Background Hepatitis B infection is a major health concern in Myanmar. Hepatitis B birth dose vaccination to prevent mother-to-child transmission is not universal, especially in births outside of health care facilities. Little is documented about delivery of immunization programs in rural Myanmar or in conflict-affected regions. To address this gap, this study describes the implementation of a novel community delivered neonatal hepatitis B immunization program in rural Karenni State, Myanmar. Methods A mixed-methods study assessed the effectiveness and feasibility of hepatitis B birth dose immunization program. 1000 pregnant women were screened for hepatitis B virus (HBV) infection using point of care testing. Neonates of HBV positive mothers were immunized with a three dose HBV vaccine schedule at birth, 1, and 6 months of age. HBV testing was completed for children at 9 months to assess for infection. Descriptive statistics were collected including demographic data of mothers, neonatal vaccination schedule completion, and child HBV positivity at 9 months. Qualitative data examining barriers to implementation were collected through semi-structured interviews, participant-observation, and analysis of program documents. Themes were codified and mapped onto the Consolidated Framework for Implementation Research. Results 46 pregnant women tested HBV positive leading to 40 live births. 39 women-child dyads were followed until the 9-month age mark. With the exception of two neonates who received their birth dose past 24 hours, all children received their vaccines on time. None of the 39 children tested positive for HBV at nine months. Themes regarding barriers included adaptability of the program to the rural setting, friction with other stakeholders and not meeting all needs of the community. Identified strengths included good communication and leadership within the implementing ethnic health organization. Conclusion A community delivered neonatal HBV vaccination program by ethnic health organizations is feasible and effective in rural Myanmar.
PurposeThis study aimed to assess the sleep quality and its associated factors among patients with type 2 diabetes mellitus (T2DM) in a private hospital in Yangon, Myanmar.Design/methodology/approachA cross-sectional study was conducted. A total of 289 T2DM patients were interviewed using a structured questionnaire. An English version of the Pittsburgh Sleep Quality Index (PSQI) was translated into Myanmar and used for assessing sleep quality.FindingsApproximately 48.4% of T2DM patients had poor sleep quality (PSQI score > 5). The mean ± SD of the PSQI global score was 5.97 ± 3.45. About 36.0% of participants reported the presence of diabetes complications, and 14.9% used sleep medication. About 27.7% had depression and 8.3% had poor family relationships. Multiple logistic regression analysis revealed that the presence of complications (AOR = 1.86; 95%CI; 1.04–3.35), poor family relationships (AOR = 5.09; 95%CI; 1.55–16.68) and depression (AOR = 7.52; 95%CI; 3.83–14.76) were significantly associated with poor sleep quality.Originality/valueThe prevalence of poor sleep quality is rather high among T2DM patients. Healthcare personnel and hospital administrators should focus on the complication status, family relationships and depression status of T2DM patients by providing regular screening for sleep quality and depression and by providing a program of sleep health education and counselling at diabetic clinics
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