Background A national mapping survey of schistosomiasis (SCH) and soil-transmitted helminthiases (STH) was conducted in The Gambia in May, 2015. The survey aimed at establishing endemicity of schistosomiasis and soil-transmitted helminthiases to inform decisions on program planning and implementation of mass drug administration (MDA). Methodology/Principal findings A cross-section of 10,434 eligible school aged children (SAC), aged 7 to 14 years old were enrolled in the survey. The participants were randomly sampled from 209 schools countrywide using N/50, where N = total eligible children per school. Stool, and urine samples were provided by each child and examined for schistosomiasis and soil-transmitted helminthic infections using double Kato-Katz, urine filtration, dipstick techniques and CCA rapid test kits. Data were managed using online LINKS system enabling real-time data availability and access. Epi Info version 3.5.3 and health mapper version 4.3.2 were used to generate outputs of endemicity and distribution. Descriptions of mapped districts for MDA eligibility and frequency were done with reference to WHO PC strategy recommendations. Mapping results indicated that nationally, the prevalence of schistosomiasis (SCH) and soil-transmitted helminthiases (STH) was 4.3% and 2.5% respectively. In terms of distribution STH are more common in Western Region One (WR1) at 4.1% prevalence, then Lower River Region (LRR) 3.6%, and Western Region Two (WR2) 3.0%. In contrast, SCH indicated much higher prevalence in Central River Region (CRR) at a rate of 14.2%. This is within medium prevalence range, and is followed by Upper River Region (URR) at 9.4%, which is within low prevalence range. At the district level, schistosomiasis prevalence seems to be highest in Niani district (22%) in CRR. Banjul island, the capital city, seems to have the highest prevalence of STH (up to 55%), followed by Kombo South with 22% prevalence. Schistosoma haematobium characterised by haematuria, was the most dominant infection of schistosomiasis discovered followed by Schistosoma mansoni which reported in 0.1% of infections. Out of 42 districts mapped 14, or 38%, of them are co-endemic for soil-transmitted helminthiases (ascariasis, trichuriasis, and hook-worm infections) and schistosomiasis (S. haematobium and S. mansoni). Conclusions We identified that 24/42(57%) districts mapped in The Gambia are endemic for schistosomiasis expressing the need for preventive chemotherapy. Twenty (47%) of the districts mapped are endemic for STH. However, only two STH endemic districts namely Banjul (55%) and Kombo South (22%) were within rates eligible for mass drug administration.
Our aim was to study the prevalence and incidence of patients with human immunodeficiency virus (HIV) in the general population in Stockholm, Sweden. We also aimed to study mortality among individuals with HIV and to explore co-morbidities. The study population included all living persons who resided in Stockholm County, Sweden, as of 31 December 2012 (N = 2,212,435). Information on all consultations between 2007 and 2012 was obtained from primary health care, specialist outpatient care and inpatient care. Analyses were done by age and gender. All patients with a recorded diagnosis of HIV were included. The prevalence of HIV was calculated using 2012 data. The prevalence of HIV in Stockholm area as per end of December 2012 was as low as 0.1% in females and 0.2% in males, and the annual incidence of HIV continued to decline over the years. In recent years, cancers, diabetes and hypertension were about as common in individuals with HIV as in the general population. Males with HIV had 3- to 4-fold higher age-adjusted odds of being diagnosed with depression and 3-fold higher odds of anxiety disorders and women had 1.6 to 2-fold higher age-adjusted odds of depression and anxiety disorders, than males and females in the general population, respectively. The relatively good somatic health observed in this study could be attributed to nearly optimal HIV therapy in Sweden. The mental health of HIV patients was significantly worse than that in the general population and needs further attention.
Introduction: Irrational prescription and use of antibiotics are found to be risk factors to the spread of antibiotic resistance. Studies have shown that more than half of the admitted patients at the Paediatric Department of the Edward Francis Small Teaching Hospital (EFSTH) in The Gambia have been treated with antibiotics in the year 2015 alone. It was also evident that 74.5% of clinical isolates were resistant to ampicillin which was the most prescribed antibiotic among these patients. Therefore, the need to assess health care workers’ knowledge, attitude and practices on the phenomenon of anti-microbial resistance (AMR) and antibiotic usage in the Gambia. Materials and Methods: This cross-sectional study was conducted using self-administered questionnaires which were adopted from related studies. The questionnaires were administered at 60 randomly selected health facilities (both public and private) from around the country with a sample size of 225 respondents in 2016. Descriptive analyses were performed for each study variable and rates were reported as percentages. The results are presented in the form of contingency tables with their respective related Chi-squared (χ2) statistics values. The interpretations of the P-values are based on the less than or equal to 0.05 (5%) significance level. Result: The study revealed that 63.27% of the respondents were nurses, 41.7% of them had a work experience between 0-4 years of service and most of the respondents work in the urban areas. Most of health care workers have knowledge on the right usage of antibiotics and understood that frequent usage of antibiotic could compromise the effectiveness of antibiotics. The study found 94.14% of the health care workers agreed there exists antibiotic abuse in both hospital and community settings. However, 23.08% of the respondents are not aware those antibiotics are not effective against viral infections such as common cold. Conclusion: Therefore, majority of the health care workers had knowledge about antibiotic resistance and are aware of the frequent and abuse of antibiotic use could contribute to the development of antibiotic resistance in the country. However, they were less informed of the cost involved in the treatment and management of multidrug resistance patients using fewer and expensive antibiotics. Moreover, some of the health care workers had misconception on the treatment of viral infections with antibiotics (such as antibacterial) and there also exists disproportionate distribution of trained health workers in the country. Therefore, refresher training on prudent usage of antibiotics for health care workers especially doctors and nurses must be strengthened.
Objective: We compare individuals with newly diagnosed HIV with sex-, age-, and socioeconomic status-matched HIV-negative controls, with the aim of studying the frequency of health care visits, the types of clinics visited, registered diagnoses, and psychopharmacotherapy. Methods: The data were collected through the Stockholm Region administrative database (Stockholm Regional Health Care Data Warehouse) for men and women (people) living with newly diagnosed HIV (PLWH) in their medical records (930 men, 450 women) and controls. The odds ratios (ORs) with 99% confidence intervals (CIs) for psychiatric comorbidities and relevant pharmacotherapies were calculated during the 2011-2018 period. Results: Substance use disorder was higher in PLWH than in controls, before and after newly diagnosed HIV in men (OR = 1 year before 4.36 [99% CI = 2.00-9.5] and OR = 1 year after 5.16 [99% CI = 2.65-10.08]) and women (OR = 1 year before 6.05 [99% CI = 1.89-19.40] and OR = 1 year after 5.24 [99% CI = 1.69-16.32]). Health care contacts and psychiatric disorders were more common in cases than controls 1 and 2 years after diagnosis, particularly for depression in men 1 year after HIV (OR = 3.14, 99% CI = 2.11-4.67), which was not found in women (1 year OR = 0.94, 99% CI = 0.50-1.77). Conclusions: Before newly diagnosed HIV, PLWH have the same level of psychiatric diagnoses as their controls, except for substance use disorder. Psychiatric problems are more common in PLWH than in their controls after newly diagnosed HIV.
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