Search results for: risk of poverty

Authors: Fatmah Almathkour

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Managing and controlling the construction supply chain (CSC) are very important components of effective construction project execution. The goals of managing the CSC are to reduce uncertainty and optimize the performance of a construction project by improving efficiency and reducing project costs. The heart of much SC activity is addressing risk, and the CSC is no different. The delivery and consumption of construction materials is highly variable due to the complexity of construction operations, rapidly changing demand for certain components, lead time variability from suppliers, transportation time variability, and disruptions at the job site. Current notions of managing and controlling CSC, involve focusing on one project at a time with a push-based material ordering system based on the initial construction schedule and, then, holding a tremendous amount of inventory. A two-stage methodology was proposed to coordinate the feed-forward control of advanced order placement with a supplier to a feedback local control in the form of adding the ability to transship materials between projects to improve efficiency and reduce costs. It focused on the single supplier integrated production and transshipment problem with multiple products. The methodology is used as a design tool for the CSC because it includes an external storage site not associated with one of the projects. The idea is to add this feature to a highly constrained environment to explore its effectiveness in buffering the impact of variability and maintaining project schedule at low cost. The methodology uses deterministic optimization models with objectives that minimizing the total cost of the CSC. To illustrate how this methodology can be used in practice and the types of information that can be gleaned, it is tested on a number of cases based on the real example of multiple construction projects in Kuwait.

Keywords: construction supply chain, inventory control supply chain, transshipment

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Authors: Jiashu Shen, Guoting Zhang, Zhicheng Wang, Yu Wang, Yun Liang, Siyu Zou, Fan Yang, Kun Tang

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Objectives: This study aims to enhance the understanding of paid blood donors’ characteristics in Chinese population and devise strategies to protect these paid donors. Background: Paid blood donation was the predominant mode of blood donation in China from the 1970s to 1998 and caused several health and social problems including largely increased the risk of infectious diseases with nonstandard operation in unhygienic conditions. Methods: This study utilized the cross-sectional data from the China Kadoorie Biobank with about 0.5 million people from 10 regions of China from 2004 to 2008. Multivariable logistic regression was performed to examine the associations between socio-demographic factors and paid blood donation. Furthermore, a stratified analysis was applied in education level and annual household income by rural and urban areas. Results: The prevalence of paid blood donation was 0.50% in China and males were more likely to donate blood than females (Adjusted odds ratio (AOR) =0.81, 95%Confident Intervals (CI): 0.75-0.88). Urban people had much lower odds than rural people (AOR =0.24, 95%CI: 0.21-0.27). People with a high annual household income had lower odds of paid blood donation compared with that of people with low income (AOR=0.37, 95%CI: 0.31-0.44). Compared with people who didn’t receive school education, people in a higher level of education had increased odds of paid blood donation (AOR=2.31, 95%CI: 1.94-2.74). Conclusion: Paid blood donors in China were associated with those who were males, living in rural areas, with low annual household income and educational background.

Keywords: China Kadoorie Biobank, Chinese population, paid blood donation, socio-demographic factors

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Authors: R. C. Tiwari, N. P. Bhandary, D. B. Thapa Chhetri, R. Yatabe

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The research enlightens the various issues of lake expansion and stability of the moraine dam of Imja lake. The Imja lake considered that the world highest altitude lake (5010m from m.s.l.), located in the Khumbu, Sagarmatha region of Nepal (27.90 N and 86.90 E) was reported as one of the fast growing glacier lakes in the Nepal Himalaya. The research explores a common phenomenon of lake expansion and stability issues of moraine dam to justify the necessity of lake lowering efforts if any in future in other glacier lakes in Nepal Himalaya. For this, we have explored the root causes of rapid lake expansion along with crucial factors responsible for the stability of moraine mass. This research helps to understand the structure of moraine dam and the ice, water and moraine interactions to the strength of moraine dam. The nature of permafrost layer and its effects on moraine dam stability is also studied here. The detail Geo-Technical properties of moraine mass of Imja lake gives a clear picture of the strength of the moraine material and their interactions. The stability analysis of the moraine dam under the consideration of strong ground motion of 7.8Mw 2015 Barpak-Gorkha and its major aftershock 7.3Mw Kodari, Sindhupalchowk-Dolakha border, Nepal earthquakes have also been carried out here to understand the necessity of lake lowering efforts. The lake lowering effort was recently done by Nepal Army by constructing an open channel and lowered 3m. And, it is believed that the entire region is now safe due to continuous draining of lake water by 3m. But, this option does not seem adequate to offer a significant risk reduction to downstream communities in this much amount of volume and depth, lowering as in the 75 million cubic meter water impounded with an average depth of 148.9m.

Keywords: finite element method, glacier, moraine, stability

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Yu-Che Cheng, Min-Lih Chang, Ke-Hao Cheng, Chuan-Cheng Wang

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Taiwan is an island located along the southeastern coast of the Asian continent, located between Japan and the Philippines. It is surrounded by the sea on all sides. However, due to the presence of the Central Mountain Range, the rivers on the east and west coasts of Taiwan are relatively short. This geographical feature results in a phenomenon where, despite having rainfall that is 2.6 times the world average, 58.5% of the rainwater flows into the ocean. Moreover, approximately 80% of the annual rainfall occurs between May and October, leading to distinct wet and dry periods. To address these challenges, Taiwan relies on large reservoirs, storage ponds, and groundwater extraction for water resource allocation. It is necessary to construct water treatment facilities at suitable locations to provide the population with a stable and reliable water supply. In general, the construction of a new water treatment plant requires careful planning and evaluation. The process involves acquiring land and issuing contracts for construction in a sequential manner. With the increasing severity of global warming and climate change, there is a heightened risk of extreme hydrological events and severe water situations in the future. In cases of urgent water supply needs in a region, relying on traditional lengthy processes for constructing water treatment plants might not be sufficient to meet the urgent demand. Therefore, this study aims to explore the use of simplified water treatment procedures and the construction of rapid "temporary water treatment plants" to tackle the challenges posed by extreme climate conditions (such as a century-long drought) and situations where water treatment plant construction cannot keep up with the pace of water source development.

Keywords: temporary water treatment plant, emergency water supply, construction site groundwater, drought

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Authors: Ferruh Taspinar, Ismail Saracoglu, Emrah Afsar, Eda O. Okur, Gulce K. Seyyar, Gamze Kurt, Betul Taspinar

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Although it is thought that abdominal adiposity is one of the risk factor for postural deviation, such as increased lumbar lordosis, the body mass index is not sufficient to indicate effects of abdominal adiposity on spinal alignment and postural changes. The aim of this study was to investigate the correlation with detailed body composition and spine alignment in healthy young adults. This cross-sectional study was conducted with sixty seven healthy volunteers (37 men and 30 women) whose ages ranged between 19 and 27 years. All participants’ sagittal spinal curvatures of lumbar and thoracic region were measured via Spinal mouse® (Idiag, Fehraltorf, Switzerland). Also, body composition analysis (whole body fat ratio, whole body muscle ratio, abdominal fat ratio, and trunk muscle ratio) estimation by means of bioelectrical impedance was evaluated via Tanita Bc 418 Ma Segmental Body Composition Analyser (Tanita, Japan). Pearson’s correlation was used to analysis among the variables. The mean lumbar lordosis and thoracic kyphosis angles were 21.02°±9.39, 41.50°±7.97, respectively. Statistically analysis showed a significant positive correlation between whole body fat ratio and lumbar lordosis angle (r=0.28, p=0.02). Similarly, there was a positive correlation between abdominal fat ratio and lumbar lordosis angle (r=0.27, p=0.03). The thoracic kyphosis angle showed also positive correlation with whole body fat ratio (r=0.33, p=0.00) and abdominal fat ratio (r=0.40, p=0.01). The whole body muscle ratio showed negative correlation between lumbar lordosis (r=-0.28, p=0.02) and thoracic kyphosis angles (r=-0.33, p=0.00), although there was no statistically correlation between trunk muscle ratio, lumbar and thoracic curvatures (p>0.05). The study demonstrated that an increase of fat ratio and decrease of muscle ratio in abdominal region or whole body shifts the spinal alignment which may adversely affect the spinal loading. Therefore, whole body composition should be taken into account in spine rehabilitation.

Keywords: body composition, lumbar lordosis, spinal alignment, thoracic kyphosis

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Authors: Elham Ahmadi

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This study is conducted with the aim of investigating the effect of moderate physical activity (60% of maximal heart rate-MHR) on blood pressure in an elderly female with hypertension. Hypertension is considered a modifiable risk factor for cardiovascular disease through physical activity. The purpose and significance of this study were to investigate the role of exercise as an alternative therapy since some patients exhibit sensitivity/intolerance to some drugs. Initially, 65 hypertensive females (average age = 49.7 years) (systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) and 25 hypertensive females as a control group (average age = 50.3 years and systolic blood pressure, SBP >140 mmHg and/or diastolic blood pressure, DBP>85 mmHg) were selected. The subjects were divided based on their age, duration of disease, physical activity, and drug consumption. Then, blood pressure and heart rate (HR) were measured in all of the patients using a sphygmomanometer (pre-test). The exercise sessions consisted of warm-up, aerobic activity, and cooling down (total duration of 20 minutes for the first session up to 55 minutes in the last session). At the end of the 12th session (mid-test) and final session (24th session), blood pressure was measured for the last time (post-test). The control group was without any exercise during the study. The results were analyzed using a t-test. Our results indicated that moderate physical activity was effective in lowering blood pressure by 6.4/5.6–mm Hg for SBP and 2.4/4.3mm Hg for DBP in hypertensive patients, irrespective of age, duration of disease, and drug consumption ( P<.005). The control group indicates no changes in BP. Physical activity programs with moderate intensity (approximately at 60% MHR), three days per week, can be used not only as a preventive measure for diastolic hypertension (DBP>90 mmHg high blood pressure) but also as an alternative to drug therapy in the treatment of hypertension, as well.

Keywords: endurance exercise, elderly female, hypertension, physical activity

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Authors: Abdul-Razak Saeed

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Addressing the climate change crisis that this generation faces has evolved to include the consideration of a policy mechanism referred to as reduced emissions from deforestation and forest degradation with plus components of conservation, sustainable forest management and enhancement of forest carbon stocks (REDD+). REDD+ emerged from the International level of UNFCCC but its implementation is by developing countries. It challenges the development paradigm of nations that depend on the unsustainable clearing of forests and land use change for economic development whilst posing as an opportunity or risk for forest community livelihoods, institutions and their interaction with the forest resources. As a novel policy mechanism, it is imperative to gain global insight into local contexts of its implementation and to understand local level mobilization of their agency for institutional sustainability as reconfigured by new carbon economy initiatives like REDD+. Using a systematic review process, as the initial stages of this study, secondary data of REDD+ projects across the globe were evaluated to pick up gaps in research and that of on ground REDD+ implementation. Primary data was gathered from 30 actors in the government, NGO, private sector and traditional authorities using face-to-face semi structured interviews in Ghana; participation in meetings and workshops and policy and strategy document reviews. Preliminary findings of the study include REDD+ knowledge being a key determinant of power distribution and affects who shapes the process; in Ghana, informal relationships are playing key roles in advancing REDD+ unlike in traditional forestry and a subjectivity shift of local communities from an 'emotive-link' of environmental care to one of 'economic self-seeking and enriching' domain of thought.

Keywords: climate change, communities, forests, REDD+

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Authors: Emmanuelle Maria, Pierre Crançon, Gaëtane Lespes

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The knowledge of uranium migration processes within underground environments is a major issue in the environmental risk assessment associated with nuclear activities. This process is identified as strongly controlled by adsorption mechanisms, thus leading to strongly delayed migration paths. Colloidal ligands are likely to significantly increase the mobility of uranium in natural environments. The ability of colloids to mobilize and transport uranium depends on their origin, their nature, their structure, their stability and their reactivity with uranium. Thus, the colloidal mobilization and transport properties are often described as site-specific. In this work, the colloidal phases of two leachates obtained from two different horizons of the same podzolic soil were characterized with a speciation approach. For this purpose, a multi-technique strategy was used, based on Field-Flow Fractionation coupled to Ultraviolet, Multi-Angle Light Scattering and Inductively Coupled Plasma Mass Spectrometry (AF4-UV-MALS-ICPMS), Transmission Electron Microscopy (TEM), Electrospray Ionization Orbitrap Mass Spectrometry (ESI-Orbitrap), and Time-Resolved Laser Fluorescence Spectroscopy (TRLFS-EEM). Thus, elemental composition, size distribution, microscopic structure, colloidal stability and possible organic and/or inorganic content of colloids were determined, as well as their association with uranium. The leachates exhibit differences in their physical and chemical characteristics, mainly in the nature of organic matter constituents. The multi-technique investigation strategy used provides original data about colloidal phase structure and composition, offering a new vision of the way the uranium can be mobilized and transported in the considered soil. This information is a real significant contribution opening the way to our understanding and predicting of the colloidal transport.

Keywords: colloids, migration, multi-technique, speciation, transport, uranium

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Authors: Eric Muñoz de la Torre, Julián González Trinidad, Efrén González Ramírez

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Rain varies greatly in its duration, intensity, and spatial coverage, it is important to have sub-daily rainfall data for various applications, including risk prevention. However, the ground measurements are limited by the low and irregular density of rain gauges. An alternative to this problem are the Satellite Precipitation Products (SPPs) that use passive microwave and infrared sensors to estimate rainfall, as IMERG, however, these SPPs have to be validated before their application. The aim of this study is to evaluate the performance of the IMERG: Integrated Multi-satellitE Retrievals for Global Precipitation Measurament final run V06B SPP in a semi-arid region of Mexico, using 4 automatic rain gauges (pluviographs) sub-daily data of October 2019 and June to September 2021, using the Minimum inter-event Time (MIT) criterion to separate unique rain events with a dry period of 10 hrs. for the purpose of evaluating the rainfall properties (depth, duration and intensity). Point to pixel analysis, continuous, categorical, and volumetric statistical metrics were used. Results show that IMERG is capable to estimate the rainfall depth with a slight overestimation but is unable to identify the real duration and intensity of the rain events, showing large overestimations and underestimations, respectively. The study zone presented 80 to 85 % of convective rain events, the rest were stratiform rain events, classified by the depth magnitude variation of IMERG pixels and pluviographs. IMERG showed poorer performance at detecting the first ones but had a good performance at estimating stratiform rain events that are originated by Cold Fronts.

Keywords: IMERG, rainfall, rain gauge, remote sensing, statistical evaluation

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Authors: Kherbache Mehdi

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Within the framework of the validation of the Master in business administration marketing and sales in INSIM institute international in management Blida, we get the opportunity to do a professional internship in Sonelgaz Enterprise and a thesis. The thesis deals with the integration of social networking in the communication strategy of a company. The problematic is: How communicate with social network can be a solution for companies? The challenges stressed by this thesis were to suggest limits and recommendations to Sonelgaz Enterprise concerning social networks. The whole social networks represent more than a billion people as a potential target for the companies. Thanks to research and a qualitative approach, we have identified tree valid hypothesis. The first hypothesis allows confirming that using social networks cannot be ignored by any company in its communication strategy. However, the second hypothesis demonstrates that it’s necessary to prepare a strategy that integrates social networks in the communication plan of the company. The risk of this strategy is very limited because failure on social networks is not a restraint for the enterprise, social networking is not expensive and, a bad image which could result from it is not as important in the long-term. Furthermore, the return on investment is difficult to evaluate. Finally, the last hypothesis shows that firms establish a new relation between consumers and brands thanks to the proximity allowed by social networks. After the validation of the hypothesis, we suggested some recommendations to Sonelgaz Enterprise regarding the communication through social networks. Firstly, the company must use the interactivity of social network in order to have fruitful exchanges with the community. We also recommended having a strategy to treat negative comments. The company must also suggest delivering resources to the community thanks to a community manager, in order to have a good relation with the community. Furthermore, we advised using social networks to do business intelligence. Sonelgaz Enterprise can have some creative and interactive contents with some amazing applications on Facebook for example. Finally, we recommended to the company to be not intrusive with “fans” or “followers” and to be open to all the platforms: Twitter, Facebook, Linked-In for example.

Keywords: social network, buzz, communication, consumer, return on investment, internet users, web 2.0, Facebook, Twitter, interaction

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Authors: Bernice Lottering, Yi-Wen Lin

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Chronic pain and depression have an estimated 80% rate of comorbidity with unsatisfactory treatment interventions signifying the importance of developing effective therapeutic interventions for a serious chronic condition affecting a large majority of the global population. Chronic pain is defined as persistent pain presenting for over 3 months. This disease state increases the risk of developing depression in comparison to healthy individuals. In the current study, complete Freund’s adjuvant (CFA) was used to induce cell-mediated chronic inflammatory pain in a murine model. Significant mechanical and thermal hyperalgesia was induced, alongside observable depression-like behaviors. These conditions were attenuated through the use of electroacupuncture (EA). Similarly, these effects were also investigated with respect to the transient receptor potential vanilloid 1 (TRPV1), by analyzing the effects of TRPV1 gene deletion on the comorbidity of chronic pain and depression. The expression of the TRPV1 inflammatory response, and related downstream molecules, including protein kinases (PKs), mitogen-activated protein kinase (MAPKs), and transcriptional factors, were significantly reduced in the thalamus, prefrontal cortex (PFC), hippocampus, and periaqueductal gray (PAG) of CFA-treated mice. In addition, phosphorylated N-methyl-D-aspartate (NMDA) receptor 1 was also found to be reduced in the aforementioned areas, suggesting potential application and validity in a clinical setting. Our study determined the prospective therapeutic effects of EA in the treatment of chronic inflammatory pain and depression comorbidity and provides a novel and detailed mechanism underlying EA-mediated analgesia. These findings may be relevant in the utilization of clinical intervention approaches related to chronic pain and depression comorbidity.

Keywords: chronic pain, depression, NMDA, prefrontal cortex, TRPV1

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Authors: Zahra F. Al-Khateeb, Shenel Shekerzade, Hasna Boumenar, Siân M. Henson, Jordi L. Tremoleda, A. T. Michael-Titus

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Traumatic brain injury (TBI) is the leading cause of disability and death in young adults and also increases the risk ofneurodegeneration. The mechanisms linking moderate to severe TBI to neurodegeneration are not known. It has been proposed that cellular senescence inductionpost-injury could amplify neuroinflammation and induce long-term changes. The impact of these processes after injury to an immature brain has not been characterised yet. We carried out a controlled cortical impact injury (CCI) in juvenile 1 month-old male CD1 mice. Animals were anesthetised and received a unilateral CCI injury. The sham group received anaesthesia and had a craniotomy. A naïve group had no intervention. The brain tissue was analysed at 5 days and 35 days post-injury using immunohistochemistry and markers for microglia, astrocytes, and senescence. Compared tonaïve animals, injured mice showed an increased microglial and astrocytic reaction early post-injury, as reflected in Iba1 and GFAP markers, respectively; the GFAP increase persisted in the later phase. The senescence analysis showed a significant increase inγH2AX-53BP1 nuclear foci, 8-oxoguanine, p19ARF, p16INK4a, and p53 expression in naïve vs. sham groups and naïve vs. CCI groups, at 5 dpi. At 35 days, the difference was no longer statistically significant in all markers. The injury induced a decrease p21 expression vs. the naïve group, at 35 dpi. These results indicate the induction of a complex senescence response after immature brain injury. Some changes occur early and may reflect the activation/proliferation of non-neuronal cells post-injury that had been hindered, whereas changes such as p21 downregulation may reflect a delayed response and pro-repair processes.

Keywords: cellular senescence, traumatic brain injury, brain injury, controlled cortical impact

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Authors: Eva Tvrdá, Boris Botman, Marek Halenár, Tomáš Slanina, Norbert Lukáč

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In vitro storage and processing of animal semen represents a risk factor to spermatozoa vitality, potentially leading to reduced fertility. A variety of substances isolated from natural sources may exhibit protective or antioxidant properties on the spermatozoon, thus extending the lifespan of stored ejaculates. This study compared the ability of different concentrations of the Salvia officinalis extract on the motility, mitochondrial activity, viability and reactive oxygen species (ROS) production by bovine spermatozoa during different time periods (0, 2, 6 and 24 h) of in vitro culture. Spermatozoa motility was assessed using the Computer-assisted sperm analysis (CASA) system. Cell viability was examined using the metabolic activity MTT assay, the eosin-nigrosin staining technique was used to evaluate the sperm viability and ROS generation was quantified using luminometry. The CASA analysis revealed that the motility in the experimental groups supplemented with 0.5-2 µg/mL Salvia extract was significantly lower in comparison with the control (P<0.05; Time 24 h). At the same time, a long-term exposure of spermatozoa to concentrations ranging between 0.05 µg/mL and 2 µg/mL had a negative impact on the mitochondrial metabolism (P<0.05; Time 24 h). The viability staining revealed that 0.001-1 µg/mL Salvia extract had no effects on bovine male gametes, however 2 µg/mL Salvia had a persisting negative effect on spermatozoa (P<0.05). Furthermore 0.05-2 µg/mL Salvia exhibited an immediate ROS-promoting effect on the sperm culture (P>0.05; Time 0 h and 2 h), which remained significant throughout the entire in vitro culture (P<0.05; Time 24 h). Our results point out to the necessity to examine specific effects the biomolecules present in Salvia officinalis may have individually or collectively on the in vitro sperm vitality and oxidative profile.

Keywords: bulls, CASA, MTT test, reactive oxygen species, sage, Salvia officinalis, spermatozoa

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Authors: Koninika Mukherjee, Dilwar Hussain

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Introduction: One of the most prevalent psychopathologies among the youth is social anxiety. The presence of comorbid disorders further complicates diagnosis and treatment. One of the most commonly co-occurring disorders, along with social anxiety, is related to eating behavior. Objective: Identifying the risk and protective factors and the mechanism through which the effect of these disorders might help in treatment and prevention. So, the stated objective of the present study is to investigate the role of fear of negative evaluation and social appearance anxiety in the relationship of parental bonding with social anxiety and comorbid disordered eating. Method: A cross-sectional study was conducted with 411 Indian undergraduates. Data collection was done with the help of self-report measures like the social interaction anxiety scale, parental bonding instrument, brief fear of negative evaluation, social appearance anxiety scale, and the eating attitudes test. SPSS Amos 22.0 version was used for path analyses. Results: Out of the different dimensions of parental bonding, only maternal care and the father’s granting of behavioural freedom proved significant in the development and maintenance of social anxiety and disordered eating behaviour and symptoms. Fear of negative evaluation and social appearance anxiety mediated the impact of the mother’s care on social anxiety and comorbid disordered eating. However, only fear of negative evaluation seemed to mediate the effect of paternal granting of behavioral freedom on social anxiety and comorbid issues. Implications: One of the vital contributions of this study is looking at perceived maternal and paternal bonding separately in the path model. Identifying parenting dimensions significantly related to social anxiety and comorbid disorders can aid in establishing consensus around operational definitions and in the formulation of comprehensive assessments. Future Directions: Future research can include both participant and parental perceptions of parental bonding.

Keywords: social anxiety, disordered eating, fear of negative evaluation, social appearance anxiety

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Authors: Yogita Tulsian, A. Yadav

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Background: India reports 3,600 cholera cases annually. In August 2013, a cholera outbreak was reported in Jalgaon district, Maharashtra state. We sought to describe the epidemiological characteristics,identify risk factors, and recommend control measures. Methods: We collected existing stool and water testing laboratory results, and conducted a1: 1 matched case-control study. A cholera case was defined as a resident of Vishnapur or Malapur villagewith onset of acute watery diarrhea on/ after 1-July-2013. Controls were matched by age, gender and village and had not experienced any diarrhea for 3 months. We collected socio-demographic characteristics, clinical presentation, and food/travel/water exposure history and conducted conditional logistic regression. Results: Of 50 people who met the cholera case definition, 40 (80%) were from Vishnapur village and 30 (60%) were female. The median age was 8.5 years (range; 0.3-75). Twenty (45%) cases were hospitalized, twelve (60%) with severe dehydration. Three of five stool samples revealed Vibrio cholerae 01 El Tor, Ogawa and samples from 7 of 14 Vishnapur water sources contained fecal coliforms. Cases from Vishnapur were significantly more likely to drink from identified contaminated water sources (matched odds ratio (MOR) 3.5; 95% confidence interval (CI): 1-13), or from a river/canal (MOR=18.4;95%CI: 2-504). Cases from Malapur were more likely to drink from a river/canal (MOR=6.2; 95%CI: 0.6-196). Cases from both villages were significantly more likely to visit the forest (MOR 6.3; 95%CI: 2-30) or another village (MOR 3.5; 95%CI; 0.9-17). Conclusions: This outbreak was caused by Vibrio cholerae, likely through contamination of water in Vishnapur village and/or through drinking river/canal water. We recommended safe drinking water for forest visitors and all residents of these villages and use of regular water testing.

Keywords: cholera, case control study, contaminated water, river

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Authors: Ayodeji Adebayo, Tolulope Soyannwo, Oluwakemi A. Sigbeku

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Intimate Partner Violence (IPV) is a significant public health problem with adverse health consequences. There is increasing evidence of association of IPV with mental health problems. Understanding the association between IPV and mental health status of women of reproductive aged group in the rural communities in Nigeria can provide information to improve maternal health status. Therefore, this study was conducted to examine the relationship between experience of IPV and mental health status of women of reproductive aged group in a rural community in Southwest Nigeria. A community based cross-sectional survey was conducted using a cluster sampling technique to select 283 non-pregnant women of reproductive age group (15-49 years Mental health was assessed based on respondents’ experience of any symptoms of depression, anxiety and/or low self-esteem. IPV was assessed over a period of 12 months and the forms of IPV assessed were emotional, physical and sexual. An interviewer administered questionnaire was used to collect information on experience of IPV, reproductive history and factors influencing mental health. Data was analyzed using descriptive statistics, Chi-square and multivariate logistic regression at 5% level of significance. The mean age of respondents was 26.1± 7.8 with 57.1% aged 15-24years. More than half (58.0%) were married. Overall, 60.7% of respondents had mental health problems while 84.8% experienced all categories of violence. The pattern of IPV includes physical violence (10.7%), emotional violence (82.7%) and sexual violence (20.8%). Women who experienced sexual violence by a partner are most likely to suffer from all mental issues. Also, gynaecological morbidities are associated with increasing risk of mental health problems. The research demonstrates an urgent need for mental health policies to recognize the relationship between intimate partner violence, gynaecological morbidities and mental health problems in women in Nigeria.

Keywords: intimate partner violence, mental health, reproductive age group, women

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Authors: Mohammadreza Salek Faramarzi, Touraj Taghikhany

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In this paper, seismic fragility assessment of a recently developed hybrid structural system, known as the strongback system (SBS) is investigated. In this system, to mitigate the occurrence of the soft-story mechanism and improve the distribution of story drifts over the height of the structure, an elastic vertical truss is formed. The strengthened members of the braced span are designed to remain substantially elastic during levels of excitation where soft-story mechanisms are likely to occur and impose a nearly uniform story drift distribution. Due to the distinctive characteristics of near-field ground motions, it seems to be necessary to study the effect of these records on seismic performance of the SBS. To this end, a set of 56 near-field ground motion records suggested by FEMA P695 methodology is used. For fragility assessment, nonlinear dynamic analyses are carried out in OpenSEES based on the recommended procedure in HAZUS technical manual. Four damage states including slight, moderate, extensive, and complete damage (collapse) are considered. To evaluate each damage state, inter-story drift ratio and floor acceleration are implemented as engineering demand parameters. Further, to extend the evaluation of the collapse state of the system, a different collapse criterion suggested in FEMA P695 is applied. It is concluded that SBS can significantly increase the collapse capacity and consequently decrease the collapse risk of the structure during its life time. Comparing the observing mean annual frequency (MAF) of exceedance of each damage state against the allowable values presented in performance-based design methods, it is found that using the elastic vertical truss, improves the structural response effectively.

Keywords: IDA, near-fault, probabilistic performance assessment, seismic fragility, strongback system, uncertainty

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Authors: Arman Kishan, Mark Haft, Steve Li, Duc Nguyen, Dawn Laporte

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Objective: Patients with Type 2 diabetes (T2DM) often face higher postoperative complication rates. Limited data exist on outcomes in T2DM patients undergoing carpal tunnel release (CTR). This study aims to compare complication rates between endoscopic CTR (ECTR) and open CTR (OCTR) in patients with T2DM. Methods: This was a retrospective cohort study using the TriNetX database of 56741 patients with T2DM undergoing ECTR (N= 14,949) or OCTR (N= 41,792). Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complication rates between the two treatment methods in patients with T2DM. Results: Patients with T2DM undergoing ECTR had a significantly lower incidence of 90-day wound infection (p < 0.001), 90-day wound dehiscence (p < 0.001), and nerve injury (p < 0.001) when compared to patients who underwent OCTR. After matching, there was a significantly higher number of T2DM patients undergoing ECTR who had peripheral vascular disease (p = 0.045) and hypertension (p = 0.020) when compared to the OCTR group. These patients also had a lower incidence of fluid and electrolyte disorders (p = 0.002) and chronic blood loss anemia (p = 0.025). Conclusion: ECTR presents a superior choice for T2DM patients undergoing CTR, yielding significantly lower rates of wound infection, wound dehiscence, and nerve injury within 90 days post-surgery—reducing the risk by 31%, 48%, and 59%, respectively. These findings support the adoption of ECTR as the preferred method in this patient population, potentially leading to improved postoperative outcomes.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, carpal tunnel syndrome, postoperative complications in patients with diabetes mellitus

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Authors: Marta Kozuń, Krystian Toczewski, Sylwester Gerus, Justyna Wolicka, Kamila Boberek, Jarosław Filipiak, Dariusz Patkowski

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Long gap esophageal atresia is a congenital defect and is a challenge for pediatric surgeons all over the world. There are different surgical techniques in use to treat atresia. One of them is esophageal elongation but the optimal suture placement technique to achieve maximum elongation with low-risk complications is still unknown. The aim of the study was to characterize the process of esophageal elongation from the biomechanical point of view. Esophagi of white Pekin Duck was used as a model based on the size of this animal which is similar to a newborn (2.5-4kg). The specimens were divided into two groups: the control group (CG) and the group with sutures (SG). The esophagi of the control group were mounted in the grips of the MTS Tytron 250 testing machine and tensile test until rupture was performed. The loading speed during the test was 10mm/min. Then the SG group was tested. Each esophagus was cut into two equal parts and that were fused together using surgical sutures. The distance between both esophagus parts was 20mm. Ten both ends were mounted on the same testing machine and the tensile test with the same parameters was conducted. For all specimens, force and elongation were recorded. The biomechanical properties, i.e., the maximal force and maximal elongation, were determined on the basis of force-elongation curves. The maximal elongation was determined at the point of maximal force. The force achieved with the suture group was 10.1N±1.9N and 50.3N±11.6N for the control group. The highest elongation was also obtained for the control group: 18mm±3mm vs. 13.5mm ±2.4mm for the suture group. The presented study expands the knowledge of elongation of esophagi. It is worth emphasizing that the duck esophagus differs from the esophagus of a newborn, i.e., its wall lacks striated muscle cells. This is why the parts of animal esophagi used in the research are may characterized by different biomechanical properties in comparison with newborn tissue.

Keywords: long gap atresia treatment, esophageal elongation, biomechanical properties, soft tissue

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Authors: Mattahias Maj, Fabio Tatzgern, Karl Adam, Damir Kahrimanovic, Markus Varga

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Torpedo ladles are necessary transport carriages in steel production to move the molten crude iron from the blast furnace to the steel refining plant. This requires the ladles to be high temperature resistant and insulate well to preserve the temperature and hold the risk of solidification at bay. Therefore, the involved refractories lining the inside of the torpedo ladles are chosen mostly according to their thermal properties, although wear of the materials by the liquid iron is also of major importance. In this work, we combined investigations of the thermal behaviour with wear studies of the lining over the whole lifetime of a torpedo ladle. Additional numerical simulations enabled a detailed model of the mechanical loads and temperature propagation at the various stations (heating, filling, emptying, cooling). The core of the investigation were detailed 3D measurements of the ladle’s cavity and thereby quantitative information of the wear progress at different time intervals during the lifetime of the ladles. The measurements allowed for a separation of different wear zones according to severity, namely the “splash zone” where the melt directly hits the ladle, the “melt zone” where during transport always liquid melt is present, and the “slag zone”, where the slag floats on the melt causing the most severe wear loss. Numerical simulations of the filling process were taken to calculate stress levels and temperature gradients, which led to the different onset of wear on those zones. Thermal imaging and punctual temperature measurements allowed for a study of the thermal consequences entailed by the wear onset. Additional “classical” damage analysis of the worn refractories complete the investigation. Thereby the wear mechanisms leading to the substantial wear loss were disclosed.

Keywords: high temperature, tribology, liquid-solid interaction, refractories, thermography

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Authors: Madhuri S. Ghate, Rahul P. Chavhan, Shriya S. Nahar

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Learning objective: •To describe Magnetic Resonance Imaging (MRI) imaging appearances of typical and atypical uterine fibroids with emphasis on differentiating it from other similar conditions. •To classify uterine fibroids according to International Federation of Gynecology and Obstetrics (FIGO) Sub-classifications system and emphasis on its clinical significance. •To show cases with atypical imaging appearances atypical fibroids Material and methods: MRI of Pelvis had been performed in symptomatic women of child bearing age group on 1.5T and 3T MRI using T1, T2, STIR, FAT SAT, DWI sequences. Contrast was administered when degeneration was suspected. Imaging appearances of Atypical fibroids and various degenerations in fibroids were studied. Fibroids were classified using FIGO Sub-classification system. Its impact on surgical decision making and clinical outcome were also studied qualitatively. Results: Intramural fibroids were most common (14 patients), subserosal 7 patients, submucosal 5 patients . 6 patients were having multiple fibroids. 7 were having atypical fibroids. (1 hyaline degeneration, 1 cystic degeneration, 1 fatty, 1 necrosis and hemorrhage, 1 red degeneration, 1 calcification, 1 unusual large bilobed growth). Fibroids were classified using FIGO system. In uterus conservative surgeries, the lesser was the degree of myometrial invasion of fibroid, better was the fertility outcome. Conclusion: Relationship of fibroid with mucosal and serosal layers is important in the management of symptomatic fibroid cases. Risk to fertility involved in uterus conservative surgeries in women of child bearing age group depends on the extent of myometrial invasion of fibroids. FIGO system provides better insight into the degree of myometrial invasion. Knowledge about the atypical appearances of fibroids is important to avoid diagnostic confusion and untoward treatment.

Keywords: degeneration, FIGO sub-classification, MRI pelvis, uterine fibroids

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Authors: Rosalina Penaloza, Joanna Navarro, Pauline Jolly, Anna Junkins, Carlos Seas, Larissa Otero

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Background: Tuberculosis (TB) case detection in Peru relies on passive case finding. This strategy relies on the assumption that the community is aware that a persistent cough is a possible symptom of TB and that formal health care needs to be sought. Despite its importance, health knowledge specific to TB is underexplored in Peru. This study aimed to assess health literacy and level of TB knowledge among outpatients attending a referral hospital in Lima, Peru. The goal was to ascertain knowledge gaps in key areas relating to TB, to identify and prioritize subgroups for intervention, and to provide insight for policy and community interventions considering health literacy. Methods: An observational cross-sectional study was conducted using a survey to measure sociodemographic factors, tuberculosis knowledge, and health literacy. Bivariate and Multivariate logistic regression was performed to study the associations between variables and to account for potential confounders. The study was conducted at Hospital Cayetano Heredia in Lima, Peru from June – August 2017. Results: 272 participants were included in the analysis. 57.7% knew someone who had had TB before, 9% had had TB in the past. Two weeks a cough was correctly identified as a symptom that could be TB by 69.1%. High TB knowledge was found among 149 (54.8%) participants. High health literacy was found among 193 (71.0%) participants. Health literacy and TB knowledge were not significantly associated (OR 0.9 (95%CI 0.5-1.5)). After controlling for sex, age, district, education, health insurance, frequency of hospital visits and previous TB diagnosis: High TB knowledge was associated with knowing someone with TB (aOR 2.7 (95%CI 1.6-4.7)) and being a public transport driver, (aOR 0.2 (95%CI 0.05-0.9)). Not being poor was the single factor associated with high health literacy (aOR 3.8 (95%CI 1.6-8.9)). Conclusions: TB knowledge was fair, though 30% did not know the most important symptom of TB. Tailoring educational strategies to risk groups may enhance passive case detection especially amongst transport workers in Lima, Peru.

Keywords: health literacy, Peru, tuberculosis, tuberculosis knowledge

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Authors: Y. P. Wang, J. K. Chen, C. H. Lee, G. H. Huang, M. C. Wang, S. W. Chen, Y. T. Kuan, H. C. Lin, C. Y. Huang, W. H. Liang, W. C. Lin, H. C. Yu

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The hi-tech industries in the Science Park at southern Taiwan were heavily damaged by a strong earthquake early 2016. The financial loss in this event was attributed primarily to the automated stocker system handling fully processed products, and recovery of the automated stocker system from the aftermath proved to contribute major lead time. Therefore, development of effective means for protection of stockers against earthquakes has become the highest priority for risk minimization and business continuity. This study proposes to mitigate the seismic response of the stockers by introducing viscous fluid dampers in between the ceiling and the top of the stockers. The stocker is expected to vibrate less violently with a passive control force on top. Linear damper is considered in this application with an optimal damping coefficient determined from a preliminary parametric study. The damper is small in size in comparison with those adopted for building or bridge applications. Component test of the dampers has been carried out to make sure they meet the design requirement. Shake table tests have been further conducted to verify the proposed scheme under realistic earthquake conditions. Encouraging results have been achieved by effectively reducing the seismic responses of up to 60% and preventing the FOUPs from falling off the shelves that would otherwise be the case if left unprotected. Effectiveness of adopting a viscous fluid damper for seismic control of the stocker on top against the ceiling has been confirmed. This technique has been adopted by Macronix International Co., LTD for seismic retrofit of existing stockers. Demonstrative projects on the application of the proposed technique are planned underway for other companies in the display industry as well.

Keywords: hi-tech industries, seismic protection, automated stocker system, viscous fluid damper

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Authors: Jerome E. Abiemo, Takeshi Mizunoya

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The Aveyime community in the Volta region of Ghana is one of the major hubs for rice production. In the past, rice farmers applied organic pesticides to control pests, and compost as a soil amendment to improve fertility and productivity. However, the introduction of chemical pesticides and fertilizers have led many farmers to convert to inorganic system of rice production, without considering the social costs (e.g. groundwater contamination and health costs) related to the use of pesticides. The study estimates and compares the private and social BCRs of organic and inorganic systems of rice production. Both stratified and simple random sampling techniques were employed to select 300 organic and inorganic rice farmers and 50 pesticide applicators. The respondents were interviewed with pre-tested questionnaires. The Contingent Valuation Method (CVM) which elucidates organic farmers` Willingness-to-Pay (WTP) was employed to estimate the cost of groundwater contamination. The Cost of Illness (COI) analysis was used to estimate the health cost of pesticide-induced poisoning of applicators. The data collated, was analyzed with the aid of Microsoft excel. The study found that high private benefit (e.g. increase in farm yield and income) was the most influential factor for the rapid adoption of pesticides among rice farmers. The study also shows that the social costs of inorganic rice production were high. As such the social BCR of inorganic farming (0.2) was low as compared to organic farming (0.7). Based on the results, it was recommended that government should impose pesticide environmental tax, review current agricultural policies to favour organic farming and promote extension education to farmers on pesticide risk, to ensure agricultural and environmental sustainability.

Keywords: benefit-cost-ratio (BCR), inorganic farming, pesticides, social cost

Procedia PDF Downloads 445

Authors: Shiran Bord, Assaf Oshri, Matthew W. Carlson, Sihong Liu

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Background: Alcohol-impaired driving (AID) and binge drinking are major health concerns among college students. Although the link between binge drinking and AID is well established, knowledge regarding binge drinking patterns, the factors influencing binge drinking, and the associations between consumption patterns and alcohol-related risk behaviors is lacking. Aims: To examine heterogeneous trajectories of binge drinking during college and tests factors that might predict class membership as well as class membership outcomes. Methods: Data were obtained from a sample of 1,265 college students (Mage = 18.5, SD = .66) as part of the Longitudinal Study of Violence Against Women (N = 1,265; 59.3% female; 69.2% white). Analyses were completed in three stages. First, a growth curve analysis was conducted to identify trajectories of binge drinking over time. Second, growth curve mixture modeling analyses were pursued to assess unobserved growth trajectories of binge drinking without predictors. Lastly, parental drinking variables were added to the model as predictors of class membership, and AID and being a passenger of a drunk driver were added to the model as outcomes. Results: Three binge drinking trajectories were identified: high-convex, medium concave and low-increasing. Parental drinking was associated with being in high-convex and medium-concave classes. Compared to the low-increasing class, the high convex and medium concave classes reported more AID and being a passenger of a drunk driver more frequently. Conclusions: Parental drinking may affect children’s later engagement in AID. Efforts should focus on parents' education regarding the consequences of parental modeling of alcohol consumption.

Keywords: alcohol impaired driving, alcohol consumption, binge drinking, college students, parental modeling

Procedia PDF Downloads 251

Authors: H. M. N. L. Handagiripathira

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The distributions of naturally occurring and anthropogenic radioactive materials were determined in surface sediments taken at 27 different locations along the bank of Negombo Lagoon in Sri Lanka. Hydrographic parameters of lagoon water and the grain size analyses of the sediment samples were also carried out for this study. The conductivity of the adjacent water was varied from 13.6 mS/cm to 55.4 mS/cm near to the southern end and the northern end of the lagoon, respectively, and equally salinity levels varied from 7.2 psu to 32.1 psu. The average pH in the water was 7.6 and average water temperature was 28.7 °C. The grain size analysis emphasized the mass fractions of the samples as sand (60.9%), fine sand (30.6%) and fine silt+clay (1.3%) in the sampling locations. The surface sediment samples of wet weight, 1 kg each from upper 5-10 cm layer, were oven dried at 105 °C for 24 hours to get a constant weight, homogenized and sieved through a 2 mm sieve (IAEA technical series no. 295). The radioactivity concentrations were determined using gamma spectrometry technique. Ultra Low Background Broad Energy High Purity Ge Detector, BEGe (Model BE5030, Canberra) was used for radioactivity measurement with Canberra Industries' Laboratory Source-less Calibration Software (LabSOCS) mathematical efficiency calibration approach and Geometry composer software. The mean activity concentration was found to be 24 ± 4, 67 ± 9, 181 ± 10, 59 ± 8, 3.5 ± 0.4 and 0.47 ± 0.08 Bq/kg for 238U, 232Th, 40K, 210Pb, 235U and 137Cs respectively. The mean absorbed dose rate in air, radium equivalent activity, external hazard index, annual gonadal dose equivalent and annual effective dose equivalent were 60.8 nGy/h, 137.3 Bq/kg, 0.4, 425.3 mSv/year and 74.6 mSv/year, respectively. The results of this study will provide baseline information on the natural and artificial radioactive isotopes and environmental pollution associated with information on radiological risk.

Keywords: gamma spectrometry, lagoon, radioactivity, sediments

Procedia PDF Downloads 111

Authors: Shree Kumar Maharjan

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Climate change has varied impacts on diverse livelihood sectors, which is more prominent at the community level. The stakeholders and local institutions have been supporting the communities either by building adaptive capacities and resilience or minimizing the impacts of different adaptation interventions. Some of these interventions are effective, whereas others need further dynamisms and exertions considering the complexity of the risks and vulnerabilities. Hence, consolidated efforts of concerned stakeholders are required to minimize and adapt the present and future impacts. This study digs out and analyses the perceptions of local stakeholders in climate change adaptation in Madi and Deukhuri valleys of Nepal through a questionnaire survey. The study has categorized the local stakeholders into 5 groups in the study sites – Farmers groups and cooperatives, Government, I/NGOs, Development banks and education and other organizations. The local stakeholders revealed flood, drought, cold wave and riverbank erosion as the major climatic risks and hazards found in the sites eventually impacting on the loss of agricultural production, loss of agricultural land and properties, loss of livestock, the emergence of diseases and pest. The stakeholders believed that most of the farmers dealing with these impacts based on their traditional knowledge and practices, followed by with the support of NGOs and with the help of neighbors and community. The major supports of the stakeholders to deal with these impacts were on training and awareness, risk analysis and minimization, livelihood improvement, financial support, coordination and networking and facilitation in policy formulation. The stakeholders emphasized primarily on capacity building, appropriate technologies, community-based planning and monitoring, prioritization to the poor and the marginalized and establishment of community fund respectively for building adaptive capacities.

Keywords: climate change adaptation, local stakeholders, Madi, Deukhuri, Nepal

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Authors: Luksanaporn Krungkraipetch

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Pterygium is a frequent ocular surface lesion that begins in the limbal conjunctiva within the palpebral fissure and spreads to the cornea. The lesion is more common in the nasal limbus than in the temporal, and it has a wing-like aspect. Indications for surgery, in decreasing order of significance, are growth over the corneal center, decreased vision due to corneal deformation, documented growth, sensations of discomfort, and esthetic concerns. The aim of this study is twofold: first, to determine the frequency of pterygium recurrence after surgery at the mentioned hospital, and second, to identify the factors that influence the recurrence of pterygium. The research design is a retrospective examination of 164 patient samples in an eastern Thai university hospital (Code 13766). Data analysis is descriptive statistics analysis, i.e., basic data details about pterygium surgery and the risk of recurrent pterygium, and for factor analysis, the inferential statistics chi-square and ANOVA are utilized. Twenty-four of the 164 patients who underwent surgery exhibited recurrent pterygium. Consequently, the incidence of recurrent pterygium after surgery was 14.6%. There were an equal number of men and women present. The participants' ages ranged from 41 to 60 years (62, 8 percent). According to the findings, the majority of patients were female (60.4%), over the age of 60 (51.2%), did not live near the beach (83.5%), did not have an underlying disease (92.1%), and 95.7% did not have any other eye problems. Gender (X² = 1.26, p = .289), age (X² = 5.86, p = .119), an address near the sea (X² = 3.30, p = .081)), underlying disease (X² = 0.54, p = .694), and eye disease (X² = 0.00, p = 1.00) had no effect on pterygium recurrence. Recurrences occurred in 79.1% of all surgical procedures and 11.6% of all patients using the bare sclera technique. The recurrence rate for conjunctival autografts was 20.9% for all procedures and 3.0% for all participants. Mitomycin-C and amniotic membrane transplant techniques had no recurrence following surgery. Comparing the surgeries done on people with recurrent pterygium did not show anything important (F = 1.13, p = 0.339). In conclusion, the prevalence of pterygium recurrence following pterygium, 14.6%, does not differ from earlier research. Underlying disease, other eye conditions, and surgical procedures such as pterygium recurrence are unaffected by pterygium surgery.

Keywords: pterygium, recurrence pterygium, pterygium surgery, excision pterygium

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Authors: Teklay Gebrecherkos, Dawit Wolday, Muhamud Abdulkader

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Background: COVID-19 symptomatology in Africa appears significantly less serious than in the industrialized world. Our hypothesis for this phenomenon, being a different, more activated immune system due to parasite infections contributes to reduced COVID-19 outcome. We investigated this hypothesis in an endemic area in sub sub-saharan Africa. Methods: Ethiopian COVID-19 patients were enrolled and screened for intestinal parasites, between July 2020 and March 2021. The primary outcome was the proportion of patients with severe COVID-19. SARS-CoV-2 infection was confirmed by RT-PCR on samples obtained from nasopharyngeal swabs, while direct microscopic examination, modified Ritchie concentration, and Kato-Katz methods were used to identify parasites and ova from a fresh stool sample. Ordinal logistic regression models were used to estimate the association between parasite infection and COVID-19 severity. Models were adjusted for sex, age, residence, education level, occupation, body mass index, and comorbidities. Data were analyzed using STATA version 14. P-value <0.05 was considered statistically significant. Results: A total of 751 SARS-CoV-2 infected patients were enrolled, of whom 284 (37•8%) had an intestinal parasitic infection. Only 27/255 (10•6%) severe COVID-19 patients were co-infected with intestinal parasites, while 257/496 (51•8%) non-severe COVID-19 patients appeared parasite positive (p<0.0001). Patients co-infected with parasites had lower odds of developing severe COVID-19, with an adjusted odds ratio (AOR) of 0•14 (95% CI 0•09–0•24; p<0•0001) for all parasites, AOR 0•20 ([95% CI 0•11–0•38]; p<0•0001) for protozoa, and AOR 0•13 ([95% CI 0•07–0•26]; p<0•0001) for helminths. When stratified by species, co-infection with Entamoeba spp., Hymenolopis nana, and Schistosoma mansoni implied a lower probability of developing severe COVID-19. There were 11 deaths (1•5%), and all were among patients without parasites (p=0•009). Conclusions: Parasite co-infection is associated with a reduced risk of severe COVID-19 in African patients. Parasite-driven immunomodulatory responses may mute hyper-inflammation associated with severe COVID-19.

Keywords: COVID-19, SARS-COV-2, intestinal parasite, RT-PCR, co-infection

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