SummaryIn 2001, WHO developed a pole for the administration of praziquantel without the use of weighing scales with encouraging results in African populations. In the present study, the pole was tested on height/weight data from 9,354 individuals from 11 non-African countries. In more than 98% of the individuals (C.I. 97.8-98-4) the pole estimated an acceptable dosage (30-60 mg/kg) -a performance not statistically different from the one observed in African populations. Reproducing the present pole in the form of a strip of paper and including it in each container of praziquantel would greatly facilitate the administration of the drug in large-scale interventions. Keywords Praziquantel administration; WHO dose poleThe regular treatment of vulnerable groups with praziquantel is WHO's principal strategy for schistosomiasis control (WHO 2003). The drug administration is simple, but, as the individual dose of praziquantel is given according to body weight, reliable weighing scales are necessary in the field, which can be problematic and expensive. Hall et al (1999) therefore suggested the use of a pole, which estimates the number of tablets needed for treatment according to an individual's height. Three poles based on data from Ghana, Malawi and Tanzania were developed and tested in each country (n=1,803, n=2,069 and n= 2,078 respectively) with positive results (Hall et al. 1999 The present study was conducted to investigate the validity of the WHO dose pole to indicate dosage of praziquantel in non-African populations. Our analysis was conducted on height-weight data previously randomly collected from 11 countries. The total number of records was 9,356, of which 7,453 were children aged between 6 and 15 years (school age).Seven data sets originated from schistosomiasis-endemic countries (including all major nonAfrican endemic countries). Four data sets, from non-endemic countries were, also included in the analysis to further confirm the worldwide validity of the WHO dose pole. Sixteen records (0.17%) were excluded from the analysis as suspected data entry errors since the weight was more than 3 standard deviations from the expected value for height.Two height intervals: between 94 cm and 110 cm (corresponding to 1 tablet) and over 178 cm (5 tablets) were added to the WHO pole (Figure 1). These new thresholds were calculated using the same equation used to define the original thresholds between 110 and 178 cm [y = 0.005x 2 -0.7909x + 44.647] .Each person's height was classified using the pole's intervals and the number of tablets and the total dose (in mg) indicated by the pole was recorded. The individual dosage was then calculated by dividing the total dose by the weight of each individual registered in the data set (in mg/kg).A dosage between 40 -60 mg/kg was considered optimal (WHO 2004) and a dosage between 30-60 mg/kg was considered acceptable for the significant activities demonstrated by praziquantel at this dosage (Taylor et al 1988).The average dose provided by the WHO pole was 44.74 mg/Kg (range 42.06 mg/...
It is generally believed that hepatitis B (HBV) and C (HCV) viruses are highly prevalent in the Republic of Yemen. This study investigated the prevalence of HBV and HCV markers in 494 blood donors from Aden, 493 blood donors from Sana'a, 97 residents from an African ethnic minority in Sana'a and 99 residents of Soqotra Island. There were significant differences in the prevalence of HBV carriage (HBsAg: 6·7, 15, 19·6 and 26·3% respectively; P<0·001); past HBV infection (anti-HBc: 17·4, 18·5, 30·9 and 59·6% respectively; P<0·001); susceptibility to HBV (absence of HBV markers: 73·3, 61·9, 38·1 and 9·1% respectively; P<0·001), infectivity of HBV carriers (HBV DNA: 51·5, 33·8, 52·6 and 65·4% respectively; P=0·028) and HCV antibodies (RIBA confirmed or indeterminate: 0·6, 0·2, 5·2 and 5·1% respectively; P<0·001). A significant difference in HBV carrier rate and a borderline significant difference in the prevalence of natural infection was observed between males and females in the African community (P=0·02 and 0·06 respectively). In contrast, in Soqotra Island, there was no significant sex difference in HBV carrier rate but susceptibility was significantly more prevalent in males (P=0·03). This study illustrates that significant difference in prevalence and epidemiology exists among different communities within the same country, reflecting political, geographical and social differences. Control strategies should take these differences into account.
The number of assessments on HIV knowledge and stigmatization among adolescents in Yemen is still very limited. This cross-sectional study aimed to have a better understanding on the level of knowledge on HIV transmission and prevention. Also, this study explored the level of stigma and discrimination among students toward people living with HIV (PLWH). The study sample consisted of 2,274 male and female students (mean age 16.6 years) randomly selected from 27 high schools in Aden, Yemen. The results revealed low levels of knowledge on major prevention measures, such as condoms, where only 49.4% knew that condoms could protect from HIV infection; and high levels of misconceptions on the modes of transmission. In addition, the study revealed a high level of stigma and discrimination toward people living with HIV. The results would serve as a baseline for implementing a school-based educational program on HIV/AIDS.
Aim: To estimate the prevalence of overweight and obesity among schoolchildren in Sana’a City (Yemen) and to examine the association with lifestyle and some socioeconomic factors. Methods: A cross-sectional study was done in public and private schools in Sana’a City during 2002–2003. We selected 1,253 students by the multistage random sampling technique. Weights and heights were measured to calculate body mass index (BMI = weight/height2). Data about age, sex, education level of the parents, food consumption and lifestyle was also collected. Results: The mean age of the children was 12.6 ± 2 years. Overweight was 6.2% and obesity was 1.8%. The prevalence of overweight and obesity was higher among private schoolchildren (p<000), females (p = 0.002), children with a sedentary lifestyle (p = 0.001) and children with a family history of obesity (p = 0.013). Also there is a positive association of overweight/obesity with the education level of the parents (p = 0.013 for the father and p = 0.19 for the mother) and consumption of unhealthy foods. Conclusion: Prevalence of overweight and obesity is low and positively associated with the education level of the father, private schooling, sedentary lifestyle, and with students who took unhealthy meals.
This study determined the costs associated with tuberculosis (TB) diagnosis and treatment for the public health services and patients in Sana'a, Yemen. Data were collected prospectively from 320 pulmonary and extrapulmonary TB patients (160 each) who were followed until completion of treatment. Direct medical and nonmedical costs and indirect costs were calculated. The proportionate cost to the patients for pulmonary TB and extrapulmonary TB was 76.1% and 89.4% respectively of the total for treatment. The mean cost to patients for pulmonary and extrapulmonary TB treatment was US$ 108.4 and US$ 328.0 respectively. The mean cost per patient to the health services for pulmonary and extrapulmonary TB treatment was US$ 34.0 and US$ 38.8 respectively. For pulmonary and extrapulmonary TB, drug treatment represented 59.3% and 77.9% respectively of the total cost to the health services. The greatest proportionate cost to patients for pulmonary TB treatment was time away from work (67.5% of the total cost), and for extrapulmonary TB was laboratory and X-ray costs (55.5%) followed by transportation (28.6%). Coûts associés au diagnostic et au traitement de la tuberculose pour les patients et les services de santé publics au Yémen RÉSUMÉ La présente étude a déterminé les coûts associés au diagnostic et au traitement de la tuberculose pour les services de santé publics et pour les patients à Sanaa (Yémen). Les données ont été recueillies de façon prospective auprès de 320 patients atteints de tuberculose pulmonaire et extrapulmonaire (160 pour chaque forme), suivis jusqu'à la fin de leur traitement. Les coûts médicaux et non médicaux directs et les coûts indirects ont été calculés. La part du coût supportée par les patients était de 76,1 % du coût total du traitement dans le cas de la tuberculose pulmonaire, et de 89,4 % dans le cas de la tuberculose extrapulmonaire. Le coût moyen du traitement de la tuberculose pulmonaire et extrapulmonaire pour les patients était respectivement de 108,4 USD et 328,0 USD, ce qui équivalait à un coût moyen par patient de 34,0 USD et 38,8 USD, respectivement. Pour les services de santé, le traitement médicamenteux de la tuberculose pulmonaire et extrapulmonaire représentait 59,3 % et 77,9 % respectivement du coût total. Pour les patients atteints de tuberculose pulmonaire, l'absence du travail représentait le coût le plus important du traitement (67,5 % du coût total) ; pour les patients atteints de tuberculose extrapulmonaire, les dépenses liées aux analyses de laboratoire et auxradiographies (55,5 %) étaient les coûts proportionnellement les plus importants, suivies par les frais de transport (28,6 %).
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