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Research Article
Leveraging Pareto Analysis of Outpatient Morbidity for Strategic Drug Procurement and Health Promotion in Resource-Constrained Setting in Ghana
Richmond Bediako Nsiah*
,
James Ankamah,
Theresah Krah,
Akua Kumi Yeboah,
Dominic Nyarko,
Jonathan Mawutor Gmanyami,
Florence Owusuaa Peprah,
Frank Prempeh,
Charlotte Yeboah Domfeh,
Isaac Ayirebi,
Mark Bonnir,
Isaac Morrison,
Margaret Morrison,
Patrick Larbi-Debrah,
Geoffrey Akungoe Ayambire,
Priscilla Sarkodie,
Kenneth Baga Sabogu,
Obed Atsu-Ofori,
Kwame Kusi Agyemang,
Daniel Ike Adinkrah
Issue:
Volume 12, Issue 6, December 2024
Pages:
154-164
Received:
21 September 2024
Accepted:
11 October 2024
Published:
13 November 2024
Abstract: Background: Effective health management in resource-limited settings requires strategic resource allocation and intervention planning. Pareto analysis, based on the 80/20 rule, aids in identifying key health conditions impacting outpatient morbidity, guiding intervention prioritization and resource optimization. This study applied Pareto analysis on outpatient morbidity data from Goaso Government Hospital, Ghana, to identify common health conditions and improve drug procurement and health promotion strategies. The methodology also serves as a guide for applying Pareto chart analysis to enhance decision-making in healthcare delivery. Methods: A cross-sectional study was conducted analyzing outpatient department (OPD) data from January to December 2023. Data were extracted from the Ghana Health Service Monthly Outpatient Morbidity Reports via the District Health Information Management System 2 (DHIMS 2). Data analysis was conducted using SPSS version 20 to estimate the mean and standard deviation. Microsoft Excel 2016 was employed for Pareto analysis and the creation of column charts. Results: The analysis revealed that female patients had a higher average number of outpatient cases (M = 259, SD = 430.7) compared to male patients (M = 156, SD = 282.5). Key conditions contributing to 80% of the cases included Upper Respiratory Tract Infections (URTIs), Pneumonia, Malaria, Acute Urinary Tract Infections (UTIs), Diarrhoeal diseases, Typhoid Fever, Anaemia, Rheumatism/Arthritis, Skin Diseases, and Septicaemia. Notably, young adults (ages 20-34) and children (ages 1-4) were most affected. Conclusions: A strategic approach to drug procurement is essential due to high disease prevalence. Key actions include maintaining a three-month supply of ACTs for malaria, stocking essential antibiotics, and ensuring a two-month supply of ORS. Utilizing data-driven forecasting and establishing strong supplier partnerships are crucial for optimizing drug availability. Simultaneously, targeted health promotion efforts should focus on respiratory health, malaria prevention, UTIs, WASH practices, anaemia, rheumatism, and skin diseases through public education. Additionally, qualitative research, such as patient interviews and provider surveys, is recommended to understand high morbidity rates and evaluate existing interventions.
Abstract: Background: Effective health management in resource-limited settings requires strategic resource allocation and intervention planning. Pareto analysis, based on the 80/20 rule, aids in identifying key health conditions impacting outpatient morbidity, guiding intervention prioritization and resource optimization. This study applied Pareto analysis o...
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Research Article
Yearly Assessment of Weather and Air Quality Impact on Respiratory Disease Hospitalizations: Faial Island (Azores) Study
Issue:
Volume 12, Issue 6, December 2024
Pages:
165-178
Received:
28 September 2024
Accepted:
17 October 2024
Published:
18 November 2024
Abstract: Building upon our previous research conducted at weekly and monthly intervals, this study investigates the yearly dynamics of weather conditions and air quality on respiratory diseases, specifically tailored to Faial Island in the Azores. Expanding our analysis to a yearly basis allows for a more comprehensive understanding of long-term trends and seasonal variations in hospital admissions. Drawing upon extensive daily data spanning from 2008 to 2019, sourced from the Statistics Service of Hospital da Horta, the Meteorological Observatory Príncipe Alberto de Mónaco, and the Air Quality Monitoring Network of the Azores, we examined the differentiated relationships between yearly meteorological variables, such as temperature, dew point, and wind direction, and respiratory health outcomes. Additionally, we explored the persistent influence of air quality indicators, including suspended particulate matter with an aerodynamic diameter of 10 micrometers (µm) or less (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3), across different seasons and years. By incorporating yearly data into our analysis, this study aims to provide a comprehensive and nuanced understanding of the interplay between environmental factors and respiratory disease hospitalizations, thereby informing targeted interventions and public health strategies in insular regions. The principal component analysis (PCA) applied to the yearly data reveals interesting correlation patterns between meteorological variables and hospitalizations for respiratory diseases such as asthma, pneumonia, and rhinitis. Hospital admissions were found to increase during periods of lower temperatures and smaller temperature amplitudes, suggesting that prolonged cold conditions may exacerbate symptoms of these diseases. Additionally, atmospheric pollutant concentrations, such as suspended particles PM10, SO2, NO2, and O3, significantly varied across seasons, with a notable influence on the exacerbation of respiratory diseases. In insular regions like the Azores, these findings highlight the importance of targeted public health strategies to mitigate the impact of environmental factors on respiratory health.
Abstract: Building upon our previous research conducted at weekly and monthly intervals, this study investigates the yearly dynamics of weather conditions and air quality on respiratory diseases, specifically tailored to Faial Island in the Azores. Expanding our analysis to a yearly basis allows for a more comprehensive understanding of long-term trends and ...
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Research Article
The Effect of Post-Traumatic Stress Disorder on Reproductive Intention in Women of Childbearing Age: A Cross-Sectional Survey
Jiquan Zhang,
Fan Xu*,
Wei Qing,
Xiaoyan Li,
Birong Xiao,
Lin He
Issue:
Volume 12, Issue 6, December 2024
Pages:
179-185
Received:
8 October 2024
Accepted:
29 October 2024
Published:
20 November 2024
Abstract: Background: With the aggravation of China's aging population, China's population structure has undergone great changes, China's fertility rate and birth rate decline has always been a concern of the government, and mental health issues are an important part of creating a healthy birth atmosphere. Objective: To investigate whether the level of post-traumatic stress disorder (PTSD) affects the reproductive intention of women of reproductive age, and to analyze the influencing factors of reproductive intention of women. Methods: This study was a cross-sectional survey design, using convenience sampling method to survey women of childbearing age who were followed up in the postpartum outpatient clinic of a tertiary hospital from August 2023 to March 2024, and the survey instrument included a general information questionnaire, a questionnaire on the willingness to reproduce, and an impact of event scale- Revised, which was statistically analyzed using SPSS 27.0, and a binary logistic regression model was used to analyze the influencing factors of reproduction intention, and P<0.05 was taken as statistically different. Results: Reproduction intention of women of childbearing age accounted for 42.9%, and age, education, residence, and PTSD were independent influencing factors of reproduction intention of women of childbearing age. Conclusion: The research results show that age, education level, place of residence and PTSD are independent factors influencing women's willingness to have children again. The higher the level of PTSD, the lower the willingness to have children again. Therefore, attention should be paid to women's postpartum mental health problems, and more family and social support should be provided to improve their mental health status, so as to enhance the level of willingness to have children again.
Abstract: Background: With the aggravation of China's aging population, China's population structure has undergone great changes, China's fertility rate and birth rate decline has always been a concern of the government, and mental health issues are an important part of creating a healthy birth atmosphere. Objective: To investigate whether the level of post-...
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Research Article
Phenomena of Inertia Bias in Research, Practicalities of Possible Adjustment
Oleksandr Ocheredko*
Issue:
Volume 12, Issue 6, December 2024
Pages:
186-192
Received:
1 October 2024
Accepted:
12 November 2024
Published:
21 November 2024
Abstract: In academic research, bias refers to a type of systematic error that can distort measurements and/or affect investigations and their results. Biases can be present in both quantitative and qualitative research. The common effect of biases is undermining the power of statistical tests, therefore findings induced to support H0 hypothesis. Corrections depend on nature of bias and aimed to recover magnitude of association. Corrections use analytical constructs therefore applied in data analysis stage. Considered in the paper is of novel type and tentatively named inertia bias. This bias is of directed uncertainty about true value of index. One can find it in the range of designs and measures. The essence is the exposure takes time to shift index to new equilibrium. The problem is that researcher usually unaware of time required for index to settle down at new equilibrium. Therefore one inevitably measures the transition states instead of equilibrium yielding different magnitudes of attenuated association. How to obtain measure equilibrium value is the focus of the paper. Given the dynamical setup I referred to first order nonlinear differential equations, in particular logistic differential equation that meats necessary prerequisites: it should be separable equation, it has to have stable state, solutions have to descend or ascend toward equilibrium with the tangency in time. This paper describes range of circumstances where researcher faces the problem along with suggested solution, calculus, and tested software.
Abstract: In academic research, bias refers to a type of systematic error that can distort measurements and/or affect investigations and their results. Biases can be present in both quantitative and qualitative research. The common effect of biases is undermining the power of statistical tests, therefore findings induced to support H0 hypothesis. Corrections...
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Research Article
Gardnerella-associated Vaginosis Among Women of Child-Bearing Age Attending a Tertiary Hospital-Cameroon: Prevalence and Predicting Factors
Issue:
Volume 12, Issue 6, December 2024
Pages:
193-203
Received:
17 October 2024
Accepted:
11 November 2024
Published:
21 November 2024
Abstract: Background: Gardnerella vaginalis being one of the major causes of bacterial vaginosis poses serious health problems by causing damage to the vaginal epithelial cells and disrupt the protective barrier of the mucosa, thereby increasing susceptibility to sexually transmitted diseases, and complications during pregnancy. Objective: This descriptive cross-sectional study was aimed at determining the prevalence and predicting factors for the occurrence of Gardnerella-associated vaginosis among women of reproductive age attending a tertiary hospital in Cameroon. Methods: The study was performed on 200 women, randomly selected and of reproductive age, who attended the Buea Regional hospital from April to June 2024. A well-structured and pretested questionnaire was used to obtain demographic and clinical data from volunteers. Sterile swabs were used to collect vaginal samples which were inoculated on Colombia agar with 5% sheep infusion and incubated at 37°C for 24 hours. Gram staining, microscopy, biochemical testing and presence of Clue cells were used to identify Gardnerella vaginalis infection. Statistical analyses were performed using the SPSS version 22.0 and Odd Ratios to determine the relationship among variables at a significance level P<0.05. Results: Results showed that 124 cases were positive for Gardnerella vaginalis infection (62.0%). The mean age of participants was 25.15±0.731 years and patients between 16-25 years recorded the highest prevalence (39%) of Gardnerella vaginalis infection. Socioeconomically, unemployed participants showed the highest prevalence (65.3%), although the difference was not significant (P=0.49). Abnormal vaginal discharge was significantly (P=0.02) associated with the highest prevalence (75%) among other clinical parameters. This study revealed significant associations of the use of antiseptic soap while douching (OR: 4.92; 95% CI: 1.4–13.66; P=0.026), being sexually active (OR: 2.88; 95% CI: 1.1-10.06; P=0.04), as well as diabetes (OR: 3.13; 95% CI: 1.99–9.43; P=0.041) and regular intake of anti-inflammatory drugs (OR: 4.01; 955 CI: 1.2-13.01; P=0.038), which strongly predicted occurrence of Gardnerella vaginalis infection. Conclusion: Mindful of the above analyses, it is important that women of reproductive age must be promptly checked for bacterial vaginosis and determine predicting factors for its occurrence, which will help policy makers to put in place appropriate preventive and treatment measures to curb complications during pregnancy and transmission of STDs.
Abstract: Background: Gardnerella vaginalis being one of the major causes of bacterial vaginosis poses serious health problems by causing damage to the vaginal epithelial cells and disrupt the protective barrier of the mucosa, thereby increasing susceptibility to sexually transmitted diseases, and complications during pregnancy. Objective: This descriptive c...
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Research Article
Modification of Macronutrient Intake for Prevention of Gout in Japanese People in 2022: 2024 Update
Takashi Koguchi*
Issue:
Volume 12, Issue 6, December 2024
Pages:
204-229
Received:
20 October 2024
Accepted:
4 November 2024
Published:
26 November 2024
Abstract: In Japan, the prevalence of gout has increased markedly since the 1960s. Following on from the previous report, the aim of this article is to suggest what macronutrient intake is important for the prevention of gout in Japanese people in 2022 referencing the results of clinical research reported. As the previous report, the author used the data of the Comprehensive Survey of Living Conditions in Japan for the number of gout patients (1986-2022) and the data of the National Health and Nutrition Survey in Japan (1946-2022) for the intake of macronutrients. Macronutrient intake of Japanese people in 2022 were compared with those in 2019. The relationship between the number of gout patients and macronutrient intake in Japanese people was examined. The number of gout patients of Japanese people in 2022 was higher compared to that in 2019 (2019: 1.254 million; 2022: 1.306 million). Almost all gout patients were adults, and the number of gout patients were higher in men than in women. Compared to the Japanese diet in 2019, in the Japanese diet in 2022, the mean ratio of energy intake from protein in total energy intake (Protein/Energy) was the same and the mean ratio of energy intake from fat in total energy intake (Fat/Energy) increased by 0.5% and the mean ratio of energy intake from carbohydrate in total energy intake (Carbohydrate /Energy) decreased by 0.5%. The daily intake of dietary fiber of Japanese men (aged ≥ 15 years) in 2022 was below the Adequate Intakes (AIs) established by the Institute of Medicine of the National Academy of Sciences in the U.S. The Fat/Energy and Saturated fatty acids/Energy and the daily intake of saturated fatty acids, monounsaturated fatty acids, and n-6 polyunsaturated fatty acids were positively correlated with the number of gout patients, respectively. Whereas the Protein/Energy and the daily intake of energy, total carbohydrate, total protein, animal protein, and vegetable protein were negatively correlated with the number of gout patients, respectively. Modification of macronutrient intake for the prevention of gout in Japanese people (especially adults) in 2022 is suggested as follows: reduce the mean ratio of energy intake from saturated fatty acids in total energy intake (Saturated fatty acids/Energy); limiting or decreasing intake of fat, saturated fatty acids, cholesterol; increase intake of carbohydrate (particularly dietary fiber) and protein (particularly animal protein from low-fat dairy products and vegetable protein).
Abstract: In Japan, the prevalence of gout has increased markedly since the 1960s. Following on from the previous report, the aim of this article is to suggest what macronutrient intake is important for the prevention of gout in Japanese people in 2022 referencing the results of clinical research reported. As the previous report, the author used the data of ...
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Research Article
The Anterolateral Thigh Flap for Lower Leg & Foot Reconstruction in a Tertiary Hospital in Northern Bangladesh: Our Observation and Outcome
Issue:
Volume 12, Issue 6, December 2024
Pages:
230-236
Received:
25 October 2024
Accepted:
11 November 2024
Published:
29 November 2024
Abstract: Introduction: The Anterior Lateral thigh flap (ALT) free flap can be considered one of the reconstructive tools in lower leg and foot reconstruction. It has a long and reliable pedicle, and dissection is comparatively easy, which makes it extremely suitable as a free flap. This study aimed to evaluate the versatility of the flap in covering lower leg and foot defects. Methods: This was a prospective observational study conducted in the Department of Plastic Surgery, Rangpur Medical College Hospital, Rangpur, Bangladesh, from January 2023 to December 2023. In our study, we included 16 patients with defects in the lower leg and foot who received an ALT-free flap as a reconstructive treatment. We analyzed the preoperative, intraoperative, and postoperative variables of our respondents. Results: In this study, 16 patients (12 males and 4 females) with an average of 34.25 years old were included. Among them 13 were traumatic cases, 2 electrical burn wounds, and one oncologic case. Survival rates of the free flap were 87.5% (14) with two failure cases. There were no complications at the donor site. In this study, 75% (12) cases showed excellent outcomes where there were no signs, or symptoms of venous congestion or arterial insufficiency, no infection or dehiscence, and the donor site was primarily closed with good flap adhesion. Conclusion: This study shows that the ALT-free flap is a versatile flap that allows it to cover the defect successfully and ALT adaptation was satisfactory in terms of varied location and size.
Abstract: Introduction: The Anterior Lateral thigh flap (ALT) free flap can be considered one of the reconstructive tools in lower leg and foot reconstruction. It has a long and reliable pedicle, and dissection is comparatively easy, which makes it extremely suitable as a free flap. This study aimed to evaluate the versatility of the flap in covering lower l...
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Research Article
Delirium in Adult Critical Care Unit: Prevalence and Outcomes at Regional Hospital
Issue:
Volume 12, Issue 6, December 2024
Pages:
237-243
Received:
7 November 2024
Accepted:
21 November 2024
Published:
9 December 2024
Abstract: Background: Delirium is an acute confusional state that affects 30-80% of admitted patients to intensive care units. According to the literature, delirium may worsen patients’ and hospital outcomes. No research studies regarding delirium prevalence and outcomes were found in Oman. Objective: This study aims to determine the prevalence and outcomes of delirium in Adult patients admitted to the Intensive Care Unit (ICU) at a regional hospital. Methodology: This study followed an observational longitudinal design. A consecutive sampling method for six months was used for selecting Adult Intensive Care Unit (AICU) patients after 48 hours of ICU admission and a total of 76 patients aged 18 years and older were included. Confusion Assessment Method in Intensive Care Unit (CAM-ICU) instrument (CAM-ICU worksheet and Daily Assessment Checklist) was used for assessing patients’ prevalence and outcomes of delirium. A training program was provided for adult intensive care doctors and nurses regarding using the CAM-ICU tool one month before the study. Social Packages for the Social Sciences Program (SPSS) version 20 was used for data analysis. Results: More than half of the participants were male (63%), while the age group above 65 years (42%) had more positive cases. Results indicated a high prevalence of delirium in AICU (77%) of admitted patients. Outcomes of delirium in AICU indicated two outcomes, duration in AICU and ventilation days. Duration in ICU (M= 15.53, SD= 21.27) while ventilation days indicated a (M=13.30, SD=20.69). The result indicated a significant positive relationship between age, duration days in ICU, and ventilation days to delirium (p=0.001). Conclusion: The results from this study indicated a high prevalence of delirium in AICU and delirium is associated with longer duration in AICU and longer ventilation days. Identifying delirium prevalence and outcomes can enhance the early management of delirium and improve patients’ and hospital outcomes. In addition, results from this study can improve the knowledge and skills of healthcare providers in using the CAM-ICU assessment as a valid tool for assessing delirium in Intensive care unit (ICU) patients.
Abstract: Background: Delirium is an acute confusional state that affects 30-80% of admitted patients to intensive care units. According to the literature, delirium may worsen patients’ and hospital outcomes. No research studies regarding delirium prevalence and outcomes were found in Oman. Objective: This study aims to determine the prevalence and outcomes ...
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Research Article
A Research on How Obesity Tax is Implemented in Turkey and Some Countries
Gulnur Yildiz*
Issue:
Volume 12, Issue 6, December 2024
Pages:
244-250
Received:
24 August 2024
Accepted:
21 October 2024
Published:
16 December 2024
DOI:
10.11648/j.ajhr.20241206.19
Downloads:
Views:
Abstract: Obesity has been a serious problem for countries from past to present. The pandemic period we have experienced in recent years has also negatively affected this situation and it is known that the obesity rate has increased in many countries. Since obesity occurs as a result of the calories taken more than the calories taken, the inactivity of people due to the curfew during the pandemic period triggered obesity. Since obesity causes many chronic diseases, it also negatively affects society. The measurement of obesity is based on the body mass index (BMI) and is calculated by dividing the individual's weight by the square of their height when calculating the body mass index (BMI). According to the results, your body is underweight, overweight, obese, etc. It is learned which ketogor it is. As a result of the calculation, individuals in the obese class are also interested in other health problems in their bodies. For this reason, states have found a solution to this problem with taxes. This problem, which is taxed differently in each country, is generally not a new tax, but arises in addition to existing taxes or taxes. In all countries, the problem of obesity is tried to be prevented with different methods and this tax is included in the law with different names in each country. For example, the so-called fat tax is a tax on foods with high levels of fat. The Sugar Tax is an additional tax on foods and beverages that contain a high percentage of sugar. Obesity Tax, on the other hand, is applied to foods that are high in calories and cause obesity. The goal is to encourage individuals to consume healthy foods by discourageing foods that cause obesity through taxes on public revenues.
Abstract: Obesity has been a serious problem for countries from past to present. The pandemic period we have experienced in recent years has also negatively affected this situation and it is known that the obesity rate has increased in many countries. Since obesity occurs as a result of the calories taken more than the calories taken, the inactivity of peopl...
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Research Article
Mothers' Experiences with Postnatal Home Visits by Community Health Nurses in Selected Districts in Ashanti Region, Ghana
Yvonne Agyeman-Duah*,
Million Bimerew
Issue:
Volume 12, Issue 6, December 2024
Pages:
251-256
Received:
11 November 2024
Accepted:
26 November 2024
Published:
16 December 2024
DOI:
10.11648/j.ajhr.20241206.20
Downloads:
Views:
Abstract: Background: Efforts have been made to improve maternal and child health care globally, with a focus on promoting postnatal care for mothers and babies. Timely intervention during the postpartum period can potentially avert health issues from progressing into chronic conditions, which could have lasting consequences on women, infants, and their families. In spite of the known significance of postnatal visits for enhancing maternal and child health care, concerns still exist regarding maternal and infant health care in the Ashanti Region and Ghana as a whole. This study aimed to explore and describe mothers’ experiences of postnatal home visits received from community health nurses’ (CHNs) in selected districts of the Ashanti Region, Ghana. Method: Qualitative research method was used to collect data from the study participants. Semi-structured interviews were conducted using 15 postnatal mothers. Data were analysed using a thematic analysis approach. Results: One main theme and two categories emerged from the overall analysis of the data from the mothers. Theme emerged was: experiences of mothers during postnatal home visits. The two key categories included: 1. Encouraging experiences with postnatal home visits; highlighting emotional support, skilled nursing care, dedicated time and continuous support from some CHNs and 2. Barriers to effective postnatal home visitation; emphasizing challenges such as negative attitudes of some CHNs, resource constraints, cultural conflicts with evidence-based modern practices and inconsistent caregivers. Conclusion: Mothers appreciated the convenience of receiving baby assessments and immunizations at home, avoiding long queues and reducing transportation costs. Furthermore, trusting, respectful relationship between nurses and mothers significantly enhances communication, making mothers more receptive to guidance and health advice. Attentive listening, emotional support, and consistent care from community health nurses contribute to a positive bond, leading to greater comfort and confidence among mothers in discussing health concerns.
Abstract: Background: Efforts have been made to improve maternal and child health care globally, with a focus on promoting postnatal care for mothers and babies. Timely intervention during the postpartum period can potentially avert health issues from progressing into chronic conditions, which could have lasting consequences on women, infants, and their fami...
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