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Bista S, Chatzidiakou L, Jones RL, Benmarhnia T, Postel-Vinay N, Chaix B. Associations of air pollution mixtures with ambulatory blood pressure: The MobiliSense sensor-based study. Environ Res 2023; 227:115720. [PMID: 36940820 DOI: 10.1016/j.envres.2023.115720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 05/08/2023]
Abstract
Air pollution is acknowledged as a determinant of blood pressure (BP), supporting the hypothesis that air pollution, via hypertension and other mechanisms, has detrimental effects on human health. Previous studies evaluating the associations between air pollution exposure and BP did not consider the effect that air pollutant mixtures may have on BP. We investigated the effect of exposure to single species or their synergistic effects as air pollution mixture on ambulatory BP. Using portable sensors, we measured personal concentrations of black carbon (BC), nitrogen dioxide (NO2), nitrogen monoxide (NO), carbon monoxide (CO), ozone (O3), and particles with aerodynamic diameters below 2.5 μm (PM2.5). We simultaneously collected ambulatory BP measurements (30-min intervals, N = 3319) of 221 participants over one day of their lives. Air pollution concentrations were averaged over 5 min to 1 h before each BP measurement, and inhaled doses were estimated across the same exposure windows using estimated ventilation rates. Fixed-effect linear models as well as quantile G-computation techniques were applied to associate air pollutants' individual and combined effects with BP, adjusting for potential confounders. In mixture models, a quartile increase in air pollutant concentrations (BC, NO2, NO, CO, and O3) in the previous 5 min was associated with a 1.92 mmHg (95% CI: 0.63, 3.20) higher systolic BP (SBP), while 30-min and 1-h exposures were not associated with SBP. However, the effects on diastolic BP (DBP) were inconsistent across exposure windows. Unlike concentration mixtures, inhalation mixtures in the previous 5 min to 1 h were associated with increased SBP. Out-of-home BC and O3 concentrations were more strongly associated with ambulatory BP outcomes than in-home concentrations. In contrast, only the in-home concentration of CO reduced DBP in stratified analyses. This study shows that exposure to a mixture of air pollutants (concentration and inhalation) was associated with elevated SBP.
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Affiliation(s)
- Sanjeev Bista
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis Team, Faculté de Médecine Saint-Antoine, 27 Rue Chaligny, 75012, Paris, France.
| | - Lia Chatzidiakou
- Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
| | - Roderic L Jones
- Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Scripps Institution of Oceanography, University of California, 9500 Gilman Drive #0725, San Diego, CA, La Jolla, 92093, USA
| | | | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis Team, Faculté de Médecine Saint-Antoine, 27 Rue Chaligny, 75012, Paris, France
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Bista S, Fancello G, Chaix B. Acute ambulatory blood pressure response to short-term black carbon exposure: The MobiliSense sensor-based study. Sci Total Environ 2022; 846:157350. [PMID: 35870594 DOI: 10.1016/j.scitotenv.2022.157350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/07/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Documented relationships between black carbon (BC) exposure and blood pressure (BP) have been inconsistent. Very few studies measured both BC exposure and ambulatory BP across the multiple daily environments visited in the general population, and none adjusted for personal noise exposure, a major confounder. Our study addresses these gaps by considering 245 adults living in the Grand Paris region. Personal exposure to BC was monitored for 2 days using AE51 microaethalometers. Ambulatory BP was measured every 30 min after waking up using Arteriograph 24 monitors (n = 6772). Mixed effect models with a random intercept at the individual level and time-autocorrelation structure adjusted for personal noise exposure were used to evaluate the associations between BC exposure (averaged from 5 min to 1 h before each BP measurement) and BP. To increase the robustness of findings, we eliminated confounding by unmeasured time-invariant personal variables, by modelling the associations with fixed-effect models. All models were adjusted for potential confounders and short-term time trends. Results from mixed models show that a 1-μg/m3 increase in 5-minute averaged BC exposure was associated with an increase of 0.57 mmHg in ambulatory systolic blood pressure (SBP) (95 % CI: 0.30, 0.83) and with an increase of 0.36 mmHg in diastolic blood pressure (DBP) (95 % CI: 0.14, 0.58). The slope of the exposure-response relationship gradually decreased for both SBP and DBP with the increase in the averaging period of BC exposure from 5 min to 1 h preceding each BP measurement. Findings from the fixed-effect models were consistent with these results. There was no effect modification by noise in the associations, across all exposure windows. We found evidence of a relationship between BC exposure and acute increase in ambulatory SBP and DBP after adjustment for personal noise exposure, with potential implications for the development of adverse cardiovascular outcomes.
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Affiliation(s)
- Sanjeev Bista
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France.
| | - Giovanna Fancello
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France
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Chaix B, Bista S, Wang L, Benmarhnia T, Dureau C, Duncan DT. MobiliSense cohort study protocol: do air pollution and noise exposure related to transport behaviour have short-term and longer-term health effects in Paris, France? BMJ Open 2022; 12:e048706. [PMID: 35361634 PMCID: PMC8971765 DOI: 10.1136/bmjopen-2021-048706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION MobiliSense explores effects of air pollution and noise related to personal transport habits on respiratory and cardiovascular health. Its objectives are to quantify the contribution of personal transport/mobility to air pollution and noise exposures of individuals; to compare exposures in different transport modes; and to investigate whether total and transport-related personal exposures are associated with short-term and longer-term changes in respiratory and cardiovascular health. METHODS AND ANALYSIS MobiliSense uses sensors of location, behaviour, environmental nuisances and health in 290 census-sampled participants followed-up after 1/2 years with an identical sensor-based strategy. It addresses knowledge gaps by: (1) assessing transport behaviour over 6 days with GPS receivers and GPS-based mobility surveys; (2) considering personal exposures to both air pollution and noise and improving their characterisation (inhaled doses, noise frequency components, etc); (3) measuring respiratory and cardiovascular outcomes (smartphone-assessed respiratory symptoms, lung function with spirometry, resting blood pressure, ambulatory brachial/central blood pressure, arterial stiffness and heart rate variability) and (4) investigating short-term and longer-term (over 1-2 years) effects of transport. ETHICS AND DISSEMINATION The sampling and data collection protocol was approved by the National Council for Statistical Information, the French Data Protection Authority and the Ethical Committee of Inserm. Our final aim is to determine, for communicating with policy-makers, how scenarios of changes in personal transport behaviour affect individual exposure and health.
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Affiliation(s)
- Basile Chaix
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, INSERM, Paris, France
| | - Sanjeev Bista
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, INSERM, Paris, France
| | - Limin Wang
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, INSERM, Paris, France
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California San Diego, La Jolla, California, USA
| | - Clélie Dureau
- Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, INSERM, Paris, France
| | - Dustin T Duncan
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
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Bista S, Dureau C, Chaix B. Personal exposure to concentrations and inhalation of black carbon according to transport mode use: The MobiliSense sensor-based study. Environ Int 2022; 158:106990. [PMID: 34991251 DOI: 10.1016/j.envint.2021.106990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 10/19/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Epidemiological evidence suggests that motorized vehicle users have a higher air pollutant exposure (especially from vehicle exhaust) than active (walking or cycling) transport users. However, studies often relied on insufficiently diverse sample and ignored that minute ventilation has an effect on individuals' inhaled dose. This study examined commuters' breathing zone concentration and inhaled doses of black carbon (BC) when travelling by different transport modes in the Grand Paris region. METHODS Personal exposure to BC was continuously measured with MicroAethalometer (MicroAeth AE51) portable monitors strapped on participants' shoulder with tube inlet at the level of the neck (breathing zone), and inhaled doses were derived from several methods estimating ventilation [based on metabolic equivalents from accelerometry [METs], heart rate, and breathing rate]. Trip stages and transport modes were assessed from GPS and mobility survey data. Breathing zone concentrations and inhaled doses of BC were compared across transport modes at the trip stage level (n = 7495 for 283 participants) using linear mixed effect models with a random intercept at individual level. RESULTS Trip stages involving public transport and private motorized transport were associated with a 2.20 µg/m3 (95% CI: 1.99, 2.41) and 2.29 µg/m3 (95% CI: 2.10, 2.48) higher breathing zone concentration to BC than walking, respectively. Trip stages with other active modes had a 0.41 µg (95% CI: 0.25, 0.57) higher inhaled dose, while those involving public transport and private motorized transport had a 0.25 µg (95% CI: -0.35, -0.15) and 0.19 µg (95 %CI: -0.28, -0.10) lower inhaled dose of BC per 30 min than walking. CONCLUSION The ranking of transport modes in terms of personal exposure was markedly different when breathing zone concentrations and inhaled doses were considered. Future studies should take both into account to explore the relationship of air pollutants in transport microenvironments with physiological response.
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Affiliation(s)
- Sanjeev Bista
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France.
| | - Clélie Dureau
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Nemesis team, Faculté de Médecine Saint-Antoine, 27 rue Chaligny, 75012 Paris, France
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Ranjit R, Bista S, Manandhar P, Subedi S. Periodontitis and Diabetes: How Well the Patients have Knowledge about the Established Interrelationship? Kathmandu Univ Med J (KUMJ) 2022; 20:87-92. [PMID: 36273298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Background Type 2 diabetes is an escalating health problem in Nepal and it holds a strong bidirectional Inter relationship with periodontitis. However, lack of its knowledge and motivation among patients may deteriorate and complicate their condition. Objective To assess knowledge among general population regarding the relation between diabetes and periodontitis and to evaluate the role of dentists and physicians in suggesting the diabetic patients for oral health care. Method A cross-sectional study was conducted among the patients visiting Department of Periodontics, Gandaki Medical College. A total 422 patients were interviewed using a set of pretested questionnaire and at the end they were counselled about the impact of diabetes mellitus on periodontal status and vice versa. Result Majority of the patients 257 (60.9%) had no idea about the interrelation between periodontitis and diabetes mellitus. Almost all the patients 363 (86.02%) assumed that poor oral health cannot increase the risk of developing diabetes and amongst those who had knowledge about this relation, the major source of information was their diabetic friends and relatives 46 (10.9%) and other sources such as syllabus 46 (10.9%). Only handful of patients 30 (7.10%) were informed about the relation by their dentist. Ironically, none of them were provided information about the interrelation by their treating physician. Conclusion Overall, only few participants had knowledge about the bidirectional relation between periodontitis and diabetes. Hence, our findings support the greater need for more targeted and specific health education along with close collaboration between dentists and physicians.
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Affiliation(s)
- R Ranjit
- Department of Periodontology and Oral Implantology, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal
| | - S Bista
- Department of Periodontology and Oral Implantology, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal
| | - P Manandhar
- Department of Prosthodontics and Maxillofacial Prosthetics, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal
| | - S Subedi
- Department of Periodontology and Oral Implantology, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal
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Bista S, Debache I, Chaix B. Physical activity and sedentary behaviour related to transport activity assessed with multiple body-worn accelerometers: the RECORD MultiSensor Study. Public Health 2020; 189:144-152. [PMID: 33242758 DOI: 10.1016/j.puhe.2020.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 09/10/2020] [Accepted: 10/09/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The study explored the physical activity and sedentary behaviours related to transport activity. The aim was to provide evidence to support public health and transport policies encouraging people to reach daily recommendations of physical activity. STUDY DESIGN The study design of this study is a cross-sectional study design. METHODS Between 2013 and 2015, the RECORD MultiSensor Study collected data from 155 participants using two accelerometers worn on the thigh and trunk. In addition, data were collected from Global Positioning System (GPS) receivers and a GPS-based mobility survey. Relationships between transport modes and the durations and partition patterns of physical behaviours were established at the trip stage (n = 7692) and trip levels (n = 4683) using multilevel linear models with a random effect at the individual level and taking into account temporal autocorrelation. RESULTS Participants travelled for a median of 1 h 45 min per day. Trip stages and trips involving walking, other active modes or public transport were associated with a lower sitting duration and a higher moderate-to-vigorous physical activity (MVPA) duration than trips with a personal motorised vehicle. Using public transport was associated with a lower number of transitions between sedentary behaviours and non-sedentary behaviours, and with a higher number of transitions between non-sedentary behaviours and MVPA than relying on a private motorised vehicle. CONCLUSIONS This study is the first to assess the association of transport mode with physical activity and sedentary behaviours captured with thigh- and trunk-worn accelerometers at both the trip stage and trip levels. The results demonstrate that, in addition to active transport modes, encouraging people to use public transport increases physical activity and reduces sedentary time.
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Affiliation(s)
- S Bista
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Nemesis Research Team, F75012, Paris, France.
| | - I Debache
- Institut Pluridisciplinaire Hubert Curien (IPHC) UMR 7178, Centre National de la Recherche Scientifique (CNRS), Université de Strasbourg, 67000, Strasbourg, France
| | - B Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Nemesis Research Team, F75012, Paris, France
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Rana J, Ahmmad Z, Sen KK, Bista S, Islam RM. Socioeconomic differentials in hypertension based on JNC7 and ACC/AHA 2017 guidelines mediated by body mass index: Evidence from Nepal demographic and health survey. PLoS One 2020; 15:e0218767. [PMID: 31986173 PMCID: PMC6984730 DOI: 10.1371/journal.pone.0218767] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 01/02/2020] [Indexed: 01/30/2023] Open
Abstract
Background Unlike developed countries, higher socioeconomic status (SES-education, and wealth) is associated with hypertension in low and middle-income countries (LMICs) with limited evidence. We examined the associations between SES and hypertension in Nepal and the extent to which these associations vary by sex and urbanity. The body mass index (BMI) was examined as a secondary outcome and assessed as a potential mediator. Materials and methods We analyzed the latest Nepal Demographic and Health Survey data (N = 13,436) collected between June 2016 and January 2017, using a multistage stratified sampling technique. Participants aged 15 years or older from selected households were interviewed with an overall response rate of 97%. Primary outcomes were hypertension and normal blood pressure defined by the widely used Seventh Report of the Joint National Committee (JNC7) and the American College of Cardiology/American Heart Association (ACC/AHA) 2017. Results The prevalence of hypertension was higher in Nepalese men than women. The likelihood of being hypertensive was significantly higher in the higher education group compared with the lowest or no education group for men (OR 1.89 95% CI: 1.36, 2.61) and for women (OR 1.20 95% CI: 0.79, 1.83). People in the richest group were more likely to be hypertensive compared with people in the poorest group for men (OR 1.66 95% CI: 1.26, 2.19) and for women (OR 1.60 95% CI: 1.20, 2.12). The associations between SES (education) and hypertension were partially modified by sex and fully modified by urbanity. BMI mediated these associations. Conclusions The higher SES was positively associated with the higher likelihood of having hypertension in Nepal according to both JNC7 and ACC/AHA 2017 guidelines. These associations were mediated by BMI, which may help to explain broader socioeconomic differentials in cardiovascular disease (CVD) and related risk factors, particularly in terms of education and wealth. Our study suggests that the mediating factor of BMI should be tackled to diminish the risk of CVD in people with higher SES in LMICs.
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Affiliation(s)
- Juwel Rana
- Research and Innovation Department, South Asia Institute for Social Transformation (SAIST), Dhaka, Bangladesh
- Department of Public Health, North South University, Dhaka, Bangladesh
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
- * E-mail:
| | - Zobayer Ahmmad
- Department of Sociology, University of Utah, Salt Lake City, Utah, United States of America
| | | | - Sanjeev Bista
- Advanced Biostatistics and Epidemiology, Ecole des Hautes Etudes en Sante Publique, Rennes, France
| | - Rakibul M. Islam
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Bista S, Hutzell E, Smith D, Bhatta M. Relationship between substance use disorders with encounters and the criminal justice system among persons diagnosed with schizophrenia or schizoaffective disorders. Ann Epidemiol 2019. [DOI: 10.1016/j.annepidem.2019.06.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Patro R, Bista S, Varshney A. Social snapshot: a system for temporally coupled social photography. IEEE Comput Graph Appl 2011; 31:74-84. [PMID: 24807972 DOI: 10.1109/mcg.2010.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Social Snapshot actively acquires and reconstructs temporally dynamic data. The system enables spatiotemporal 3D photography using commodity devices, assisted by their auxiliary sensors and network functionality. It engages users, making them active rather than passive participants in data acquisition.
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Dumre SP, Sapkota K, Adhikari N, Acharya D, Karki M, Bista S, Basanyat SR, Joshi SK. Asymptomatic throat carriage rate and antimicrobial resistance pattern of Streptococcus pyogenes in Nepalese school children. Kathmandu Univ Med J (KUMJ) 2010; 7:392-6. [PMID: 20502080 DOI: 10.3126/kumj.v7i4.2760] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Streptococcus pyogenes or Group A streptococcus (GAS) causes several suppurative and non suppurative infections. In addition to pharyngitis and skin infections, GAS are also the causative agent of post-streptococcal infection syndromes such as acute rheumatic fever (ARF) and post-streptococcal glumerulonephritis (PSG). GAS frequently colonises in the throat of an asymptomatic person. Pharyngeal carriage rates of GAS among healthy school children vary with geographical location and seasons. OBJECTIVES We carried out this preliminary study to determine the throat carriage rate and antimicrobial resistance trend of Streptococcus pyogenes or Group A streptococcus (GAS) among the Nepalese school children. MATERIALS AND METHODS Four schools situated at different locations of Kathmandu valley were included in the study. Throat swabs from 350 students of age group 5-15 years were collected, immediately transported to the laboratory and were processed for S. pyogenes following standard microbiological procedures. Antimicrobial susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion method following CLSI guidelines. RESULTS S. pyogenes was isolated from 10.9% (38/350) of the screened children. The GAS colonisation rate was statistically insignificant (P>0.05) with sex and age sub-groups, although the rate was slightly higher among girls and age sub-group 9-12 years. No significant difference in carrier rate was observed among different schools (P>0.05). All isolates were susceptible to azithromycin. No resistance was detected for penicillin and its derivative antibiotic ampicillin. Highest resistance rate was observed for cotrimoxazole (71.0%) followed by chloramphenicol (7.8%), ciprofloxacin (5.2%) and erythromycin (5.2%). CONCLUSION Antibiotic resistant GAS isolated from asymptomatic Nepalese school children is a public health concern. When screened and appropriately treated with antibiotics, carriers can be prevented from spreading of streptococcal infections in the school environment and the community. Preventing cross infections would ultimately reduce the incidence of life-threatening sequelae which are debilitating and difficult to treat. It is recommended to conduct regular screening and GAS surveillance in schools, and maintain rational use of antibiotics to minimise GAS carriage/infections and resistance.
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Affiliation(s)
- S P Dumre
- National Public Health Laboratry, Teku, Kathmandu, Nepal.
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Mishra P, Subish P, Upadhyay DK, Bista S, Alam K, Bhandari RB. Medication counseling center in a teaching hospital. JNMA J Nepal Med Assoc 2005; 44:129-34. [PMID: 16751815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
Patient compliance is often not achieved during drug therapy. Many reasons including lack of patients' understanding regarding medication and disease, poor socioeconomic pattern, unavailability of drugs are attributed to this situation. Providing counseling to patients can improve their understanding regarding medication, disease and life style modifications which in turn improves compliance. Medication counseling centers are one of the means to counsel the patients. The study was conducted to analyze the performance of such a center at Manipal Teaching Hospital, a teaching hospital in Western Nepal. Patients were counseled as per the Omnibus Budget Reconciliation Act-1990 guidelines and data were collected from the documentation form of the center and analyzed. Results indicated that 84.5% of the patients were directed to the medication counseling center by the pharmacists. Nearly one quarter of the population was either asthmatic or chronic obstructive pulmonary disease patients. Bronchodilators were found to be the major therapeutic category of drugs and were found in 26.7% of the patients. Among the various counseling aids, placebo inhalers were used in 45.1% of the patients. The counseling pharmacists dedicated an average time period of 6-10 minutes in about 42.1% of the patients. Language was found to be the major barrier while counseling 16.5% of the patients. The study concluded that the medication counseling center can play a definite role in enhancing patients' understanding about medications and disease pattern, which in turn may improve patient compliance.
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Affiliation(s)
- P Mishra
- Manipal Teaching Hospital, Manipal College of Medical Sciences, Pokhara, Nepal.
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