Public Health Action最新文献_第10页

Using digital chatbots to close gaps in healthcare access during the COVID-19 pandemic. 在2019冠状病毒病大流行期间，使用数字聊天机器人弥合医疗保健获取方面的差距。

IF 1.4

Public Health Action Pub Date : 2022-12-21 DOI: 10.5588/pha.22.0046

C Tzelios, C Contreras, B Istenes, A Astupillo, L Lecca, K Ramos, L Ramos, K Roca, J T Galea, M Tovar, C D Mitnick, J Peinado

{"title":"Using digital chatbots to close gaps in healthcare access during the COVID-19 pandemic.","authors":"C Tzelios, C Contreras, B Istenes, A Astupillo, L Lecca, K Ramos, L Ramos, K Roca, J T Galea, M Tovar, C D Mitnick, J Peinado","doi":"10.5588/pha.22.0046","DOIUrl":"https://doi.org/10.5588/pha.22.0046","url":null,"abstract":"Introduction: Chatbots have emerged as a first link to care in recent years. The COVID-19 pandemic, and consequent health system disruptions, expanded their use. Socios En Salud (SES) introduced chatbots in Peru, which experienced one of the highest excess COVID mortalities in the world.Methods: SES and the government identified unmet population health needs, which could be amenable to virtual interventions. Chatbots were developed to screen individuals for these conditions; we describe the period of deployment, number of screenings, and number of people who received services.Results: Between April 2020 and May 2021, SES deployed nine ChatBots: four for mental health, two for maternal and child health, and three for chronic diseases: breast cancer, hypertension, diabetes mellitus, and obesity. Mental health services were provided to 42,932 people, 99.99% of those offered services. The other ChatBots reached fewer people. Overall, more than 50% of eligible people accepted chatbot-based services.Discussion: ChatBot use was highest for mental health. Chatbots may increase connections between a vulnerable population and health services; this is likely dependent on several factors, including condition, population, and penetration of smart phones. Future research will be critical to understand user experience and preferences and to ensure that chatbots link vulnerable populations to appropriate, high-quality care.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 4","pages":"180-185"},"PeriodicalIF":1.4,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716819/pdf/i2220-8372-12-4-180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10422057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Strategic response to COVID-19 in Ethiopia. 埃塞俄比亚 COVID-19 的战略对策。

IF 1.4

Public Health Action Pub Date : 2022-12-21 DOI: 10.5588/pha.22.0007

D K Huluka, A W Ashagrie, T H Gebremariam, H Y Ahmed, R A Kebede, A B Binegdie, K G Gebrehiwot, M Tadesse, M Sultan, W W Dode, A A Tumebo, A Abayneh, Y Seman, T Firew, C B Sherman, N W Schluger, D A Haisch

{"title":"Strategic response to COVID-19 in Ethiopia.","authors":"D K Huluka, A W Ashagrie, T H Gebremariam, H Y Ahmed, R A Kebede, A B Binegdie, K G Gebrehiwot, M Tadesse, M Sultan, W W Dode, A A Tumebo, A Abayneh, Y Seman, T Firew, C B Sherman, N W Schluger, D A Haisch","doi":"10.5588/pha.22.0007","DOIUrl":"10.5588/pha.22.0007","url":null,"abstract":"COVID-19, the novel coronavirus, has posed a major threat to low- and middle-income countries (LMICs) due to inadequate health infrastructure and human resources. Ethiopia, a low-income country with the second largest population in Africa, has coordinated a strategic response, leveraging existing infrastructure and health systems and mobilizing public health professionals and specialist expert physicians for a multifaceted, unified government approach and adaptive response. Resource limitations, particularly in critical care, have still posed challenges, but the public health and clinical interventions thus far have prevented the catastrophic toll that many predicted. As the pandemic continues, Ethiopia expects to use a triple care model integrated at all levels, consisting of COVID-19 care, isolation care for suspected cases, and essential health services, and urges intensified non-pharmaceutical interventions alongside equitable global vaccine distribution as the ultimate answers to pandemic control. This paper draws on existing data, national planning and guidelines, and expertise from health leadership to describe this response in hopes of providing an example of how future large-scale health challenges might be faced in LMICs, using Ethiopia's successes and challenges in facing the pandemic.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 4","pages":"191-194"},"PeriodicalIF":1.4,"publicationDate":"2022-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9716818/pdf/i2220-8372-12-4-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents. 对改善儿童和青少年艾滋病治疗效果的干预措施进行过程评估。

IF 1.3

Public Health Action Pub Date : 2022-09-21 DOI: 10.5588/pha.22.0009

M Seguin, S Dringus, S Chiomvu, T Apollo, E Sibanda, V Simms, S Bernays, R Chikodzore, N Redzo, P Mlilo, L Ndlovu, P Nzombe, B Ncube, K Kranzer, R Abbas Ferrand, C D Chikwari

{"title":"Process evaluation of an intervention to improve HIV treatment outcomes among children and adolescents.","authors":"M Seguin, S Dringus, S Chiomvu, T Apollo, E Sibanda, V Simms, S Bernays, R Chikodzore, N Redzo, P Mlilo, L Ndlovu, P Nzombe, B Ncube, K Kranzer, R Abbas Ferrand, C D Chikwari","doi":"10.5588/pha.22.0009","DOIUrl":"10.5588/pha.22.0009","url":null,"abstract":"Setting: Children and adolescents with HIV encounter challenges in initiation and adherence to antiretroviral therapy (ART). A community-based support intervention of structured home visits, aimed at improving initiation, adherence and treatment, was delivered by community health workers (CHWs) to children and adolescents newly diagnosed with HIV.Objectives: To 1) describe intervention delivery, 2) explore CHW, caregiver and adolescents' perceptions of the intervention, 3) identify barriers and facilitators to implementation, and 4) ascertain treatment outcomes at 12 months' post-HIV diagnosis.Design: We drew upon: 1) semi-structured interviews (n = 22) with 5 adolescents, 11 caregivers and 6 CHWs, 2) 28 CHW field manuals, and 3) quantitative data for study participants (demographic information and HIV clinical outcomes).Results: Forty-one children received at least a part of the intervention. Of those whose viral load was tested, 26 (n = 32, 81.3%) were virally suppressed. Interviewees felt that the intervention supported ART adherence and strengthened mental health. Facilitators to intervention delivery were convenience and rapport between CHWs and families. Stigma, challenges in locating participants and inadequate resources for CHWs were barriers.Conclusion: This intervention was helpful in supporting HIV treatment adherence among adolescents and children. Facilitators and barriers may be useful in developing future interventions.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 3","pages":"108-114"},"PeriodicalIF":1.3,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria. 便携式数字x射线在尼日利亚农村社区用于结核病诊断前筛查。

IF 1.4

Public Health Action Pub Date : 2022-06-21 DOI: 10.5588/pha.21.0079

B Odume, E Chukwu, T Fawole, N Nwokoye, C Ogbudebe, O Chukwuogo, S Useni, C Dim, E Ubochioma, D Nongo, R Eneogu, T Lagundoye Odusote, O Oyelaran, C Anyaike

{"title":"Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria.","authors":"B Odume, E Chukwu, T Fawole, N Nwokoye, C Ogbudebe, O Chukwuogo, S Useni, C Dim, E Ubochioma, D Nongo, R Eneogu, T Lagundoye Odusote, O Oyelaran, C Anyaike","doi":"10.5588/pha.21.0079","DOIUrl":"https://doi.org/10.5588/pha.21.0079","url":null,"abstract":"Setting: This pilot project was conducted in hard-to-reach communities of two Niger Delta States in the South-South Region of Nigeria.Objective: To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.Design: DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) ⩾60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.Results: A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (P < 0.001).Conclusion: TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 2","pages":"85-89"},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176193/pdf/i2220-8372-12-2-85.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Hearing aid support for patients with DR-TB in Ethiopia. 埃塞俄比亚为耐药结核病患者提供助听器支持。

IF 1.4

Public Health Action Pub Date : 2022-06-21 DOI: 10.5588/pha.21.0068

G Teferra, K Teklemariam, D F Wares, C Negeri, A Bedru

{"title":"Hearing aid support for patients with DR-TB in Ethiopia.","authors":"G Teferra, K Teklemariam, D F Wares, C Negeri, A Bedru","doi":"10.5588/pha.21.0068","DOIUrl":"https://doi.org/10.5588/pha.21.0068","url":null,"abstract":"Setting: Previous and current patients with drug-resistant TB (DR-TB) who had documented treatment-related hearing impairment due to second-line injectable (SLI) use were identified from different DR-TB treatment initiation centres in Ethiopia.Objective: To assess selected patients with DR-TB for eligibility for hearing aids and provide hearing aids to 10 eligible patients.Design: This was an observational cohort study. Patients were followed up for 8 months, with hearing assessments conducted at 1, 3 and 8 months to objectively assess hearing capacity.Results: Of 12 patients assessed for hearing aids eligibility, 10 were fitted with hearing aids (type XTM XP P4) and followed up for 8 months. \"Formal\" improvement was observed only in one patient. However, \"general quality of life\" appeared to be improved in nine patients.Conclusion: Minimal \"formal\" improvement was observed. However, the study was too small to say whether hearing aids should, or should not, be recommended as a public health measure. This needs a larger better controlled follow-up study. The all-oral DR-TB treatment regimens should be used for all patients with DR-TB in Ethiopia. However, as a proportion of patients with DR-TB are likely to continue receiving SLIs in the foreseeable future, they will require close audiometry assessment and appropriate care.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 2","pages":"74-78"},"PeriodicalIF":1.4,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9176189/pdf/i2220-8372-12-2-74.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

A structured community engagement strategy to support uptake of TB active case-finding. 有组织的社区参与战略，支持开展结核病主动病例发现工作。

IF 1.4

Public Health Action Pub Date : 2022-03-21 DOI: 10.5588/pha.21.0059

J T Galea, D Puma, C Tzelios, H Valdivia, A K Millones, J Jiménez, M B Brooks, C M Yuen, L Lecca, M C Becerra, S Keshavjee

{"title":"A structured community engagement strategy to support uptake of TB active case-finding.","authors":"J T Galea, D Puma, C Tzelios, H Valdivia, A K Millones, J Jiménez, M B Brooks, C M Yuen, L Lecca, M C Becerra, S Keshavjee","doi":"10.5588/pha.21.0059","DOIUrl":"https://doi.org/10.5588/pha.21.0059","url":null,"abstract":"Background: In Lima, Peru, a mobile TB screening program (\"TB Móvil\") was implemented in high TB prevalence districts to increase TB screening. Community engagement activities to promote TB Móvil were simultaneously conducted.Objective: To describe a structured, theory-driven community engagement strategy to support the uptake of TB Móvil.Methods: We adapted Popular Opinion Leader (POL), an evidence-based social networking intervention previously used in Peru to promote HIV testing, for TB Móvil. Community health workers, women who run soup kitchens, and motorcycle taxi drivers served as \"popular opinion leaders\" who disseminated information about TB Móvil in everyday conversations, aided by a multi-media campaign. Performance indicators of POL included the number/characteristics of persons screened; number of multimedia elements; and proportion of persons with abnormal radiographs hearing about TB Móvil before attending.Results: Between February 2019 and January 2020, 63,899 people attended the TB Móvil program at 210 sites; 60.1% were female. The multimedia campaign included 36 videos, 16 audio vignettes, flyers, posters, community murals and \"jingles.\" Among attendees receiving an abnormal chest X-ray suggestive of TB, 48% (6,935/14,563) reported hearing about TB Móvil before attending.Conclusions: POL promotes the uptake of TB Móvil and should be considered as a strategy for increasing TB screening uptake.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"12 1","pages":"18-23"},"PeriodicalIF":1.4,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8908875/pdf/i2220-8372-12-1-18.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9695614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali. 马里巴马科活动性肺结核成人的儿童家庭接触者的异烟肼预防疗法。

IF 1.3

Public Health Action Pub Date : 2021-12-21 DOI: 10.5588/pha.21.0061

M Tolofoudie, A Somboro, B Diarra, Y S Sarro, H B Drame, A C G Togo, M Sanogo, A Dembele, T Togun, E Nkereuwem, B Baya, B Konate, U Egere, M Traore, M Maiga, K Saliba-Shaw, B Kampmann, S Diallo, S Doumbia, M Sylla

{"title":"Isoniazid preventive therapy in child household contacts of adults with active TB in Bamako, Mali.","authors":"M Tolofoudie, A Somboro, B Diarra, Y S Sarro, H B Drame, A C G Togo, M Sanogo, A Dembele, T Togun, E Nkereuwem, B Baya, B Konate, U Egere, M Traore, M Maiga, K Saliba-Shaw, B Kampmann, S Diallo, S Doumbia, M Sylla","doi":"10.5588/pha.21.0061","DOIUrl":"10.5588/pha.21.0061","url":null,"abstract":"Background and objective: Isoniazid preventive therapy (IPT) is known to reduce the risk of developing active TB in about 59% in children aged ⩽15 years. We assessed adherence, completion and adverse events among children who were household contacts of a newly diagnosed adult with smear-positive TB in Bamako, Mali.Methods: Children aged <15 years living in the same house with an adult smear-positive index case were enrolled in the study in the Bamako Region after consent was obtained from the parent or legal guardian. Adherence was assessed based on the number of tablets consumed during 6 months.Results: A total of 260 children aged <15 years were identified as household contacts of 207 adult patients with smear-positive TB during the study period. Among all child contacts, 130/260 (50.0%) were aged 0-4 years and were eligible for IPT; 128/130 (98.5%) were started on IPT and 83/128 (64.8%) completed with good adherence at the end of the 6 months, and without any significant adverse events.Conclusion: We successfully implemented IPT with good acceptance, but low completion rate. The Mali National TB Program and partners should expand this strategy to reach more children in Bamako and the whole country and create greater awareness in the population.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 4","pages":"191-195"},"PeriodicalIF":1.3,"publicationDate":"2021-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8680184/pdf/i2220-8372-11-4-191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9857513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. 尼泊尔一家三级医院尿路感染的低产量但高水平的多药耐药性。

IF 1.4

Public Health Action Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0044

R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar

{"title":"Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal.","authors":"R Baral, L B Shrestha, N Ortuño-Gutiérrez, P Pyakure, B Rai, S P Rimal, S Singh, S K Sharma, B Khanal, K Selvaraj, A M V Kumar","doi":"10.5588/pha.21.0044","DOIUrl":"https://doi.org/10.5588/pha.21.0044","url":null,"abstract":"Setting: There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal.Objective: To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal.Design: This was a cross-sectional study using secondary laboratory data.Results: Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August.Conclusion: Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"70-76"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575377/pdf/i2220-8372-11-s1-70.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39624215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal. 尼泊尔加德满都一家三级医院尿路感染的高多药耐药性。

IF 1.4

Public Health Action Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0035

S Shakya, J Edwards, H A Gupte, S Shrestha, B M Shakya, K Parajuli, H P Kattel, P S Shrestha, R Ghimire, P Thekkur

{"title":"High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal.","authors":"S Shakya, J Edwards, H A Gupte, S Shrestha, B M Shakya, K Parajuli, H P Kattel, P S Shrestha, R Ghimire, P Thekkur","doi":"10.5588/pha.21.0035","DOIUrl":"https://doi.org/10.5588/pha.21.0035","url":null,"abstract":"Setting: Tribhuvan University Teaching Tertiary Care Hospital, Kathmandu, Nepal, May-October 2019.Objective: 1) To describe the bacteriological profile, 2) to identify the antimicrobial resistance (AMR) pattern, and 3) to find the demographic characteristics associated with the presence of bacterial growth and multidrug resistance (MDR) in adult urine samples undergoing culture and drug susceptibility testing.Design: This was a hospital-based, cross-sectional study using routine laboratory records.Results: Among 11,776 urine samples, 16% (1,865/11,776) were culture-positive, predominantly caused by Escherichia coli (1,159/1,865; 62%). We found a high prevalence of resistance to at least one antibiotic (1,573/1,865; 84%) and MDR (1,000/1,865; 54%). Resistance to commonly used antibiotics for urinary tract infections (UTIs) such as ceftazidime, levofloxacin, cefepime and ampicillin was high. Patients aged ⩾60 years (adjusted prevalence ratio [aPR] 1.6, 95% CI 1.4-1.7) were more likely to have culture positivity. Patients with age ⩾45 years (45-59 years: aPR 1.5, 95% CI 1.3-1.7; ⩾60 years: aPR 1.4, 95% CI 1.2-1.6), male sex (aPR 1.3, 95% CI 1.2-1.5) and from inpatient settings (aPR 1.4, 95% CI 1.2-1.7) had significantly higher prevalence of MDR.Conclusion: Urine samples from a tertiary hospital showed high prevalence of E. coli and MDR to routinely used antibiotics, especially among inpatients. Regular surveillance and application of updated antibiograms are crucial to monitor the AMR situation in Nepal.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"24-31"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal. 尼泊尔一家三级医院耐甲氧西林金黄色葡萄球菌的流行情况。

IF 1.4

Public Health Action Pub Date : 2021-11-01 DOI: 10.5588/pha.21.0042

P Pradhan, P Rajbhandari, S B Nagaraja, P Shrestha, R Grigoryan, S Satyanarayana, H Davtyan

{"title":"Prevalence of methicillin-resistant Staphylococcus aureus in a tertiary hospital in Nepal.","authors":"P Pradhan, P Rajbhandari, S B Nagaraja, P Shrestha, R Grigoryan, S Satyanarayana, H Davtyan","doi":"10.5588/pha.21.0042","DOIUrl":"https://doi.org/10.5588/pha.21.0042","url":null,"abstract":"Setting: Patan Hospital, Lalitpur, Nepal.Objectives: To describe 1) the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) and its antibiotic sensitivity pattern; 2) the demographic and clinical characteristics associated with MRSA infections; and 3) the treatment outcomes of in-patients with MRSA infection among patients with S. aureus infection between January 2018 and December 2020.Design: This was a cross-sectional study using electronic and paper-based hospital records of patients with S. aureus infection.Results: Of the 1,804 patients with S. aureus infection, 1,027 patients (57%, 95% CI 55-59) had MRSA. The MRSA were susceptible to vancomycin (100%), linezolid (96%), doxycycline (96%), chloramphenicol (86%) and cotrimoxazole (70%), and resistant to erythromycin (68%), clindamycin (56%), gentamycin (58%), ciprofloxacin (92%) and ofloxacin (91%). The prevalence of MRSA was higher in 2019, among out-patients, and in respiratory samples, and lower in blood samples. Of the 142 in-patients with MRSA, 93% had a successful clinical outcome (cured/improved).Conclusion: More than 50% of patients with S. aureus infection had MRSA that were resistant to commonly available antibiotics. This calls for strengthening surveil-lance and good infection control practices in this hospital.","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"11 Suppl 1","pages":"46-51"},"PeriodicalIF":1.4,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8575383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39623768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3