Ali İhsan Bozkurt

Patterns of active and passive smoking, and associated factors, in the South-east Anatolian Project (SEAP) region in Turkey

BackgroundSmoking is an important health threat in Turkey. This study aimed to determine the frequency of and main factors associated with smoking in persons of 15 years and over, and the frequency of passive smoking in homes in the South-east Anatolian Project (SEAP) Region in Turkey.MethodsA cross sectional design was employed. The sample waschosen by the State Institute of Statistics using a stratified cluster probability sampling method. 1126 houses representing the SEAP Region were visited.Questionnaires about tobacco smoking and related factors were applied to 2166 women and 1906 men (of 15 years old and above) in their homes. Face-to-face interview methods were employed. Participants were classified as current, ex, and non-smokers. The presence of a regular daily smoker in a house was used as an indication of passive smoking. The chi-square andlogistic regressionanalysis methods were used for the statistical analysis.ResultsThe prevalence of smoking, in those of 15 years and over, was 11.8% in women and 49.7% in men. The prevalence of current smokers was higher in urban (34.5 %) than in rural (22.8 %) regions. The mean of total cigarette consumption was 6.5 packs/year in women and 17.9 packs/year in men. There was at least one current smoker in 70.1% of the houses.ConclusionSmoking is a serious problem in the South-eastern Anatolian Region. Male gender, middle age, a high level of education and urban residency were most strongly associated with smoking.

Prevalence of lower urinary tract symptoms, overactive bladder and urinary incontinence in western Turkey: results of a population-based survey.

To estimate the prevalence of lower urinary tract symptoms, urinary incontinence and overactive bladder in western Turkey.

PREVALENCE AND HEMATOLOGICAL CHARACTERISTICS OF β-THALASSEMIA TRAIT IN GAZIANTEP URBAN AREA, TURKEY

Thalassemia is one of the most common hereditary disorders in the Mediterranean region and studies have shown that the prevalence of β-thalassemia trait is high in the southern part of Turkey. Gaziantep is a city located near this region and, therefore, the authors investigated the prevalence and hematological characteristics of the β-thalassemia traits in primary school students in Gaziantep. Sixty primary schools were selected from a list of all primary schools using a systematic sampling method. Data were collected by a face-to-face questionnaire. Osmotic fragility testing (OFT) using single-tube 0.36% NaCl solution was used for the screening of β-thalassemia. Students who were positive in regard to OFT went through a series of testing, including a complete blood count, serum ferritin levels, serum iron, and hemoglobin electroforesis. Chi-square test was used in statistical analysis. Of the 2439 students enrolled to the study from the selected 60 classrooms, 1353 (55.5%) were male and 1086 (44.5%) were female. The OFT was positive in 115 (4.7%) of the participants. CEA and confirmatory HPLC results of the students who were positive OFT indicated that 70 (60.8%) had normal results, 33(28.7%) showed high HbA2 levels, 7 (6.1%) showed high HbA2 and HbF levels, 5(5.2%) showed high HbA2 and Fe-deficiency anemia, and none showed increased HbF levels. The overall prevalence of β-thalassemia trait was 1.84%. No gender differentials and highest rates among the Kahramanmaras (3.5%) and Sanliurfa (1.7%) born students were the other significant findings of this study. Implementation of a routine carrier-screening program offering genetic counseling, prenatal diagnosis, and selective termination of affected fetuses would be a wise approach to eliminate this disease from the region.

Seroprevalence of human cystic echinococcosis and risk factors in animal breeders in rural communities in Denizli, Turkey

INTRODUCTION Cystic echinococcosis (CE) is a serious public health problem in sheep-raising regions of Turkey. The aim of this study was to determine the prevalence and associated risk factors of echinococcosis in rural regions of Denizli in Turkey. METHODOLOGY This study was undertaken in four townships in Denizli County between May 2009 and July 2009. Family members were interviewed to assess possible risk factors for infection and tested for anti-E. granulosus antibodies by enzyme-linked immunosorbent assay (ELISA). RESULTS Of the 1,133 individuals included in the study, 78 (6.9%) were found to be anti-EG seropositive. Multivariate analysis showed that the 30-39 year age group (odds ratio [OR]: 3.29; 95% confidence interval [CI]: 1.30 ± 8.33; p = 0.01), the ≥ 60 year group (OR: 4.08; 95% CI: 1.57 ± 10.61; p = 0.004), and the group that reported sometimes or never getting veterinary care for their animals (OR: 1.75; 95% CI: 1.05 ± 2.93; p = 0.032) had higher rates of seropositivity. Multivariate analysis showed that education was not significantly associated with seropositivity. Furthermore, no significant correlation with location, occupation, dog ownership or contact with dogs, or with cattle and/or sheep/goat ownership was found. Regular veterinary care and education had significant effects on lowering the prevalence of CE. CONCLUSIONS Our results suggest that preventive measures, such as regular veterinary care for animals and educative and supportive activities oriented to the people working in farming and animal husbandry should be taken to decrease the prevalence of human CE in Turkey.

Obesity prevalence in gaziantep, Turkey.

Background: Obesity is associated with reduced quality of life, development of serious chronic conditions such as heart disease and diabetes, increased medical care costs, and premature death. Environmental effects, especially feeding habits may cause hyperinsulinemia and obesity. A Healthy People 2010 objective is to reduce the proportion of adults who are obese to 15%. Materials and Methods: This cross-sectional study was conducted on 1647 persons in a sample representing Gaziantep, Turkey. Over the selected 329 houses, 310 houses were reached (94.2%) and data about 1315 related persons was collected. The body mass index (BMI) shows the relationship between the weight and the height of people, calculated by the ratio of mass by kg over the square value of height measure. In statistical analyses chi-square, students t-test and logistic regression analysis were used. Results: The mean BMI increased with time for both sex, whereas decreased for 60+ age group. The fastest increase for both sex was seen while transition from 18 year to 19-29 age groups occurred. Another increase in women was in 30-39 age group; BMI=25.08±4.39 in 19-29 ages whilst BMI=29.02±5.79 in 30-39 ages. The increases in both sex in other age groups were not as much as in this group. Conclusion: Obesity is not only a problem in the Gaziantep but is also a major health concern in Europe and other regions of the world. As an accepted method against obesity, life-style changes should be put into use from childhood supported in school and family life.

The prevalence of fibromyalgia among textile workers in the city of Denizli in Turkey

Aim:  Fibromyalgia (FM) is characterized by chronic widespread pain, fatigue, reduced sleep quality and multiple tender points. A recent population study from Turkey found the prevalence of FM as 3.6%. A prevalence study among workers has not yet been performed. We performed a prevalence survey among working population in the city of Denizli in Turkey.

Compliance Status of Product Labels to the International Code on Marketing of Breast Milk Substitutes

The aim of this study was to determine the compliance status of product labels regarding Article 9 of the International Code on Marketing of Breast-milk Substitutes (the Code) in Denizli province, Turkey. A cross-sectional study design was employed to determine the compliance status. The product labels were obtained from a convenience sample of five supermarkets, one store and 5 pharmacies in the City centre and district of Honaz. Using a data collection form prepared by previously published studies, data were collected between July 26, 2010 and August 06, 2010. Data collection form included 13 criteria. In addition, we checked the boxes for the availability of a Turkish written label. Forty product labels of 7 companies were reached and evaluated. These products consisted of 83.0% of the products marketed by these companies in Turkey. Thirty seven (92.5%) of the labels violated Article 9 of the Code in terms of one or more criteria. Thirty four (85.0%) of the labels had photos or pictures idealizing the use of infant formula. Nine (22.5%) had a photo, a picture or any representation of an infant, and five (12.5%) had text which idealize the use of infant formula or discouraging breastfeeding. Eight (20%) did not state that breastfeeding is the best. Four (10%) had a term such as ‘similar to breast milk or human milk’. In conclusion, the majority of the product labels of breast milk substitutes marketed in our country violate the Code. It is appropriate that the Turkish Ministry of Health, medical organizations, companies, and NGOs work more actively to increase awareness of this issue.

The Prevalence of Nocturia and Nocturnal Polyuria: Can New Cutoff Values Be Suggested According to Age and Sex?

Purpose The aims of this study were to assess the prevalence of nocturia and nocturnal polyuria (NP) and to define new cutoff values according to age and sex for both conditions. Methods Data from a population-based prevalence survey conducted among a random sample of 2,128 adults were analyzed in this study. Participants were requested to fill out a questionnaire including the International Continence Society (ICS) definitions of lower urinary tract symptoms and the International Consultation on Incontinence Questionnaire - Short Form. Additionally, a 1-day bladder diary was given to each individual. The participants were divided into 5 age groups. The prevalence of nocturia was calculated based on definitions of nocturia as ≥1 voiding episodes, ≥2 episodes, and ≥3 episodes. NP was evaluated according to the ICS definition. The mean±standard errors and 95th percentile values were calculated in each group as new cutoff values for NP. Results The prevalence of nocturia was estimated as 28.4%, 17.6%, and 8.9% for ≥1, ≥2, and ≥3 voiding episodes each night, respectively. When nocturia was defined as 2 or more voiding episodes at night, the prevalence decreased significantly. The mean NP index was 29.4%±15.0% in men and 23.1%±11.8% in women. For the age groups of <50 years, 50–59 years, and ≥60 years, the new cutoff values for the diagnosis of NP were calculated as 48%, 69%, and 59% for men and 41%, 50%, and 42% for women, respectively. Conclusions We found that the definition of nocturia was still controversial and that waking up once for voiding might be within the normal spectrum of behavior. The definition of NP should be modified, and new cutoff values should be defined using the data presented in our study and in other forthcoming studies.

Evaluation of a mass measles vaccination campaign among school children aged 7–14 years old in Denizli, Turkey

ObjectiveTo determine the pre-campaign level of measles seropositivity and to evaluate the effect of a mass measles vaccination campaign on measles seroposivity among primary school children in Denizli, Turkey.MethodsThe study was completed in two socioeconomically different areas of Denizli, Turkey, with a sample size of 520 students. One primary school from each area and one classroom from each grade were randomly included in the sample. Before and 2-months after the measles mass vaccinations, blood samples were collected from the students and measles specific IgGs were studied.ResultsThe pre-campaign overall seropositivity was 74.7%. Post-campaign overall seropositivity increased to 96.5%. Pre-campaign seropositivity among 8-graders was significantly lower than that in other grades (57.5%, p<0.001) and the difference was explained by the number of vaccinations 8-graders received. Except for the number of vaccination doses, other factors did not have any effect on seropositivity.ConclusionsThe mass measles vaccination programs have a potential to control measles for developing countries. In addition, more than one dose of measles vaccination is required for developing countries.

Respiratory Systems of Dental Technicians Negatively Affected during 5 Years of Follow-Up

BACKGROUND Dental laboratory technician is one of the professions in which dust exposure is frequently experienced and therefore the health of workers has to be monitored. AIMS In this study, changes in the pulmonary functions and of pneumoconiosis frequencies among dental technicians after five years were investigated by comparing the results of two screenings carried out in 2008 and 2013. STUDY DESIGN Cohort study. METHODS In 2008 and 2013, Provincial Health Directorate carried out two different health screenings covering all of the dental technicians working in dental laboratories in Denizli. In both screenings, a questionnaire was applied, with which socio-demographic and workplace properties of the technicians were obtained. In addition, Pulmonary function tests (PFT) and standard chest X-rays of the technicians were performed. The results of these two screenings were evaluated by a chest specialist, and physical examinations were performed as necessary. In 2013, technicians who had pathologies underwent computerized tomography (HRCT). In this study, the study group was composed of dental laboratory technicians that participated in both screenings (2008 and 2013) and the data obtained from the screenings were compared. The gathered data were analyzed using paired student-t and X(2) tests. RESULTS A total of 125 dental laboratory technicians participated in the two screenings. Overall, 92% of the technicians were male and the mean age of the participants was 35. Technicians were working for 9 hours a day, 6 days a week. Total exposure time was calculated to be around 41 thousand hours. Approximately 60% of workers were smokers. When the results of PFT were analyzed, 73% of the first evaluations were found to be normal; however, this ratio decreased to 51% in the second analysis five years later. In the second PFT measurement, compared to the first, there was a 23% decrease in the forced vital capacity (FVC) value, and a 15.7% decrease in forced expiratory volume in one second (FEV1). While restrictive disorder was found 25% in the first PFT evaluations, this ratio increased to 31% in the second PFT. When the radiological results were considered, 62% of the first X-ray results were found to be normal but this ratio decreased to 18% in 2013. While reticular/reticulonodular opacities were found in 11% of cases in 2008, it increased to 30% in 2013. Seven technicians were diagnosed with pneumoconiosis (5.6%). CONCLUSION Respiratory tracts of the technicians were negatively affected during the five year period. The number of pneumoconiosis cases (5.6%) shows that it is necessary to adopt comprehensive work health and safety precautions for laboratories.