Access to voluntary counselling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counsellors to promote community-based voluntary counselling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. A cross-sectional questionnaire survey was conducted. Logistic regression was used to identify predictors of the tendency to stigmatize people living with HIV/AIDS (PLWHAs). Focus group discussions were held and analytical coding of the data performed. The majority (91.1%) of the 403 respondents indicated a desire to know their HIV status. Most (88.1%) respondents considered locations outside of the health facility as preferred places for VCT. The majority (98.7%) of respondents approved the use of lay counsellors. About a quarter (24%) of respondents believed that it was possible to acquire HIV through sharing a drinking cup with a PLWHA. About half (52.1%) of the respondents considered that a teacher with HIV/AIDS should not be allowed to teach, while 77.2% would not buy vegetables from a PLWHA. Respondents who believed that sharing a drinking cup with a PLWHA could transmit HIV infection (OR 2.50, 95%CI 1.52-4.11) and respondents without formal education (OR 2.94, 95%CI 1.38-6.27) were more likely to stigmatize PLWHAs. In contrast, respondents with knowledge of the availability of antiretroviral (ARV) drugs were less likely to do so (OR 0.40, 95%CI 0.22-0.73). Findings from the thirteen focus group discussions reinforced approval for community-based VCT and lay counsellors but revealed concerns about stigma and confidentiality. In conclusion, community-based VCT and the use of lay counsellors may be acceptable options for promoting access. Interventional studies are required to assess feasibility and cost-effectiveness.
Background:The risk factors of Noncommunicable diseases (NCDs) are not routinely monitored, especially among populace reporting to hospitals to detect and also advise on preventive measures, a key strategy to reducing the impact of NCDs on the Health Care System and population. Methods: A cross-sectional survey was carried out between the months of May and June, 2010 among a sample representative of the medical and surgical out-patients population to determine the prevalence of certain risk factors of non-communicable diseases (NCDs). Participants (n = 230) were selected by systematic random sampling. Standardised international protocols were used to measure the prevalence of smoking, alcohol consumption, physical inactivity, obesity, raised blood pressure, raised blood glucose and total cholesterol. Results: The obesity level of the study population was 40.4% with 54% being overweight. Tobacco use among the respondents was 4.8%. Alcohol consumption was 64.8%, with 54.3% of the study population being physically inactive. Almost 48%and 70.9% of the participants consumed fruits and vegetables respectively, at least three days in a week. The prevalence of hypertension was 33.6% for men and 35.2% for women. The prevalence of raised glucose and total blood cholesterol level among the study population was 6.5%. Almost 62% of the participants had a combination of three or more risk factors. Conclusion: The prevalence of the significant risk factors in this study were physical inactivity (54.3%), alcohol consumption (64.8%), overweight (54%), obesity (40.4%) and raised blood pressure (34.3%). Hospitals should therefore include NCD risk factor monitoring as part of routine services.
Methods A total of 96 households treating water at home, by boiling (n¼15), filtration (n¼6) or sodium hypochlorite solution (SafewatÒ n¼75) in urban slums of Haridwar and Dehradun districts of Uttarakhand were studied. Respondents were administered a pre tested semi-structured interview schedule for identification, measurement and valuation of all the resources involved in these three methods. The mean and 95% CIs of cost of treating ten litres of drinking water were estimated. Results The cost of using Safewat, water filter and boiling was estimated to be INR 1.44[1] (1.29e1.50) INR 1.79 (1.31e2.27) INR 5.82 (5.24e6.40) per ten litres of water treated respectively. The cost of boiling was high because of the cost of fuel (69%) despite a subsidy by the government on the gas. The use of filter required an initial capital investment for. purchase of filter (Approximately INR 500). Safewat solution accounted for 13% of the total cost of treatment by chlorination. Conclusion Assuming similar effectiveness rates, Safewat use appears a more affordable alternative, with little initial investment. This makes a case for promotion, by the physicians, of water chlorination in place of the more costly option of boiling, which has been advocated for long. Introduction In Bangladesh tribal race constitutes <1% and among them Santals is the oldest and largest ethnic group. Data on risk factors of CVDs in Bangladesh, specially from tribal, are virtually nonexistent. The present study was undertaken to explore the anthropometric and clinical risk factors among the Santal in Bangladesh. Methods A total of 316 Santal participants (135 male and 181 female, aged $20 years) were screened through camps from the northwestern part of Bangladesh. Sociodemographic, anthropometric and clinical data were collected and OGTT preformed following WHO guidelines. Results The age (M6SD) of the subjects was 39 (611) years, BMI 18.762.8; WHR 0.8560.17. Using BMI for Asian 61.3% found underweight of whom 35%, 12% and 14% were in chronic energy deficiency stage I, II and III respectively; for WHR females were in risk (70%) which not corresponding with male (within range 94%). Among males & females alcohol habits ($3 serves/day) had 93% and 64%; prevalence of hypertension were 15.6% and 7.2%; dyslipidemia 49% and 29% respectively. Males had high (77%) smoking habits. The prevalence of diabetes and prediabetes among the participants were 4.4% and 11.1%. Hypertension showed significant association with age, chol, LDL and dyslipidemea with BMI, 2HBG and SBP on logistic regression analysis (p<0.05). Conclusion A substantial number of Santals are still suffering from underweight. All kind of RR are less among Santal comparing with the existing increased pattern of CVDs risk in Bangladesh, focussed attention need to reduce smoking and alcohol consumption. Introduction Trachoma control guidelines for the WHO recommend the SAFE strategy which includes surgery for trichiasis, antibiotic treatment, facial cleanliness and environmental improvement. SP5-29 SP5-3...
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