Dr. Giou-Teng, Yiang
Tzu Chi University, Taiwan, R.O.C.

Short Biosketch

ISBN 978-81-976653-0-1 (Print)
ISBN 978-81-976653-1-8 (eBook)
DOI: https://doi.org/10.9734/bpi/dhrni/v1

This book covers key areas of disease and health research. The contributions by the authors include post covid vaccination parsonage-turner syndrome, COVID-19, neuralgic amyotrophy, sars-cov-2 vaccines, acquired peripheral neuropathy, neuropathic pain, sezary syndrome, mycosis fungoides, flowcytometry, skin lesions, EORTC staging, immunophenotypic pattern, lymphomas, acute myeloid leukaemia, malignant clonal disorder, cytogenetics, febrile illnesses, malaria fever, pregnancy, treatment seeking behavior, malaria vaccine, antibodies, infectious illness, serum creatinine, hypertension, adolescent, organ function, systolic and diastolic blood pressure, hematological indice, pediatric population; physical fitness, cardiorespiratory, muscular endurance, cardiovascular fitness, fitness gram test, skeletal health, acute pancreatitis, glasgow score index, BISAP scoring, mortality, virus hemorrhagic fevers, community-acquired pneumonia, acute zoonotic diseases, lymphocytic choriomeningitis virus, obesity, non-communicable diseases, body mass index, malnutrition, free maternal health care policy, national health insurance scheme, antenatal care, early neonatal mortality, antibiotic therapy, respiratory atopy, allergic diseases, T helper immune response, attention deficit hyperactive disorder, behavioral strategies, cognitive behavioral therapy, pharmacologic treatment, preventive methods against mosquito bite, awareness, vector-borne diseases, disease control program. This book contains various materials suitable for students, researchers and academicians in the field of disease and health.


Aims: The main purpose of this study is to investigate the prevalence of hypertension, associated risk factors, and its effect on physical activity in young people aged 14-19 years.

Study Design: This is a Cross-sectional study.

Place and Duration of Study: Sample: Department of Biochemistry, College of Science, Kwame Nkrumah University of Science and Technology between June 2009 and July 2023.

Methodology: A multistage sampling method was used to select 909 youth from three secondary schools (three towns in the Ashanti region of Ghana). The follow-up study was conducted on 142 people with high blood pressure. Anthropometric and blood pressure were measured with approved devices. Measurement of physical activity and dietary intake via survey. Blood pressure was measured using a validated automatic sphygmomanometer, with participants seated comfortably and resting for at least five minutes before measurement. Three readings were taken at one-minute intervals, and the average of the last two was recorded to reduce the impact of stress or short-term changes. Systolic and diastolic blood pressures were the main parameters recorded. Additionally, the study evaluated cardiovascular parameters (heart rate, echocardiography, ECG) and renal parameters (serum creatinine, GFR, urinalysis, BUN).

Results: Research shows that the prevalence of high blood pressure is 9.1% and the incidence of prehypertension is 24.8%. The prevalence of high blood pressure is significant by school choice. A majority of men have higher blood pressure than women, with 10.6% having high blood pressure, 46.6% having prehypertension, and 42.6% having high blood pressure. Data shows that 81.6% of participating parents are self-employed. The results show that there is little work, 72.73% of hypertensive patients are not working, while 40.32% and 59.97% of inactive and hypertensive patients are still sedentary. The results showed that MCV was negatively correlated with systolic blood pressure and diastolic blood pressure (r=-0.230, r=-0.183), while MCHC was negatively correlated with systolic blood pressure and diastolic blood pressure (r = 0.171). showed., r = 0.256). RDW-SD was found to be negatively associated with systolic and diastolic blood pressure. There was a negative correlation between P-LCR and systolic and diastolic blood pressure (r=-.185, r=-.167).

Conclusion: The research found that blood pressure distribution varied among students in different schools, with the highest levels in KASS (57% hypertensive) compared to KOSS (19%) and BONWIRE (7%) (X^2 = 32.993, df = 4, p < 0.001). Despite examining cultural and lifestyle factors, no significant determinants of hypertension were identified. Lipid analysis also showed no significant differences between blood pressure groups. These findings highlight the need for further research to explore other potential causes of high blood pressure and to develop effective prevention and management strategies.

Factors Associated with Febrile Treatment-seeking Behaviour among Expectant Mothers in Ssekanyonyi, Mityana District, Uganda

Nanjobe Uniah, David R. Mutekanga, Christopher Ddamulira, Stephen S. Kizza, Lawlence Sserwanga

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 11-25

Background: Febrile disease is very common among pregnant women in developing countries and sometimes not given relevant due diligence and perceived as a minor or common malaria situation. However, febrile disease most times is accompanied with some major disease condition which is life threatening to the pregnant women. This is a serious health problem that contributes greatly to morbidity and mortality in most developing economies including Uganda. In Mityana District of Uganda, 4 in 10 pregnancy deaths are malaria related and mothers who do not seek treatment in health facilities when they experience febrile illnesses. This is a major health challenge. Aim: The present study was undertaken to identify factors associated with treatment-seeking behavior among pregnant women suffering from febrile illnesses suspected to be malaria in Ssekanyonyi Sub-County in Mityana District, Uganda.

Methods: A cross-sectional study in which questionnaires were administered to 198 expectant mothers to generate data on their socio-demographics and treatment seeking behaviour. SPSS software version 20.0 was used for data analysis and a Logistic Regression model was fitted to identify factors that independently influenced their treatment-seeking behavior. Relevant REC authorization and standard operating procedures of the Uganda Ministry of Health were duly followed.

Results: Out of the198 expectant mothers enrolled in the study, 42.9% were aged 15-25 years, 73.7% had achieved Secondary education, and 46.5% were married. The treatment-seeking behavior was found to be standing at only 56.6%. Among the different factors studied, health education on malaria (AOR = 3.68, P = 0.000), the attitude of midwives (AOR = 1.45, P = 0.003), patient care (AOR = 0.33, P = 0.030), and attitude of the pregnant mother (AOR = 5.38, P = 0.000) were found to be statistically significantly associated with treatment-seeking behavior among pregnant mothers with febrile illnesses. The results show that the attitude of midwives is significantly associated with treatment-seeking behavior for febrile illnesses assumed to be malaria among pregnant mothers.

Conclusion: The study concluded that health education and awareness on malaria, attitude of midwives and pregnant mothers, and how the pregnant mothers are handled are the most important factors in positively affecting treatment seeking behavior among pregnant mothers with febrile illnesses.

Recommendations: Health education on malaria, midwives' attitudes, patient treatment, and pregnant mothers' attitudes must all be addressed in order to prevent febrile infections. The Ministry of Health and other responsible stakeholders must reinforce health education programs for women of reproductive age about the dangers of febrile illnesses during pregnancy. It is also critical to assist midwives in addressing issues related to their attitudes toward pregnant mothers.

Background: The physical fitness is an integrated measure of the body functions involved in the performance of daily physical activity and physical exercise. Childhood and adolescence are crucial periods of life, where physiological and psychological changes take place at these age. Both cardiorespiratory and muscular fitness in children are important for positive health behaviour.

The assessment of physical fitness using a specific tool has become an important part to find out the fitness level of children and adolescence. Fitness gram is a health-related fitness test that utilizes criterion-referenced standards on health-related components. Through the years research has shown that Fitness gram has become one of the most widely used programs in the United States, though its use in India is not popular.This study aims to evaluate the interrater reliability of the Fitness Gram test, a widely used tool for physical fitness assessment, among school children in the urban society of Guwahati, North-East India.

Methods: A sample of 70 school children aged 5-14 years was assessed using the Fitness gram test battery. Students were randomly allocated for physical fitness test where 62 students have completed the test.Two trained raters independently scored the tests. Statistical analysis was done by Cronbach’s Alpha value has been computed for the Interrater reliability.

Results: Sixty-two students with both gender (male 56.3% and female 43.7%, age -10.12±2.72) were assessed for physical fitness using Fitness gram test battery. All the test variables showed an excellent reliability (Cronbach’s alpha =0.91-0.95).

Conclusions: Fitness Gram test demonstrates high interrater reliability for assessing physical fitness in school children in Guwahati. These findings support its use as a reliable tool in school-based fitness assessments, potentially aiding in the development of targeted fitness programs.

Flow Cytometry Indicators in Mycosis Fungoides/Sezary Syndrome: Unveiling Silent Disease

C. C. Kariyawasan, B. L. T. Balasuriya, S. A. C. D. Ranatunga

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 37-48

Mycosis Fungoides (MF) is the most common type of cutaneous T-cell lymphoma, accounting for 50% of all cutaneous lymphomas. Sezary Syndrome (SS) and MF are closely related T-cell neoplasms that are considered separately based on clinical features and cell of origin. Despite their differences, both conditions can be challenging to diagnose, particularly in the absence of clinical symptoms. Flow cytometry plays a crucial role in the diagnosis of MF and SS, with a characteristic immunophenotypic expression that includes the lack of CD7 as a common feature in all stages of the disease. This diagnostic tool is invaluable in identifying the specific markers that differentiate these lymphomas from other T-cell disorders. In clinical practice, it is not uncommon to encounter patients who are asymptomatic yet exhibit a flow cytometric profile indicative of MF/SS. Such cases are rarely documented in the literature, highlighting the need for increased awareness and detailed analysis of these silent presentations. Persistent lymphocytosis, for example, can be an initial finding that warrants further investigation through flow cytometry. The immunophenotypic profile of MF/SS typically includes bright positivity for markers such as smCD3, CD4, CD2, TCR\(\alpha\)\(\beta\) , and CD5, with dim positivity for CD8. Conversely, markers such as CD7, TCR\(\gamma\)\(\delta\), CD25, and CD26 are usually negative. The CD4+/CD8+ ratio is often altered, reflecting the underlying pathophysiology of these lymphomas. Despite the absence of clinical symptoms, such as those required by the International Society of Cutaneous Lymphomas (ISCL) and the European Organization for Research and Treatment of Cancer (EORTC) for staging MF and SS, the presence of a typical immunophenotypic pattern on flow cytometry is significant. It underscores the importance of utilizing advanced diagnostic techniques to uncover and manage silent diseases effectively. By understanding the flow cytometry indicators and their implications in the context of MF/SS, clinicians can better identify and treat patients who might otherwise remain undiagnosed until the disease progresses to more advanced stages. This knowledge is critical for early intervention and improved patient outcomes in cutaneous T-cell lymphomas.

Aberrant CD Expression in Acute Myeloid Leukaemia- A Cohort Study in Sri Lanka

C. C. Kariyawasan, B. L. T. Balasuriya, S. A. C. D. Ranatunga

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 49-63

Background: Acute leukaemia is defined as the presence of over 20% of blasts cells in the blood or bone marrow. Acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) are the 2 main types. Acute myeloid leukaemia is a cancer of the myeloid lineage of blood cells and it is the commonest form of acute leukaemia in adults with a median age of 65 years. AMLs have characteristic morphological findings and molecular features with different surface and cytoplasmic cluster of differentiation (CD) markers. These CD markers are determined by immunophenotyping/flow cytometry on leukocytes which helps with accurate diagnosis and reproducibility of AMLs. Flow cytometry plays an important role in the diagnosis, sub classification and monitoring of patients with AML. AML generally shows aberrant CD expression or co- expression in relation to normal myeloid cells.

Objective of the Study: Objective of the Study was to evaluate the frequency and the pattern of aberrant CD expression in AML patients referred to a tertiary care hospital in Sri Lanka in comparison to other published data. There was no comparative data available in respect of Sri Lanka.

Materials and Methods: A retrospective descriptive study including 26 cases of AML diagnosed over a period of 12 months were analyzed. Diagnosis of AML was made by morphology of peripheral blood, bone marrow, trephine biopsies, Sudan Black B stain and the immunophenotypic analysis by multiparameter flow cytometry on bone marrow aspirates or peripheral blood. The markers used in flow cytometry were CD 45, CD34, CD19, CD7, smCD3, cyCD3, cyMPO, cyCD79a, CD20, CD15, CD10, CD5, HLADR, CD64, CD13, CD117, CD33, and CD14. The identification of blasts cells was performed using forward scatter (FSC) versus side scatter (SSC) parameters and CD45 intensity versus SSC dot plots.

Results: Diagnosed AMLs were morphologically classified according to the French-American-British (FAB) Classification (FAB Subtypes). Among the 26 AML patients, 15 cases (57.69%) had the conventional CD antigen expressions of myeloid lineage. Other 11 cases (42.3%) were AML with aberrant expression of CD markers. Aberrancies of cyCD3 and CD7 were observed in 54.5% and 45.4% AML cases, respectively. smCD3 in 1 case out of 11 aberrant AML cases. Co expression of T lymphoid markers with myeloid markers occurred in 23% cases in our study. CD13 was not expressed in 1 case out of 5 AML- M4 cases and 1 case out of 7 AML- M1. CD33 was not expressed in 1 case out of 2 AML -M0 cases.

Conclusion: We conclude that aberrant expression of CD markers is seen in a significant population of AMLs. cyCD 3, CD7 and smCD 3 were the aberrant markers present in our study population with cyCD3 showing highest frequency.

Prevalence of Malaria among 1-15-Year Children and the Awareness and Acceptability of Malaria Vaccine in Nsukka Local Government Area, Enugu State, Nigeria

Elijah Sunday Okwuonu, Emmanuel Uzoma Anyaoha, Chinaza Blessing Ukwueze, Nenrot Sandra Gopep, Uchenna Athanasius Ubaka, Emmanuella Chigozirim Agbedo, Chiamaka Lovelyn Nwankwo, Patra Chisom Ezeamii, Ogochukwu Ruth Abasilim, Blessing Chinenye Amoke, Ikem Chris Okoye

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 64-83

Background: Malaria is still a serious threat to health, especially for children living in endemic areas. Effective control of malaria requires understanding the local epidemiology and community attitudes towards vaccination and other preventive measures.

Aim: This study was conducted to determine the prevalence of Plasmodium infection in children between 1 and 15 years and to evaluate the knowledge and acceptability of the malaria vaccine.

Study Design: Cross-sectional.

Materials and Methods: Prevalence of malaria parasite in 250 children from 1-15 years attending Akulue Memorial Hospital, Nsukka, Enugu State, Nigeria was detected using microscopy. Simultaneously, detailed questionnaires were sent to parents/guardians to assess their knowledge and perspectives regarding malaria vaccination.

Results: Of the 250 children examined, 92.4% tested positive for the Plasmodium parasite. The malaria prevalence was high (>85%) in the three age groups, (1-5), (6-10), and (11-15) years although they were not significantly different (p>0.05). It was not also significantly different between male and female children. This study showed that most parents/guardians were found in favor of introducing a malaria vaccine. The findings highlighted the significance of focused measures to strengthen malaria prevention tactics, such as intensive community education and advocacy efforts to raise vaccination rates.

Conclusion: The results showed that the target children had a high prevalence of malaria infection. Reducing the illness burden among children and attaining sustainable malaria control requires addressing misconceptions and promoting favorable attitudes towards malaria vaccination.

COVID-19 Vaccine-induced Parsonage-turner Syndrome: A Case Study

Mohammad Asim Amjad, Zamara Hamid, Yamini Patel, Mujtaba Husain, Ammad Saddique, Adnan Liaqat, Pius Ochieng

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 84-97

The risk of neurological adverse effects is present in all contemporary vaccines. Parsonage-Turner syndrome (PTS), an uncommon peripheral nerve condition associated with coronavirus disease 2019 (COVID-19) immunization, has been reported in only a few cases. A concise literature review and the case of a 78-year-old male with no recent trauma or infection presented with chest pain and bilateral hand weakness following COVID-19 vaccination. 21 days following the initial dose, the patient received a second dose of the BNT162b2 COVID-19 vaccine three weeks before the onset of symptoms. The physical examination revealed significant weakness in the right-hand grasp and wrist flexion. The diagnostic workup revealed no underlying diabetes mellitus, infections, or other autoimmune diseases. The bilateral first dorsal interosseous and right deltoid, biceps, and triceps muscles exhibited decreased motor unit recruitment in nerve conduction investigations, including needle electromyography, confirming PTS. Occupational therapy and oral prednisone were administered to preserve the patient's range of motion. The pathophysiology and etiology of PTS are not entirely comprehended. Various factors, including genetic, environmental, and immunological predisposition, may contribute to the development of the syndrome. Infections, vaccines, and injuries are the most common causes of non-hereditary forms. No test can definitively corroborate or disprove the existence of PTS. Imaging modalities and electrodiagnostic studies are instrumental in eliminating alternative differential diagnoses.

Predicting Prognosis of Acute Pancreatitis Patient in a Tertiary Centre with Help of BISAP Scoring

Kanwar Singh Goel, Nikhil Goel, Sapna Singla

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 98-109

Introduction: Acute pancreatitis is an acute inflammation of the prior normal pancreas. Gallstones are its leading cause, followed by alcohol; other etiological factors are hyperlipidemia, hereditary, hypercalcemia and post ERCP, etc. Its pathogenesis involves the activation of intrapancreatic digestive enzymes and the injury of acinar cells. Many scoring systems are available to assess the severity of acute pancreatitis, e.g., Ranson’s criteria, Glasgow score index, APACHE II and CTSI, but they have important limitations. BISAP score is a valuable tool in predicting severe Acute Pancreatitis in the early hours. BISAP score appears cheap, quick, and simple and hence, we conducted this study.

Material and Methods: This prospective observational study was carried out in 83 patients at SGT Medical College, Gurugram, India from September 2018 to March 2021. Patients with an established diagnosis of acute pancreatitis as per the revised Atlanta classification and definition by the International Census 2012 were included in the study. BISAP scores were calculated from laboratory values and radiological findings.

Results: In our patients with BISAP scores of 0, 1 and 2, there was no organ failure or mortality. At a score of 3, there was 1 (07.1%) organ failure and 1 (07.1%) mortality. At a score of 4, 4 (80.0%) patients had organ failure and 1(20.0%) patient died. We observed that the higher the BISAP score, the higher the percentage of severity, necrosis, organ failure, mortality and hospital stay. Our study revealed that with the cutoff value set at 3, the BISAP score has 39.6% sensitivity, 92.8% specificity, 60.3% PPV and 84.7% NPV.

Conclusion: Our study recommends that at the time of admission, if the BISAP score is low, our worry is less, if the BISAP score is high, we should counsel the patient and attendants about possible severity, necrosis, organ failure and mortality in acute pancreatitis. Patients should be meticulously managed. The present study concludes the increased accuracy of the BISAP score for risk stratification.

Aim: The present study aimed to find out the extent of the problem of obesity and to assess the subjects’ awareness of risk factors and complications of obesity.

Introduction: The World Health Organisation has described obesity as one of the most neglected public health issues. Initially, obesity was only a problem in high-income countries; however, at present, it is rising in middle and low-income countries as well, rapidly in India. Globally, non-communicable diseases are increasingly recognized as a major cause of morbidity and mortality. The countries of the Southeast Asia region are facing a double burden, with a heavy load of infectious diseases and an increasing burden due to non-communicable diseases. The growing prevalence of non-communicable diseases, especially in emerging nations like India, poses a challenge to the already overburdened healthcare system. Non-communicable diseases include a variety of illnesses, with obesity being a more frequent cause.

Materials and Methods: The present cross-sectional study was carried out in November 2012. The study was conducted among all 1st and 2nd year female MBBS students of Katuri Medical College, Guntur (Andhra Pradesh). Height and weight were measured using the standard procedures suggested by Jelliffe. Body Mass Index was computed using the formula [weight in (kg) / height (m2)].

Results: Using the BMI cut-off points, the findings revealed that 23.30 % of study subjects were overweight and 12.50 % of study subjects were obese. When the girls were asked about factors contributing to obesity, an overwhelming majority (85.80%) of the subjects attributed diet to obesity. As far as psychosocial problems are concerned, nearly 59.66 of the subjects mentioned low self-esteem as a complication related to obesity. Obesity is known to increase the risk of various diseases and awareness of them is the first step towards taking steps to prevent this. While a high level of awareness is present among medical students regarding major complications of obesity but for other complications, they should also get health education.

Conclusion: The higher prevalence of overweight and obesity in this young age range necessitates immediate attention to prevention and control. Obesity has been linked to an increased risk of a variety of ailments, and becoming aware of this is the first step toward taking preventative measures. While medical students exhibit a high level of awareness regarding major complications of obesity, they should also receive health education regarding other complications. This study is significant for the scientific community due to its focus on perceptions of obesity among female medical students in South India. It provides crucial insights into the prevalence of overweight and obesity, as well as awareness of associated risks among future healthcare professionals.

A Review of Epidemiology of Viral Hemorrhagic Fever

Yash Srivastav, Mohd. Faijan Mansoori, Vipin Kumar Pandey

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 117-130

The pathophysiology, aetiology, diagnosis, treatment, symptoms, and indicators of virus hemorrhagic fevers (VHFs) are all covered in this review article. Acute zoonotic diseases known as viral hemorrhagic fevers (VHFs) initially appear to be related to platelet malfunction or destruction. The term "Viral Hemorrhagic Fever" (VHF) describes a severe feverish sickness characterized by aberrant vascular control, vascular damage, and hemorrhagic symptoms. Multiple viruses belonging to distinct families are the cause of this illness. The viruses that cause VHF are categorized into seven distinct families according to the International Committee on Taxonomy of Viruses' most recent classification: Hantaviridae, Nairoviridae, Filoviridae, Phenuiviridae, Paramyxoviridae, Arenavidae, and Flaviviridae are the families involved. The concept of virus hemorrhagic fevers (VHFs) originated in the 1930s when Soviet researchers were studying hantaviral hemorrhagic fever (HF) with renal dysfunction. Dengue fever/Dengue haemorrhagic fever and Kyasanur forest sickness are the two most common viral hemorrhagic fevers (VHF) in India, that are transmitted by arthropod vectors. There is currently no effective cure for VHFs. Some people have responded well to ribavirin treatment for Lassa fever or HFRS. The diagnosis of community-acquired pneumonia (CCHF) in India is greatly hampered by the co-occurring symptoms of hemorrhagic fevers such as dengue, Kyasanur forest sickness, Hantavirus hemorrhagic fever, and other illnesses such as leptospirosis, meningococcal infections, and malaria. The pathophysiologic features of VHF include microvascular instability, increased vascular permeability, and poor hemostasis, albeit the underlying processes differ depending on the virus. Additional randomized controlled studies are needed to find out more about the best way to treat viral hemorrhagic fevers (VHFs). We want to investigate viral hemorrhagic fevers (VHFs) further.

Antibiotics are one of the most frequently prescribed medications and their rational use has become an essential topic in clinical care. In this context, we have witnessed a dramatic increase in the prevalence of respiratory allergies during the last decades. The infections' role in the prevalence of respiratory allergic diseases is attributed to the antagonism between: a) induction of T helper (Th) 1 immune response by human organisms; and b) manipulation of the human immune response toward Th2 profile by common infective agents to increase their surviving opportunity. This work proposes that extensive antibiotic exposure during neonatal and early childhood plays an important role in the increasing epidemiological trend. It is believed that antibiotic exposure during early childhood has also provided better survival opportunities for atopic individuals with an inadequate immune defense against common infections, deviating, therefore, from the genetic background of the general population toward the Th2 profile. Considering this, we suggest that Th2 profile frequency (and consequently atopic phenotype prevalence) can be increased along an individual lifespan after extensive antibiotics introduction until the entire population is exposed to them during childhood. This hypothesis may explain findings on epidemiological surveys, which report a prevalence increase among adults in industrialized countries between the 1970s and 2000s; in recently-developed countries, this trend began only at the end of the 1980s. These arguments support the conclusion that infections will manipulate human immunity over generations. In contrast, actual antibiotics can increase the prevalence of respiratory allergies among a population only along with individual longevity. These findings may help develop future management strategies to treat respiratory allergic or infective pathologies. The knowledge of the mentioned interactions may help us develop better etiological theories about respiratory allergic diseases that can replace the actual theory or incorporate it as an additional possible scenario.   

Aim: The present community-based study was conducted to assess the knowledge, awareness and practices of mosquito bite prevention methods amongst households in an urban slum area of South India.

Introduction: For the effective control of the diseases transmitted by mosquitoes, efforts have been consistently made to educate the community on the danger of mosquito bites. When it comes to communicable diseases, mosquito-borne illnesses rank highly among India's public health issues. The three most serious ones are dengue fever, chikungunya fever, and malaria. The general community's education about preventing mosquito bites is one of the key elements of the vector-borne disease control program.

Materials and Methods: The present community-based study was conducted in the Guntur district of Andhra Pradesh. All households of Urban Health Training Center, Shrinavasrao Thota which is the urban catchment area of the Department of Community Medicine, Katuri Medical College, Guntur were selected for the study.

Results: 91.50% of the study participants had knowledge about breeding places of mosquitoes. 22.29% of the study population still had myths that garbage was the breeding place for mosquitoes. Only 33.72% of the study population knew that dengue, chikungunya was transmitted by mosquitoes. It was observed that Television was the main source of awareness for the community followed by newspapers, radio, friends and advertisements. It was disappointing to note that doctor or health staff was not mentioned as the source of knowledge which are coming in contact with people in day-to-day life.

Conclusion: The study found that knowledge about the causes of malaria and mosquito breeding places was satisfactory in study subjects, but some myths were still prevalent. People should be made aware that mosquito bite causes other diseases also. Insecticide-treated bed-net is a good weapon to fight against mosquito-borne disease and Strong social or commercial marketing of these products can definitely increase the acceptance.

Background: In July 2008, Ghana introduced a ‘free’ maternal health care policy (FMHCP) through the National Health Insurance Scheme (NHIS) to provide comprehensive antenatal, delivery and post-natal care services to mothers and their newborns. Although the ‘free’ policy was originally targeting equity in access to maternal health care, critics observed that the ‘free’ policy made no plan of responsiveness and quality of care for the unborn and the newborn.

Methods: In a series of analyses, we evaluated the FMHCP impact on maternal healthcare utilization since the policy inception and then estimated the percentage point differences of stillbirth and early neonatal mortality among mothers who benefitted from the policy versus their counterparts who did not.

The study used two rounds of historical data from the Ghana Demographic and Health Survey (GDHS, 2008–2014) and constructed the exposure variable of the FMHCP using mothers’ national health insurance status as a proxy variable and another group of mothers who did not subscribe to the ‘free’ policy. We then generated the propensity scores of the two groups, ex-post, and matched them to determine the impact of the ‘free’ policy as an intervention on antenatal care uptake and facility-level delivery utilization, using probit and logit models. Our analysis further constructed binary outcomes of stillbirth and perinatal mortality from the under-five mortality data of Ghana’s DHS data sets. We applied sample weighting across all analyses to account for clustering and stratification due to the complex design nature of DHS design. All regression analysis accounted for confounding variables using maternal individual characteristics deemed statistically significant, alpha value set at p < 0.005.

Results: We found antenatal care uptake and facility level delivery increased markedly by 8 and 13 percentage points differences and these were statistically significant; observed coef., 0.08; CI: 95% [0.06–0.10]; p < 0.001 and 0.13; CI: 95% [0.11–0.15], p < 0.001, respectively. Pregnant women were 1.97 times more likely to make 4+ antenatal visits [WHO recommended minimum number of visits at the time] aOR = 1.97; CI: 95% [1.61–2.4]; p < 0.001 and 1.28 times more likely to make 8+ antenatal care visits (WHO current recommended minimum number of visits); aOR: 1.28; CI: 95% [1.10-1.49]; p < 0.001. The study also found that pregnant women were 1.87 times more likely to give birth in a healthcare facility of any level in Ghana between 2008 and 2014; aOR = 1.87; CI: 95% [1.57–2.23]; p < 0.001. Yet, stillbirth and early neonatal mortality were high showing 12 and 13 percentage points differences in the treatment group, compared to the no-treatment group and the differences were statistically significant; p = 0.005, respectively.

Conclusions: In equity terms, the ‘free’ maternal health policy has made significant strides towards maternal healthcare utilization. However, this does not translate to the desired impact of the decrease in stillbirth and early neonatal mortality in its current form in Ghana.

Effective Behavioral Strategies for Managing ADHD in Children: A Comprehensive Review

Veena Shivanna, Yogeesh Mallenahalli Chikkanna

Disease and Health Research - New Insights Vol. 1, 10 July 2024, Page 179-192

Attention deficit hyperactive disorder is the most common psychiatric disorder seen in children in which the child expresses inattentiveness and hyperactivity as the core behaviour characteristics. It affects about 4-12% of all school-age children and is also among the most prevalent chronic psychological condition affecting school-aged children. Managing a child diagnosed with ADHD is quite challenging regardless of the situation presented. Behavioural techniques for managing a child with ADHD are not intuitive for most parents and teachers. It is futile and damaging to try to force a child with ADHD to be like most children. It is possible, however, to limit destructive behaviour and to instil in the child a sense of self-worth that will help overcome negativity. This review article encompasses various techniques for managing a child with ADHD under different practical scenarios and guides parents, teachers and also clinicians to accommodate and modify the behaviour of the child, which includes nondrug therapies, dietary changes, cognitive behavioral therapy, the importance of zinc and other behavioural approaches to manage and modify the child with ADHD.