom self-efficacy; emergency and contraceptive pills. Conclusion: There is a prevailing need to improve -among sexuality topics- basic knowledge of reproductive biology, while at the same time insisting on the benefits of using birth control methods provided for practicing responsible sexuality.

Resumen: Objetivo: Medir el efecto de una intervención en el conocimiento de los adolescentes sobre la fase del ciclo menstrual de mayor posibilidad de embarazo e identificar sus factores asociados. Material y métodos: Estudio cuasiexperimental en comunidades rurales. Se realizó un análisis de diferencias en diferencias. Resultados: Hubo una reducción promedio de 22.1% de respuestas incorrectas sobre la fase del ciclo menstrual de mayor posibilidad de embarazo en el grupo intervención vs. control (p<0.001). Se encontraron seis factores asociados con este conocimiento: casarse y tener hijos; derecho a recibir educación e información sobre salud sexual y reproductiva; equidad de género; uso correcto del condón; autoeficacia del uso del condón y pastillas anticonceptivas y de emergencia. Conclusión: Entre las diferentes temáticas de sexualidad, prevalece la necesidad de mejorar los conocimientos básicos sobre biología de la reproducción, insistiendo a la vez sobre los beneficios que conlleva el uso de métodos anticonceptivos para ejercer una sexualidad responsable.

Estimation of prevalence of risk factors for coronary artery disease in a rural population in Howrah, West Bengal

Background: Coronary artery disease (CAD) is a major cause of death globally in both developed and developing countries. Coronary artery disease which was once thought to be a disease of the urban population is now involving the rural community in an increased number. So a study of major coronary risk factors in rural communities will help to adopt various strategies particularly behavior change and communication relevant for these communities to prevent these risk factors and lower CAD related mortality and morbidity. Objective was to estimate rates of the various risk factors for CAD and identify the high-risk groups in the rural community.Methods: A community based cross sectional study was carried out in a rural area in the Howrah district of West Bengal. Four hundred and eighteen (418) persons (212 males and 206 females) were subjected to study using structured, pretested and predesigned schedule. Coronary artery disease risk factors were assessed. Statistical analysis was done with the help of statistical software, the SPSS 20.0 for windows.Results: The study observed that prevalence of tobacco use among the study population was the most significant risk factor (42.3%). The prevalence of other coronary risk factors ranged from 10-20%. Tobacco use, alcohol consumption and sedentary life style were significantly more amongst males. Whereas truncal obesity and systolic hypertension more among females.Conclusions: Various comprehensive strategies particularly behavior change and communication targeting these high risk population need to be emphasized to lower CAD related morbidity burden in the community.

Menstrual hygiene practices of women in a rural area of Kancheepuram district, India: a cross sectional study

Background: Menstruation is a normal biological function in females and in the society, the practices followed are highly variable across different regions. This study aimed to determine the practices followed during menstruation by rural women in Kancheepuram district, Tamil Nadu, India.Methods: This community based cross sectional study was carried out between August and October 2018. Sample size of 400 was calculated by using formula 4pq/d2 and female respondents were selected from sampled households using systematic random sampling. Data were collected using a pre-tested, structured questionnaire, which were analysed using SPSS version 16.0 and presented using descriptive and analytical statistics.Results: A total of 395 women were included in the study. About 54% of females belonged to the age group of 26-35 years and 82.5% were married. Use of sanitary pads during menstruation was reported by 28.6% of the females. Other absorbents used were disposable cloths (46.3%) and reusable cloths (25.1%). About 79% of females practiced some form of restriction during menstruation. Females aged <35 years (OR: 2.55, 95% CI: 1.48-4.39) were more likely to use sanitary pad compared to older females. Females who used sanitary pad as absorbent were less likely to have symptoms of reproductive tract infections compared to those who didn’t (OR: 0.51, 95% CI: 0.28-0.94).Conclusions: Menstrual hygiene practices were found be unsatisfactory among the rural women and various restrictions during menstruation were also in practice. Women should be educated about the importance of use of sanitary pads and the harms of using cloths. Awareness also needs to be created to abolish the unnecessary restrictions that are imposed on women to be followed during menstruation.

Drinking water quality, sanitation and hygiene practices in a rural community of Sokoto State, Nigeria

Background: In many developing countries, Nigeria inclusive, water quality and the risk of waterborne diseases are critical public health concerns. Safe drinking water, sanitation and hygiene are among the five key strategies aimed at combating neglected tropical diseases. Objective: The objective of the study was to assess drinking water quality, household sanitation, and hygiene practices in a rural community. Materials and Methods: A descriptive cross-sectional study was carried out at Tunga Magaji, a rural community of Wamakko local government area, which is one of the Metropolitan Local Government Area of Sokoto state. A total of 391 households participated and were selected using a multistage sampling technique. Household questionnaires and checklist were used to collect data, which were analyzed using IBM Statistical Package for the Social Sciences version 20.0. Results were presented in tables and chart. Univariate analysis in the form of mean and standard deviation was carried out on continuous data. The categorical and grouped data were summarized using frequencies and percentage. Results: River/stream is the major source of their drinking water followed by dung well. Almost all the respondents (97.0%) perceived the water source to be safe for drinking even though more than half said the water has taste. All water samples were weakly basic and had a specific gravity of one. A tap point, dung well and borehole source demonstrated a significant coliform organisms (Escherichia coli) growth. Only 58% of the households have toilet facilities while the remaining uses different unsanitary methods. More than half (59%) reported washing hand always after toilet use and after handling children’s feces, although only 37% of them reported the use of soap and water. The most common health problem in the community was diarrheal diseases with a prevalence rate of 61%. Conclusion: Some drinking water source had significant coliform counts, and large proportion of households does not have sanitary facilities with the diarrheal disease being the major health problem.

The prevalence and risk factors of diabetes and hypertension in Deqing rural community / 中华疾病控制杂志

Objective This study aimed to describe the prevalence of both type 2 diabetes (T2D) and hypertension, and to explore possible risk factors. Methods A Cross-sectional study was conducted in eight towns cluster-sampled randomly from Deqing County, Zhejiang Province. Totally. 29 306 subjects aged≥18 years old were recruited into this survey. Information on general information, life styles, health status and family history of chronic diseases was collected. Physical examinations including height, weight, blood pressure, etc. were done. Fasting plasma glucose was also tested. Results The prevalence of only T2DM, only hypertension and both of them was 3.34%, 28.72%, and 2.01%, respectively. Such prevalence of both reached a peak at the age of 70-79 years old.Family history of diabetes mellitus(OR=4.94, 95% CI:3.24-7.54, P<0.001) and having a spouse(OR=2.17, 95% CI: 1.18-4.00, P=0.013) were possible risk factors of diabetes mellitus, body mass index(BMI)<24 kg/m2(OR=0.48, 95% CI: 0.39-0.59, P<0.001) was the possible protective factor of diabetes mellitus, BMI<24 kg/m2(OR=0.60, 95% CI: 0.56-0.64, P<0.001), completing compulsory education(OR=0.54, 95% CI:0.49-0.59, P<0.001) and exercise(OR=0.77, 95% CI: 0.69-0.86, P<0.001) were protective factors of hypertension, drinking(OR=1.18 , 95% CI: 1.08-1.29, P<0.001) was the possible risk factor of hypertension. BMI<24 kg/m2(OR= 0.26, 95% CI: 0.21-0.31, P<0.001), completing compulsory education(OR=0.50, 95% CI: 0.35-0.72, P<0.001) and drinking tea(OR=0.80, 95% CI:0.64-0.99, P=0.045) were protective factors of these two diseases. Farmers(OR=1.35, 95% CI: 1.04-1.76, P=0.024), family history of diabetes(OR=4.21, 95% CI: 2.71-6.57, P<0.001) and family history of hypertension(OR=1.86, 95% CI: 1.31-2.64, P=0.001) were risk factors for the co occurrence of two diseases. Conclusions The prevalence of diabetes among adults in Deqing County was relatively lower than other places. The prevalence of hypertension was close to the level of other regions. Age, overweight, alcohol consumption, family history of diabetes and hypertension were the risk factors of diabetes and hypertension. Diabetes mellitus was a high-risk group of hypertension. Further means should be taken to strengthen the self-management and treatment of this group. Further intervention action should be taken to promote health and quality of life.

Factors Affecting on the Quality of Life of the Elderly with Mild Dementia Living in Some Rural Community in Korea / 農村醫學 地域保健

OBJECTIVES: The purpose of this study is to investigate the influencing factor of the quality of life of the elderly with mild dementia in rural community. METHODS: A total of 123 elderly who were managed by public health center participated. They were diagnosed as mild dementia by MMSE-DS and CDR. Data were collected during the period from May to September in 2017 by a structured questionnaire that included general characteristics, depression, dependence, comorbidity, sleep scale. Data were analyzed by t-test, ANOVA, Pearson's correlation analysis, and multiple regression analysis. RESULTS: The quality of life was correlated significantly with depression. Depression was the factor affecting the quality of life of the elderly with mild dementia in rural community. Depression accounted for 54.0% as a variable of quality of life. CONCLUSION: This study was meaningful in that it directly measured the quality of life of the elderly with mild dementia is known to be difficult to measure and found meaningful results. it is necessary to identify the cause of depression and establish a linkage system between public health centers and health related organizations in the community. We suggest the need for individualized preventive intervention program and integrated psychological health service considering depression.