Introduction Of the 55,000 deaths per year due to rabies, 56% occur in Asia and 44% in Africa. Despite the existence of the national rabies control program in Sri Lanka, rabies is still prevalent, suggesting that animal bite victims may have failed to observe the proper first aid measures and seek immediate medical treatment. The purpose of this study is to describe the health-seeking behavior among animal bite victims of a selected population in Kandy District, Sri Lanka. The influences of subjects’ demographic characteristics to these behaviors were studied. Methods We conducted face-to-face interviews in May 2006 among households with family members having history of animal bite injuries. Data on health-seeking behaviors such as first aid measure application, immediate medical consultation, and completion of post-exposure prophylaxis (PEP) were obtained. The association between behaviors and demographic characteristics were evaluated using Chi-square test or the Fisher’s exact test. Results Of the 6968 sample population, 357 (5.1%) had history of animal bites one year prior to the survey. Most of the subjects performed first aid measures (n=297, 83.2%) and sought medical treatment (n=319, 89.4%) within 24 hours (n=295, 82.6%) of the injury. Only 9.8% (n=35) of the subjects completed the PEP. There was no association between health-seeking behavior and demographic characteristics. Two subjects died having symptoms that resembled rabies without completing the necessary PEP, and two animal specimens were sent for laboratory testing that confirmed one case of feline rabies one year prior to the study. Conclusion In general, the health-seeking behaviors of the subjects were not influenced by their demographic characteristics which may contribute to greater difficulties in controlling rabies. To strengthen the rabies control program, effective education of both the public and health sectors by thorough and adequate wound washing, and strict adherence with the recommended treatment schedule is of paramount importance.
Objectives Many ethnic groups live in northern hilly area in Lao people’s Democratic Republic. We can find some delays of development by the geographical and cultural reasons. This research clarified what kind of awareness about children’s health among the minority people living with their specific lifestyles and circumstances. Methods The participatory research for health problems was conducted to Khamu people at C-village in northern Laos. Data were analyzed qualitatively. Mothers who have children aged less than 10 years, were interviewed about illness of children and its treatment. The author interviewed about health problems with some key persons who were important position in the village. Results At C-village, they produced sticky rice which was their staple food. They depended on other food from forests. Mothers are aware that their children were always healthy when children were vigorous. Mothers brought their children to the hospital in spite of its long way when children got illness. Children had some experiences of malaria, diarrhea and other illnesses. Villagers stored up the knowledge of illness by themselves with their experience that children getting serious by specific illness. The key persons were also aware of health problems, for example malaria or parasite diseases. Conclusion At C-village, in recent years they didn’t suffer serious starving. Houses were comfortable because of its well-ventilated against hotness but structure of their houses can’t prevent children’s health by the aggression of mosquito, and smoke from kitchen. Their lives were exposed to some harmful influence; by malaria and pastured animals. About children’s health, mothers were aware of some specific illness and brought children to hospital. Mothers thought that their children had not any problems of health when they were vigorous and active. Many children had suffered some illness and villagers stored up the knowledge of illness by themselves with their experience that children got serious situation by specific illness. The key-persons and villagers expected infrastructural developments such as the high-way which was under construction at that time.
This cross-sectional study examined cigarette smoking knowledge, attitudes, and practices among medical students in a southwestern region of China. The subjects included 557 and 223 first and fourth year Chinese medical students, respectively. Comparison data were collected from 74 Japanese and 90 Vietnamese fourth year medical students. The smoking rate among the fourth year medical students in China (7.0%) was significantly higher than among the first year medical students (2.8%), and higher than among the medical students from Vietnam, but lower than the medical students from Japan. The fourth year Chinese students had a more permissive attitude toward cigarette smoking by physicians compared with the first year students, and the lowest knowledge base on cigarette smoking-related diseases among the students from all three countries. Based on a multivariate analysis, the factors associated with cigarette smoking were male gender, having friends who smoked, and exhibiting a permissive attitude toward smoking. Implementations aimed at improving tobacco education and addressing the gender differences and peer influences related to cigarette smoking are needed to improve Chinese medical students’ knowledge and attitudes about cigarette smoking, and to prevent students from starting to smoke cigarettes.
Objective Provider initiated testing and counseling (PITC) for HIV testing, which is not a mandatory HIV testing policy, to pregnant women was being introducing in many countries. The aim of this study was to assess impact and issues raised by the PITC approach for prevention of mother-to-child transmission (PMTCT) of HIV services at an antenatal clinic (ANC) in the capital of Cambodia. Method Impact of the PITC approach on the acceptance of PMTCT services was determined by comparing quantitative data indicating the uptakes of PMTCT services during the first one year of PITC with the prior one year. Results The acceptance rate of HIV testing dramatically increased from 35.9% (3,033/8,459) to 95.3% (7,780/8,162) (p<0.001), however the acceptance rate of post-test counseling after tested declined from 92.1% (2,793/3,033) to 73.9% (5,753/7,780) (p<0.001). The return rates of pregnant women tested with partners and without partners to post-test counseling were, respectively, 85.5% (1,913/2,237) and 69.7% (3,840/5,507) in PITC approach (p<0.001) although this difference was not significant in VCT approach. Conclusions Although it can be agreed that the PITC approach was an effective strategy to increase the uptake of HIV testing, the remarkable declines of the post-test counseling acceptance lead concern about unexpected needs of counselors and the possibility of negative response to the HIV testing by their partners since the women tested without partners in PITC approach are less likely to return to post-test counseling compared to VCT approach. Further investigation on the reasons why some tested women didn’t receive post-test counseling is needed to find out strategies to keep or increase the acceptance of post-test counseling safely in the PITC approach. It was suggested that we still need to take into account the roles of counseling and partners’ involvement in careful consideration of women’s personal safety even in the implementation of PITC approach.
Objective Many developing countries will be faced with a rapid aging of population in the near future. This article intends to clarify the actual situation of the public support for the social participation of the elderly in Mexico, whose aim is to extend their self-support life as long as possible. Methods The subjects of our investigation were the Culture Centers for the Third Age that National Institute of the Elderly Persons (INAPAM) operates in Mexico City. Concerning the service provision, we interviewed the staff, joined in and observed the activities for the elderly, collected and analyzed the materials published by INAPAM. Concerning the service use, we obtained information by means of questionnaires from the users. We asked them about the motives for joining in the activities of the Culture Centers, the acquisition from the participation, their daily life, and their goals during the third age, among other things. Results and Discussions Each Culture Center had a lot of courses in various areas for the functionally independent elderly. The aims of the courses were to maintain or enhance their physical function, give them occupational therapy, stimulate their intellectual curiosity, and adapt their spiritual structure to aging. The variety of the courses attracted the interest of a lot of people and contributed to giving them an incentive to be active. It was judged that generally the users were very satisfied with not only each specialized course but also each instructor who had received gerontological training. Convenient location, low-priced course fees, weekday opening throughout the year, celebration of various events, etc. made the Culture Centers supportive communities for the elderly in their daily life. The active and continuous participation in the activities that the elderly feel interested in contributes considerably to maintaining and promoting their physical and mental health. The service provided at the Culture Centers was based on this view. The users understood it, put it into practice, and had very positive attitudes toward aging. Conclusion The precedent studies confirm the effectiveness of the support for the social participation of the elderly. A problem to be solved in Mexico is how to expand the service of quality of the Culture Centers so that more elderly people all over the country can access it. It will be necessary to intensify more the coordination and collaboration among INAPAM (central government), local governments, non-government organizations and individual volunteers.