Living with Asthma in Low- and Middle-Income Countries in the Six WHO Regions.

Living with AsthmaAsthma is a highly prevalent disease. Although most people with asthma can be treated effectively with certain inhaled medicines, accessing affordable care near their homes is a challenge for many people in low- and middle-income countries. We present stories from six men, women, and children living with asthma in such countries.

Use of e-Cigarettes and Tobacco Products Among Youth in Turkey.

OBJECTIVE: The aim of this study was to determine high school students' views about tobacco products and e-cigarettes and e-cigarette smoking prevalence in one of Turkey's western provinces. MATERIALS AND METHODS: This cross-sectional study included 286 students. The data collection form consisted of 18 questions related to sociodemographic features and tobacco and e-cigarette use. RESULTS: Of the 286 participants, 32.2% reported having used a tobacco product in the past month, 1.02% reported having used e-cigarettes, and 15.2% have tried e-cigarettes at least once. Of those who tried e-cigarettes, 19.2% of them did so because of curiosity. A positive correlation was found between e-cigarette trial and tobacco use, with age. Smoking/e-cigarette use status was significant with "e-cigarettes are harmful" (P=.034), "e-cigarette smoke is harmful" (P = .003), and "selling and advertising e-cigarettes is prohibited" (P =.043). CONCLUSION: This study determined that 3 out of 10 youths used tobacco products, and 1 used e-cigarettes. There is a need to raise awareness among high school students and youth regarding the dangers of e-ciga- rettes and tobacco products.

Reflection of vaccine and COVID-19 fear in young groups in the COVID-19 pandemic.

OBJECTIVE: This study aims to determine the fear of COVID-19 through the opinions of individuals under the age of 18 on the COVID-19 vaccine and vaccination. METHODS: This cross-sectional study was conducted on 290 high school students studying in a central district between February 15, 2021, and March 1, 2021. The questionnaire consisted of questions about the sociodemographic characteristics of the students and COVID-19 infection and the Fear of COVID-19 Scale. RESULTS: The age of the participants ranged from 14-18; 76.9% of the study group consisted of female students; and 76.9% of the participants declared that they live in middleincome households. Participants reported that they lived in the same house with at least 2 and a maximum of 12 people; 9.7% of the participants reported that they had a COVID-19 infection; 62.4% of the participants reported that they want to get the COVID-19 vaccine; and 55.2% of the participants reported that the COVID-19 vaccine will reduce the transmission. The mean obtained from the Fear of COVID-19 Scale is 3.38±4.75 in the whole group. It was determined that there was a significant difference between genders, the effect of the vaccine on the incidence, the status of having a COVID-19 infection, and the score of the Fear of COVID-19 Scale. CONCLUSION: The attitudes of young individuals, who are one of the vulnerable groups during pandemic periods, toward vaccination are important in terms of infecting those they come into contact with and increasing the rate of infection.

Reflection of vaccine and COVID-19 fear in young groups in the COVID-19 pandemic

SUMMARY OBJECTIVE: This study aims to determine the fear of COVID-19 through the opinions of individuals under the age of 18 on the COVID-19 vaccine and vaccination. METHODS: This cross-sectional study was conducted on 290 high school students studying in a central district between February 15, 2021, and March 1, 2021. The questionnaire consisted of questions about the sociodemographic characteristics of the students and COVID-19 infection and the Fear of COVID-19 Scale. RESULTS: The age of the participants ranged from 14-18; 76.9% of the study group consisted of female students; and 76.9% of the participants declared that they live in middleincome households. Participants reported that they lived in the same house with at least 2 and a maximum of 12 people; 9.7% of the participants reported that they had a COVID-19 infection; 62.4% of the participants reported that they want to get the COVID-19 vaccine; and 55.2% of the participants reported that the COVID-19 vaccine will reduce the transmission. The mean obtained from the Fear of COVID-19 Scale is 3.38±4.75 in the whole group. It was determined that there was a significant difference between genders, the effect of the vaccine on the incidence, the status of having a COVID-19 infection, and the score of the Fear of COVID-19 Scale. CONCLUSION: The attitudes of young individuals, who are one of the vulnerable groups during pandemic periods, toward vaccination are important in terms of infecting those they come into contact with and increasing the rate of infection.

The relationship between particulate matter and childhood respiratory complaints and peak expiratory flows in Harran agricultural area.

BACKGROUND: In recent years, many studies have evaluated the increasing incidence of asthma and chronic respiratory diseases among children living close to rural areas with pesticide application. Pesticide exposure in 266 children (126 girls and 140 boys) in Sanliurfa, a cotton-producing province in Turkey, was explored in this work. Four different villages spread over 40 km2 were included. METHODS: Measurements of peak expiratory flow (PEF) in 266 children were conducted in late June, before intensive pesticide applications in the cotton-producing fields. The measurements were repeated for 72 of 266 children after pesticide application in late August. PEF, particulate matter with diameter less than 2.5 µm (PM < sub > 2.5 < /sub > ), particulate matter with diameter less than 10 µm (PM < sub > 10 < /sub > ), temperature, humidity, and wind speed were measured. RESULTS: After pesticide application, mean PM < sub > 2.5 < /sub > and PM < sub > 10 < /sub > values were significantly increased compared to before pesticide application (p < 0.001 for both parameters). After pesticide exposure, nasal discharge, sneezing, burning and itching in the eyes, cough, sputum production, wheezing, shortness of breath and chest tightness were significantly increased (p < 0.001). The mean PEF value was demonstrated to decrease significantly after pesticide application (p < 0.001). Moreover, significant negative correlations were noted between PEF and PM < sub > 10 < /sub > and between PEF and PM < sub > 2.5 < /sub > (p < 0.001). CONCLUSIONS: Intensive pesticide application causes respiratory dysfunction and increased respiratory complaints in children living near the affected agricultural areas, and impacts quality of life adversely. The results of this work can be used to develop an early warning system and methods to prevent respiratory disorders in children residing in the study area.

The Effect of Environmental Exposures on the Diagnosis of Tuberculosis in Syrian Refugees.

OBJECTIVE: Humanitarian crisis in the Middle East geography has brought refugees into being. The aim of this study is to investigate the relationship between refugees' tuberculosis diagnosis process and air pollution parameters and environmental exposures. METHODS: A total of 229 patients with tuberculosis registered at Sanliurfa Tuberculosis Dispensary during 2012-2018 were included. In this cross-sectional study, education levels, smoking status, warm-up style, and exposure to biomass, pesticides, dust storm, PM10, and sulfur dioxide were evaluated. Air parameters were received from https://www.havaizleme.gov.tr/. Bacteriological diagnosis was classified as smear-positive lung tuberculosis, smear-negative culture-positive lung tuberculosis, and other diagnostic methods. This study was approved by the Harran University Ethical Committee (10.12.2018; session: 12; decision no: 36). RESULTS: Of the 229 patients diagnosed with tuberculosis, 53.3% were males and 46.7% were females. The average age was 31.15 ± 15.16. About 24.5% of refugees lived in camps, while 75.5% lived outside of the camps. The rate of smear (+) lung tuberculosis was 38% and smear (-) culture (+) lung tuberculosis was 14.4%. Smoking (P = .007) in smear (+) cases and exposure to PM10 (P = .036) and sulfur dioxide (P = .015) in culture (+) cases were significant. CONCLUSION: Smoking and air pollution are associated with delayed diagnosis of tuberculosis and severe forms of tuberculosis. We think that as a result of smoking cessation and reduction of air pollution, tuberculosis incidence in refugees can be reduced.

Assessment of the Relationship Between Smoking and Depression in Pregnant Women.

Smoking during pregnancy has negative effects on both maternal and fetal health. One of these negative maternal effects is the potential for depression. A high rate of cigarette smoking in pregnancy is an important public health issue since it affects not only the pregnant woman but also the newborn and its healthy development. The aim of this study is to investigate the relationship between smoking, influencing factors, and depression prevalence in pregnant Syrian refugees and pregnant citizens of the Republic of Turkey (TR). Pregnant citizens in the TR and pregnant Syrian refugees who were registered at health centers between 15.04.2017 and 15.10.2017 in the border city of Ceylanpinar in the Province of Sanliurfa in Syria were visited in their living areas in the district center and at a tent village, respectively. A total of 414 pregnant women agreed to participate in the study and were included in the survey. To collect data for the cross-sectional study, a sociodemographic and pregnancy characteristics questionnaire was used, in addition to the Fageström Test for Nicotine Dependence (FTND) and the Beck Depression Inventory (BDI). The rate of smoking in all pregnant women was determined to be 49.3% (n = 204) before pregnancy and 37.9% (n = 157) during pregnancy. A statistically significant difference was found between age groups and educational status in relation to smoking status (p = 0.005, p = 0.001). There was also a statistically significant difference between the smoking status of pregnant women and that of their partners and family members (p = 0.001, p = 0.002). The percentage of pregnant women who were passive smokers was 80.2% (n = 332), and a statistically significant difference was found between passive smoking and smoking status (Fisher; 0.000). The presence of risk for depression was detected in 49.8% (n = 206) of all pregnant women surveyed; the rate of depression risk was 50.5% (n = 104) in pregnant TR citizens and 49.5% (n = 102) in pregnant refugees, with no significant difference between the two groups. There was a statistically significant difference between smoking status in pregnancy and the presence of depression risk (p = 0.001). 32.5% of pregnant women were highly nicotine dependent. A moderate positive correlation was determined between the FTND and BDI scores of pregnant women (r = 0.346; p = 0.001). It was found that one-third of all pregnant women smoked and that one of every two showed a risk for depression. A statistically significant correlation was found between smoking status and risk for depression. No statistically significant difference was determined between the two groups, despite high levels of smoking, nicotine dependence, and depression in both. These data suggest the need to develop new preventive strategies in regard to smoking among pregnant women.

New perspective on rise of tuberculosis cases: communal living.

OBJECTIVE: Forced migration caused by wars has led to regression in health parameters, including tuberculosis. This study aims to determine the relationship between living area, family type and the number of contacts among refugees and Turkish citizens diagnosed with tuberculosis. METHOD: This study was designed using retrospective file scanning. A total of 194 patients with diagnosed TB were included in this study. In addition, patients' addresses were visited and their family lifestyles and living areas were recorded. RESULTS: Of 194 patients in the age range of 1-72 years (mean = 31.15, SD = 15.16), 98 patients were refugees. The number of contacts among refugees was 549, and their total living area was 7,740 m2. A total of 57 refugees lived in a communal living situation, and their average living area was significantly lower than that of Turkish citizens. Statistical significance was observed between family lifestyle and habitats. This was found due to the difference between nuclear families and communal living situations. CONCLUSION: Tuberculosis was found to infect more people in war-related living conditions. This situation is caused by communal living, which refers to people who are not blood relatives living together; this is new information. Communal life should be taken into account in the contact examination of refugees for tuberculosis, and the obstacles to reach health services for refugees living outside of camps should be examined.

Respiratory symptoms and pulmonary functions before and after pesticide application in cotton farming.

OJECTIVE: To investigate respiratory health problems related to pesticide exposure in the inhabitants of agricultural areas. MATERIAL AND METHODS: This study included 252 participants prior to pesticide application and 66 participants from the first group after pesticide application across four cotton farms. Symptom questionnaires were filled out by participants and respiratory function tests were measured before and after pesticide exposure. In addition, PM10, PM2.5, air temperature, and humidity were measured in all four farming villages before and after pesticide administration. RESULTS: PM10 and PM2.5 levels were significantly increased after pesticide application. After pesticide application, all participants' nose, throat, eye, and respiratory complaints increased significantly. Expected forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) percentage values decreased significantly. The rates of FVC and FEV1 values lower than 80% were 23.5% and 22%, espectively, before pesticide application, and this rate increased to 42.4% and 43.1%, respectively, after pesticide application. There was a significant negative correlation between PM10 levels and FVC, FEV1, and PEF values. After PM2.5 pesticide application, the risk of experiencing burning in the mouth, nose, and throat increased by 2.3-fold (OR: 2.316), 2.6-fold for burning symptoms in the eyes (OR: 2.593), 2.1-fold for wheezing (OR: 2.153), and 2.2-fold for chest tightness (OR: 2.211). With increased PM10 levels, the risk of chest tightness increased 1.1-fold (OR: 1.123). CONCLUSIONS: After pesticide administration, the respiratory health of the participants deteriorated. Performing pesticide applications in agriculture with harmless methods is the most important measure to be taken to protect public health.

Chest Diseases in Refugees Living in a Tent Camp and in Turkish Citizens Living in the District: Ceylanpinar Experience.

OBJECTIVES: Displacement, for whatever reason, is an urgent situation that affects both the migrant and the migratory society in a holistic manner, and that especially hurts Middle Eastern societies. Studies show that health problems experienced as a result of immigration are important in terms of cost reduction and quality of life. This study aimed to investigate chest diseases (CD) among refugees living in a tent camp and Turkish citizens living in the district Sanliurfa Ceylanpinar which is located in the South East of the Turkey. MATERIALS AND METHODS: A retrospective registry-scan type study was performed between January 2015 and December 2015. The extent of this study is the citizens of Turkish Republic and refugees who applied to Sanliurfa Ceylanpinar State Hospital CD Policlinic and Annex Building CD Policlinic and Emergency Polyclinic. The study has been divided into two groups as Refugees and Turkish citizens, the data of patients who were referred to the Chest Diseases Policlinic and Emergency Polyclinic for chest complaints were recorded. The diagnoses of chest diseases in both groups were compared. Patients who presented with a chest complaint but did not have any diagnosis were sent for further psychiatric evaluation with regard to anxiety. Tuberculosis, which is an important public health problem, was also studied in detail. RESULTS: In total; 455,882 patients were admitted to the Sanliurfa Ceylanpinar State Hospital center and Annex Building Chest Diseases Policlinic and Emergency Polyclinic with chest complaints. Pneumonia, asthma, and chronic obstructive pulmonary disease were found to occur more frequently in refugees from the tent camp than in Turkish citizens. Anxiety was higher among Turkish Citizens in patients who had a chest complaint but did not receive any diagnosis. CONCLUSION: Refugees living in tent camps and Turkish citizens living in the same area were found to have similar results in terms of respiratory diseases, including tuberculosis. Physiological and psychological effects of war were expected to be high in refugees because they were affected by immigration; however, they were no different than the physiological and psychological effects noted in local people. These data suggest that the local people as well as current immigrants may be psychologically affected.