7^th World Congress on Public Health, Nutrition & Epidemiology May 15-16, 2019 Singapore

Biography:

Edith Kabukie Bannerman is an intern Nutritionist at the Greater Accra Regional Hospital, Ghana. She had her undergraduate studies in Public Health Nutrition at the University of Health and Allied Sciences, Ghana and conducted her research around Nutrition and NCDs. She has passion in Nutrition related NCDs, Nutrition Policy as well as Maternal and Infant Nutrition and is working towards obtained a higher degree in the field.

Abstract:

INTRODUCTION AND OBJECTIVES: Metabolic syndrome (MetS) which previously was relatively uncommon among Africans south of the Sahara, is increasingly becoming a public health concern in recent times. It refers to the co-occurrence of several known cardiovascular risk factors, including insulin resistance, obesity, atherogenic dyslipidemia and hypertension. This study’s intent was to determine the prevalence of MetS, its components and compare the dietary diversity of cases and matched controls.

METHODS: An age to sex one-to-one case-control study, involving 152 middle aged adults aged 45-65 years was conducted. Metabolic syndrome was determined by both World Health Organization (WHO) and International Diabetic Federation (IDF) criteria. Anthropometry, lifestyle habits, physical activity and dietary diversity were assessed. A t-test and chi-square test were used to compare continuous and categorical variables respectively between the two groups and odds ratio to determine the association between risk factors and metabolic syndrome.

RESULTS: The overall prevalence of MetS by the WHO and IDF criteria was 34.2% and 44.7% respectively. The prevalence was found to be higher in cases (67.1%) than in controls (1.3%) with just a few cases (32.9%) being able to control their metabolic syndrome status. Comparing cases to controls, high central obesity (98.7% vs 36.8%), high BP (90.8% vs 2.6%), and high FBG (72.4% vs 1.3%) were observed. Consumption of highly diversified diets was higher among controls (77.6%) compared to cases (10.5%), just like consumption of moderately diversified diets (case: 82.9% vs. controls: 19.8%).

CONCLUSION: A third (WHO criteria) to almost half (IDF criteria) of the study participants had MetS. The triad of high central obesity, high BP and high FBG were mostly responsible for MetS in this study population. Protective health effects can be obtained from reducing/maintaining 

Biography:

Jung Kyu Choi is an expertise in evaluating the health insurance and analyzing healthcare big-data.

Abstract:

Background: Access to healthcare service can affect cancer incidence and mortality. The purpose of this study was to identify the association between transfer and mortality among patients with cancer.

Method: Data were from a population-based cohort of National Health Insurance (NHI) claims. The study population was comprised of patients living more than 200 km from Seoul with cancer diagnosed during a nine-year period (2004-2012). The final sample included 8,197 patients with cancer: 3,939 males (48.1%) and 4,258 females (51.9%). A Cox proportional hazard model was used to estimate the hazard ratio for death. Confounding variables including gender, age, type of social security, income level and disability were incorporated into the model.

Results: Among cancer patients living in the province, 2,874 (35.1%) utilized healthcare services in Seoul. About 10% (n=834) of patients died during the follow-up period. The heart rate (HR) for death of patients utilizing healthcare services in Seoul (HR: 1.26, 95% CI: 1.09~1.45) was higher than for patients who did not utilize healthcare services in Seoul. Among patients not utilizing healthcare services in Seoul, the survival probability of the rich was significantly higher than that of others.

Conclusion: Education and support are essential for cancer prevention and early detection, particularly for vulnerable social groups. To remove cancer disparities, limited access to high-quality healthcare services must be addressed. High-quality healthcare services should be equally distributed across rural markets.

Biography:

Maja Czerwińska Rogowska is currently a PhD student at Pomeranian Medical University. She has her expertise in enteral feeding and treatment malnutrition patients.

Abstract:

Malnutrition is associated with worse prognosis, a higher risk of infections and complications, worse regeneration of wounds, longer hospitalization, the increase of the total costs of treatment and higher mortality rate. Therefore, early identification of patients suffering from malnutrition should be considered a priority and so should be the actions aiming at the prevention of this problem. One of the most popular markers of malnutrition is lymphocyte concentrate. It is very cheap and routinely used. The aim of the study is to investigate the influence that the protein acquired from the kitchen diet has on lymphocyte concentrate in comparison to the influence that the protein acquired from the industrial diet has on this concentrate. The study group consist of enterally fed post-stroke patients (58 people: 34 fed home-made diet and 28 fed industrial diet). Patients were fed for 14 days. In the kitchen diet group, there was 28.5 g of protein and a decrease in concentration was observed (p<0.05). In the industrial diet group, there was 53.5 g of protein and an increase in lymphocyte concentration has been demonstrated (p<0.05). Lymphocyte concentrate is sensitive on to protein content in diet and it can be used as a cheap and popular marker in malnutrition.

Biography:

Joanna Hołowko is a PhD student of Pomeranian Medical University in Szczecin (Poland). She is currently working as a Dietician in Rehabilitation Hospital of Saint Charles Borromeo in Szczecin. She has published seven papers in reputed journals.

Abstract:

The aim of the study was to investigate the efficacy of 6 week, 2 types of diets: -500 kcal/day Caloric Restriction Diet (CR I) with an -800 kcal/day Caloric Restriction Diet (CR II) on the fatty acid profile and eicosanoids (hydroxyoctadecadienoic acids and hydroxyeicosatetraenoic acids) concentration. The study enrolled 94 Caucasian former athletes aged 20-42 who had not been active for at least five years. There were three intervention groups: CR I group (n=32), CR II group (n=34), control group (n=28). In order to evaluate the effect of diet intervention, the following variables were measured: Anthropometrics, basic biochemical variables, fatty acids and their blood derivatives profiles. The CR II group showed significantly lower levels of BMI, total cholesterol LDL, TG, total lipids, insulin and HOMA-IR (p<0.05). Subjects consuming the CR I diet significantly decreased their BMI and the level of total lipids (p<0.05). The CR II group had a significantly decreased EPA level (p<0.05). The CR I group showed a significantly increased level of the DHA (p<0.05) and improvement in the omega-3 index (p<0.05). These subjects also showed significantly lower concentrations of 15-hydroxyicosatetraenoic acid (15-HETE). Within short time, calorie restriction (-800 kcal) helps to improve lipid variables and insulin resistance. The CR I diet seems to be more advantageous in the decrease of inflammation but does not improve basic biochemical variables. We can conclude that calorie restriction can be a good choice for former athletes, although EPA and DHA supplementation is needed.

Biography:

Saroj Shinde is interested in working on the health issues of vulnerable population pockets such as pavement dwellers, tribal population, sugarcane cutters and lower caste people in India. Her specific research areas are women and health, reproductive health, migrant health, menstrual hygiene and sanitation and family planning.

Abstract:

The principle of equity has considered as more ethical and also closely allied with the human right principles. In India the drafts of the National Health Policy (NHP) are ensuring large space for the equity principle to build healthy nation. Despite of that, there are a very prevailing differences and gaps between the health status of people from different sections of society in India. People from the lower caste and the tribal population are with the lowest health status. This situation highlights that particular section counters the unjust and unfair treatment in terms of health and services. There is a need to focus inequity in the health sector because it is unnecessary and certainly avoidable to the large extent. Certainly, all three NHPs guided to make progress in achieving the goals of health for all, MDGs and now SDGs to less or large extent, however, it is to accept that at the implementation level only certain determinants of the health focused on larger scope and some neglected. This study is the result of a critical review of all the three national health policies in India from 1983 to 2017 to find out in what way equity principle gained importance in the draft. Further, to highlight the existing gap in the health status, the published reports of the National Family Health Survey I, II, III and IV also reviewed and used as the supporting sources in this study. Other articles also reviewed to understand the equity principle and to support the arguments of prevailing health inequity in India. All the policy drafts had given concern towards the equity principle. Still, we are struggling to bring it into the implementation and not meeting equity principle that has been promised by the health policies. Historically, the gaps in the health status of the people were there on the basis of caste hierarchy (General, OBCs, SCs STs) and even today we encounter the same pattern of gaps sharply.

Biography:

Mohammod Jobayer Chisti has been working in International Centre for Diarrhoeal Disease Research, Bangladesh, since 1998.

Abstract:

Background: Management of pneumonia in severely malnourished children is critically important in reducing deaths in such children. Understand the etiology of pneumonia in severely malnourished children is one of the essential components of appropriate management. Diagnosis of pneumonia in children with severe malnutrition is also intriguing. Etiology and diagnosis of pneumonia in SAM is not well described in medical literature. Data on management of pneumonia in such children are also lack.

Methods: We have done a systematic review using specific search criteria in PUBMED to evaluate the overall role of severe malnutrition in children with pneumonia in SAM children.

Results: Among a total of 215 isolates 26% were Klebsiella and 25% S. aureus species, 18% Pneumococcus, 8% each E. coli and Salmonella species. A recent study conducted in Bangladesh found 87/385 (23%) MTB as the bacterial etiology of pneumonia in SAM children. In SAM children, the sensitivity of fast breathing as a predictor of radio graphically proven pneumonia ranged from 14% to 76%, and specificity from 66% to 100%.

Surprisingly, metabolic acidosis found to have no impact on the diagnostic clinical features of pneumonia in SAM children having diarrhea. Studies revealed that as a first line therapy ampicillin and gentamicin are more effective against enteric Gram-negative bacilli than chloramphenicol in SAM children with pneumonia. Both the groups received in addition to diet, micronutrients, vitamins and minerals.

Conclusions: The currently available data suggests that the spectrum and frequency of causative agents of pneumonia in severely malnourished children differ from that observed in well-nourished children. Clinical signs are relatively poor predictors of pneumonia in severely malnourished children.  However, injectable antibiotics in addition to diet, micronutrients, vitamins and minerals are the sine quanon. High prevalence of pulmonary tuberculosis in severely malnourished children having acute pneumonia underscores the importance of further research that may help to evaluate the determinates of TB in such children.

Biography:

Tan Teck Jack is the Chief Medical Officer of TeleMedC Group, an ophthalmic diagnostics technology company originating from Silicon Valley. He is the Founder and Medical Director of Northeast Medical Group. He has more than 20 years of experience in clinical work with managing a group of clinics, a specialist center and the group’s HQ & pharmacy.

Abstract:

Statement of the Problem: The World Health Organization announced in 2018 that 422 million people worldwide suffer from diabetes mellitus. The projected impact of vision impairment and blindness caused by Diabetic Retinopathy (DR) will result in significant public health and economic consequences. DR is preventable and treatable if detected early through an annual eye screening. However, screening rates are low globally due to a paucity of trained eye-health professionals in developing countries and in rural or remote areas of developed countries.

Method: Based on the research from CSIRO Australian e-Health Research Centre, TeleMedC group commercialized an AI-based Diabetic Retinopathy screening system-DR grader, an automated DR grading and preliminary referral decision support tool for patients with diabetes. The cloud-based tele-ophthalmology system has the functionalities of: (1) Deep learning based image quality assessment tool; (2) Deep learning based DR “disease/no disease” grading for color retinal images; (3) DR lesion localization and DR level indication; (4) Preliminary report of patient referral/no referral decision; (5) DR disease audit by eye experts and developing patient referral pathway. DR grader has been deployed in a GP Super clinic at Midland, Western Australia from December 2016 onwards.

Results: Results of this implementation were published in a JAMA Network Open article (September 2018) evaluated a total of 291 patients. The system correctly identified all twelve patients with true disease (sensitivity 100%) and misclassified 23 patients as having disease (specificity 92%). The DR grader has been undergoing testing in Singapore since early 2018 at the Department of Ophthalmology, National University Hospital and in 30 GP clinics with similar or better preliminary results pending publication.

Conclusion: The AI-based DR screening system provides quick DR patient referral decision support in the primary care setting. It’s benefits patients from poorly-resourced and underserved remote areas for its low cost, time savings and high patient acceptability. The system was well received by primary care providers.

Biography:

Zoobi Khanam is working as a Post Doctoral Fellow in Institute of Medical Sciences, Banaras Hindu University, India. She has her expertise in food and nutrition and has a passion to work for food security and improving its level in the disadvantaged community. Her previous research on Food Security has suggested the pathways to improve the level of food security and ultimately the nutritional status and wellbeing of rural Indian Women. She has gained this ability after many years of experience in the area of food security. She has worked as a Lecturer of Food and Nutrition in SSPG College, R.M.L. University, U.P. India. She has been awarded with the best scientific paper in International Conference on Food and Nutrition Technology for Public Health Care (ICFNP-2012), India. She has many national and international scientific publications and has been participating in conferences, seminars and workshops to intensify her knowledge, ability and skills as well; she is also serving as an editorial board member of reputed Journals.

Abstract:

Caloric requirements above basal levels are directly dependent on the degree of activity. Activity thus becomes a very significant factor in determining the caloric adequacy of the marginal diets consumed by many individuals in technically under developed countries. Present study has examined the situation of energy expenditure and energy balance in women of reproductive age group. This study was conducted in rural areas of Varanasi district of Uttar Pradesh state, India. A community based cross sectional design was adopted. By multi stage sampling 610 women of reproductive age group (15-49 years) were interviewed with the help of a pre-designed and pre-tested schedule. Dietary intake and energy expenditure were calculated by using 24-hour dietary recall and activities performed by study subjects in previous 24 hours were recorded. Data was analyzed with the help of SPSS software.

The findings of this study revealed that as much as 67.4% study subjects were in Negative Energy Balance and 32.6% had Positive Energy Balance. The overall Energy Expenditure for study subjects was 1943.05 ±553.24 Kcal/day. There existed significant association between energy expenditure of the subjects and their age, type of family, educational status and socio-economic class (p<0.001). Negative Energy Balance was to the extent of 65.3%, 64.7% 76.8% and 56.8% in the age group of 15-24, 25-34, 35-44 and ≥45 years, respectively. This was maximum (73.8%) in illiterate and least (58.5%) in subjects with educational status as graduate and above. As much as 69.4% lower, 81.9% lower middle and 72% middle Socio-economic Status subjects had Negative Energy Balance. Since Negative Energy Balance in women of reproductive age prevailed in two third subjects and average calorie intake of the subjects was more than 80 percent of the RDA. A prospective follow up can be carried out for linking energy balance of women of reproductive age group and their nutritional status.

Biography:

Elaine first started work at the Health Promotion Centre in Curtin University as a Health Promotion Assistant & is currently the Executive Director of Red Element Health International (REHI). REHI has been a service provider for the Health Promotion Board & People Association for the past 8 years, conducted over 28 programs, & reached out to 120,000 participants. She has presented to over 14 international conferences as a guest speaker/program chair in (Australia, China, India, Thailand, Malaysia, Singapore, Japan, Sri Lanka, Vietnam, Prague, Taiwan) & made over 11 public health related media appearances. She is an active member of Singapore Nutrition & Dietetics Association, Curtin University of Technology Singapore Alumni Member & acting as ex-president for the University of Sydney Singapore Alumni.

Abstract:

Rapid transformations in demographic and socioeconomic shifts, are leading to a growing global demand for health and beauty products and services that demands holistic concepts of well-being. In addition, technological breakthroughs such as internet of things make it convenient and offer innovative solutions for well-being and engage consumers to track their own health conditions and fitness goals. This "new health economy" encompasses three key concepts: well-being, well-conditioned and well-shaped; which are shaped by wellness segments and goals that influence purchasing decisions of consumers.

The research protocol aims to examine the feasibility, challenges and capabilities in provision for each customer with an ecosystem, or platform that organizes data and insights to create an individual health and fitness, nutrition, and beauty profile. Convenience sampling of 100 consumers residing in private housing within five major districts in Singapore will be selected to participate in the study. Statistical Package for Social Science 25 will be used to conduct descriptive statistics for quantitative data while qualitative data results using focus interviews, will be translated and transcribed to identify improvements in provision of these services.

Rising income in emerging global markets is fuelling the demand for these general wellbeing products and services. Combined with technological advances, it is imperative to understand how these highly personalized services with integrated technology can be designed better to support consumer preferences; provide greater flexibility and high-quality service; and generate better health awareness among consumers.

Keywords— Beauty, consumers, health, technology, wellness

Biography:

Abu Sadat Mohammad Sayeem Bin Shahid has his experience in public health especially in nutrition and other emerging problems like childhood TB and pneumonia in developing world. He has been involved in different epidemiological research starting from observational study to clinical trial for the last 8 years. He also published his different work in different journals by which people from all over the world will be benefited in the long run.

Abstract:

Background: Bacteremia is quite common in severe acute malnourished (SAM) children with pneumonia, who often experience a fatal outcome, especially in developing countries. There is limited information in the medical literature on the risks of bacteremia in SAM children with pneumonia. We have examined the factors associated with bacteremia and their outcome in under-five children who were hospitalized for the management of pneumonia and SAM.

Methods: In this unmatched case-control study, SAM children of either sex, aged 0-59 months, admitted to the Dhaka Hospital of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b) with cough or respiratory distress and radiological pneumonia during April 2011 to July 2012 were enrolled (n=405). Those with pneumonia as well as bacteremia constituted the cases (n=18), and randomly selected SAM children with pneumonia without bacteremia constituted controls (n=54).

Results: A wide range of bacterial pathogens were isolated among the cases of which 13 (72%) were Gram negatives. Death rate was higher among the cases than the controls (28% vs. 9%) but the difference was not statistically significant (p=0.111).  In logistic regression analysis, after adjusting for potential confounders, such as the lack of DPT/oral polio/HIV/hepatitis vaccination, measles vaccination, vomiting, and clinical dehydration (some/severe) the SAM children with pneumonia as well as bacteremia more often had the history of lack of BCG vaccination (95% CI=1.17-29.98) and had diastolic hypotension (<50 mm of Hg) (95% CI=1.01-12.86) not only after correction of dehydration but also in its absence.

Conclusion: The results of our study suggest that history of lack of BCG vaccination and presence of diastolic hypotension in absence of dehydration on admission are the independent predictors of bacteremia in SAM children with pneumonia. The results indicate the importance of continuation of BCG vaccination to produce benefits beyond the primary benefits.

Biography:

Bhavna Guduguntla is a BS Candidate in Public Health from Wayne State University in Detroit, Michigan and will be pursuing a Medical Degree starting in 2019. She is a research assistant in the Department of Neurosurgery at the Wayne State University School of Medicine, a Detroit Youth Representative in UNICEF’s National Council, and a rising public health leader in Detroit, Michigan.

Abstract:

Implicit bias acts on an unconscious level, meaning an individual is usually unaware that it exists. It can be activated quickly and unknowingly by situational cues, and can silently influence verbal and non-verbal behavior, perception, and memory. The negative consequences of implicit bias disproportionately affect individuals in marginalized and minority groups, who are already proven to have a higher prevalence of health inequities.

Provider implicit bias manifests as non-timely diagnosis, disparate treatment recommendations, fewer questions asked of the patient, fewer tests performed, and behavioral change. These changes affect patient health by increasing patient stress, harming patient-provider interactions and trust, and worsening patient adherence and compliance due to reduced provider trust. General trends show that implicit bias affects health outcomes of adults through higher incidence, mortality, and advanced staging at diagnosis for various cancers. Implicit bias affects health outcomes of children through disparities in infant mortality rates, chronic disease, organ transplantation, and leukemia-related deaths. These patterns are not just present in the United States, but are also persistent in the United Kingdom, New Zealand, Australia, Canada, South Africa, and Brazil.

By incorporating a comprehensive training curriculum, health systems may correct for the negative effects of provider implicit bias by teaching employees how to recognize, mitigate, and ultimately overcome their implicit biases. Studies have shown that specialized in-classroom training results in a 9% decrease in employee implicit bias. With that said, more research must be dedicated to novel intervention designs to mitigate the effects of provider implicit bias on patient health inequities.

Biography:

Luke Power is a Masters Student at York University in Toronto, Canada. Throughout his academic career, Luke has focused on the causes and consequences of inequities in relation to health on both a national and international level. Consequently, his work addresses issues including, but not limited to: public health promotion, health care systems, income differentials, social determinants of health, international governance.

Abstract:

This paper provides a critical examination of the World Bank’s development document, “World Bank Group Gender Strategy: Gender Equality, Poverty Reduction, and Inclusive Growth”. The rationale for this is that, while the World Bank suggests that this strategy is a distinction from past practices, some scholars suggest otherwise (Prügl 2017). Thus, the aim of this analysis is to elucidate the implications of the proposed strategies on both gender equality and health equity. The analytical framework derives from the following disciplines: political economy, feminist political economy, and political economy of health. The philosophical underpinning of this examination reflects the tenets of critical realism. In relation to this philosophical paradigm, a critical discourse analysis is employed. Within the document there is a direct emphasis on privatization (private enterprise and financialization) and deregulation. Moreover, there is a clear re-articulation of both the state and female citizenship, whereby the former is presented as an ‘enabling agent’ and the latter becomes depoliticized. Within this paper, it is argued that these strategies lead to the further exaggeration of gender inequalities due to their impact on income and social inequalities. There is a relation between unequal income distribution and health equity: an increase in the former leads to a increase in the latter. These health inequities are compounded by the World Bank’s promotion of a ‘reduced state’ that is focused on constructing a ‘workfare’ based liberal welfare state and a citizen whose political engagement is limited to the community. Thus, instead of reducing inequalities, these strategies reinforce them.

Biography:

Following obtaining MBBS degree from Colombo Medical faculty in 2011, Dilini was involved with studies related to Public Health. She obtained her MSc in Public health in 2016. Before being chosen to follow the MD in Public Health course at Post Graduate Institute of Medicine, Colombo she served as a Field medical officer in Kalutara district, Sri Lanka. While studying as a MD trainee in Community Medicine, she is employed as a medical officer in adolescent health unit, Family Health Bureau. 

Abstract:

Demandingness and responsiveness of the parent are the two categories of parenting styles. The impact of parent-adolescent relationship on psychosocial well-being of the adolescent is not optimally explored. This study was carried out to determine the impact of maternal and paternal parenting style on self-esteem and life satisfaction of the adolescents. A cross-sectional, descriptive study was carried out among 439 adolescents through cluster sampling in grades 9 and 10 in four public schools in Panadura education division in Sri Lanka. A self-administered questionnaire consisting of socio-demographic details, questions extracted from Parent Authority Questionnaire, Rosenberg’s Self-esteem Scale and Life Satisfaction Scale was used to collect data. Paternal parenting style was significantly associated with self-esteem (p=0.002) and life satisfaction (p= 0.002) of adolescents while the relationship was less defined for maternal parenting style. Unlike in western societies authoritative mothering or authoritative fathering was not significantly associated with adolescent self-esteem and life satisfaction in our study setting.  At p=0.05 significance level different combination of parenting styles were not significantly associated with adolescent self-esteem and whereas its relationship with the life-satisfaction of adolescents was significant.

Biography:

Sphindile Magwaza has expertise in public health program management and is passionate to implement evidence based interventions and influence policy making to improve health outcomes and quality of life. Her work involves providing technical assistance to government, civil society organizations using global best practices, tools, research findings and quality improvement approaches that will bolster health systems across the African region.

Abstract:

Statement of the Problem: To determine HIV treatment uptake and status among females 50 years and older in 20 priority facilities in Ghana, as global studies report that this group has less access to quality HIV services . Methodology & Theoretical Orientation: Cross sectional study, of all HIV patient files were audited between May 2017-January 2018, to determine the number and characteristics of clients currently on antiretroviral therapy (ART) and the number of clients loss to follow up (LTFU) or in need of ART initiation (Pre-ART). Findings: The audit highlights the need for targeted HIV testing with strong linkage to treatment as only 7% of women were newly initiated on HIV treatment since Treat all policy implementation. The average time to enroll clients new on antiretroviral therapy (ART) was 3.2 days post HIV positive diagnosis showing good linkage to care. However, of those new on ART, 13% were LFTU, since the launch of Treat All policy in October 2016. Viral load monitoring and scale up need to be strengthened as only 10% of files reviewed documented VL monitoring in this age group, even though 55% had VL results showing HIV virus suppression (< 1000 copies/ml).

Biography:

Ashish Sinha has been completed MBBS in 2000 MD in Coomunity Medicine in 2008 at age of 31 Yrs from Pt Ravishankar University, Raipur Chhattisgarh India. He is working as Assistant Professor in Govt Meddical College. He has published 10  papers in reputed journals. He worked as Team leader in statewide nutrition survey for continuous 3 Years under the umbrela of Medical educational institute. He worked as a Surveillance Medical Officer (SMO) in National Polio Surveillance Project (A Govt. of India & WHO Collaboration) for Polio Erradication for 2 years in High Risk areas. State Epidemiologist in Chhattisgarh AIDS Control Society with additional responsibility of Madhya Pradesh in the same position. Worked as Senior Resident in Dept. of Community Medicine in School of Public Health Post Graduate Institute of Medical Education &Research(PGIMER)Chandigarh. 

Abstract:

Statement of the Problem: Malnutrition is a one of the major social and public health concern in India.  Data shows that every 3rd child is underweight in India. There is a similar situation in Chhattisgarh with 37% children underweight. Women and Child Development Department does annual weighing campaign i.e. Wajan Tyohar, through community participation  conducted through  growth monitoring and provides community based supplementary nutrition at village level through front-line anganwadi workers. Anthropometric measurement is the main tool to assess the nutrition status of children. An initiative was taken to validate the data reported by front-line workers in Chhattisgarh during the Nawa Jatan (“new care”) weighing campaign. A statistically representative sample of children was selected across the state and anthropometric measurement was done by post graduate students of Community Medicine department. Findings: In August 2016 Dept. of WCD did a universal weighing campaign for children and 30.13% of them were reported as being underweight. The validation exercise reports 37.76% as being underweight.  The underweight children were followed up for next six months with special focus on their supplementary nutrition by front-line workers. After six months of this intervention 41.6% improved their nutrition status and reached normal (out of 30.13% reported underweight in August). As per validation report 39.6% children reached normal (out of 37.76% reported underweight in August). As per WCD department the overall program effectiveness is 41.6% in terms of improving the malnutrition status of underweight children. The validation exercise plays a vital role as supportive supervision and in capacity building of front-line workers. This exercise shows that the problem is bit more than estimated by front-line anganwadi workers. The intervention has improved skills and work outcome of front-line workers.

Biography:

French Medical ID professional specialized in infectious diseases, internal medicine, certified in Immunology and Pediatric, MBA vaccinology and years of clinical practice.

Certified in Health and Diplomacy with Lived multi-country medical “field “experience in Southeast Asia (India in particular), West/Central/East Europe.

Over 17 years of experience in senior medical lead positions in pharmaceutical research and development for European and USA companies for various therapeutic areas for adults and children. Member of World alliance against antibiotic resistance and French immunology society (SFI) administrative board and several international  academic societies with focus at innovation of R&D. reflecting immunology and genetic variability,  role of immunologic approach for treatment and diagnostic to  tackle problem  of resistance and role of microbiota to empower host immune response with extensive clinical application.

Member of international advisory group (CHD India)  in order to attract attention to crucial importance of health issues for sustainable economic development and security.

Years of expertise to work on project related to global health more focused at Eurasia and Asia (India in particular)

Abstract:

Microbiota under 3 years old fluctuates and is more impressionable to environmental factors than the adult microbiota.

 Lifestyle where nutrition plays one of key factors along with  sanitization, caesarean sections, antibiotic usage, immunizations.

There are several pediatric diseases associated with alterations of the intestinal microbiota like athopy and asthma, obesity, diabetes, inflammatory bowel diseases and neurodegenerative diseases and a raising scientific evidence concerning link between microbiota immune response and communicable – infectious & tropical diseases.

Breastfeeding, introduction of solid food, regional lifestyle and diet (geographical variations) are factors influencing gut microbiota. Regardless of the origin of gut associated commensals, a number of studies have attempted to identify the mechanism by which breastfeeding promotes overall immune health via entero- mammary pathway.

Early life changes in microbiota composition can alter susceptibility to developing obesity later in life. Many studies shown presence/absence of specific microbes can modulate and program life-long changes in immunity and further clinical study might help understand exact paths on metabolic disease progression.

Research showed that impact of diet and environmental change stresses on the host can be passed on maternally to children through epigenetic modulation of the DNA by methylation. Thus maternal dietary and microbial exposures are also crucial to the development of the microbiota early in life as children may inherit genes with differing potential for predisposition for malnutrition or obesity, based on the diet of their mother.

A study showed that treatment of obese mice with Akkermansia muciniphila reduced high fat diet induced metabolic disorders, including fat mass gain, metabolic endotoxemia, adipose tissue inflammation and insulin resistance. By understanding the differing energy harvest and metabolic capabilities of each child’s gut microbiota, there might be support for crafting microbiota based interventions (supported already by preclinical data and research) to reverse susceptibility to obesity early in life and clinical data  might support research evidence.

Early life therapeutic approach and improved intestinal health might be accessible tool to combat obesity and malnutrition.

There is a real need for cohort global clinical studies that survey the infant microbiome and metabolome from birth and during at least the first year of life. Full understanding of  disease-related changes gathered could allow to  create interventions that rationally shift the microbiota in infants to construct a healthy intestinal environment from a young age particularly which is particularly pertinent in emerging countries .

Biography:

Joanne Martin is a current undergraduate medical student from the United Kingdom. Her research interests are in health inequalities and social determinants of health. 

Abstract:

Introduction:

MSM in Malawi have a HIV prevalence (around 20%) that is twice that of the general population (9.2%). Despite research identifying MSM as one of the ‘high-risk’ HIV groups in Malawi, work and research in this area has largely focused of heterosexual and mother-to-child transmission. Task shifting is a process used to expand health care services by moving tasks from highly trained and skilled health personnel to those who are less trained (e.g. community health workers). This has been used in Malawi to expand HIV testing, counselling and treatment however, it had not been targeted at the MSM population thus far.

Methods:

A literature search was carried out using Medline, EMBASE and PubMed. Key search terms were used. The search topics included: the strengths of task shifting and the sexual behaviors, attitudes and challenges faced by MSM in Malawi. Limitation criteria was set to ensure the most appropriate and recent research was reviewed and included in this review.

Results:

The results obtained suggest that task shifting may be used to overcome some of the barriers faced by MSM but it is not clear if task shifting could overcome all of them. Key themes were identified and conclusions were drawn from these themes. 

Conclusion or Interpretation:

The results indicate that there may be a role for Task Shifting in reducing the prevalence of HIV in this high-risk group. However, from the results it is unclear to what extent task shifting can do this as the challenges faced are complex.

Biography:

Zeinab Kasemy has an expertise in Epidemiology and public health. My aim is to study diseases in many fields in order to help the experts find solutions 

Abstract:

The aim was to assess the prevalence of metabolic syndrome (MetS) and its associated risk factors in Menoufia University students. Background: MetS is a growing public health concern worldwide. The rapid sociocultural transition associated with major changes in lifestyle and eating habits has been claimed for the rising rates of MetS among young adults and children, which is the leading cause of developing type II diabetes and cardiovascular diseases. Participants and methods: A cross-sectional study was conducted during the academic year 2016/2017 at Menoufia University on 455 university students aged 18–25 years. The students were chosen from four faculties using multistage random sample. Anthropometric measurements were obtained. Blood pressure, fasting glucose level, and fasting lipid profile were also measured. MetS was diagnosed using adult treatment panel-III guidelines. Results: The overall prevalence of MetS was 16.7%, which was more frequent among female students. The most prevalent MetS components were increased waist circumference (41.8%) followed by high triglyceride levels (40.2%) and reduced high-density lipoprotein-cholesterol levels (36.3%). The predisposing factors for having MetS included the following: being female, older than 20 years, obese, physically inactive, high levels of stress, and a positive family history of hypertension and diabetes. Conclusion: MetS is considered as a public health problem among Menoufi a University students. These findings indicate the need for health promotion and prevention programs directed toward the screening, diagnosis, and management of MetS among university students.

Biography:

Carolina Reinoso is a 5^th year BSPH candidate studying at The Ohio State University. Her research is an extension of her participation in the University of Michigan Summer Enrichment Program at the University of Michigan School of Public Health through the Department of Health Management and Policy. Ms. Reinoso conducted this research during her time at the Community Health and Social Service Center in Detroit, Michigan. Food insecurity is one of her many health equity passions, and she is committed to improving minority health, both at the local and global level. Ms. Reinoso plans to study worldwide sustainable systems in graduate school and hopes to construct improved pathways for improving health care systems and population health.  

Abstract:

Food insecurity is one of the leading problems in Public Health. Low-Income Hispanics alone make up more than half of the food insecure population, making up 57.7 million of the U.S. total population;  a total 8% of Latinos are in poverty compared to all people in the U.S, and 20% are food insecure compared to 13% of the rest of the population. Seeing this immense disparity, it is important to evaluate the barriers that confine them into food insecurity. 

With the current enforcements of immigration laws and cuts on initiatives like the Affordable Care Act which covered millions of Hispanics, it has led to more contributing barriers that have confined this vulnerable population into food insecurity. According to an Immigrant and Minority Health study, 211 Latinos were interviewed within their homes to assess the barriers they are experiencing while being food insecure. From the study, the majority of the participants stated that Health insurance, transportation, and lack of employment opportunity were all barriers that confine them.

A systematic review conducted by the PCD  analyzed the correlated effects of food insecurity, food deserts, and lack of job opportunity. Overall, 60% of Hispanic households were below $25,000 per year or at/below $19,450 per year. The association is a concern and demonstrates how we must focus on affordability and accessibility to combat this health inequality.

Programs have not been self-sufficient enough to eliminate and aide low-Income Hispanics out of food insecurity. The lack of current research that analyzes the contributing barriers of food insecurity mostly evaluates the after effects. To have key measures of success, Public Health leaders as a collective must tackle food insecurity at a multivariate level. Food Prescription programs need to expand their access of outreach in order to feed all individuals instead of just one portion of the population.

Biography:

Zolani Metu is the founding CEO of Decolonial Mental Health (Pty) Ltd, a start-up company that provides afro-centric solutions to complex mental health problems in South Africa. He is passionate about addressing health inequities and social determinants of health, with attention to mental health. The Mandela Rhodes Scholar holds a Master of Social Sciences (cum Laude, Mental health Research) from the prestigious University of Cape Town, and currently works as a Pre-PhD Intern at WITS University’s School of Public Health. Zolani has work experience from Washington DC, USA where he worked on an AIDS Free, USAID/PEPFAR project at a Public Health Consultancy known as John Snow Inc. He also worked in Burundi, East Africa, for an organization called Village Health Works; where he focused on Maternal Mental Health. Zolani also holds a strong passion for leadership and is an alumnus of the South African Washington International Program (SAWIP).

Abstract:

Biography:

She is interested in working on the health issues of vulnerable population pockets such as pavement dwellers, tribal population, sugarcane cutters, and lower caste people in India. Her specific research areas are Women and health, Reproductive health, Migrant health, Menstrual hygiene and sanitation and family planning.

Abstract:

Statement of the Problem: The principle of equity has considered as more ethical and also closely allied with the human right principles. In India  the drafts of the National health policy are ensuring large space for the equity principle to build healthy nation. Despite of that,  there are a very prevailing differences and gaps between the health status of people from different sections of  society in India. People from the lower caste and the tribal population are with the lowest health status. This situation highlights that particular section counters the unjust and unfair treatment in terms of health and services. There is a need to focus inequity in the health sector because it is unnecessary and certainly avoidable to the large extent. Certainly, all three NHPs guided to make progress in achieving the goals of “health for all, MDGs and now SDGs to less or large extent, however, we need to accept that at the implementation level  only certain determinants of the health  focused on larger scope and some neglected.Methodology  This article is the result of a critical review of all the three National health policies in India from 1983 to 2017 to find out in what way equity principle gained importance in the draft. Further, to highlight the existing gap in the health status, the published reports of the National Family health survey I, II, III, and IV also reviewed and used as the supporting sources in this article. Other articles also reviewed to understand the equity principle and to support the arguments of prevailing health inequity in India. Findings: All the policy drafts had given concern towards the equity principle. Still, we are struggling to bring it into the implementation and not meeting equity principle that has been promised by the Health Policies. Historically, the gaps in the health status of the people were there on the basis of caste hierarchy (General, OBCs, SCs STs) and even today we encounter the same pattern of gaps sharply.  

Biography:

Anupama is MBA graduate in Health care management and also did MS International Health Policy and Management from Heller School for Social Policy, Brandeis University, US.  She is currently a independent consultant in health sector. Earlier to that, she was Senior Manager Health Division with Ecorys India Pvt Ltd. I also served as Assistant Professor Hospital and Health Management at International Institute of Health Management Research (IIHMR) Delhi. Over 16years of experience in Indian and International industry, she has been providing consultative technical support to Ministry of Public Health and other leading NGO’s in Afghanistan. She is also a editorial board review member for Bulletin of World Health Organisation and certified auditor for MoHFW National Quality Assurance Standards in Public Health India. She is also founding member of Uniworld Care Private limited and SPARK.FiT. Ms. Anupama is also a national athlete and world champion in powerlifting.

Abstract:

Statement of the Problem: Iron deficiency is prevalent in two thirds of the children and women of child bearing age in most developing countries. NFHS-4 MP has the prevalence of Anemia 21.4% in urban area and 27.4%, in rural. Double fortification of salt with iodine and iron is an ideal way to eliminate iron deficiency along with iodine.  Methodology- study to assess behaviour of consumers/ vendors & PDS system through qualitative research and identify key barriers and enablers for behaviour change related to consumption of DFS was implemented in five districts of MP. The findings showed Multi prong BCC strategy has to be adopted based on socio-economic status and literacy levels of the households, along with mobile based innovation and local traditions

Biography:

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