ABSTRACT
UNLABELLED: Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. POPULATION: This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.-Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study. CHWs conducted interviews with people with hearing loss (n = 20) and focus groups with their family/friends (n = 27) and with members of the community-at-large (n = 47). The research team conducted interviews with FQHC providers and staff (n = 12). Individuals experienced depression, sadness, and social isolation, as well as frustration and even anger regarding communication. Family members experienced negative impacts of deteriorating communication, but expressed few coping strategies. There was general agreement across data sources that hearing loss was not routinely addressed within primary care and assistive hearing technology was generally unaffordable. Community members described stigma related to hearing loss and a need for greater access to hearing health care and broader community education. Findings confirm the causal sequence of hearing impairment on quality of life aggravated by socioeconomic conditions and lack of access to hearing health care. Hearing loss requires a comprehensive and innovative public health response across the socio-ecological framework that includes both individual communication intervention and greater access to hearing health resources. CHWs can be effective in tailoring intervention strategies to community characteristics.
ABSTRACT
Objetivo Evaluar la prevalencia de infecciones por Chlamydia trachomatis en un grupo de mujeres sintomáticas y asintomáticas que asistieron a control en servicios de ginecología en centros de salud de Maracaibo, estado Zulia. Métodos Se incorporaron al estudio 168 pacientes que asistieron a dos centros de salud de Maracaibo. Se llevó a cabo evaluación ginecológica basada en examen pélvico, de áreas profundas de la vagina y cuello uterino. Las pacientes fueron clasificadas en grupos etarios y de acuerdo a la presencia de manifestaciones clínicas. Para investigar C. trachomatis, se aplicaron dos ensayos de amplificación de ADN del plásmido endógeno y del gen OMP1, a partir de hisopados endocervicales. Resultados Se evaluaron 168 pacientes, 81 (48,2 por ciento) sintomáticas y 87 (51,8 por ciento) asintomáticas. Se encontró una prevalencia de 7,7 por ciento en la población total evaluada. La prevalencia fue de 9,9 por ciento y 5,8 por ciento para las pacientes sintomáticas y asintomáticas, respectivamente (p>0,05). El grupo de pacientes de 18-28 años exhibió la más alta prevalencia (13,7 por ciento) (p=0,0322). Las manifestaciones clínicas predominantes fueron secreción mucopurulenta (35,8 por ciento) y cervicitis (21 por ciento). C. trachomatis fue detectada en 7,1 por ciento pacientes con secreción mucopurulenta y 23,5 por ciento casos de cervicitis, pero no se demostró asociación significativa entre infección y manifestaciones clínicas individuales (p>0,05). Conclusión Se encontró una mediana prevalencia de infecciones por C. trachomatis en la población evaluada, exhibiendo mayor frecuencia en mujeres jóvenes. Este microorganismo debería ser investigado en mujeres jóvenes sexualmente activas, independientemente de su condición sintomática o asintomática.
Objective Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. Methodology 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. Results 168 patients were evaluated; 81 (48,2 percent) were symptomatic and 87 (51,8 percent) asymptomatic, A 7,7 percent prevalence (p>0.05) was found in the total population (9,9 percent prevalence for symptomatic patients and 5,8 percent for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 percent) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 percent) and cervicitis (21 percent). C. trachomatis was detected in 7,1 percent of patients having mucopurulent secretion and 23,5 percent of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). Conclusion Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.
Subject(s)
Adolescent , Adult , Female , Humans , Middle Aged , Chlamydia Infections/epidemiology , Chlamydia trachomatis , Age Factors , Chlamydia Infections/diagnosis , Chlamydia trachomatis/genetics , Chlamydia trachomatis/isolation & purification , DNA, Bacterial/analysis , Data Interpretation, Statistical , Polymerase Chain Reaction , Prevalence , Uterine Cervicitis/diagnosis , Uterine Cervicitis/microbiology , Venezuela/epidemiologyABSTRACT
OBJECTIVE: Evaluating Chlamydia trachomatis infection prevalence in a group of symptomatic and asymptomatic females attending gynaecology services in health centres in Maracaibo in the state of Zulia in Venezuela. METHODOLOGY: 168 patients attending two health centres in Maracaibo were included in this study. Gynaecological evaluation was based on examining the pelvis, deep areas of the vagina and the cervix. Patients were classified into groups according to age and the presence of clinical manifestations. Two DNA amplification assays of endogenous plasmid and the omp1 gene taken from endocervical swabs were used for investigating C. trachomati. RESULTS: 168 patients were evaluated; 81 (48,2 %) were symptomatic and 87 (51,8 %) asymptomatic, A 7,7 % prevalence (p>0.05) was found in the total population (9,9 % prevalence for symptomatic patients and 5,8 % for asymptomatic ones). The 18- 28 year old patient group exhibited the highest prevalence (13,7 %) (p=0.0322). The predominant clinical manifestations were mucopurulent secretion (35,8 %) and cervicitis (21 %). C. trachomatis was detected in 7,1 % of patients having mucopurulent secretion and 23,5 % of cervicitis cases; however, no significant association between infection and individual clinical manifestations was shown (p>0.05). CONCLUSION: Medium C. trachomatis infection prevalence was found In the population being assessed here, the highest frequency being exhibited in young females. This microorganism should be investigated in sexually-active young women, regardless of their symptomatic or asymptomatic status.