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1.
BMC Public Health ; 24(1): 1208, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38693499

ABSTRACT

The recalcitrance of Mycobacterium tuberculosis (MTB) to eradication was related to achieving a nonreplicating (dormant) state and the increasing global burden of HIV coinfection. Consequently, understanding the knowledge and perception of the population at risk of tuberculosis-HIV infection is essential to designing a strategy of intervention embraced by the target population. A cross-sectional study was conducted among Nomads in Adamawa State, Nigeria. A multistage sampling technique was employed to recruit consented participants. Self-administered questionnaires were used to gather the required information from 4 nomadic schoolteachers in each selected school. Data were entered into a Microsoft Excel sheet where trends and tables of collated data were developed. The findings show that only 13.5% of the participants expressed the correct perceptions of the complementary relationship between HIV and TB. More people in government employment (35%) understand the coexisting relationship of TB-HIV infections. At the same time, cattle herders and crop farmers who practice the prevalent occupation lack knowledge of TB-HIV relatedness. Across gender, only a proportion of males (14.8%) than females (10.5%) were more likely to show an understanding of the complementary association of HIV and TB, and this difference showed statistical significance (p = 0.0001). In conclusion, male gender, education at a degree or professional level, and employment with the government are factors associated with positive perceptions of TB/HIV relatedness. Thus, there is a need to intensify communication to educate Nomads on HIV and TB-related issues.


Subject(s)
HIV Infections , Health Knowledge, Attitudes, Practice , Tuberculosis , Humans , Nigeria/epidemiology , Male , Female , HIV Infections/epidemiology , HIV Infections/psychology , Cross-Sectional Studies , Adult , Tuberculosis/epidemiology , Tuberculosis/psychology , Middle Aged , Young Adult , Surveys and Questionnaires , Comorbidity , Coinfection/epidemiology , Adolescent
2.
BMC Public Health ; 24(1): 918, 2024 Mar 28.
Article in English | MEDLINE | ID: mdl-38549091

ABSTRACT

BACKGROUND: In Chad, malaria remains a significant public health concern, particularly among nomadic populations. Geographical factors and the mobility of human populations have shown to be associated with the diversity of Plasmodium species. The study aims to describe the malaria prevalence among nomadic children and to investigate its associated factors. METHODS: A cross-sectional study was conducted in February and October 2021 among nomadic communities in Chad. Blood sample were collected and tested from 187 Arab, Fulani and Dazagada nomadic children aged 3-59 months using malaria rapid diagnostic test (RDT). A structured electronic questionnaire was administered to their parents to collect information about the socio­economic data. Malaria testing results were categorized according to the SD BIOLINE Malaria Ag Pf/Pan RDT procedures. Logistic regression analysis was used to determine key risk factors explaining the prevalence of malaria. STATA version IC 13 was used for statistical analysis. RESULTS: The overall malaria prevalence in nomadic children was 24.60%, with 65.20% being Plasmodium falciparum species and 34.8% mixed species. Boys were twice as likely (COR = 1.83; 95% CI, 0.92-3.62; p = 0.083) to have malaria than girls. Children whose parents used to seek traditional drugs were five times more likely (AOR = 5.59; 95% CI, 1.40-22.30, p = 0.015) to have malaria than children whose parents used to seek health facilities. Children whose parents reported spending the last night under a mosquito net were one-fifth as likely (AOR = 0.17; 95% CI, 0.03-0.90, p = 0.037) to have malaria compared to children whose parents did not used a mosquito net. Furthermore, Daza children were seventeen times (1/0.06) less likely (AOR = 0.06; 95% CI, 0.01-0.70, p = 0.024) to have malaria than Fulani children and children from households piped water as the main source were seven times more likely (AOR = 7.05; 95% CI, 1.69-29.45; p = 0.007) to have malaria than those using surface water. CONCLUSIONS: Malaria remains a significant public health issue in the nomadic communities of Chad. Community education and sensitization programs within nomad communities are recommended to raise awareness about malaria transmission and control methods, particularly among those living in remote rural areas. The National Malaria Control Program (NMCP) should increase both the coverage and use of long-lasting insecticidal nets (LLINs) and seasonal malaria chemoprevention (SMC) in addition to promoting treatment-seeking behaviors in nomadic communities.


Subject(s)
Insecticide-Treated Bednets , Malaria , Plasmodium , Child , Male , Female , Humans , Chad , Cross-Sectional Studies , Malaria/diagnosis , Malaria/epidemiology , Malaria/prevention & control , Water
3.
Article in English | MEDLINE | ID: mdl-38443463

ABSTRACT

BACKGROUND: Household air pollution (HAP) is a major risk factor of non-communicable diseases, causing millions of premature deaths each year in developing nations. Populations living at high altitudes are particularly vulnerable to HAP and associated health outcomes. OBJECTIVES: This study aims to explore the relationships between activity patterns, HAP, and an HAP biomarker among 100 Himalayan nomadic households during both cooking and heating-only periods. METHODS: Household CO was monitored in 100 rural homes in Qinghai, China, at 3500 m on the Himalayan Plateau among Himalayan nomads. Carboxyhemoglobin (COHb) was used as a biomarker to assess exposure among 100 male and 100 female heads of household. Linear mixed-effects models were used to explore the relationship between COHb and activity patterns. RESULTS: Cooking periods were associated with 7 times higher household CO concentrations compared with heating periods (94 ± 56 ppm and 13 ± 11 ppm, respectively). Over the three-day biomarker-monitoring period in each house, 99% of subjects had at least one COHb measurement exceeding the WHO safety level of 2%. Cooking was associated with a 32% increase in COHb (p < 0.001). IMPACT STATEMENT: This study on household air pollution (HAP) in high-altitude regions provides important insights into the exposure patterns of nomadic households in Qinghai, China. The study found that cooking is the primary factor influencing acute carbon monoxide (CO) exposure among women, while heating alone is sufficient to elevate CO exposure above WHO guidelines. The results suggest that cooking-only interventions have the potential to reduce HAP exposure among women, but solutions for both cooking and heating may be required to reduce COHb to below WHO guidelines. This study's findings may inform future interventions for fuel and stove selection to reduce HAP and exposure among other populations.

4.
Niger J Clin Pract ; 26(6): 709-719, 2023 Jun.
Article in English | MEDLINE | ID: mdl-37470643

ABSTRACT

Background: The recent drop in immunization coverage in Nigeria has left more than 3.25 million children unimmunized and has risen concern over immunization completion among the under-five children. More so among underserved communities of pastoralist nomads and farmers that were isolated from immunization services because of operational and sociocultural factors. Materials and Methods: A cross-sectional analytical (comparative analysis) study was carried out among 550 eligible caregivers of under-five children in nomadic and farming communities in Niger State, Nigeria. The mothers and caregivers paired with under-five children were recruited into the study using a multistage sampling technique. Data was collected using a validated interviewer-administered questionnaire. Data was analyzed with the statistical software package (version 23). Results: More than half of the under-five children studied were males in both the nomadic (57.5%) and farming (52.0%) communities. The aggregated score of immunization knowledge was significantly (P < 0.001) better (Good 44.4%; Fair 49.8%) among farmers compared to their nomads' counterpart (Good 21.1%; Fair 43.6%). Conversely, almost all the respondents (98.2%) in nomadic community significantly had a good overall perception of childhood immunization compared to 77.1% in the farming community. More farmers' children (99.6%) had received immunization compared to 92.4% of the nomads' children. About 87.3% of farmers compared to 76% of the nomads' (76.0%) children reported immunization completion. About 50.5% of the farmers' and 41.4% of the nomads' children have achieved immunization on card inspection. Conclusion: This study revealed that average immunization completion reported among under-five children in both farming and nomadic communities is higher than the national average. It is recommended that more strategies are needed to intensify immunization campaigns targeted at populations in Nigeria.


Subject(s)
Immunization , Vaccination , Male , Female , Humans , Child , Nigeria , Cross-Sectional Studies , Agriculture
5.
Trans R Soc Trop Med Hyg ; 117(7): 485-488, 2023 07 04.
Article in English | MEDLINE | ID: mdl-36912044

ABSTRACT

In Africa, pastoral populations face several underrecognized health issues. The livelihoods of pastoralists revolve around possession of livestock and they are constantly moving in search of water and pasturage. They are predisposed to chronic zoonotic infections but may also suffer from non-acute non-zoonotic cosmopolitan infectious and non-infectious chronic medical conditions. Given their migratory lifestyle, livelihood, geographic inaccessibility, communication barriers, illiteracy and poverty, it is challenging for pastoralists to access lengthy inpatient clinical care and long-term periodic follow-up that may be required to achieve control or cure of subacute, chronic or lifelong diseases. The challenges and management modalities of complicated subacute bacterial endocarditis requiring critical clinical considerations, long-term medical and surgical interventions in a stateless Arab camel herder are described to highlight the plight of pastoralists. Innovative clinical and public health strategies are suggested to authorities and healthcare institutions to improve access to care for non-acute diseases among them.


Subject(s)
Delivery of Health Care , Public Health , Animals , Africa South of the Sahara/epidemiology , Livestock
6.
Front Public Health ; 11: 1098646, 2023.
Article in English | MEDLINE | ID: mdl-36817936

ABSTRACT

Introduction: The COVID-19 pandemic has posed the in-service training of agents of the Farmers, Rural People, Nomads Social Insurance Fund (hereafter the Fund) to many problems. In-service training is one of the most effective development factors for organizational goals. This sort of training will increase employees' skills and subsequently improve their job performance. Accordingly, the present research mainly aimed to shed light on the effect of in-service training policy on employees' capabilities and job performance. Methods: The research was conducted among the agents of the Fund in Fars province, Iran (N = 197) out of whom 127 agents were sampled by simple randomization. The research instrument was a standard questionnaire whose face and content validity was confirmed by a panel of experts and its reliability was determined by calculating Cronbach's alpha in a pilot study. The results showed that the indicators used to measure the research variables were acceptably consistent with the factor structure and the theoretical framework of the research. Results and discussion: Based on the findings, in-service training in the Fund during the COVID-19 pandemic has had a positive and significant effect on the agents' capabilities (communication and team-working skills, creativity and problem-solving skills, commitment and responsibility, technical information and knowledge, and technical and practical skills) and job performance at the individual, technical, and general levels. Also, the agents' capabilities have had a positive and significant influence on their job performance. It can be concluded that in-service training can influence the agents' capabilities and job performance and improve organizational performance during the COVID-19 pandemic. Thus, the enhancement of in-service training courses' quantity and quality during the COVID-19 pandemic can influence the job performance of the agents at the individual, general, and technical performance levels.


Subject(s)
COVID-19 , Financial Management , Transients and Migrants , Humans , Farmers , Pilot Projects , Pandemics , Reproducibility of Results , Social Security
7.
Licere (Online) ; 26(03): 51-77, set.2023.
Article in Portuguese | LILACS-Express | LILACS | ID: biblio-1523872

ABSTRACT

Este estudo, de natureza qualitativa, teve por objetivo investigar os conteúdos informacionais disseminados no site Movimento Nômades Digitais, buscando compreender os processos de autogestão de lazer-trabalho nesse estilo de viver. A pesquisa do tipo exploratória foi pautada em análise documental e estudo de caso. Os resultados apontam alguns paradoxos no equilíbrio entre as formas de concepção da autogestão do trabalho e as possíveis ressonâncias na autogestão do lazer. Essas mudanças no estilo do trabalho podem não representar, igualmente, mais flexibilidade de tempo e possibilidades de vivências de experiências significativas no lazer, sobretudo, pelos aspectos econômicos, políticos, culturais e organizacionais envolvidos. A autogestão do lazer parece não poder ser diretamente associada à autogestão do trabalho dos nômades digitais, já que outros elementos entram em cena, para além da opção pessoal em si.


This qualitative study aimed to investigate the informational content disseminated on the Movimento Nômades Digitais website, seeking to understand the leisure-work self-management processes in this lifestyle. Exploratory research was based on document analysis and case study. Results point to some paradoxes in the balance between the forms of conception of work self-management and the possible resonances in leisure self-management. These changes in the style of work may not represent, equally, more flexibility of time and possibilities of living meaningful experiences in leisure, due to the economic, political, cultural and organizational aspects involved. The self-management of leisure does not seem to be directly associated with the self-management of work by digital nomads, since other elements come into play, in addition to the personal option itself.

8.
Cell ; 185(8): 1402-1413.e21, 2022 04 14.
Article in English | MEDLINE | ID: mdl-35366416

ABSTRACT

The Avars settled the Carpathian Basin in 567/68 CE, establishing an empire lasting over 200 years. Who they were and where they came from is highly debated. Contemporaries have disagreed about whether they were, as they claimed, the direct successors of the Mongolian Steppe Rouran empire that was destroyed by the Turks in ∼550 CE. Here, we analyze new genome-wide data from 66 pre-Avar and Avar-period Carpathian Basin individuals, including the 8 richest Avar-period burials and further elite sites from Avar's empire core region. Our results provide support for a rapid long-distance trans-Eurasian migration of Avar-period elites. These individuals carried Northeast Asian ancestry matching the profile of preceding Mongolian Steppe populations, particularly a genome available from the Rouran period. Some of the later elite individuals carried an additional non-local ancestry component broadly matching the steppe, which could point to a later migration or reflect greater genetic diversity within the initial migrant population.


Subject(s)
Asian People , DNA, Ancient , Genetics, Population , Asian People/genetics , Genome , History, Ancient , Human Migration/history , Humans , Sulfur
9.
BMC Health Serv Res ; 22(1): 151, 2022 Feb 05.
Article in English | MEDLINE | ID: mdl-35123475

ABSTRACT

BACKGROUND: For more than the last two decades, older Australians travelling domestically in self-sufficient accommodation and recreational vehicles for extended periods of time have been referred to as 'Grey Nomads'. By 2021 more than 750,000 such recreational vehicles were registered in Australia. Tourism data for the year to September 2017 show 11.8 million domestic camping and caravanning trips in Australia, 29% of which were people aged 55 and over. As the 'baby boomer' generation increasingly comes to retirement, the size of this travelling population is growing. This term applies to the spike in birth rates after World War II from 1946-1964. This growing group of domestic travellers are potential healthcare consumers in remote areas but relatively little is known about their travel, healthcare needs or care seeking practices. Grey nomads have been described as reflective of the age-comparable sector of the Australian population in that many live with chronic illness. Early concerns were raised that they may "burden" already stretched rural and remote healthcare services but relatively little is known about the impact of these travellers. METHODS: The aim of this study was to explore the utilisation of healthcare services in remote locations in Australia by grey nomads including women travellers, from the perspective of healthcare professionals working in these settings. The study objective was to interview healthcare professionals to seek their experience and details of service delivery to grey nomads. In March 2020 [prior to state border closures due to the COVID-19 pandemic] a field study was conducted to identify the impact of grey nomads on healthcare services in remote New South Wales and Queensland. A qualitative approach was taken to explore the perspectives of nursing healthcare managers working in remote towns along a popular travel route. With appropriate Research Ethics Committee approval, managers were purposively sampled and sample size was determined by data saturation. Thirteen managers were contacted and twelve interviews were scheduled to take place face to face in the healthcare facilities (small hospitals with acute care and aged care services) at mutually convenient times. A semi-structured interview schedule was developed in line with the research aim. The interviews were audio-recorded, transcribed and thematic analysis was undertaken concurrently with data collection for ongoing refinement of questions and to address emerging issues. RESULTS: These nursing managers described a strong service and community ethos. They regarded travellers' healthcare needs no differently to those of local people and described their strong commitment to the provision of healthcare services for their local communities, applying an inclusive definition of community. Traveller presentations were described as predominantly exacerbations of chronic illness such as chest pain, medication-related attendances, and accidents and injuries. No hospital activity data for traveller presentations were available as no reports were routinely generated. Travellers were reported as not always having realistic expectations about what healthcare is available in remote areas and arriving with mixed levels of preparedness. Most travellers were said to be well-prepared for their travel and self-management of their health. However, the healthcare services that can be provided in rural and remote areas needed to be better understood by travellers from metropolitan areas and their urban healthcare providers. CONCLUSION: Participants did not perceive travellers as a burden on health services but recommendations were made regarding their expectations and preparedness. Australia's national transition to electronic health records including a patient-held record was identified as a future support for continuity of care for travellers and to facilitate treatment planning. With no current information to characterise traveller presentations, routinely collected hospital data could be extracted to characterise this patient population, their presentations and the resources required to meet their care needs.


Subject(s)
COVID-19 , Rural Health Services , Transients and Migrants , Aged , Australia/epidemiology , Female , Health Personnel , Hospitals , Humans , Middle Aged , Pandemics , SARS-CoV-2
10.
Malar J ; 21(1): 56, 2022 Feb 19.
Article in English | MEDLINE | ID: mdl-35183185

ABSTRACT

BACKGROUND: Nomadic populations in Chad are at increased risk of contracting malaria because of their lifestyle. Being highly mobile they are often excluded from disease control programmes, and access to preventive measures and treatment is more difficult. Effective malaria control interventions take account of local modes of transmission, patterns of care-seeking behaviour and community perceptions of cause and prevention practices. There is currently little information about malaria knowledge and perceptions among nomadic groups in Chad, or their awareness of malaria control interventions and this study sought to address this knowledge gap. METHODS: A mixed methods study, including a cross-sectional survey with men and women (n = 78) to determine the level of knowledge and use of malaria prevention strategies among Arabs, Peuls and Dagazada nomadic groups. Three focus group discussions were conducted with women to explore their representation of malaria and knowledge of preventive methods. Key informant interviews were held with leaders of nomadic groups (n = 6) to understand perception of malaria risk among itinerant communities. RESULTS: Nomads are aware of the risk of malaria, recognize the symptoms and have local explanations for the disease. Reported use of preventive interventions such as Seasonal Malaria Chemoprevention (SMC) for children and Intermittent Preventive Treatment (IPT) of malaria in pregnancy was very low. However, 42.3% of respondents reported owning at least one LLIN and 60% said they slept under an LLIN the night before the survey. In case of a malaria episode, nomads seek clinicians, informal drug sellers in the street or market for self-medication, or traditional medicine depending on their financial means. Interviews with nomad leaders and discussions with women provide key themes on: (i) social representation of malaria risk and (ii) social representation of malaria and (iii) perspectives on malaria prevention and (iv) malaria treatment practices. CONCLUSION: The nomadic groups included in this study are aware of risk of malaria and their level of exposure. Local interpretations of the cause of malaria could be addressed through tailored and appropriate health education. Except for LLINs, malaria prevention interventions are not well known or used. Financial barriers lowered access to both mosquito nets and malaria treatment. Reducing the barriers highlighted in this study will improve access to the healthcare system for nomadic groups, and increase the opportunity to create awareness of and improve uptake of SMC and IPT among women and children.


Subject(s)
Arabs , Malaria , Chad , Child , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Malaria/prevention & control , Male , Patient Acceptance of Health Care , Pregnancy
11.
Transbound Emerg Dis ; 69(4): e547-e553, 2022 Jul.
Article in English | MEDLINE | ID: mdl-34558217

ABSTRACT

Cutaneous leishmaniasis (CL) is one of the most important health challenges in hyperendemic countries like Iran. Geospatial information systems-based studies have shown that factors, including land cover, altitude, slope temperature, rainfall and animal livestock, affect CL distribution in Kohgyloyeh and Boyerahmad province, southwestern Iran. However, the question of the influence of nomadic tribes, who travel with their goats and sheep, on CL is unanswered. We, therefore, investigated their role in CL epidemiology from 2008 to 2017 and compare them with geoclimatic factors. CL patient demographic data and their village/city addresses were retrieved from Provincial Health Center and mapped on the geographic information system (GIS) layer of the province's political divisions. Nomadic travel routes (NTRs) with a 2 km buffer were generated and their effect on CL was investigated together with the interpolated layers of rainfall, temperatures, humidity, slope, elevation, land covers, by binary regression. CL was significantly more common in villages/cities in the 2 km NTR zone (p value < .001; OR = 1.96; 95% CI = 1.4-2.745). Geoclimatic factors, including slope, elevation, rainfall, temperatures, humidity and most of the landcovers, were not significantly different inside and outside the NTR. Areas of irrigated farm were the only effective landcover on CL (p value = .049; OR = 2.717; 95% CI = 1.003-7.361) within the NTR versus non-NTR. Living within NTRs almost doubled the risk of acquiring CL. Several factors for this include passage through areas of high sand fly activity, increased contact between sandflies and humans, sheep and goats, and feeding on their blood and faeces, and low availability of health facilities that should be more investigated and considered in the future control programs.


Subject(s)
Leishmaniasis, Cutaneous , Psychodidae , Sheep Diseases , Altitude , Animals , Humans , Humidity , Iran/epidemiology , Leishmaniasis, Cutaneous/epidemiology , Leishmaniasis, Cutaneous/veterinary , Sheep , Sheep Diseases/epidemiology
12.
Rural Remote Health ; 21(3): 6517, 2021 07.
Article in English | MEDLINE | ID: mdl-34303325

ABSTRACT

INTRODUCTION: This scoping literature review explored the characteristics and behaviours of a subset of Australia's older population: 'grey nomads', many who live and travel with type 1 or 2 diabetes mellitus. Grey nomads are people aged more than 55 years, who travel in caravans or motorhomes for extended periods of time around rural and remote areas of Australia. Grey nomads are challenging the established view of ageing in Australia by their lifestyle choices, which include social and economic contribution, independence and furthering of personal fulfilment. However, some evidence suggests that grey nomads experience health issues while in rural locations, which exerts a significant burden on already under-resourced Australian rural health services. This review seeks knowledge on grey nomads' self-management of diabetes while travelling, with the aim of understanding their experiences and identifying support services and strategies that would facilitate improved self-management. Furthermore, this review seeks knowledge of how Australia's rural and remote health services support the nomads with diabetes and the influence of this burgeoning population on such services. METHODS: A scoping review methodology provided the methods to map the current evidence concerned with this broad and complex topic. A systematic six-step framework was adopted: identifying the research question; identifying relevant literature; selecting studies; charting the findings; collating, summarising and reporting results; and a final consultation. RESULTS: The grey nomads in this review travelled long distances through the often-harsh Australian countryside where they sought, privacy, isolation, self-sufficiency and a closeness with nature. Although their motivations included life- and health-enhancing experiences, most grey nomads travelled with at least one chronic health condition, which they did not consider as a barrier to adopting a grey nomad lifestyle. However, many were under-prepared for their health needs when in rural or remote Australia. Specific literature concerning grey nomads and self-management of diabetes was not found but salient aspects of diabetes self-management were identified and included a well-developed relationship with their diabetes healthcare provider; a relationship that relied on ongoing communication and support. When travelling, the ability to form or sustain supportive relationships with local health care providers was limited due to sparseness of rural services and the perceived transient nature of the relationship. Increasingly, grey nomads utilised digital technology via telemedicine or social media sites for information and advice on health issues. The local pharmacies in rural and remote locations were also identified as sources of support and services. CONCLUSION: The literature showed that the grey nomad population had a similar distribution of chronic illness, including diabetes, to that of the general Australian population, but very little was published about how they self-manage conditions when in remote locations where healthcare services were limited. The emerging roles of digital technology and development opportunities for pharmacists offer new and innovative avenues to support grey nomads with diabetes while travelling in rural and remote Australia.


Subject(s)
Diabetes Mellitus , Rural Health Services , Self-Management , Transients and Migrants , Australia , Diabetes Mellitus/therapy , Humans
13.
Public Health Nutr ; 24(5): 984-992, 2021 04.
Article in English | MEDLINE | ID: mdl-32312349

ABSTRACT

OBJECTIVE: To explore the scope of metabolic syndrome (MetS) and its relationship to the major dietary patterns among an urbanised and semi-urbanised Tibetan population in transition from nomadic to settled settings. DESIGN: Cross-sectional. SETTING: Community-based. PARTICIPANTS: Urbanised and semi-urbanised Tibetan adults (n 920, aged 18-90 years), who have moved from nomadic to settled living environments, answered questionnaires on food consumption frequency and lifestyle characteristics through structured face-to-face interviews and completed anthropometric measurement and metabolic biomarker tests. RESULTS: MetS prevalence was 30·1 % in males and 32·1 % in females. Low HDL-cholesterol and central obesity were the leading metabolic abnormalities (86·3 and 55·8 %, respectively). Three major dietary patterns - urban, western and pastoral - were identified. Beef/mutton was an important food group for all three identified dietary patterns. In addition, the urban dietary pattern was characterised by frequent consumption of vegetables, tubers/roots and refined carbohydrates; the western pattern was characterised by sweetened drinks, snacks and desserts; and the pastoral pattern featured tsamba (roasted Tibetan barley), Tibetan cheese, butter tea/milk tea and whole-fat dairy foods. Individuals in the highest quintile of urban dietary pattern scores were found to be at a higher risk of developing MetS (OR 2·43, 95 % CI 1·41, 4·18) and central obesity (OR 1·91, 95 % CI 1·16, 3·14) after controlling for potential confounders. CONCLUSIONS: MetS was common among urbanised and semi-urbanised Tibetan adult population in transition. The urban dietary pattern, in particular, was a risk factor for MetS. To prevent MetS, nutrition interventions need to be tailored to address the variety of local diet patterns to promote healthy eating.


Subject(s)
Metabolic Syndrome , Adult , Cross-Sectional Studies , Diet , Feeding Behavior , Female , Humans , Male , Metabolic Syndrome/epidemiology , Metabolic Syndrome/etiology , Risk Factors , Tibet
14.
Asia Pac J Public Health ; 33(1): 84-92, 2021 01.
Article in English | MEDLINE | ID: mdl-33164566

ABSTRACT

Bhutan aims to achieve 100% institutional delivery coverage. While evidence indicates improved institutional delivery coverage over the years, coverage in some of the districts is only 49%. This study was aimed at exploring barriers to institutional delivery in three low-coverage districts. In-depth qualitative interviews and six focus group discussions were conducted in December 2015. The analysis was done as per the Braun and Clarke's 6-phase guide to doing thematic analysis. This study sheds light on 15 barriers for institutional deliveries, which include hesitancy to seek health care when the pregnancy is out of wedlock, the restriction of alcohol consumption at health centers, fear of hypothermia in cold places, pastoralism, health care providers shortage, lack of maternity waiting home and food, distance, difficult terrain, lack of transportation services, and financial constraints. Some of these barriers could be unique to Bhutan. The coverage could be improved considerably if the recommendations in this article are implemented.


Subject(s)
Delivery, Obstetric/statistics & numerical data , Health Services Accessibility , Adolescent , Adult , Bhutan , Female , Focus Groups , Home Childbirth/statistics & numerical data , Humans , Middle Aged , Pregnancy , Qualitative Research , Socioeconomic Factors , Young Adult
15.
J Family Med Prim Care ; 9(1): 131-135, 2020 Jan.
Article in English | MEDLINE | ID: mdl-32110578

ABSTRACT

AIM: To assess the perceived oral health beliefs, traditional practices, and oral health status of nomads. METHODS: A cross-sectional study was conducted among 115 nomads residing in various places of Tamilnadu. Information regarding socio-demographics such as age, gender, occupation, and place of residence were obtained. Study participants were interviewed with a pre-tested questionnaire consisting questions related to oral health beliefs and oral health practices. Clinical examination was carried out to record the oral health status using a proforma. RESULTS: A significant Chi-square association was found with oral health-related beliefs (P < 0.01). However, 30.9% had perceived strong beliefs, 64.3% of the subjects used toothbrush, and 20% had at least one oral mucosal lesion. CONCLUSION: A significant proportion of nomads had perceived oral health beliefs, which had a significant association with their traditional practices and their oral health was much deteriorated.

16.
Data Brief ; 29: 105026, 2020 Apr.
Article in English | MEDLINE | ID: mdl-32071955

ABSTRACT

This paper reports LA-ICP-MS 87Sr/86Sr isotopic data collected from archaeological human remains uncovered in Manzherok region, Altai Republic, Russian Federation ("Mobility of nomads in central Asia: chronology and 87Sr/86Sr isotope evidence from the Pazyryk barrows of northern Altai, Russia" [1]. The skeletal remains derive from Scythian barrows dated to 6th - 3rd century BC located at Chultukov Log 1 cemetery. The Chultukov Log cemetery, located approximately 470km south of Novosibirsk, is considered the biggest nomadic burial ground in the Upper Altai and the Sayan Mountains. To enrich the information on prehistoric mobility of ancient nomadic populations in Central Asia, strontium isotopic data were collected using a Nu plasma (II) MC-ICP-MS equipped with ESI NWR193-based laser ablation system from premolar teeth of 8 adult individuals (4 males and 4 females), associated mainly with the Pazyryk culture. Additionally, we report bioavailable strontium data from single Equus caballus specimen (found at Chultukov Log 9 settlement) from Manzherok territory. In this study we have successfully applied and tested new in-depth decontamination protocol for total (<95%) removal of contaminants, necrotic tissue and dental calculus in archaeological materials based on a clinical irrigation procedure with NaOCl and EDTA. Strontium LA-ICP-MS 87Sr/86Sr isotopic data presented in this paper were obtained from prehistoric human teeth previously decontaminated according to this method. These data will provide valuable resources for isotopic analyses of prehistoric transportation systems in Central Asia, including residential mobility of ancient nomads inhabiting steppe zone, Mongolia and NW China.

17.
Trans R Soc Trop Med Hyg ; 114(5): 372-377, 2020 05 07.
Article in English | MEDLINE | ID: mdl-31825495

ABSTRACT

BACKGROUND: Human toxocariasis is caused by the larval stage of Toxocara canis and Toxocara cati. This cross-sectional study was conducted to evaluate the seroprevalence and the risk factors associated with Toxocara infection in nomads of Boyer-Ahmad County in the southwest of Iran. METHODS: A total of 968 blood samples were collected from nomads. A structured questionnaire, containing sociodemographic data, was completed for each participant. Sera were evaluated for anti-Toxocara antibodies, using the T. canis excretory-secretory antigens prepared from the second stage larvae, in an ELISA system. RESULTS: Among the 968 participants, 220 (22.7%) were males and 748 (77.3%) were females; the mean age was 40.71 y. Anti-Toxocara IgG antibodies were detected in 14 (1.4%) of the 968 nomads. The association between Toxocara infection and gender, age, contact with dogs, residential area and level of education were not statistically significant (p>0.05). CONCLUSIONS: The findings of the study revealed a low prevalence rate of toxocariasis in nomadic communities in southwest Iran. Geographic location and climatic conditions as well as the lifestyle and sociodemographic features of the participants may contribute to the low prevalence rate of Toxocara infection.


Subject(s)
Toxocariasis , Transients and Migrants , Animals , Antibodies, Helminth , Cross-Sectional Studies , Dogs , Enzyme-Linked Immunosorbent Assay , Female , Humans , Iran/epidemiology , Risk Factors , Seroepidemiologic Studies , Toxocariasis/epidemiology
18.
Ann Ig ; 32(1): 50-55, 2020.
Article in English | MEDLINE | ID: mdl-31713576

ABSTRACT

BACKGROUND: Toxoplasma gondii is the agent of a zoonotic protozoan infection with worldwide distribution. The rates of infection in different areas are depending on climatic conditions and also social and cultural habits of the people. This cross-sectional study aimed to find out the seroprevalence of toxoplasmosis in nomadic people in Boyer-Ahmad County, in the southwest of Iran. METHODS: Blood samples (5 mL) were collected from 1005 individuals of nomadic tribes of Boyer-Ahmad County in Kohgiluyeh and Boyer-Ahmad Province in 2016. A predesigned questionnaire, containing basic epidemiological information was filled out for each subject during the sampling. Sera were evaluated for anti-T. gondii antibodies (both IgG and IgM), using a commercial ELISA kit. Collected data were analyzed by SPSS, using descriptive statistics and Chi-square test. RESULTS: Out of the 1005 studied subjects, 227 (22.6%) were male and 778 (77.4%) were female. The mean age of participants was 41 years (SD: ±17). The most represented (24.4%) age class was 21-30 years and the least (1.9%) 1-10 years. Anti-T. gondii antibodies were detected in 174 (17.3%) of the cases. No statistically significant associations were found between seropositivity to T. gondii and area of residence, age, gender and educational levels of the participants. CONCLUSIONS: Findings of this study show that the seroprevalence of toxoplasmosis among the nomads of Kohgiluyeh and Boyer-Ahmad province is alike to other communities in our country. Further study is required to elucidate the genotype of T. gondii in this community.


Subject(s)
Toxoplasmosis/epidemiology , Transients and Migrants/statistics & numerical data , Adolescent , Adult , Age Distribution , Antibodies, Protozoan/blood , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Infant , Iran/epidemiology , Iran/ethnology , Male , Middle Aged , Seroepidemiologic Studies , Toxoplasma/immunology , Toxoplasmosis/blood , Young Adult
19.
Midwifery ; 79: 102556, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31634758

ABSTRACT

AIM: More than half of all maternal deaths worldwide occur in sub-Saharan Africa (SSA). For nomadic pastoralists (30 to 60 million) in SSA, the risk of maternal death is very high because of the low proportion of assisted deliveries in the areas where they live. The objective of this research was to understand the determinants of using skilled birth attendants in relation to the perceptions of quality, geographic accessibility, and financial affordability of health services by nomadic women. METHODS: We used a qualitative research design, inspired by ethnography. Research was conducted in the commune of Gossi (Mali), where 90% of the population is nomadic. The study population consisted of 26 nomadic women living in their camps. Saturation and diversification guided sampling. Semi-structured individual interviews and non-participant observation enabled concomitant data collection. Thematic content analysis was performed using QDA Miner software. RESULTS: Our results show that only 10 women used assisted childbirth for their last delivery. These women thought that health workers were competent and well trained, and they liked the fact that these workers were recruited locally. Similarly, these 10 women deemed the health workers' attitude acceptable and appreciated their availability. In contrast, the majority of participants (16 women) were prevented or discouraged from using skill birth attendants. Some of them did not use them because they were afraid of being undressed, of giving birth on a table, and especially of male staff. They also said that they did not have access to information about health services. In addition, respondents considered health services very difficult to access due to distances, unavailable means of transportation, and costs perceived as being expensive. CONCLUSION: Our results identify several determinants of the use or non-use of skilled birth attendants by nomadic women in relation to the context and way of life. In addition, our findings call for future research to better understand these determinants and to deepen, refine, and test emerging strategies that seem potentially hopeful with respect to facilitating the use of skilled birth attendance in SSA.


Subject(s)
Delivery, Obstetric/psychology , Health Services Accessibility , Midwifery , Patient Acceptance of Health Care , Transients and Migrants , Adolescent , Adult , Female , Humans , Interviews as Topic , Mali , Pregnancy , Rural Population , Transients and Migrants/psychology , Young Adult
20.
J Ethnopharmacol ; 244: 112164, 2019 Nov 15.
Article in English | MEDLINE | ID: mdl-31419498

ABSTRACT

ETHNOPHARMACOLOGICAL RELEVANCE: Ethnoveterinary medicine is vastly under-documented, especially in North Africa, where livestock care is increasingly medicalised. Despite evidence of the interdependence of ethnoveterinary practices and ethnomedicine for human care, the overlap between these two systems and the possible drivers of similarity are rarely addressed in ethnopharmacological literature. Here, we present the first quantitative comparison of remedies used to treat human and animal health among a pastoral society. AIMS: This study aims to document the plants and other materials used in ethnoveterinary medicine among nomadic herders in the Algerian steppe. We calculate the overlap with remedies used for human health and evaluate some of the possible drivers of similarities between the two interlinked medical systems. METHODS: The field study was conducted in spring 2018 with 201 local knowledge holders in five provinces in the central part of the Algerian steppe. Forty-six camps and ten weekly animal markets were visited. After obtaining prior informed consent, data was collected through structured interviews. Anonymous sociodemographic information was collected along with veterinary use data. Plant specimens were acquired, identified and deposited in the Botanical Laboratory Herbarium of the University of Tiaret. Ethnobotanical information was structured in use reports and therapeutic applications organised into 13 simple categories. Plants used in ethnoveterinary medicine were compared to those used in human health care using a Chi square test, and ethnoveterinary use was predicted using a generalised linear model with use for human care and plant family as predictive variables. Logistic regressions were also used to test if any specific medicinal application predicts shared use in human and veterinary medicine. RESULTS: Sixty-six plant species from 32 botanical families and ten non-vegetable remedies were documented. Plants from the Lamiaceae, Asteraceae, Fabaceae and Apiaceae families were most commonly used. The plants most often cited by interviewees are all harvested from the wild (Echinops spinosissimus Turra, Atriplex halimus L., Artemisia campestris L., Juniperus phoenicea L. and Peganum harmala L.). Leaves are the most commonly used plant part and decoction is the most common preparation method. There are important similarities between remedies used to treat humans and other animals: two thirds of the remedies used in ethnoveterinary medicine are also used in human health care, and these represent half of the human health treatments. Use for human health and plant family both predict the use of a medicinal plant in veterinary medicine, but no correlation is found regarding specific therapeutic applications. CONCLUSIONS: Traditional veterinary knowledge is still key to sheep and goat herders in the Algerian steppe, but a knowledge transmission gap seems to exist between older and younger generations, and ethnoveterinary practices may disappear in the near future. Treatments for human and animal care overlap to a large extent, and a causal relationship possibly exists for, at least, some of them. However, overall a smaller number of remedies are used to treat animals than humans and for less therapeutic applications. This difference in the diversity of therapeutic applications and remedies should be the object of future research.


Subject(s)
Animal Diseases/drug therapy , Health Knowledge, Attitudes, Practice , Medicine, Traditional , Phytotherapy/veterinary , Plants, Medicinal , Adult , Algeria , Animals , Ethnopharmacology , Female , Humans , Male , Middle Aged , Transients and Migrants , Young Adult
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