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- André, Malin, 1949-, et al.
(författare)
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The management of infections in children in general practice in Sweden. : a repeated 1-week diagnosis-prescribing study in 5 counties in 2000 and 2002.
- 2005
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Ingår i: The Journal of Infectious Diseases. - : Informa UK Limited. - 0022-1899 .- 0036-5548 .- 1651-1980. ; 37:11-12, s. 863-869
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Tidskriftsartikel (refereegranskat)abstract
- A diagnosis-prescribing study was performed in 5 Swedish counties during 1 week in November in 2000 and repeated in 2002. The aim of the present study was to analyse data for children 0-15y of age who consulted a general practitioner with symptoms of an infection. During the 2 weeks studied, 4049 children were consulted. Respiratory tract infections (RTI) were the predominant diagnoses, above all among the youngest children, while the proportion of urinary tract infections and skin infections increased with increasing age. Between the y 2000 and 2002, the proportion of children allocated the diagnosis streptococcal tonsillitis and pneumonia decreased (p<0.01 and p<0.001, respectively) while the proportion of common cold increased (p<0.001). Antibiotic prescribing decreased from 55% to 48% (p<0.001) for respiratory infections between the years studied. The only significant changes in type of antibiotics prescribed were the increase of isoxazolylpenicillins (p<0.001) used for skin infection and the decrease of macrolides (p=0.001). A diagnostic test was used in more than half of the consultations. Of children allocated a RTI diagnosis, 36% were prescribed antibiotics when a C-reactive protein test was performed compared to 58% in those not tested. Further studies are needed in general practice to determine the optimal use of near-patient tests in children with RTI.
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- Björkman, Ingeborg, et al.
(författare)
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Health promotion at Swedish pharmacies : views of the staff
- 2008
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Ingår i: Pharmacy Practice (Internet). - 1886-3655. ; 6:4, s. 211-218
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Tidskriftsartikel (refereegranskat)abstract
- The role of pharmacy has changed dramatically during the last decades, which has led to new demands on pharmacy personnel. Objective: This study aims at exploring the attitudes of Swedish pharmacy personnel on their role as public health promoters and to look at the opportunities and obstacles they identify in the efforts to widen the pharmacy remit to include a wider health approach. Method Eight focus group discussions were conducted with a strategic sample of pharmacy personnel working in two counties in Sweden. The discussions were transcribed verbatim and analysed by qualitative inductive analysis. Results Five themes were identified, “Pharmacy activities impact on public health”, “The employer, Apoteket AB”, “The new role welcomed”, “Obstacles in the new role”, and “Need of change and support”. Conclusion The concept of pharmacy personnel as public health promoters was not initially in the mindset of the participants. In the process of discussion, the impact of traditional pharmacy practice as well as new pharmacy based initiatives on public health gradually became more obvious to them. The findings show a pharmacy staff involved in a process of change. The participants have not yet landed in their new role as public health promoters and the study shows that practical as well as conceptual support is needed in order for pharmacy personnel to play a more important role in public health.
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- Jonsson, Leif, et al.
(författare)
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Exploring unexplained twofold differences in sales of cardiovascular drugs between two neighbouring Swedish municipalities.
- 2005
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Ingår i: Pharmacoepidemiol Drug Saf. - : Wiley. - 1053-8569 .- 1099-1557. ; 14:5, s. 349-55
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To analyse sales data for cardiovascular drugs and to explore the long-standing unexplained inter-municipality differences in out-patient sales, especially for ACE inhibitors/angiotensin II antagonists (ATC-group C09) and statins (C10AA) between two Swedish neighbouring municipalities. METHODS: Crude and age-standardised data regarding drug sales on prescription from the National Corporation of Swedish Pharmacies, was analysed. In subsequent qualitative interviews, the sales data were presented to a number of purposefully chosen key persons exploring their explanations of the long-standing large differences in the sales between the two neighbouring municipalities. RESULTS: The study confirms previous analyses that large inter-municipality differences in out-patient sales of cardiovascular drugs exist between the municipalities, differences that remained when data were standardised. In the year 2002, for example, the age-standardised out-patient sales of drugs in ATC-group C09 was 64.4 defined daily dose (DDD)/1000 inhabitants/day in one municipality compared to 112.1 in the other. For ATC-group C10AA, the corresponding figures were 41.7 and 80.9 respectively. All interviewees considered so called treatment traditions as the most important reason for the observed differences. Taking part in clinical trials was also believed to be of great importance. Activities of the Drug and Therapeutic Committees (DTC), the presence of a hospital in the municipality, marketing activities by pharmaceutical companies or differences in morbidity were not considered of major importance in explaining the differences. CONCLUSIONS: Large differences in sales data between the two municipalities remained despite age and sex standardisation. Key informants shared the view that differences in the so called 'treatment traditions' were most important for the differences.
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- Lan, Pham Thi, et al.
(författare)
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Knowledge and practice among healthcare providers in rural Vietnam regarding sexually transmitted infections
- 2009
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Ingår i: Sexually Transmitted Diseases. - 0148-5717 .- 1537-4521. ; 36:7, s. 452-458
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess knowledge and reported practice regarding sexually transmitted infections (STI) among healthcare providers in rural Vietnam and to examine background characteristics possibly associated with knowledge and practice. METHODS: A cross-sectional study using a self-completed questionnaire was carried out in 2006 among 465 healthcare providers in rural Vietnam. The questionnaire included questions on providers' characteristics, STI knowledge, and case scenarios of 4 common STI syndromes. Correct answer was scored 1, "do not know" or incorrect answer was scored 0. Linear and logistic regressions were applied. RESULTS: Diseases considered as STI were gonorrhea and syphilis by 83% of the respondents, 70% believed partner treatment necessary for bacterial vaginosis or candidiasis cases. Sharing clothes/food or kissing was commonly mentioned as transmission routes (60%). Median scores of knowledge and reported practice were 29 (range: 0-50) and 2 (range: 0-20), respectively. Among the respondents, 34% had a knowledge score of less than 25 and 78% had a practice score of less than 10. Characteristics predicting higher level of knowledge were being a medical doctor, assistant medical doctor, midwife, or serving STI patients. Characteristics predicting higher level of practice were serving STI patients, being a midwife or female provider, and having participated in STI or reproductive tract infection training courses. Respondents who reported treating STI patients had a higher level of knowledge and reported practice than the others.
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- Lan, Pham Thi, et al.
(författare)
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Lack of knowledge about sexually transmitted infections among women in North rural Vietnam
- 2009
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Ingår i: BMC Infectious Diseases. - : Springer Science and Business Media LLC. - 1471-2334. ; 9, s. 85-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The serious long-term complications of sexually transmitted infections (STI) in women and newborns are well-documented. Particularly, STI imply considerable social consequences for women. Low STI knowledge has been shown to be associated with unsafe sex. In Vietnam, misconceptions regarding STI exist, and rural women delay seeking care for STI. The aim of the study was to investigate knowledge of STI among women aged 15 to 49 years in a rural district of Vietnam and to evaluate possible associations between socioeconomic factors and STI knowledge. METHODS: A cross-sectional population-based study using face-to-face interviews was carried out between March and May 2006 in a demographic surveillance site in rural Vietnam. In total, 1805 women aged 15-49 years were randomly selected to participate in the study. The interviews were based on a structured questionnaire including questions on sociodemographic characteristics of the women and their knowledge about STI. Each correct answer was scored 1, incorrect or do not know answer was scored 0. Multivariate analyses were applied to examine associations between socio-economic conditions and STI knowledge. Intra-cluster correlation was calculated to examine similarities of STI knowledge within clusters. RESULTS: Of the 1,805 respondents, 78% (73% married vs. 93% unmarried, p < 0.001) did not know any symptoms of STI, 50% could not identify any cause of STI, 59% (54% married vs. 76% unmarried, p < 0.001) did not know that STI can be prevented. Only 31% of the respondents (36% married vs. 14% unmarried, p < 0.001) answered that condom use could protect against STI, and 56% considered partner treatment necessary. Of 40 possible correct answers, the mean knowledge score was 6.5 (range 0-26, median 6). Young, unmarried women and women who lived in the highlands or mountainous areas demonstrated very low levels of STI knowledge (regression coefficients -1.3 and -2.5, respectively, p < 0.001). Experience of an induced abortion was significantly associated with a higher level of knowledge. CONCLUSION: The low levels of STI knowledge found among women of reproductive age in a rural district of Vietnam indicate an urgent need of health education interventions, of which, young and unmarried women should be specifically targeted.
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- Olsen, Birgitta, et al.
(författare)
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First ever population-based assessment of Mycoplasma genitalium in Vietnam : low prevalence among married women of reproductive age in rural areas
- 2008
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objective: To analyse the prevalence of Mycoplasma genitalium infection in a population-based study among sexually active married women from a demographic surveillance site in a rural geographical area of Vietnam.Materials and Methods: Women, 18-49 years of age, were randomly selected to participate. DNA was isolated from endocervical swabs sampled from 990 participating women. The M. genitalium MgPa adhesion gene was detected using a real-time PCR with TaqMan probeResults: Eight (0.8% [95% confidence interval, 0.25-1.35%]) of the included women were infected with M. genitalium. Two of these positive women reported clinical symptoms. One additional M. genitalium positive but symptom-free woman, however, showed clinical signs of vaginitis. None of the M. genitalium positive women was concomitantly infected with Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum or HIV. Furthermore, there was no obvious association between M. genitalium infection and vaginal douching, use of intra-uterine device (IUD), or occurrence of bacterial vaginosis, candidiasis, or Trichomonas vaginalis.Conclusions: The prevalence of M. genitalium among sexually active married women in Vietnam was relatively low. However, more large, well-designed and appropriately performed studies in other population groups including unmarried women and men, and in other geographical areas, rural as well as urban, are crucial in order to extract any evidence-based conclusions regarding the overall prevalence of STIs, including M. genitalium infections, in the Vietnamese society. The present study compiled with such future studies may form the basis for a national sexual health strategy for prevention, diagnosis, and surveillance of STIs, including M. genitalium infections, in Vietnam.
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