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Article ; Online: Knowledge, Attitude and Practices of rabies during an outbreak in Samtse Municipality, Bhutan

Karma Lhendup / Kinley Wangdi

Journal of Family Medicine and Primary Care, Vol 11, Iss 9, Pp 5361-

A cross-sectional study

2022 Volume 5368

Abstract: Background: A rabies outbreak in dogs occurred on February 22, 2021, in the Samtse Municipality, Bhutan. A rapid response team (RRT) was activated comprising of human and animal health teams to investigate and contain this outbreak. An assessment of the ... ...

Abstract	Background: A rabies outbreak in dogs occurred on February 22, 2021, in the Samtse Municipality, Bhutan. A rapid response team (RRT) was activated comprising of human and animal health teams to investigate and contain this outbreak. An assessment of the knowledge, attitude, and practice (KAP) on rabies was elicited during this period to develop evidence-based education material. Methods: A face-to-face KAP questionnaire was administered to a volunteer member of 55 households in two communities (Norbuling and Xing Workshop areas) following the rabies outbreak in the Samtse Municipality from March 15 to 22, 2021. Descriptive statistics were used to describe the demographic characteristics. The associations between the KAP scores were assessed using the Pearson correlation coefficient. Results: Of the 55 respondents, 63.6% (35) had poor knowledge, 90.9% (50) and 63.6% (35) reported good attitude and practice toward rabies. Three (5.5%) participants had not heard about rabies. The other misconceptions were that rabies can be prevented with antibiotics (67.3%, 37), dressing the bite wounds (20.0%, 11), and seeking treatment from the local healer (5.5%, 3). Correct knowledge was reported on excessive salivation as the sign of the rabid animal (58.2% 32), rabies prevention through vaccination (81.8%, 45), and seeking medical care on the same day (94.5%, 52). Eighty-nine percent (49) vaccinated their dogs and domestic animals annually, 100% received post-exposure prophylaxis (PEP) after an animal bite, 78.2% (43) washed the animal bite wounds with soap and water, and 9.1% (5) would consult the local healer for animal bites. A majority (78.2%, 43) of them agreed that rabies is a serious public health problem in the Samtse Municipality and 49.1% (27) agreed that the public was adequately informed about rabies. A positive correlation was observed between the knowledge-practice scores (r = 0.3983, P value = 0.0026), and attitude-practice scores (r = 0.4684, P value < 0.001). Conclusion: The poor knowledge of rabies in ...
Keywords	attitude ; bhutan ; knowledge ; outbreak ; practice ; rabies ; samtse ; Medicine ; R
Subject code	306
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Systematic Review and Meta-Analysis of the Proportion Estimates of Disseminated Intravascular Coagulation (DIC) in Malaria

Thitinat Duangchan / Manas Kotepui / Suriyan Sukati / Yanisa Rattanapan / Kinley Wangdi

Tropical Medicine and Infectious Disease, Vol 8, Iss 289, p

2023 Volume 289

Abstract: Disseminated intravascular coagulation (DIC) is a potentially life-threatening condition that causes systemic coagulation to be turned on and coagulation factors to be used up. However, the evidence for DIC in malaria patients is still not clear, and ... ...

Abstract	Disseminated intravascular coagulation (DIC) is a potentially life-threatening condition that causes systemic coagulation to be turned on and coagulation factors to be used up. However, the evidence for DIC in malaria patients is still not clear, and small case series and retrospective studies have shown varying results. This meta-analysis was intended for the evaluation of the evidence of DIC among malaria patients using a meta-analysis approach. The protocol for the systematic review was registered at PROSPERO as CRD42023392194. Studies that investigated DIC in patients with malaria were searched in Ovid, Scopus, Embase, PubMed, and MEDLINE. The pooled proportion with 95% confidence intervals (CI) of DIC among malaria patients was estimated using a random-effects model. A total of 1837 articles were identified, and 38 articles were included in the meta-analysis. The overall proportion of DIC in malaria was 11.6% (95% CI: 8.9%–14.3%, I 2 : 93.2%, 38 studies). DIC in severe falciparum malaria and fatal malaria was 14.6% (95% CI: 5.0–24.3%, I 2 : 95.5%, 11 studies) and 82.2% (95% CI: 56.2–100%, I 2 : 87.3, 4 studies). The estimates of DIC among severe malaria patients who had multi-organ dysfunction with bleeding, cerebral malaria, acute renal failure, and ≥2 complications were 79.6% (95% CI: 67.1–88.2%, one study), 11.9% (95% CI: 7.9–17.6%, one study), 16.7% (95% CI: 10.2–23.3%, ten studies), and 4.8% (95% CI: 1.9–7.7%, nine studies), respectively. The proportion estimates of DIC among the patients with malaria depended on the Plasmodium species, clinical severity, and types of severe complications. The information from this study provided useful information to guide the management of malaria patients. Future studies are needed to investigate the association between Plasmodium infection and DIC and to understand the mechanism of malaria-induced DIC.
Keywords	malaria ; DIC ; disseminated intravascular coagulation ; Plasmodium ; systematic review ; meta-analysis ; Medicine ; R
Subject code	616
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Aetiologies and Risk Factors of Prolonged Fever Admission in Samtse Hospital, Bhutan, 2020

Tsheten Tsheten / Karma Lhendup / Thinley Dorji / Kinley Wangdi

International Journal of Environmental Research and Public Health, Vol 19, Iss 7859, p

2022 Volume 7859

Abstract: Febrile illness is a common cause of hospital admission in developing countries, including Bhutan. Prolonged fever admission can add considerable strain on healthcare service delivery. Therefore, identifying the underlying cause of prolonged hospital ... ...

Abstract	Febrile illness is a common cause of hospital admission in developing countries, including Bhutan. Prolonged fever admission can add considerable strain on healthcare service delivery. Therefore, identifying the underlying cause of prolonged hospital stays can improve the quality of patient care by providing appropriate empirical treatment. Thus, the study’s aims were to evaluate the aetiologies and factors of prolonged fever admission in Samtse Hospital, Bhutan. Fever admission data from 1 January to 31 December 2020 were retrieved from the Samtse Hospital database. Prolonged hospital stay was defined as those with >5 days of hospital admission. Univariable and multivariable logistic regression was used to identify risk factors for a prolonged hospital stay. Of 290 records, 135 (46.6%) were children (≤12 years), 167 (57.6%) were males, and 237 (81.7%) patients were from rural areas. The common aetiologies for fever admissions were respiratory tract infection (85, 29.3%) and acute undifferentiated febrile illness (48, 16.6%). The prolonged stay was reported in 87 (30.0%) patients. Patients from rural areas (adjusted odds ratio [AOR] = 4.02, 95% CI = 1.58–10.24) and those with respiratory tract infections (AOR = 5.30, 95% CI = 1.11–25.39) and urinary tract infections and kidney disease (AOR = 8.16, 95% CI = 1.33–49.96) had higher odds of prolonged hospital stay. This epidemiological knowledge on prolonged hospital stay can be used by the physician for the management of fever admission in Samtse Hospital.
Keywords	developing countries ; prolonged fever admission ; infections ; health services ; epidemiology ; aetiologies ; Medicine ; R
Subject code	360
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Risk Factors of Symptomatic COVID-19 in Samtse District, Bhutan

Karma Lhendup / Tsheten Tsheten / Tshewang Rinzin / Kinley Wangdi

Frontiers in Public Health, Vol

2022 Volume 10

Abstract: IntroductionAll Coronavirus disease 2019 (COVID-19) positive cases in Samtse District, Bhutan were isolated in the isolation facilities managed by the government hospitals. This study aimed to identify the socio-demographic risk factors for developing ... ...

Abstract	IntroductionAll Coronavirus disease 2019 (COVID-19) positive cases in Samtse District, Bhutan were isolated in the isolation facilities managed by the government hospitals. This study aimed to identify the socio-demographic risk factors for developing COVID-19 symptoms amongst these patients.Methods and MaterialsA secondary data of the COVID-19 positive cases from isolation facilities of Samtse District from 5 May to 7 September 2021 was used for this study. Survival analysis was carried out to estimate the cumulative probability of symptom onset time by each risk factor. Kaplan–Meier curves were used to estimate the probabilities for the onset of symptoms at different time points and a log-rank test was employed to assess the differences between covariates.ResultsA total of 449 patients were included, of which 55.2% were males and 73.3% (328) were aged >18 years. The mean age was 42 years with a range of 3 months to 83 years. Forty-seven percent (213) reported at least one symptom. Common symptoms were fever (32.3%, 145), headache (31.6%, 142), and cough (30.1%, 135), respectively. Males were 64% less likely to be symptomatic than females [adjusted hazard ratio (aHR) = 0.36, 95% confidence interval (CI) 0.183–0.917]. Farmers (aHR = 3.17, 95% CI 1.119–8.953), and drivers and loaders (aHR = 3.18, 95% CI 1.029–9.834) were 3 times more likely to be symptomatic compared to housewives. Residents of Samtse sub-districts were 5 times more likely to be symptomatic than those living in other sub-districts (aHR = 5.16, 95% CI 2.362–11.254).ConclusionThe risk of developing COVID-19 symptoms was being fe male, farmers, drivers and loaders, and residents of the Samtse sub-district. These high-risk groups should be provided additional care when in isolation facilities.
Keywords	COVID-19 ; Bhutan ; symptomatic ; risk factors ; survival analysis ; Samtse District ; Public aspects of medicine ; RA1-1270
Subject code	150
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Spatial Analysis of HIV Infection and Associated Risk Factors in Botswana

Malebogo Solomon / Luis Furuya-Kanamori / Kinley Wangdi

International Journal of Environmental Research and Public Health, Vol 18, Iss 3424, p

2021 Volume 3424

Abstract: Botswana has the third highest human immunodeficiency virus (HIV) prevalence globally, and the severity of the epidemic within the country varies considerably between the districts. This study aimed to identify clusters of HIV and associated factors ... ...

Abstract	Botswana has the third highest human immunodeficiency virus (HIV) prevalence globally, and the severity of the epidemic within the country varies considerably between the districts. This study aimed to identify clusters of HIV and associated factors among adults in Botswana. Data from the Botswana Acquired Immunodeficiency Syndrome (AIDS) Impact Survey IV (BIAS IV), a nationally representative household-based survey, were used for this study. Multivariable logistic regression and Kulldorf’s scan statistics were used to identify the risk factors and HIV clusters. Socio-demographic characteristics were compared within and outside the clusters. HIV prevalence among the study participants was 25.1% (95% CI 23.3–26.4). HIV infection was significantly higher among the female gender, those older than 24 years and those reporting the use of condoms, while tertiary education had a protective effect. Two significant HIV clusters were identified, one located between Selibe-Phikwe and Francistown and another in the Central Mahalapye district. Clusters had higher levels of unemployment, less people with tertiary education and more people residing in rural areas compared to regions outside the clusters. Our study identified high-risk populations and regions with a high burden of HIV infection in Botswana. This calls for focused innovative and cost-effective HIV interventions on these vulnerable populations and regions to curb the HIV epidemic in Botswana.
Keywords	Botswana ; HIV ; spatial analysis ; clusters ; risk factors ; Medicine ; R
Subject code	310
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The trend of tuberculosis case notification and predictors of unsuccessful treatment outcomes in Samdrup Jongkhar district, Bhutan

Kinley Penjor / Kuenzang / Tshokey Tshokey / Kinley Wangdi

Heliyon, Vol 7, Iss 3, Pp e06573- (2021)

A fourteen-year retrospective study

2021

Abstract: Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan.A fourteen- ...

Abstract	Tuberculosis (TB) continues to be an important public health issue in Bhutan. This study aims to describe the trend of tuberculosis and investigate factors associated with a unsuccessful treatment outcome in Samdrup Jongkhar District in Bhutan.A fourteen-year (2004–2017) case records in two TB centres of Dewathang and Samdrup Jongkhar Hospitals were reviewed and analyzed to examine trends in case notification and treatment outcomes. Univariable and multivariable logistic regression analysis was undertaken to identify covariates of unsuccessful TB treatment.Of the total of 820 TB cases registered in surveillance record, 729 cases were analysed. Males made up 53.8% (397) of total cases and the median age was 29 years (range: 2–87 years). A gradual downward trend in TB case notification was noticed in the district with overall case notification rate of 139/100,000 during the study period. The annual treatment success rate was over 90% except for years 2013–2015 with overall treatment success rate for the study period at 93%. A re-treatment TB patient, sputum-positive at the second month of treatment and being of Indian nationality were significant correlates of unsuccessful treatment outcomes. The overall TB inclidence has declined and TB treatment success rate was above WHO recommended 90% in Samdrup Jongkhar District during the study period. A special attention should be paid to the poor treatment outcome predictors including re-treatment cases and failed sputum conversion at the second month of treatment.
Keywords	Bhutan ; Tuberculosis ; Infection ; Risk factors ; Modelling ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	616
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cross-border malaria drivers and risk factors on the Brazil–Venezuela border between 2016 and 2018

Kinley Wangdi / Erica Wetzler / Paola Marchesini / Leopoldo Villegas / Sara Canavati

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 13

Abstract: Abstract Globally, cross-border importation of malaria has become a challenge to malaria elimination. The border areas between Brazil and Venezuela have experienced high numbers of imported cases due to increased population movement and migration out of ... ...

Abstract	Abstract Globally, cross-border importation of malaria has become a challenge to malaria elimination. The border areas between Brazil and Venezuela have experienced high numbers of imported cases due to increased population movement and migration out of Venezuela. This study aimed to identify risk factors for imported malaria and delineate imported malaria hotspots in Roraima, Brazil and Bolivar, Venezuela between 2016 and 2018. Data on malaria surveillance cases from Roraima, Brazil and Bolivar, Venezuela from 2016 to 2018 were obtained from national surveillance systems: the Brazilian Malaria Epidemiology Surveillance Information System (SIVEP-Malaria), the Venezuelan Ministry of Health and other non-government organizations. A multivariable logistic regression model was used to identify the risk factors for imported malaria. Spatial autocorrelation in malaria incidence was explored using Getis-Ord (Gi*) statistics. During the study period, there were 11,270 (24.3%) and 4072 (0.7%) imported malaria cases in Roraima, Brazil and Bolivar, Venezuela, respectively. In the multivariable logistic regression for Roraima, men were 28% less likely to be an imported case compared to women (Adjusted Odds Ratio [AOR] = 0.72; 95% confidence interval [CI] 0.665, 0.781). Ages 20–29 and 30–39 were 90% (AOR = 1.90; 95% CI 1.649, 2.181) and 54% (AOR = 1.54; 95% CI 1.331, 1.782) more likely to be an imported case compared to the 0–9 year age group, respectively. Imported cases were 197 times (AOR = 197.03; 95% CI 175.094, 221.712) more likely to occur in miners than those working in agriculture and domestic work. In Bolivar, cases aged 10–19 (AOR = 1.75; 95% CI 1.389, 2.192), 20–29 (AOR = 2.48; 95% CI 1.957, 3.144), and 30–39 (AOR = 2.29; 95% CI 1.803, 2.913) were at higher risk of being an imported case than those in the 0–9 year old group, with older age groups having a slightly higher risk compared to Roraima. Compared to agriculture and domestic workers, tourism, timber and fishing workers (AOR = 6.38; 95% CI 4.393, 9.254) ...
Keywords	Medicine ; R ; Science ; Q
Subject code	306
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Knowledge and attitude on sexually transmitted infections and contraceptive use among university students in Bhutan

Thinley Dorji / Karma Wangmo / Dendup Tshering / Ugyen Tashi / Kinley Wangdi

PLoS ONE, Vol 17, Iss

2022 Volume 8

Abstract: Objectives The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under ... ...

Abstract	Objectives The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under Royan University of Bhutan (RUB). Methods This was a cross-sectional study using an online questionnaire. The questionnaire was developed in Google forms and the link was shared through the college WeChat groups. The questionnaire consisted of four parts on socio-demographic, sexual behaviour and contraceptive use, knowledge, and attitude on STIs. All the students under RUB were invited to participate voluntarily in this study. The socio-demography was presented in frequency and proportion. Result A total of 1,283 students participated in this survey and 55.0% (701) were females. Of this, 29.4% (377) were sexually active and 94.4% reported using modern contraception. Commonly used contraceptives were: condoms (83.8%, 316) and emergency contraceptives (20.6%, 78), respectively. The mean knowledge and attitude scores on STI were 9.94 (range 2–20) and 12 (range 2–14), respectively. Good knowledge and attitude on STI were reported in 53.2% (683) and 70.1% (899) of participants. Conclusion Students reported average knowledge and a good attitude towards STI. Contraceptive use among university students was low. There is a need to strengthen health education on STIs in schools and universities. All forms of contraceptives especially condoms should be made easily available to sexually active people.
Keywords	Medicine ; R ; Science ; Q
Subject code	300
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Knowledge and attitude on sexually transmitted infections and contraceptive use among university students in Bhutan.

Thinley Dorji / Karma Wangmo / Dendup Tshering / Ugyen Tashi / Kinley Wangdi

PLoS ONE, Vol 17, Iss 8, p e

2022 Volume 0272507

Abstract	Objectives The unmet needs of contraception can lead to unintended pregnancy and transmission of sexually transmitted infections (STI). Therefore, this study aimed to evaluate the contraception use, knowledge, and attitude on STI among students under Royan University of Bhutan (RUB). Methods This was a cross-sectional study using an online questionnaire. The questionnaire was developed in Google forms and the link was shared through the college WeChat groups. The questionnaire consisted of four parts on socio-demographic, sexual behaviour and contraceptive use, knowledge, and attitude on STIs. All the students under RUB were invited to participate voluntarily in this study. The socio-demography was presented in frequency and proportion. Result A total of 1,283 students participated in this survey and 55.0% (701) were females. Of this, 29.4% (377) were sexually active and 94.4% reported using modern contraception. Commonly used contraceptives were: condoms (83.8%, 316) and emergency contraceptives (20.6%, 78), respectively. The mean knowledge and attitude scores on STI were 9.94 (range 2-20) and 12 (range 2-14), respectively. Good knowledge and attitude on STI were reported in 53.2% (683) and 70.1% (899) of participants. Conclusion Students reported average knowledge and a good attitude towards STI. Contraceptive use among university students was low. There is a need to strengthen health education on STIs in schools and universities. All forms of contraceptives especially condoms should be made easily available to sexually active people.
Keywords	Medicine ; R ; Science ; Q
Subject code	300
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Geographical variations of food insecurity and its associated factors in Bangladesh

Md Tariqujjaman / Mahfuzur Rahman / Kinley Wangdi / Gobinda Karmakar / Tahmeed Ahmed / Haribondhu Sarma

PLoS ONE, Vol 18, Iss 1, p e

Evidence from pooled data of seven cross-sectional surveys.

2023 Volume 0280157

Abstract: Food insecurity has multiple negative effects on maternal and child health and nutritional outcomes. There is a dearth of up-to-date evidence on the prevalence of food insecurity in Bangladesh based on geographical variations. We investigated the ... ...

Abstract	Food insecurity has multiple negative effects on maternal and child health and nutritional outcomes. There is a dearth of up-to-date evidence on the prevalence of food insecurity in Bangladesh based on geographical variations. We investigated the prevalence of food insecurity based on geographical variations and its associated factors. We pooled data from seven cross-sectional surveys conducted in 15,009 households from March 2015 to May 2018. This study was a part of the evaluation of the Maternal Infant Young Child Nutrition Phase 2 programme implemented by BRAC, one of the largest international non-governmental organizations located in Bangladesh that covered rural areas in 26 districts and two urban slums in Dhaka, Bangladesh. We used Household Food Insecurity Access Scale (a widely used scale to measure household food insecurity) to estimate the food insecurity status from the data collected through a face-to-face interview using a structured questionnaire. Hot spot analysis was conducted using the Getis-Ord Gi* statistic. The multiple logistic regression model was applied to explore the associated factors of food insecurity. The food insecurity hotspots were in the northwestern, central-southwestern, and coastal districts of Bangladesh. The overall prevalence of mild, moderate, and severe food insecurity were 12.7%, 13.8%, and 3.5%, respectively. In the adjusted model, household heads and caregivers of children with five or more years of schooling had respectively 42% (adjusted odds ratio (AOR): 0.58, 95% confidence interval (CI): 0.52, 0.64) and 46% (AOR: 0.54; 95% CI: 0.49, 0.61) less likelihood to suffer from food insecurity. Households in the middle (AOR: 0.58, 95% CI: 0.52, 0.65) and rich (AOR: 0.32, 95% CI: 0.28, 0.36) wealth status had lower odds of food insecurity. Food insecurity is widely spread in rural districts of Bangladesh and the degree of vulnerability is higher among the households of the northwestern, central-southwestern, and coastal areas of Bangladesh. Comprehensive interventions ...
Keywords	Medicine ; R ; Science ; Q
Subject code	360
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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