Elçin Balcı

Tularemia outbreaks in Kayseri, Turkey: An evaluation of the effect of climate change and climate variability on tularemia outbreaks

OBJECTIVES The aim of this study was to evaluate the epidemiological characteristics of tularemia outbreak and the effect of climate variability on this outbreak in Kayseri. METHODS The outbreak places, infection dates, source of infection, and the number of cases were recorded and analyzed. This information was obtained from the Regional Public Health Department. Climate data were supplied by the Regional Meteorological Service. RESULTS The first case in Sariz was recorded in 2005. Thereafter, 2 cases were reported in 2006 and 1 case in 2007. During 2010, 21 cases were recorded in 7 towns, 62 cases in 2011 and 27 cases in 2012. A total number of 110 cases were recorded in 12 out of 16 towns in Kayseri Province between 2010 and 2012. The majority of cases were seen in the north-eastern, east and south-eastern parts of Kayseri Province; located in higher altitudes (over 1000m from sea level). It was accepted that the outbreak was originated from water sources and was confirmed by few number of water samples collected from outbreak areas. Considering climate variations, the outbreak occurred between 1988 and 2009 during a dry, low humid, high temperature period after rainy season. CONCLUSION A tularemia outbreak was observed between 2010 and 2012 with the initiation of rainy years. High temperature for a long period accompanied by low rainfall and low humidity may affect the vectors biology and initiate a tularemia outbreak in high plateaus in Kayseri Province and around.

Body mass index percentiles for Turkish children aged 0-84 months

Background: Reference body mass index (BMI) percentiles are needed to follow secular changes in Turkish children aged 0–84 months. Obesity prevalence in this age group is also not well documented. Aim: The aim of this study was to determine BMI percentiles and the prevalences of overweight and obesity in Turkish children aged 0–84 months. The authors also tried to compare actual BMI status with World Health Organization (WHO) standards. Subjects and methods: This study used data from the Anthropometry of Turkish Children aged 0–6 years (ATCA-06) study. This cross-sectional study, conducted from September 2009 to May 2010 in Kayseri, Turkey, included 2683 children (1359 girls, 1324 boys) aged 0–84 months. Centile curves were constructed using the LMS method. Results: It was found that BMI percentiles of Turkish children were higher than WHO standards in early childhood. The overweight and obesity prevalences were identical in both genders, 10.0% and 4.9%, respectively. Conclusion: This study provides both BMI reference values and prevalence figures for overweight and obesity in children aged 0–84 months, residing in Kayseri city, in Turkey. It is believed that these data can be of use in following secular changes as well as for comparisons with international standards.

Comparison of life quality of pregnant adolescents with that of pregnant adults in Turkey

Abstract Objectives. This study aimed to determine the quality of life of pregnant adolescents aged < 20 years and pregnant adults aged between 20–29 years, to evaluate the effects of gestational periods on the quality of life, and to compare the quality of life scores of pregnant adolescents and adults. Methods. This study was performed in Turkey in 2007. Totally, 147 pregnant adolescents aged < 20 years and 156 pregnant adults aged between 20 and 29 years were included. A questionnaire on socio-demographic and obstetric characteristics was administered by face-to-face interviewing method, and Short Form-36 scale was applied. Results. The mean quality of life scores ranged between 44.2 and 56.1 points for the adolescents and between 44.6 and 59.9 points for the adults. All quality of life scores, except bodily pain, were lower for adolescents than for adults. It was determined that the quality of life scores in pregnancy were generally lower in the first trimester, significantly increased in the second trimester, and decreased to the lowest level in the third trimester. Conclusions. Quality of life scores of the pregnant adolescents were significantly lower than the pregnant adults. Physical care, support, and education programs may be beneficial to increase the quality of life levels in pregnancy.

Prevalence and risk factors of onychomycosis in primary school children living in rural and urban areas in Central Anatolia of Turkey

BACKGROUND Onychomycosis is a world-wide public health concern in children, requiring epidemiological data for different regions for control and prevention. AIM The aim of this study was to evaluate the predominant pathogens and risk factors for onychomycosis in school children living in Kayseri, Turkey. METHODS This study included 8122 school children, aged 5-16 years, living in the rural and urban areas around Kayseri. Onychomycosis was clinically classified as distal and lateral subungual (DLSO), proximal subungual, superficial white, endonyx and totally dystrophic onychomycosis. Nail samples from children with clinically diagnosed onychomycosis were collected, examined by direct microscopy and inoculated for culture study. The demographic features and possible risk factors were recorded and assessed by logistic regression models. RESULTS We clinically diagnosed onychomycosis in 152 out of 8,122 (0.18%) school children. DLSO was the most frequent clinical diagnosis (120/152, 78.9%). Culture-positive onychomycosis was detected in 27/152 (17.7%) children. The prevalence of culture-positive onychomycosis was determined as 0.33%. All culture-positive samples were only from toenails. The onychomycosis causative agents were dermatophytes in 17/27 cases (62.9%), including Trichophyton rubrum 12 (44.4%), Trichophyton mentagrophytes 1 (3.7%), Trichophyton tonsurans 1 (3.7%) and Trichophyton spp. 3 (11.1%) and yeasts in 10/27 cases (37.1%), including Candida glabrata 4 (14.8%), Candida parapsilosis 1 (3.7%), Trichosporon 2 (7.4%) and Rhodotorula 3 (11.1%). Age, fathers occupation, number of siblings and rooms were statistically associated with the frequency of onychomycosis. CONCLUSIONS Although to be prevalence of onychomycosis in school children in central Anatolia of Turkey seems very low degree, pediatric onychomycosis is a growing public health concern all over the world. Children having more siblings or unemployed fathers and children living in small house as well as older children should be examined carefully for onychomycosis.

Sore throat in primary care project: a clinical score to diagnose viral sore throat

Abstract Objective. Viral agents cause the majority of sore throats. However, there is not currently a score to diagnose viral sore throat. The aims of this study were (i) to find the rate of bacterial and viral causes, (ii) to show the seasonal variations and (iii) to form a new scoring system to diagnose viral sore throat. Methods. A throat culture for group A beta haemolytic streptococci (GABHS) and a nasopharyngeal swab to detect 16 respiratory viruses were obtained from each patient. Over a period of 52 weeks, a total of 624 throat cultures and polymerase chain reaction analyses were performed. Logistic regression analysis was performed to find the clinical score. Results. Viral infection was found in 277 patients (44.3%), and GABHS infection was found in 116 patients (18.5%). An infectious cause was found in 356 patients (57.1%). Rhinovirus was the most commonly detected infectious agent overall (highest in November, 34.5%), and the highest GABHS rate was in November (32.7%). Analysis of data provided a scoring system, called the Mistik Score, to diagnose viral sore throat. The predictive model for positive viral analysis included the following variables: absence of headache, stuffy nose, sneezing, temperature of ≥37.5°C on physical examination, and the absence of tonsillar exudate and/or swelling. The probability of a positive viral analysis for a score of 5 was 82.1%. Conclusion. The Mistik Score may be useful to diagnose viral sore throat. We suggest its use either alone or in combination with the Modified Centor Score.

Risk factors for overweight and obesity in children aged 2-6 years.

Abstract Background: Understanding risk factors that may vary culturally can help improve preventive strategies for obesity. This is the first cross-sectional study aimed to determine the risk factors for overweight/obesity in children aged 2–6 years in a central Anatolian city in Turkey. Methods: A total of 1582 children (1351 healthy, 231 overweight/obese) aged 2–6 years were included from the Anthropometry of Turkish Children aged 0–6 years database. Age, gender, birth weight, birth order, mother’s age, mother’s body mass index (BMI), weight gain of mothers during pregnancy, presence of gestational diabetes, breastfeeding duration, history of formula feeding, mother’s and father’s education, mother’s job, monthly income, smoking at home and physical activity, sleep duration and duration of television (TV) watching of the children were evaluated as independent risk factors. Logistic regression analyses were performed to investigate risk factors for overweight/obesity. Results: Having a high family income compared to bad [odds ratio (OR)=1.96; 95% confidence interval (CI): 1.237–3.106], increased the time of watching TV during the weekend (OR=1.094; 95% CI: 1.032–1.159), and similar physical activity level according to their peers compared to less (OR=2.957; 95% CI: 1.056–8.282) were found to be significantly associated with a higher risk of overweight/obesity in children aged 2–6 years old. Conclusions: The early childhood period seems to be important in the establishment of healthy behavioral patterns, especially limitation of TV watching and encouragement of physical activity. Obesogenic environment in families with high incomes need to be revealed.

University Students Food Literacy and Food Safety Knowledge, Attitudes and Behaviors “Example of Amasya University Sabuncuoğlu Şerefeddin Health Services Vocational School

Objective: Know food safety and food literacy refers to our ability to reach healthy food. Nutrition and food habits are one of the most important factors affecting people’s health. Measuring and reaching consumers safe food levels and measures of food literacy will be an important step in improving public health. This study was conducted to measure the knowledge of university students about food literacy and food safety and to determine attitudes and behaviors related to the topic. Methods: This study was conducted between May and June 2016 at the age of 18 years and over in Amasya University Health Services Vocational School. Survey form data based on the face-to-face interview method and the literature was used in the whole. Questionnaires were directed to students who included food safety, food literacy, average monthly spending on food, and factors affecting food choices. The data were evaluated by SPSS ÖZET Amaç: Gıda güvenliğini bilmek ve gıda okuryazarlığı; sağlıklı gıdaya ulaşma konusundaki yeteneğimizi ifade etmektedir. Beslenme ve gıda alışkanlıkları insan sağlığını etkileyen en temel faktörlerdendir. Tüketicilerin güvenli gıdaya ulaşma ve gıda okuryazarlığı konusundaki bilgilerinin ölçülmesi ve bu alana müdahale edilmesi toplum sağlığını iyileştirmede önemli bir adım olacaktır. Bu çalışma, üniversite öğrencilerinin gıda okuryazarlığı ve gıda güvenliği hakkındaki bilgilerini ölçmek, konuya ilişkin tutum ve davranışlarını belirlemek amacıyla yapılmıştır. Yöntem: Bu çalışma 2016 yılının Mayıs-Haziran ayları arasında Amasya Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulunda okuyan 18 yaş ve üstü bireylerde yapılmıştır. Yüz yüze görüşme yöntemi ile literatüre dayalı olarak hazırlanmış anket formu veri toplamada kullanılmıştır. Anket formunda yer alan gıda güvenliği, gıda okuryazarlığı, gıda için aylık ortalama harcama tutarları, gıda tercihlerini etkileyen faktörleri içeren 1Amasya Üniversitesi, Sabuncuoğlu Şerefeddin Sağlık Hizmetleri Meslek Yüksekokulu, Amasya 2Erciyes Üniversitesi Tıp Fakültesi, Halk Sağlığı Anabilim Dalı, Kayseri Geliş Tarihi / Received : Kabul Tarihi / Accepted : İletişim / Corresponding Author : Zehra İNCEDAL-SONKAYA Amasya Üni. İpekköy Yerleşkesi Sabuncuoğlu Şerefeddin Sağ.Hiz. Mes. Y.okulu Amasya Türkiye Tel : +90 543 389 40 82 E-posta / E-mail : zehra.incedal@amasya.edu.tr] DOI ID : 10.5505/TurkHijyen.2018.99710 Türk Hijyen ve Deneysel Biyoloji Dergisi İncedal-Sonkaya Z, Balcı E, Ayar A. Üniversite öğrencilerinin gıda okuryazarlığı ve gıda güvenliği konusunda bilgi, tutum ve davranışları “Amasya Üniversitesi Sabuncuoğlu Şerefeddin Sağlık Hizmetleri Meslek Yüksekokulu örneği”. Turk Hij Den Biyol Derg, 2018; 75(1): 53-64 11.11.2016 11.08.2017 Makale Dili “Türkçe”/Article Language “Turkish”

Opinions and Behaviors on Use of Packaged Water Among the People Applying to Family Health Centers in Kayseri City Center

Objective: This study was purposed to determine the opinions and behaviours on use of packaged water among the people applying to family health centres in Kayseri city centre. Methods: The cross-sectional and descriptive survey was conducted on 1143 people aged 18 years and over who applied to Family Health Centers (ASM) located in Kayseri city center at February-March 2015. The data were gathered via questionnaire. SPSS 15.0 statistical package program was used for analyzing the data evaluated in the computer. Chi-square tests were used for comparisons, p<0.05 was considered significant. Results: The rate of preference of packed water for drinking was found to be 18.1%. Only 38.5% of the participants was believing in the cleanliness of tap water. Most preferred reasons for packed water were; ease of handling (50.4%), thought to be clean (36.5%) and dislike of tap water (20.4%). The packaged water consumption was higher among the people who were unmarried, in the 18-25 age group, in good economic status, having not child, living with two or three person in same house. ÖZET Amaç: Bu çalışma, Kayseri il merkezlerindeki aile sağlığı merkezlerine başvuranların içme suyu olarak ambalajlı su kullanımıyla ilgili düşünce ve davranışlarını ortaya koymayı amaçlandı. Yöntem: Kesitsel ve tanımlayıcı tipte olan araştırma 2015 yılı Şubat-Mart aylarında Kayseri merkez ilçelerinde bulunan aile sağlığı merkezlerine (ASM) başvuran 18 yaş ve üstü 1143 kişi üzerinde gerçekleştirildi. Veriler yüzyüze görüşülerek anket aracılığıyla toplandı. Bilgisayar ortamında değerlendirilen verilerin analizlerinde SPSS 15.0 istatistik paket programı kullanıldı. Karşılaştırmalarda ki kare testi kullanıldı ve p<0,05 anlamlı kabul edildi. Bulgular: İçme suyu olarak her zaman ambalajlı su tercih etme oranı %18,1 olarak bulundu. Tüm katılımcıların %38,5’ i şebeke suyunun temiz olduğunu düşünmekteydi. Ambalajlı suyun en fazla tercih sebepleri sırasıyla; taşıma kolaylığı (%50,4), temiz olduğu düşüncesi (%36,5) ve musluk suyunun tadını sevmeme (%20,4) idi. Evli olmayanlarda, 18-25 yaş grubunda olanlarda, çocuk sahibi olmayanlarda, ekonomik durumu iyi olanlarda, evde yaşayan kişi sayısı üç ile beş arasında olanlarda ambalajlı su tüketimi daha fazla bulundu. 1Erciyes Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, KAYSERİ İletişim / Corresponding Author : Arda BORLU Erciyes Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı, 38030, Kayseri Türkiye Tel : +90 352 207 66 66 E-posta / E-mail : ardaborlu@gmail.com DOI ID : 10.5505/TurkHijyen.2017.21932 Türk Hijyen ve Deneysel Biyoloji Dergisi Borlu A, Balcı E, Öztürk A. Kayseri il merkezinde Aile Sağlığı Merkezlerine başvuranların hazır su kullanımına ilişkin görüş ve davranışları. Turk Hij Den Biyol Derg, 2017; 74(EK-1): 113-118 Makale Dili “Türkçe”/Article Language “Turkish” 2. ULUSLARARASI SU VE SAĞLIK KONGRESİ 2017

Knowledge and Attitudes of Medical and Non-Medical Turkish University Students about Cervical Cancer and HPV Vaccination.

BACKGROUND This study was conducted to determine knowledge, attitudes and practices about cervical cancer and HPV vaccination of students studying in various faculties of Erciyes University. MATERIALS AND METHODS The study was performed among the first and fourth grade students of Medicine, Theology, Education and Economics and Administrative Sciences (FEAS) faculties of Erciyes University. It was aimed to reach 1,073 students and 718 were evaluated. A questionnaire consisting of 48 questions related to the socio-demographic characteristics, knowledge, attitude and practices about cervical cancer and HPV vaccination was administered to the students. The chi-square test and logistic regression were used for the statistical analyses. RESULTS Of the students, 78.3% were aware of cervical cancer, while 36.1% of them were aware of the HPV vaccine. The percentage hearing about cervical cancer and HPV vaccination was significantly higher among the students of the medical faculty than the others and among fourth grade students comparing with the first grade. The marital status and the presence of a health worker in the family had no significant impact on the knowledge level of the students. The acceptability of the HPV vaccination was low among all students. CONCLUSIONS The knowledge levels of the university students about cervical cancer and HPV vaccination are inadequate. This deficiency is more pronounced among the non-medical students and there is no significant increase during the faculty years. Non-medical students must be provided with information about important public health issues by elective courses. HPV vaccination could provide many benefits for men and women by decreasing the morbidity and mortality of cervical, anal, and penile cancers.

Rational Drug Use of Nurses

ABSTRACT Objective: At this study to be aimed to assess status of the knowledge of nurses who working in public and private health institutions in Sivas province use of medication fort he treatment during their illnesses and patients and the attitudes of rational drug application. Matherials and methods: the researc planned to attend 750 nurses but it has been completed with participation of 641 nurses (Reaching rate 85,5%). This is a descriptive and cross-sectional study. in the study data were collected with a questionaire, percentages stated and chi square test was used for analysis. Results: %95,3 of nurses were females and mean age of them 29.21±4.85 years. The rate of contacting a doktor in case of illness is higher in 39.1% of nurses in the 21-30 age group and 48.6% of nurses working in primary care institutions. The level of self-treating is higher in 45.5 % of nurses working less than a year in profession .In the case of illness, 53% of nurses stated that they had left the medicine when signs of disease over. %98.8 of nurses expressed that they know effects of drugs used and 99.1% of them stated they know the side effects of drugs used. The entire group of postgraduate education status stated that they have not received the drug recommended by others. The level of suggesting a drug to someone else fort he same disease is higher in 65.8% of the group 31 years and older and group working over 40 hours per week. It were determined that used in consultation with the physician 65.2% of nurses antibiotics, 87.5% of them weiht loss drug and 82.7% of them contraceptive . 99.5% of the nurses have expressed that they inform to patients about use of their medications. Among the issues that expressed informations took place the application form of drugs (51.0 %)and information of need to consult one if deemed one unexpected effect (59.6%) . Also has been identified that of nurses acquired inform about drugs from drug book (vademecum) (87.5 % ) and they save the remaining drugs in their home at the refrigator (50.9 %). Conclusions: Nurses who in young age group and have high education level more sensitive on rational drug use. Key Words: Nurses, Rational Drug Use, Knowledge,Attitude, Behaviour.