Advances in Public Health

Dengue is a major public health problem in Sarawak, Malaysia. Since 2011, the Ministry of Health of Malaysia has created an electronic database (e-Dengue) for all dengue cases in Malaysia. This database of cases includes socio-demographic and locality data, clinical symptoms and signs, and results from rapid dengue assays. This study analyses data extracted from this database to describe the epidemiology and determine which factors are more likely to indicate or predict an outbreak of dengue. A total of 14,020 cases from 2013 to 2022 were extracted, with 4,636 cases reported from outbreaks. The highest incidence was 112.22 per 100,000 population in 2016, with 2,773 cases. Over this period, there were 37 deaths, with the highest in 2016 with seven deaths. The case fatality rate ranged from 0.12% to 0.75%. Predictors of outbreaks include younger age (0.984 (0.980–0.989)), female (1.584 (1.387–1.821)), cases from rural areas (0.398 (0.346–0.458)), unemployed (1.179 (1.005–1.383)), students (1.450 (1.163–1.808)). For clinical markers, rash (1.315 (1.056–1.638)) and NS1 antigen test positivity (3.474 (2.952–4.088)) were a predictor of outbreaks, while diarrhoea (0.160 (0.055–0.465)) was a predictor for single cases. Although rainfall, climate change, and population density are known predictors of dengue, socio-demographic factors, clinical signs, and NS1 antigen are additional predictors of dengue that will allow for early detection and control.

Background. Adherence to tuberculosis (TB) treatment is essential for curing the disease and for preventing drug resistance. Most studies report that substance abuse is associated with high discontinuation of TB treatment, which is a barrier to the effective management of the TB control and prevention program. Insufficient data exist on the effects of the nyaope drug use on TB treatment adherence among patients with the disease. Hence, the current study aimed to qualitatively explore the perceptions of caregivers regarding the influence of nyaope and alcohol use on tuberculosis treatment adherence among tuberculosis patients in Limpopo Province, South Africa. Materials and Methods. Qualitative, exploratory and descriptive designs were used. The nonprobability purposive sampling method was used to select eight TB focal nurse and eight facility operational managers from eight selected community health centers in Limpopo Province. Data were collected through in-depth interviews, and it was guided by data saturation. Data were analyzed using Colaizzi’s method. Trustworthiness was ensured, and ethical considerations were observed in the study. Results. The study results of the study show four individual major themes that emerged from the data analysis: (1) challenges in treatment adherence; (2) disruption of follow-up and DOT support systems; (3) reluctance toward social support; and (4) resistance to health educational and counseling interventions. Conclusion. The study reveals that nyaope and alcohol use significantly impede TB treatment adherence. In response, the conclusion advocates for integrating services within healthcare facilities to enhance TB treatment effectiveness. This proposed integration aims to create a cohesive and interconnected healthcare system capable of identifying, supporting, and treating TB patients with substance abuse issues more effectively. The study recommends incorporating the Alcohol Use Disorders Identification Test questionnaire for all newly diagnosed TB patients. This proactive measure will enable early identification of individuals who may be experiencing harmful or hazardous alcohol use. Following the identification process, it is advisable to offer further counseling to those in need and link them to a deaddiction center for specialized support. This approach not only aids in the comprehensive care of TB patients but also addresses underlying issues that could potentially hinder their treatment adherence and overall recovery.

Globally, overweight and obesity among children have been acknowledged as a growing public health concern. In sub-Saharan Africa, the prevalence of overweight and obesity is high. In Uganda, there is a significant burden of overweight and obesity. This study was conducted to determine the prevalence and associated factors that influence overweight and obesity among primary school children in Southwestern Uganda. A cross-sectional study utilized a self-administered questionnaire and anthropometric tools to collect data. A three-stage sampling procedure was used to select four schools that participated in this study. A total of 422 children participated in our study. Participant’s weight and height were measured using SECA Scale, Model 885, and a wall-mounted stadiometer, respectively. Data were analyzed using STATA v11.0. The prevalence of overweight/obesity was descriptively analyzed. Associated factors were determined using bivariate and multivariate analysis. Findings revealed that 54.3% of participants were walking to school compared to 45.7% that were cycling/bicycling and 76.3% playing and doing household chores as opposed to 23.7% that spent their leisure time through reading and watching TV, 74.2% took more than two meals per day, and 79.4% often took vegetables and fruits compared to 20.6% that took them most of the time. The study found an overall prevalence of 20% for overweight/obesity. There was a statistical association between overweight/obesity and ownership of residence (O.R.: 0.4, 95% C.I.: 0.2–0.8), modes of transport (O.R.: 8.2, 95% C.I.: 3.4–20.0), leisure time activities (O.R.: 0.4, 95% C.I.: 0.2–0.7), frequency of consuming vegetables and fruits (O.R.: 2.8, 95% C.I.: 1.4–5.5), and the type of school attended (O.R.: 0.2, 95% C.I.: 0.1–0.4). However, only the mode of transport (A.O.R.: 5.0, 95% C.I.: 1.9–13.0) was independently associated with overweight/obesity on multivariate logistic regression analysis. Girls who participated in our study were more overweight than boys. Overweight/obesity existed more in private schools than public schools. Modes of transport were only found to be strongly associated with overweight/obesity. There is a need to establish evidence-based strategies to inform policy on prevention of childhood overweight/obesity.

South Africa is facing a high burden of COVID-19 pandemic with low-vaccine coverage in the African Region. We aimed to investigate the temporal changes and impacts in health behaviors on vaccine acceptability in pre-, during-, and post-vaccine roll-out periods. In this cross-sectional study, we used the combined data from the nationally conducted “COVID-19 Vaccine Surveys (CVACS)” (May 2020–February/March 2022). Semiparametric regression models were used to capture the nonlinear association between the vaccine acceptability and health behaviors. Our study provided compelling evidence for a substantial decline in COVID-19 vaccine trust which shifted from 62%–70% to 26%–42% overtime. Participants younger than 40 years of age were less likely to receive the vaccine before it became available. However, this association changed in the postvaccine period with significant uptake in vaccine acceptance in younger groups. South Africans who identified themselves as black were more likely to intend to receive (aORs ranged: 1.93−3.60) and to trust the vaccine’s safety and efficacy (aORs ranged:1.79−1.23) in all time periods. “Mask wearing” and “frequent hand washing” were the most commonly reported behaviors. Given the lower rates of vaccine acceptability and a reduction in preventative health behaviors, monitoring the spread of infections is crucial and may have significant clinical and epidemiological implications.

Background. It is necessary to monitor the health disorders of healthcare practitioners exposed to a complex of occupational hazards to optimize their activities and substantiation of preventive health measures. The purpose of the study was the hygienic assessment of occupational hazards, analysis of data on self-assessment of the state of health (SASH questionnaire) among healthcare practitioners (MRI diagnostics specialists, ultrasound diagnostics specialists, and ophthalmologists, as a control group) exposed to nonionizing radiation, ultrasound, and noise. Materials and Methods. An analysis of hygienic parameters of the working environment (workplace) and questionnaire data of healthcare practitioners were carried out. The number of illnesses and absences from work, the level of quality of life, the level of depression, and the self-assessment of the state of health were evaluated according to the questionnaire. Results. An analysis of workloads made it possible to rank the severity and intensity of labor. Health disorders (according to the self-assessment of the state of health), the number of absences from work due to illness, an increase in complaints and level of depression, and a decrease in the level of quality of life were corresponded to the severity of labor. It was revealed that healthcare practitioners were exposed to a number of hazards during their work (above the threshold limit value (TLV)), which caused an increase in health disorders. Conclusions. During the organization of workplace ergonomics and implementation of preventive measures directed to maintaining health and early diagnosis of diseases, one should take into account the hygienic indicators of the working environment that exceed TLV, the results of self-assessment of the state of health (complaints) and morbidity of healthcare practitioners, the level of quality of life and the level of depression.

Objective. This study evaluates the effectiveness of the “150 Minutes Program” in increasing awareness and fostering positive behavior changes regarding recommended physical activity guidelines among Saudi college students. Initiated as part of the national “Sports for All Challenge,” this program targets college students to improve their understanding of the U.S. Department of Health and Human Services’ physical activity guidelines. Methods. Engaging over 250 Saudi college students from 17 student groups across the United States, the program employs two intervention strategies: a general awareness campaign and the application of physical activity guidelines tailored to the Saudi student community. The study assesses the program’s impact through pre-/post-surveys, evaluating changes in participants’ awareness levels and physical activity behaviors. Results. A total of 110 participants completed either the presurvey (n = 35) or postsurvey (n = 75). Results indicate a significant rise in participants’ awareness of recommended physical activity guidelines, increasing from an initial 4% to 22.9%. Postprogram surveys reveal positive shifts in physical activity behaviors, with 51.4% of participants meeting adult physical activity guidelines, compared to 40% before the program. The average physical activity levels also demonstrated an increase. Conclusion. The 150 Minutes Program proves effective not only in enhancing awareness but also in instigating positive physical activity behavior changes among Saudi college students. The study contributes valuable insights to the evolving landscape of physical activity interventions within college populations, emphasizing the need for targeted programs, and collaborations with student organizations to ensure sustained impact and scalability.