Survival analysis of hospitalized COVID-19 patients in New Yangon General Hospital by prognostic indicators

Background: Coronavirus disease (COVID-19) is an infectious disease of the SARS-CoV-2 virus and it can infect anyone resulting in serious illness and death. Methods: A retrospective cohort study was conducted in New Yangon General Hospital (NYGH), Yangon between September and November, 2022. Previous records of COVID-19 in-patients admitted to NYGH from 1st June to 31st October, 2021, were reviewed. COVID-19 in-patients who tested positive by real-time reverse transcriptase-polymerase chain reaction (RT-PCR) or rapid diagnostic test (RDT) were included in this study. Multivariate analysis by Cox proportional-hazards (CPH) model was used to identify the prognostic indicators associated with the survival of COVID-19 inpatients. Results: Of (460) COVID-19 positive patients, there were 133 (28.9%) deaths with mortality rate of 16.9 per 1000 person-days. Then, 97 (72.9%) deaths occurred within 21 days of symptom onset, with median survival time of 28 (95% CI: 25-36) days. The results of the CPH model showed that the abnormal chest X-ray (CXR) [aHR=3.8, 95% CI: (1.1, 12.6), p=0.032], SpO2 level below 92% [aHR=3.7, 95% CI: 2.3, 5.9, p<0.001)], serum creatinine level more than 133 µmol/L [aHR=1.9, 95% CI: 1.1, 3.2, p=0.025] and C-reactive protein level (CRP) more than 10 mg/L [aHR=3.9, 95% CI: 1.2, 12.9, p=0.027] were the prognostic indicators of COVID-19 death among inpatients in NYGH. Conclusions: Patients with abnormal CXR result, low SpO2 level, high serum creatinine level, and high CRP level may have increased risks of death among COVID-19 inpatients in NYGH. Thus, close monitoring of the hospitalized COVID-19 inpatients by using these prognostic indicators should be emphasized.

Prevalence of Staphylococcus aureus, its antimicrobial resistance and relation to food hygiene practices of food handlers: analysis of food and non-food items from market food shops in Yangon, Myanmar

Background: Staphylococcus aureus is the common cause of food poisoning and its rising antibiotic resistance poses a severe threat to public health. In Myanmar, S aureus isolation and AMR pattern in food and non-food objects studied at the markets are still limited. This research filled the information gaps regarding the prevalence of S aureus in food and non-food items from market food shops relation to hygienic practices of the food handlers and assessed its antimicrobial resistance. Methods: Cross-sectional study was conducted at sixteen markets in Yangon during 2022. The study included 75 food handlers to assess their hygiene practices. From each shop, one food and one non-food samples were taken to reach the total 150 samples. Chi-square test was used for analysis. Results: S aureus was found in 4% of food samples and 5.3% of non-food samples. Bacterial contamination in food was satisfactory, 17.3% to unsatifactory, 60% while non-food samples were 4%, clean to 73.3%, very contaminted. Drug resistance to benzyl penicillin, azithromycin, erythromycin, clindamycin, lincomycin in food samples and tetracycline in both samples were found. Hygiene practices was good among 57.3% of food handlers and there was no association between practices and S aureus prevalence although positivity was higher among the samples taken from the shops of handlers with poor hygiene practices. Conclusions: The prevalence of S aureus was not different between food and non-food samples and not associated with the hygiene practices of food handlers.

High incidence of Plasmodium knowlesi malaria compared to other human malaria species in several hospitals in Malaysia

@# Through the regional control programme, Malaysia has been successfully reducing the incidence of Plasmodium falciparum and Plasmodium vivax infections. However, the incidence of zoonotic malaria Plasmodium knowlesi infection is increasing and now has been the major cause of malaria in Malaysia especially Malaysian Borneo. The emergence of knowlesi infection has threatened the malaria elimination programme which the government aims to reduce the overall malaria infections by 2020. Unlike other benign human Plasmodium spp., P. knowlesi can cause fatal infections. The aim of this study was to determine the incidence and distribution of five human malaria parasites including P. knowlesi in Peninsular Malaysia and Malaysian Borneo. A total of 112 blood samples were collected from seven states and district hospitals in Peninsular Malaysia and Malaysian Borneo from year 2015 to 2016. The samples were examined by microscopy and further confirmed by nested PCR assay targeting 18S rRNA gene of Plasmodium spp. Following the nested PCR assays, a total of 54 (48.2%) samples were positive for P. knowlesi infections, 12 (10.7%) cases were positive for P. vivax infections, followed by 7 (6.3%) cases of P. falciparum and 4 (3.5%) cases of P. malariae. There were 3 cases (2.7%) of mixed infections (P. knowlesi/P. vivax). However, no cases were identified as P. ovale. A total of 32 (28.6%) cases were found as negative infections. LoopMediated Isothermal Amplification Assay (LAMP) was performed to confirm inconclusive results produced by microscopy and nested PCR. P. knowlesi showed the highest prevalence in Sarawak (n= 30), Sabah (n=13), Pulau Pinang (n=5) and Pahang (n=6). PCR and LAMP was not able to detect a large number of microscopy positive samples due to DNA degradation during storage and shipping. Among all the states involved in this study, the highest prevalence of P. knowlesi infection was found in Sabah and Sarawak.

Correlates of symptoms of depression and anxiety among clinic patients in Western Jamaica / Correlaciones de los síntomas de depresión y ansiedad entre los pacientes de los consultorios de Jamaica Occidental

OBJECTIVES: There is a paucity of studies on psychosocial disorders in clinic populations in Jamaica. Therefore, we sought to determine the prevalence and correlates of symptoms of depression and anxiety in a clinic population in western Jamaica. METHODS: A total of 338 participants from four outpatient clinics of the Western Regional Health Authority (WRHA) were screened for symptoms of depression and anxiety using questions from the Beck Depression Inventory-II and the Beck Anxiety Inventory. The Chi-square test was used to examine differences in symptoms of anxiety and depression by gender. Multivariate linear and logistic regression were used to examine the associations between symptoms and sociodemographic variables with significance set at p < 0.05. RESULTS: Approximately 30% of participants had moderate or severe depression symptoms while 18.6% had moderate or severe anxiety symptoms. Participants aged 30-39 years were more likely than older participants to have moderate or severe anxiety symptoms (odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.39, 5.56). Women reported a statistically significant higher prevalence of anxiety symptoms (10.0% vs 7.1%, p = 0.003). There was also a statistically significant difference between anxiety means by gender. Furthermore, income was found to be a significant predictor of anxiety for women only (p = 0.0113). Married persons were more likely than those who had never married to have moderate or severe anxiety symptoms (OR: 2.57, 95% CI: 1.14, 5.76). CONCLUSIONS: Our findings suggest that the prevalence of depression may be higher than global estimates in similar outpatient settings. Screening and intervention efforts may need to focus on younger persons, women, and married persons.

OBJETIVOS: Son escasos los estudios realizados sobre trastornos psicosociales en la población clínica de Jamaica. Por lo tanto, intentamos determinar la prevalencia y las correlaciones de los síntomas de depresión y ansiedad en una población clínica en Jamaica occidental. MÉTODOS: Un total de 338 participantes de cuatro clínicas de atención ambulatoria de la Dirección Regional de la Salud (conocida por sus siglas en inglés WRHA) fueron expuestos a una prueba de tamizaje a fin de detectar síntomas de depresión y ansiedad usando preguntas del Inventario de Depresión de Beck II y el Inventario de Ansiedad de Beck. La prueba de Chi-cuadrado fue utilizada para examinar las diferencias en los síntomas de ansiedad y depresión por género. Se usó la regresión lineal y logística multivariada para examinar las asociaciones entre los síntomas y las variables sociodemográficas con significación de p < 0.05. RESULTADOS: Aproximadamente el 30% de los participantes presentaron síntomas de depresión moderada o severa, mientras que el 18.6% presentaron síntomas de ansiedad severa o moderada. Los participantes con edad de 30 a 39 años eran más proclives a presentar síntomas de ansiedad moderada o severa (odds-ratio [OR]: 2.0, 95% intervalo de confianza [IC]: 1.39, 5.56) que los participantes de mayor edad. Las mujeres reportaron una prevalencia mayor, estadísticamente significativa, de los síntomas de ansiedad (10.0% vs 7.1%, p = 0. 003). También hubo una diferencia estadísticamente significativa entre los promedios de ansiedad por género. Además, se halló que los ingresos constituyen un predictor significativo de ansiedad sólo para las mujeres (p = 0.0113). Las personas casadas tenían más probabilidades de presentar síntomas de ansiedad moderada o severa (OR: 2.57, IC del 95%: 1,14, 5.76) que las personas que nunca se habían casado. CONCLUSIONES: Nuestros hallazgos sugieren que la prevalencia de la depresión puede ser superior a la que indican los estimados globales para pacientes externos similares. El estudio señala la posibilidad de que los esfuerzos de tamizaje e intervención deban centrarse en las personas más jóvenes, las mujeres y las personas casadas.

Evaluating a theory-based health education intervention to improve awareness of prostate cancer among men in Western Jamaica / Evaluación de una intervención de base teórica en educación para la salud con el fin de desarrollar una mejor concientización con respecto al cáncer de próstata entre los hombres de la región occidental de Jamaica

OBJECTIVE: To evaluate the impact of a theory-based health education intervention on awareness of prostate cancer and intention to screen among men in Western Jamaica. METHODS: One hundred and eighty-eight men attending outpatient clinics in a hospital in Western Jamaica completed an interviewer-administered pretest survey. Following the pretest, participants received a health education intervention related to prostate cancer and an immediate post-test survey. RESULTS: There were statistically significant increases in the percentage of correct responses between the pretest and post-test (p < 0.05). The greatest improvement was among items measuring knowledge of prostate cancer screening tests. Participants moved across the Stages of Change theoretical constructs indicating intention to screen. CONCLUSION: The sample was receptive to information about prostate cancer and the use of a theory-based educational intervention positively influenced knowledge of prostate cancer risk factors, symptoms, and types of screenings. Practice implications: This theory-based patient education programme can be replicated to promote awareness of prostate cancer and informed screening methods including potential risk associated with screening behaviours.

OBJETIVO: Evaluar el impacto de una intervención de base teórica en educación para la salud sobre la conciencia acerca del cáncer de próstata y la disposición de los hombres en la región occidental de Jamaica, a someterse a pruebas de detección. MÉTODOS: Ciento ochenta y ocho hombres que asistían a las clínicas de consulta externa en un hospital en el occidente de Jamaica llenaron una encuesta de entrada administrada por el entrevistador. Tras la prueba de entrada, los participantes recibieron una intervención de educación para la salud en relación con el cáncer de la próstata e inmediatamente una encuesta de salida. RESULTADOS: Hubo aumentos estadísticamente significativos en el porcentaje de respuestas correctas entre la prueba de entrada y la prueba de salida (p < 0.05). La mayor mejora se observó en los ítems que medían el conocimiento acerca de las pruebas de detección del cáncer de próstata. Los participantes se movieron a través de los constructos teóricos de las etapas de cambio, indicando la intención de tamizaje. CONCLUSIÓN: La muestra fue receptiva a la información sobre el cáncer de próstata, y el uso de una intervención educativa de base teórica tuvo una influencia positiva sobre el conocimiento acerca de los factores de riesgo, síntomas y tipos de pruebas de detección del cáncer de próstata.