RESUMO
BACKGROUND: People with comorbid mental illness (MI) and chronic physical illness (CPI) face a range of health and quality of life challenges. The appropriate screening and management of comorbid MI and CPI are crucial to improving outcomes for this population. Despite this, there is a dearth of research exploring the health system response to the screening and management of patients with these comorbidities in public primary care settings, in several jurisdictions including Jamaica. This study explored and described the attitudes, perspectives, experiences, and practices of policymakers, primary care physicians, psychiatrists, and mental health nurses regarding screening and management of comorbid MI and CPI. METHOD: Twenty-nine participants representing policymakers, primary care physicians, psychiatrists, and mental health nurses took part in semi-structured interviews. Data was collected over the period April to November 2020 and subject to thematic analysis. RESULTS: Three overarching themes emerged from the data related to: 1) Policies and Protocols; 2) Clinical Practice; and 3) Personnel. The interplay of these themes illustrated fragmentation and gaps between national policies and guidelines and clinical practice. The findings also identified factors related to personnel, including barriers that limit clinicians' abilities to adequately screen and manage this patient population. CONCLUSION: There is a need for the continued development and revision of policies and protocols that support integrated care for patients with comorbid MI and CPI in primary care settings in Jamaica. Additionally, programs and strategies to improve clinicans knowledge, skills and access to resources are necessary to help them offer improved quality of care around screening and management for this patient population.
Assuntos
Transtornos Mentais , Qualidade de Vida , Humanos , Jamaica/epidemiologia , Transtornos Mentais/complicações , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Saúde Mental , Comorbidade , Pesquisa QualitativaRESUMO
There is evidence of an elevated risk of hypertension in populations that are primarily of African origin. Hypertension is predominantly asymptomatic, necessitating increased awareness. May Measurement Month was a descriptive, population-based, cross-sectional study of blood pressure (BP) screening and awareness campaign conducted in 2019 in a sample of 2550 participants (≥18 years) in Jamaica. In total, 1791 (70.2%) of the participants were female, 756 (29.6%) were male, with an average age of 49.3 years, and a body mass index (kg/m2) of 28.5 (6.2). Of all participants, 2289 (89.8%) were black and 154 (6.0%) were of mixed races. Twenty-two (0.9%) had never had their BP measured, whereas 354 (13.9%) had their measurements more than a year ago, and 2129 (83.5%) had measured within the year. Of all 2550 participants, 1055 (41.4%) had hypertension, 69.9% of our subjects with hypertension were aware, whereas only 62.5% were on antihypertensive medication and 27.8% had controlled BP (systolic <140 mmHg and diastolic BP <90 mmHg). Of 660 participants on antihypertensive medication, 44.4% had controlled BP. Two hundred and seventy-six (15.4%) of women reported hypertension in a previous pregnancy. Hypertension with previous pregnancy was positively correlated with current elevation. These results suggest a high rate of raised BP among community dwellers whose hypertension had not been previously diagnosed by a health professional and warrant proactive approaches that promote community-based awareness, and regular measurements.
RESUMO
The objective of this study was to assess whether students' sense of belonging at school was associated with cannabis use among secondary school students in Barbados. This was a cross-sectional study involving a nationally representative weighted sample of 8,538 students drawn from 2nd to 6th forms across public and private secondary schools in Barbados in 2013. Descriptive and inferential statistics was performed using SPSS. Students who had a sense of belonging at school, were attending public schools and were in the 2nd form, had higher odds of reporting past-year and past-month cannabis use. We conclude that there was a significant positive association between students' sense of belonging at school and cannabis use.
Assuntos
Comportamento do Adolescente/psicologia , Uso da Maconha/psicologia , Comportamento Social , Estudantes/psicologia , Adolescente , Barbados , Estudos Transversais , Feminino , Humanos , Masculino , Instituições AcadêmicasRESUMO
Multidrug-resistant tuberculosis (MDR-TB) is presently a major public health threat. MDR-TB patients face diverse financial and psychosocial difficulties. Researchers conducted in-depth interviews based on interview guides with 42 participants. Data were analyzed using categorization, coding, generation of themes, and thematic memo writing. The key findings were as follows: Out of the 42 patients, 30 (71.4%) were males and 12 (28.6%) were females. All patients received financial stipends for transport and monthly social support. The patients however needed more financial support than they received (suggesting high unmet financial needs). Patients suffered depressive mood before and during treatment but received inadequate mental health/psychosocial care and treatment. Patients developed hearing impairment as a major adverse drug reaction, but the care and treatment they received were inadequate. In conclusion, the programmatic support provided for MDR-TB patients' financial and mental health/psychosocial needs and auditory drug side effects fell short of their need. Programmes for control of MDR-TB should increase budgetary allocations and ramp up mechanisms for provision of mental health/psychosocial support and care/treatment for drug side effects.
Assuntos
Avaliação das Necessidades , Apoio Social , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria , Pesquisa Qualitativa , Reembolso de IncentivoRESUMO
There is a high and increasing proportion of single-parent families in Jamaica. This has raised concerns about the potential impact of single-parent families on the social, cognitive and behavioural development of children, including their sexual relationships. The aim of this study was to investigate the association between being raised in a single-parent family and age of sexual debut among young people in Jamaica. The study was cross-sectional in design, and based on a multi-stage sampling procedure. The study was conducted in July/September 2016. The study sample comprised 233 respondents (110 males and 123 females) aged from 18 to 35 years (mean 26.37 years; SD 5.46). Respondents completed a self-administered questionnaire with questions on socio-demographic characteristics, family structure, sexual debut and current sexual behaviour. Ninety-seven (41.7%) respondents grew up in single-parent families. A total of 201 (86.3%) had had sex (102 males and 99 females). Their mean age of sexual debut was 15.51 years (SD 3.41). Sixty-five (32.3%) had early sexual debut (<16 years). Respondents from single-parent families were more likely to have had early sexual debut (56.9%; n=37) compared with those from two-parent families (43.1%, n=28; p=0.004). Only 44.6% (n=29) of those who experienced early sexual debut used a condom during their first sexual encounter compared with 73% (n=100) of those who had a later sexual debut (≥16 years; p=<0.001). A single-father family structure was a significant predictor of early sexual debut (AOR 5.5; 95%CI: 1.1-25.8). The study found a significant association between single-parent family structure and age of sexual debut.
Assuntos
Coito , Países em Desenvolvimento , Comportamento Sexual/estatística & dados numéricos , Família Monoparental/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Criança , Preservativos/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Jamaica , Masculino , Fatores Socioeconômicos , Adulto JovemRESUMO
Background: The prevalence of cigarette smoking is high among adolescents in the Caribbean, including Jamaica. Age of initiation of cigarette smoking varies among adolescents. A number of factors has been reported to influence early age of initiation of cigarette smoking. The aim of this study was to determine if parental smoking status was associated with early age of onset of cigarette smoking among Jamaican adolescents. Methods: Data from the Jamaican National School Survey (NSS) conducted in 2013 were analysed. The nationally representative sample comprised of 3,365 students enrolled in 8th grade to 12th grade in 38 public and private secondary schools. Descriptive and inferential statistics were computed using SPSS. Results: The mean age of initiation of cigarette smoking among the subjects was 12.4years [SD: 2.69]. There was no significant association between parental cigarette smoking status and the age of initiation of cigarette smoking among the adolescents (female X2 = 0.753, P = 0.861; male X2 = 6.953, P = 0.073). Logistic regression analysis showed that parental smoking status was not a predictor of early age of initiation of cigarette smoking among the adolescents (father/ guardian AOR= 0.81, 95% CI= 0.56- 1.11; mother/guardian AOR= 0.96, 95% CI= 0.44 2.10; both parent AOR= 0.49, 95%CI= 0.22- 1.07). However, having a parent with secondary education was a risk factor for early initiation of smoking (AOR= 1.71, 95%CI= 1.13-2.57), while being in 8th grade was a protective factor against early age of initiation of cigarette smoking (AOR= 0.43, 95% CI= 0.23 - 0.80). Conclusion: Parental smoking cigarette smoking status was not a predictor of early age of cigarette smoking initiation among Jamaican adolescents.
Assuntos
Comportamento do Adolescente , Pais/psicologia , Fumantes/psicologia , Fumar/epidemiologia , Fumar/psicologia , Estudantes/psicologia , Adolescente , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Fatores de Risco , Instituições AcadêmicasRESUMO
Background: Religion sometimes shapes behaviours and experiences of its members including alcohol consumption. The aim of this study was to examine the possible influence of religious affiliation on alcohol consumption in Jamaica since they are predominantly Christians. Methods: Using a cross-sectional study design, we analysed data from National Household Survey 2,016 of 4,623 participants. Descriptive and inferential statistics were performed using SPSS. Results: Out of the 4,623 participants, majority 3,244 (70.2%) were above the age of 26 years and of Christian religion 3,737 (80.8%). Christian religious affiliation was significantly associated with past year and past month use of alcohol (AOR= 1.44, 95% CI=1.14-1.82 and AOR =1.34, 95% CI=1.03- 1.74 respectively). Being a male (AOR= 2.95, 95% CI=2.51- 3.47), and employed (AOR= 2.11, 95% CI= 1.49- 2.98) were significant risk factors for lifetime alcohol consumption. Age 12 17 years (AOR= 0.30, 95% CI=0.21- 0.43) and attaining primary education level (AOR=0.60, 95% CI=0.45-0.80) were protective factors against lifetime alcohol consumption. Conclusion: Being of Christian religion was significantly, positively associated with past year and past month alcohol consumption. Male gender and being employed were also risk factors for lifetime alcohol consumption.
Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Religião , Adolescente , Adulto , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
Objective: Alcohol is one of the most commonly consumed substances in Jamaica, despite the many health problems associated with excessive alcohol use. The aim of this study was to identify potential risk factors for alcohol binge drinking among Jamaicans, and determine if there were significant gender differences in the associations between identified risk factors and frequent binge drinking. Methods: Data collected from the 2016 National Household Survey Jamaica were analysed. Descriptive and inferential statistics were computed using SPSS. Binary logistic regression analysis was used to determine factors associated with frequent binge drinking. Results: The total number of respondents was 4623. Females were 2,535 (54.8%) compared to males 2088 (45.2%). In bivariate analysis, there was a significant association between age and frequent binge drinking among males (X2 = 11.11, p =0.004), but not among females (X2 = 2.03, p = 0.36). Similarly, there was a significant association between employment and frequent binge drinking for males but not for females (X2= 12.85, p= 0.002; X2= 2.49, p= 0.29 respectively). In multivariate analysis, age 12- 17 years was significantly, inversely associated with frequent binge drinking in the crude logit model but not in the adjusted logit model (crude odds ratio [COR] 0.21, 95%CI= 0.6- 0.66; adjusted odds ratio [AOR] = 0.51, 95%CI= 0.12- 2.13 respectively). Employment was significantly, positively associated with frequent binge drinking in the adjusted logit model (employed: AOR= 3.63, 95% CI= 1.05- 12.59) among males. Among females, age showed no significant association with frequent binge drinking. Only having primary/ lower education was significantly, positively associated with frequent binge drinking among females (AOR= 5.17, 95%CI= 1.36- 19.65). Conclusion: Risk factors for frequent binge drinking differed by gender; being employed was a risk factor for males while having primary (or lower) education was a risk factor for females.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/epidemiologia , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores Sexuais , Inquéritos e Questionários , Adulto JovemRESUMO
Background: Underage alcohol use is a pervasive problem with serious health, social and safety consequences. This study was undertaken to assess alcohol use by primary school children in Trinidad and Tobago, and to identify associated risk factors. Methods: We analysed data collected from 40 primary schools in Trinidad and Tobago by the National Alcohol and Drug Abuse Prevention Programme (NADAPP). The sample comprised of children aged 8 -15 years old, in standards 3, 4 and 5. Result: Out of the 2052 children, 648 (31.6%) have consumed alcohol in their lifetime, and same proportion reported ever being drunk (31.6%). Male gender was significantly associated with lifetime alcohol use (AOR =1.60, 95% CI= 1.25 - 2.05). Children not living with their father (AOR= 2.45, 95% CI=1.86- 3.24) and those whose fathers have either primary or secondary education (AOR = 1.88, 95%CI=1.07 - 3.31; AOR= 1.58, 95%CI=1.12 - 2.23 respectively) were at higher risk for lifetime alcohol consumption. However, age group 8 11 years was significantly inversely associated with lifetime alcohol consumption (AOR= 0.67, 95% CI=0.48 - 0.94). Conclusion: Being a male student, not living with father, and father attaining either primary or secondary education level were significantly associated with increased likelihood for lifetime alcohol use. However, children between 8 11 years were less likely to consume alcohol.
Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários , Trinidad e Tobago/epidemiologiaRESUMO
Background: The prevalence of alcohol use is quite high in the Caribbean region, and specifically, in Barbados. Alcohol use has been documented to negatively affect the way students behave within and outside school. This study set out to examine the role alcohol plays in students' behavioural problems at school. Methods: An analysis of crosssectional data collected during the National Secondary Schools Survey was done. Mean (and standard deviation), frequencies and percentages were computed, and differences in proportions among the groups were assessed using Pearson's Chi Square. Multivariate analysis using binary logistic regression was done to determine the association between explanatory variables and outcome variables. Results: In bivariate analysis, behavioural problems at school were significantly associated with age (p= 0.001), grade (p= 0.000), sense of belonging at school (p= 0.000), relationship with teachers (p= 0.000), and past month alcohol use (p= 0.007). In multivariate analysis, students' having frequent behavioural problems at school was significantly associated with neither past year nor past month alcohol use (AOR= 1.13, 95% CI= 0.91- 1.40, AOR= 1.02, 95% CI= 0.83- 1.24 respectively). Significant inverse associations were found between students' behavioural problems and age (11- 14 years: AOR= 0.53, 95% CI= 0.33- 0.84; AOR= 0.51, 95% CI= 0.32- 0.82 for models 1 and 2 respectively), and relationship with teachers (very good: AOR= 0.10, 95% CI= 0.07- 0.16; AOR= 0.13, 95% CI= 0.09- 0.20 for models 1 and 2 respectively). Conclusion: Neither past year nor past month alcohol consumption by students was associated with frequent behavioural problems at school. Students who were younger than 17 years, and who had a relationship with their teachers that was not very bad were significantly less likely to engage in frequent behavioural problems.
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Comportamento Problema/psicologia , Instituições Acadêmicas , Estudantes/psicologia , Adolescente , Adulto , Barbados/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Inquéritos Epidemiológicos , Humanos , Masculino , Prevalência , Adulto JovemRESUMO
Background: In Barbados and the wider Caribbean region, alcohol is widely consumed by adolescents and young people, including those in secondary schools. The high prevalence of alcohol use, and its potential adverse effects are a source of concern to policy makers and the general population, which calls for better understanding of the drivers of this problem. This study thus aimed at investigating whether parental alcohol drinking habit is a predictor of alcohol use among secondary school students in the country. Methods: The predictor variables and response variables in the study were categorical, and so descriptive, univariate analysis consisted of computation of frequencies and percentages. Bivariate analysis using Pearson's Chi Square was done to test for significant differences in the response variables among groups. Logistic regression modeling was used in multivariate analysis to determine the predictor variables that were significantly associated with the response variables. Results: Significant associations were seen between students' age, (P= 0.00), grade (P=0.00), fathers' drinking habit (P=0.00), mothers' drinking habit (P=0.00), and both past year and past month alcohol use, in bivariate analysis. Logit model shows that students whose fathers drink only on weekends, sometimes during the week, or every day, respectively, had significantly increased risk of alcohol use in the past month (AOR= 2.62, 95%CI= 1.81- 3.77; AOR= 1.85, 95%CI= 1.19- 2.85; AOR= 2.18, 95%CI= 1.49- 3.18). Students whose mothers drink only on special occasion had significantly higher risk of alcohol use in the past year and past month (AOR= 1.99, 95%CI= 1.06- 3.74; AOR= 2.30, 95%CI= 1.36- 3.89 respectively). Conclusion: Having fathers who drink only on weekend, sometimes during the week and every day were significantly positively associated with alcohol use in the past month. Having mothers who drink only on special occasion was a risk factor for past year and past month alcohol use. However, having mothers who drin
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Pais/psicologia , Estudantes/psicologia , Adolescente , Barbados/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Prevalência , Fatores de Risco , Instituições AcadêmicasRESUMO
Alcohol consumption has significant health, social and economic implications. Alcohol is the most prevalent psychoactive substance used by Jamaican adolescents. The aim of this study was to determine whether alcohol is associated with sexual risk behaviour among Jamaican adolescents. Methods: The data from National Secondary School Survey (NSS) conducted in 2013 was analysed. Descriptive statistics consisting of frequencies, percentages and Pearson's Chi square was done. Multivariate analysis was done using binary logistic regression. Result: The mean age of alcohol initiation among the participants was 12.3years [SD: 2.74]. There were significant associations between gender (X2= 14.56; p= 0.000), relationship with father/guardian (X2: 10.71; P= 0.03), relationship with mother (X2= 15.16; P= 0.004) and conversation with parents/ guardians about dangers of drug abuse (X2= 8.16; P=0.004). Adolescents who were males (AOR= 0.62, 95% CI= 0.43 - 0.88), in the 8th grade (AOR= 0.51, 95% CI= 0.26 - 0.98) or in the 10th grade (AOR: 0.52, 95% CI: 0.32 - 0.85) were less likely to engage in sexual risk behaviour. Lifetime alcohol consumption, past year alcohol consumption and past month alcohol consumption were not significantly associated with sexual risk behaviour (AOR= 0.35, 95% CI= 0.04 - 3.46; AOR= 1.75, 95% CI= 0.59 - 5.09, AOR= 0.78 95% CI= 0.56 - 1.11 respectively). Conclusion: Lifetime, past one year and past one month alcohol consumption among the students were not risk factors for sexual risk behavior (non-condom use) among Jamaican adolescents.
Assuntos
Comportamento do Adolescente/efeitos dos fármacos , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Assunção de Riscos , Comportamento Sexual/efeitos dos fármacos , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Fatores de Risco , Estudantes/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
Background: Cigarette is one of the most widely used addictive substances and a leading cause of death. Prevalence of cigarette smoking has been reported to be high in the Caribbean, including Jamaica. The aim of this study was to determine whether students' relationship with teachers influences their cigarette smoking behaviour in Jamaica. Methods: This was a statistical analysis of data based on a nationally representative sample of 3,365 secondary school students drawn from 8th to 12th grade across 38 secondary schools in Jamaica in 2013. Descriptive and inferential statistics were performed using SPSS. Results: There were significant differences in the past year and past month cigarette smoking respectively among students who had very good, good, average, bad and very bad relationship with their teachers (X2 = 11.67, p = 0.02; X2 = 9.61, p = 0.04) respectively. Students with very good relationship with teachers, were significantly less likely to report smoking cigarette in the past month (AOR= 0.09, 95% CI= 0.01- 0.88). Students who were 2 - 10 years, had very good relationship with teacher and father, and whose parents knew friends very well, were 0.96, 0.69, 0.70 and 0.94 times as likely to report smoking cigarette in the past year. However, these associations were not significant after controlling for other factors. Conclusion: Students' relationship with their teachers has a strong influence on cigarette smoking. Students with very good relationship with teachers were significantly less likely to report smoking cigarette in the past month.
Assuntos
Comportamento do Adolescente/psicologia , Fumar Cigarros/epidemiologia , Relações Interpessoais , Professores Escolares , Estudantes/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adolescente , Criança , Pré-Escolar , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica , Masculino , Prevalência , Fatores de Risco , Instituições Acadêmicas , Meio Social , Inquéritos e QuestionáriosRESUMO
Background: Alcohol consumption among young people is a major public health problem world-wide and in Jamaica. A number of factors have been reported to affect alcohol use among high school students. The aim of this study was to investigate the influence of perception of the harmfulness of alcohol on alcohol use among secondary school students in Jamaica. Methods: Data collected from a nationally representative sample of 3,365 students were analyzed. Descriptive and inferential statistics were performed using SPSS. Results: Students' perception of risk of drinking alcohol frequently and getting drunk respectively had positive and significant associations with past month alcohol use (AOR= 1.44, 95% CI= 1.09- 1.88 and AOR= 1.38, 95% CI= 1.02- 1.86, respectively) compared to students who felt that drinking alcohol frequently and getting drunk were very harmful. Males, 12 years or younger were significantly less likely to use alcohol in the past month (AOR= 0.77, 95% CI=0.60- 0.97; AOR= 0.68, 95% CI= 0.53-0.97 respectively). Students with good relationship with their mothers were less likely to use alcohol in the past year and past month (AOR= 0.55, 95% CI= 0.35-0.87; AOR= 0.50, 95% CI= 0.32- 0.78). Conclusion: Risk perception of the harmfulness of alcohol significantly affects alcohol use among secondary school students in Jamaica. Males, 12 years or younger, who had good relationship with mothers, were significantly less likely to use alcohol in past month
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/psicologia , Atitude Frente a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estudantes/psicologia , Adolescente , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/epidemiologia , Criança , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Prevalência , Medição de Risco , Inquéritos e QuestionáriosRESUMO
The aim of this study was to examine the potential relationship between Jamaican secondary students' alcohol drinking habits and their family structure. Methods: Data collected from a nationally representative survey of 3,365 students were analysed. Descriptive and inferential statistics were performed. Results: Out of the 3,365 students, 1,044 (31.0%) were from single-parent families. Single-parent families, married-parent families and common law-parent families were significantly associated with lifetime use of alcohol (AOR= 1.72, 95% CI= 1.06 - 2.79; AOR= 1.73, 95% CI= 1.07- 2.81, AOR= 1.94, 95%CI= 1.17- 3.21 respectively). However, family structure was not significantly associated with past year and past month alcohol use. Students whose parents "sometimes" knew their whereabouts were significantly less likely to use alcohol in their lifetime compared to students whose parents "Always" knew where the students were. Conclusion: Family structure is an independent predictor of alcohol use among high school students in Jamaica. Being from single-parent families, married-parent and common- law parent families were significantly associated with increased likelihood for lifetime alcohol use.
Assuntos
Comportamento do Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Relações Familiares , Família Monoparental/psicologia , Estudantes/psicologia , Adolescente , Estudos Transversais , Feminino , Seguimentos , Humanos , Jamaica/epidemiologia , Masculino , Instituições AcadêmicasRESUMO
BACKGROUND: National tuberculosis (TB) programmes globally rely heavily on passive case finding for detecting TB in the community as advocated by the World Health Organization (WHO). TB case detection is low in Nigeria despite improvement in TB services and coverage. METHODS: A retrospective evaluation of an active case-finding intervention utilizing community-based approaches and targeted systematic TB screening in Ebonyi State, Nigeria was done. The analysis was performed using Epi Info. RESULTS: Using community-based and health-facility-based systematic screening strategies, 218,751 persons were screened, with 19.7% of them being presumptive TB cases. Among these, 23,729 (55.1%) submitted sputum samples for microscopy, and 764 (3.2%) had smear-positive TB. In addition, 683 individuals were diagnosed with other forms of TB using X-ray and clinical evaluation giving a total of 1447 all forms of TB cases. The overall number needed to screen (NNS) to find one person with all forms of TB through the project was 151. The NNS was 53 for general outpatients, 88 through contact tracing, and 110 among HIV-infected persons. CONCLUSIONS: Active case-finding strategies achieved good yields though early loss to follow-up was high. Active case finding is recommended for integration into national TB control policy and practice.
Assuntos
Redes Comunitárias , Tuberculose/diagnóstico , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Controle de Doenças Transmissíveis , Feminino , Infecções por HIV/diagnóstico , Instalações de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Nigéria/epidemiologia , Estudos Retrospectivos , Escarro/microbiologia , Tuberculose/epidemiologia , Tuberculose/microbiologia , Tuberculose/prevenção & controle , Organização Mundial da Saúde , Adulto JovemRESUMO
INTRODUCTION:: Mycolactones, secreted by Mycobacterium ulcerans, were previously believed to prevent super infection in Buruli ulcer lesions. However, little is known about secondary bacterial infections in these lesions. This study evaluated contaminating bacterial flora and their antibiotic susceptibility patterns in cases of previously untreated Buruli ulcer disease from three states in Southern Nigeria. METHODS: A prospective analysis was conducted between January and June of 2015 using wound swabs from eligible patients with Buruli ulcer disease, confirmed by quantitative-polymerase chain reaction, with active ulcers. Microbiological analyses including isolation of bacteria, species identification of isolates, and drug susceptibility tests were performed. RESULTS: Of 51 patients, 27 (52.9%) were female. One or more bacterial species of clinical importance was isolated from each patient. A total of 17 different microbial species were isolated; 76.4% were Gram-negative and 23.6% were Gram-positive isolates. The most common bacterial species detected was Staphylococcus aureus (24%), followed by Aeromonas hydrophila (13%), Pseudomonas aeruginosa (13%), and Klebsiella pneumoniae (11%). Drug susceptibility tests showed a particularly high frequency of resistance to commonly used antimicrobials in Nigeria for Staphylococcus aureus. CONCLUSIONS: Super bacterial infections occur in Buruli ulcer lesions in Nigeria, and these infections are associated with high rates of resistance to commonly used antibiotics in the country.
Assuntos
Antibacterianos/farmacologia , Úlcera de Buruli/microbiologia , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Adolescente , Adulto , Criança , Coinfecção , Feminino , Bactérias Gram-Negativas/classificação , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/classificação , Bactérias Gram-Positivas/isolamento & purificação , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Nigéria , Estudos Prospectivos , Adulto JovemRESUMO
Abstract INTRODUCTION: Mycolactones, secreted by Mycobacterium ulcerans, were previously believed to prevent super infection in Buruli ulcer lesions. However, little is known about secondary bacterial infections in these lesions. This study evaluated contaminating bacterial flora and their antibiotic susceptibility patterns in cases of previously untreated Buruli ulcer disease from three states in Southern Nigeria. METHODS A prospective analysis was conducted between January and June of 2015 using wound swabs from eligible patients with Buruli ulcer disease, confirmed by quantitative-polymerase chain reaction, with active ulcers. Microbiological analyses including isolation of bacteria, species identification of isolates, and drug susceptibility tests were performed. RESULTS Of 51 patients, 27 (52.9%) were female. One or more bacterial species of clinical importance was isolated from each patient. A total of 17 different microbial species were isolated; 76.4% were Gram-negative and 23.6% were Gram-positive isolates. The most common bacterial species detected was Staphylococcus aureus (24%), followed by Aeromonas hydrophila (13%), Pseudomonas aeruginosa (13%), and Klebsiella pneumoniae (11%). Drug susceptibility tests showed a particularly high frequency of resistance to commonly used antimicrobials in Nigeria for Staphylococcus aureus. CONCLUSIONS Super bacterial infections occur in Buruli ulcer lesions in Nigeria, and these infections are associated with high rates of resistance to commonly used antibiotics in the country.