mHealth for Pneumonia Prevention

Introduction

Pneumonia contributes to 14% of under-five mortality in Pakistan. Delayed care seeking is one of the causes of death due to this disease. One of the most impactful strategies can be timely healthcare-seeking through CHW's. We, therefore propose to develop an intervention package for educating caregivers on pneumonia by Lady Health Workers (LHWs).

Methodology

This first phase of the feasibility study comprised of a systematic review (SR) on best mobile health-based approaches for CHWs on the management of childhood illness followed by formative research (FR). In the systematic review, 6 databases were searched, and 22 articles were included. Based on findings of SR and FR along with guidelines of WHO and UNICEF, a mobile application-based intervention package will be developed in the second phase. Recruited LHWs will use the mobile application in their monthly visits for 6 months. Text and voice messages will be sent to each caregiver. Pre and Post-intervention surveys will be conducted with the recruited caregivers to assess the impact of the intervention and FGDs with the recruited LHWs to get feedback on the intervention.

Findings

Findings of the systematic review suggest that the most common approaches of mobile health for community health workers is the use of a customized application for disease management and data collection. Findings of formative research suggest that the majority of the caregivers were not aware of the danger signs of pneumonia. Respondents agreed to the importance of an educational intervention package on pneumonia and its prevention by LHWs through mHealth.

Acknowledgment

This research was commissioned by the National Institute of Health Research using Official Development Assistance (ODA) funding. The views expressed in this publication are those of author(s) and not necessarily those of NHS, the National Institute of Health Research, or the development of Health.

Key messages

mHealth intervention employing community health workers can be a useful mode of improving healthcare services. Use of technology to raise awareness and delivered health-related information at community level can prove tremendously helpful for illness management.

Distribution and risk factors associated with intestinal parasite infections among children with gastrointestinal disorders

AIM

Prevalence and risk factors associated with intestinal parasites among children ≤ 12 years old in Nahavand county western Iran, was the objective of this search.

BACKGROUND

Intestinal parasites (IPs) are important health problems among most societies.

METHODS

This cross sectional study was carried out during 6 months from April to September 2014 in Nahavand County western Iran. Fecal samples were collected from 500 children suffering from gastrointestinal disorders (GIDs) and examined by macroscopy and microscopic (using saline and iodine wet mount, formalin-ether sedimentation, Trichrome and modified Ziehl Neelsen staining) methods. Finally, data was analyzed using Chi-square (Chi2) test and Fisher's exact test as well as logistic regression.

RESULTS

21.8% (109/500) of the samples were infected by one or more IPs. The most common parasites were Blastocystis sp. (16.2%), followed by Cryptosporidium spp. (2.6%), Giardia lamblia (1.6%), and Entamoeba coli (1.6%). Prevalence of intestinal parasite infections were significantly associated with age (OR= 2.280; CI 95% = 1.375-3.830; P<0.002), gender (OR= 0551; CI 95% = 0.348-0.875; P<0.011), contact with domestic animal or soil (OR= 0.492; CI 95% = 0.282-0.860; P<0.013) and seasons (OR= 2.012; CI 95% = 1.254-3.227; P<0.004). There was a significant correlation between IPs with diarrhea (OR= 3.027; CI 95% = 1.712-5.345; P<0.001) and nausea or vomiting (OR= 3.261; CI 95% = 1.281-8.175; P<0.013).

CONCLUSION

Blastocystis sp. was the most prevalent parasites among children in Nahavand County and Helminthes infection have been dramatically decreased. Our finding shown that gender, age, season and contact with domestic animals or soil polluted are main predictive factors for intestinal parasite infections among children in this region. Moreover, IPs infection among children with gastrointestinal disorders were significantly associated with diarrhea and vomiting or nausea signs.

PREVALENCE, RISK FACTORS AND SYMPTOMS ASSOCIATED TO INTESTINAL PARASITE INFECTIONS AMONG PATIENTS WITH GASTROINTESTINAL DISORDERS IN NAHAVAND, WESTERN IRAN

We studied the prevalence of intestinal parasites (IPs), their risk factors and associated symptoms among patients with gastrointestinal disorders. A total of 1,301 participants aged 22 days-90 years were enrolled in this study. We used a structured questionnaire to obtain socio-demographic and stool examination to investigate intestinal parasite infections. Data analysis was performed using SPSS16. The overall prevalence of intestinal parasites (IPs) was 32.2% (419/1,301). Three hundred and fifty nine cases/1,301 (27.6%) were infected with a single parasite and 60/1,301 cases (4.6%) presented polyparasitism. The most common IP was Blastocystis sp. 350/1,301 (26.9%), followed by Entamoeba coli 38/1,301 (2.92%), Giardia lamblia 30/1,301 (2.3%) and Cryptosporidium spp. 17/1,301 (1.3%). Regarding the socio-demographic variables, educational status (p = 0.001), contact with domestic animals and soil (p = 0.02), age above 15 years (p = 0.001) and seasons (p = 0.001) were significantly associated to intestinal parasitic infections. Concerning clinical characteristics, the presence of IPs was significantly associated to diarrhea (OR = 1.57; CI 95% = 1.24-1.98; p < 0.001) and dysentery (OR = 1.94; CI 95% = 1.03-3.66; p < 0.04). Our findings suggest that IPs are one of the main causal agents of gastrointestinal disorders. Improving the knowledge on local risk factors such as poverty, low level of education, poor sanitation, contact with soil and contact with domestic animal is warranted.

Particle Stability in Dilute Fermented Dairy Drinks: Formation of Fluid Gel and Impact on Rheological Properties

Fluid gels are known to be very shear-thinning materials with yield stress. In this study, the rheological properties of gellan and gellan—pectin fluid gels in fermented dairy drinks were evaluated using viscometric measurements. Both gellan- and gellan—pectin-containing solutions showed the rheological properties of fluid gels resulting in stabilization of particles; but no evidence of a fluid gel was observed for those with pectin alone and those with no hydrocolloid content. Unlike pectin, gellan gum was capable of creating significant values of yield stress and accordingly stabilized colloidal particles and extrinsic added solid particles in the fermented dairy drink. However, pectin improved the stability in combination with gellan. The origin of fluid gel formation was assumed to be both permanent interactions occurring between gellan and proteins, forming hairy particle gels and transient interactions between the particle gels. The significance of yield stress values for particle stability was demonstrated and two methods, including a noteworthy infinite apparent viscosity method and a conventional Bingham approach, were employed to calculate the values of yield stress. Both the methods showed a good application potential due to their simplicity, reasonable results and also wide availability of the instrument applied.