Objectives: School-based interventions in developing countries typically expect schoolchildren to serve as health messengers to their families as well as to the broader community. This study computationally simulates the dynamics of pervading or disappearing health information in the minds of community members after school-based interventions. Methods: A multi-agent-based model was developed as an artificial community in the laboratory. The ripple effect of the school-based intervention was then simulated and monitored for 100 days under various conditions. Results: If the probability that health information transmits among family members is greater than 0.05, the school-based intervention influences 60% to 70% of community members; by contrast, if the probability is less than 0.01, the impact disappears from the community. However, repeated interventions at 10-day intervals can shift the trend from disappearing to pervading in this latter case. Conclusion: In a community that has lower transmission probabilities, repeated interventions at shorter intervals are necessary to keep health information in the minds of community members.
Background Dementia is defined as a decline in cognition or behavior in one or more of the following areas: memory, social-interpersonal behaviors etc. It is regarded differently depending on the society of each country. To compare the effect that it has on Japanese society, we started research in Nepal. Methods We asked Medical doctors and nurses in remote areas and the capital city in Nepal about their awareness of dementia. We also examined the elderly in communities and hospitals, using the Mini-Mental State Examination (MMSE) and Hasegawa Dementia Scale Revised (HDS-R), and asked family members about the elderly’s daily life and checked Clinical Dementia Rating (CDR). Results Three out of six medical staff members in remote areas did not know the word “dementia.” However, most medical staff had seen cases of suspected dementia. The averages and deviations of MMSE and HDS-R in 6 elderly in community were 16±4.2 and 17±5.0, respectively. The average of CDR was 0.9. Conclusions There was a lack of awareness about dementia in remote areas. Nepali society was found to be tolerant of aging and dementia.
Objectives More than half of those living in developing countries do not have piped water in their homes. Although handwashing is effective for the elimination of microbes from the surface of the palms, thereby preventing the transmission of infectious diseases, the effect of using poor-quality water for handwashing is unclear. This study measured the water quality and the bacteria count on the hands of preschool children in Kathmandu, Nepal. Methods Sixty-two children were asked to follow their normal handwashing technique, and the counts of 3 microbial bacteria—viable bacteria, Escherichia coli, and total coliforms—were measured in the water source and on the children’s palms. Microbial samples from the children’s palms were collected before and after handwashing. The Wilcoxon signed-rank test was used to compare the number of bacteria on the palms before and after handwashing. Results The children washed their hands with a low volume of stored water without soap. Viable bacteria, E. coli, and total coliforms were detected in the water source. The number of viable bacteria and total coliforms on the palms increased after handwashing. In contrast, the numbers of E. coli colonies did not change after handwashing. Conclusion Handwashing with poor quality of water did not have effect on removal of bacteria from hands. In areas with limited water sources, intervention for handwashing requires strategies for not only promoting hygiene behaviors also water storage management.
A Japanese international health dictionary has been freely accessible to the public through the official website of Japan Association for International Health (JAIH). Since it is accessible only in an online environment, it can not be used in an offline environment, a common condition for field workers in developing countries. Converting the dictionary to an offline format would be the solution. Therefore, a program which reformats the up-to-date online dictionary in the official website of JAIH to popular “Electronic Book” format was developed. The resultant program will automatically execute batch processing without any manual operation.
Introduction Sales of prescription-only drugs are not well regulated in developing countries. Self-medication with antibiotics is a major concern in global public health from the perspective of increased drug resistance. In addition to common self-medication with prescription-only drugs, distribution of dangerous counterfeit drugs is a social problem in Indonesia. This study aims to examine the factors relevant to self-medication with antibiotics by clarifying customers’ behavior requesting antibiotics at pharmacies and pharmacists’ response in the capital region of Indonesia. Method Two hundreds customers who requested antibiotics were exit-interviewed at 6 community pharmacies in the Ciputat district of South Tangeran City. Structured questionnaire was used on general attribute including health insurance coverage and having/not-having prescription and instructions by pharmacists, etc. Eight informants of pharmacists and an owner from a pharmacy were interviewed by using semi-structured questionnaire. They were questioned on number of customers requesting antibiotics with/without prescriptions, pharmacists’ responses and experience of health damages. The investigation was conducted between late May and early July of 2012. Results Of the customers requesting antibiotics, 48.5% (97/200) had no prescriptions. Neither consultation with doctor nor self-medication is statistically associated with health insurance coverage. Among customers without prescriptions, 51.9% (54/104) purchased antibiotics by showing drug samples they did not take. This was significantly more frequent than those following advice by family/friends or pharmacists. Pharmacists are cautious of dispensing antibiotics without prescriptions. They assess patients, being mindful of allergy and drug resistance. Pharmacists recognize the importance of patient education and intervention in the community. Conclusion The results of exit-interview suggested that economic reason is not a dominant factor to promote self-medication. From the observations among self-medicated customers who are on over-confidence, purchase antibiotics using drug samples they left over, and having preference of advice by family/friends to advice by pharmacist, self-medication is considered based on heuristic selection as well as risk-management within their limited scope of options. The efficacy of antibiotics is manifested in a short duration so that it gives efficient feedback as well as successful experience to patients. The successful experience is considered to strengthen patients’ behavior of self-medication. Pharmacists are expected to challenge their new role to develop patient education to alter patient behaviors.