Meliksah Ertem

The epidemiological aspects of irritable bowel syndrome in Southeastern Anatolia: a stratified randomised community‐based study

Even though studies on the epidemiology of the irritable bowel syndrome (IBS) are increasing day by day, epidemiological data are still unknown in many regions. Our objective was to determine the IBS prevalence, factors associated with this prevalence and probable risk groups in Southeastern Anatolia.

Breastfeeding patterns, beliefs and attitudes among Kurdish mothers in Diyarbakir, Turkey

Aim: The aim was to rapidly assess existing breastfeeding patterns, beliefs and attitudes in the province of Diyarbakir, a socio‐economically disadvantaged region of Turkey. Methods: A cross‐sectional survey exploring demographic and breastfeeding patterns was carried out among 921 mothers with children 6–18 mo of age. Results were quantitatively analysed. Focus group interviews dealing with beliefs and attitudes were separately carried out among 107 mothers and analysed by qualitative content analysis. Results: Nearly all mothers had breastfed their infants at some time, but exclusive breastfeeding was rare. About 62.2% of the mothers had waited for at least 24 h before initiating breastfeeding. Almost half of the infants received sweetened water as a first feeding. There was agreement on the superiority of breastfeeding and awareness of its contraceptive effect. Early introduction of sugared water, water and supplementary feeds was considered desirable. Working in the fields and pregnancy were considered situations counteracting breastfeeding.

Neonatal Tetanus in the South-eastern Region of Turkey: Changes in Prognostic Aspects by Better Health Care

Neonatal tetanus is an important health problem with an estimated 500,000 deaths per year worldwide, particularly in developing countries. We analysed 56 cases of neonatal tetanus (NNT), retrospectively, who were admitted to Diyarbakir Children State Hospital between 1994 and 2001. In 1998 an intervention in a childcare intensive unit was conducted, which included a nurse education programme, increasing the number of nurses and other health staff, and more qualified management of cases. The mean age of patients was 7.9 days at admission, and the male:female ratio was 1:6. Eleven per cent of the cases had body weight under 2500 g. The mean hospitalization period was 9.9 days. All patients were born at home without medical help and 28.6 per cent were from urban areas. The case fatality rate that was formerly 88.5 per cent, decreased to 53.6 per cent by the intervention conducted in 1998. Based on our findings, we can say that improved hospitalization conditions and intensive care may reduce mortality. Enforcing preventive policies both in rural and urban areas is of great importance in the least developed regions.

Trauma type, gender, and risk of PTSD in a region within an area of conflict

The relation between trauma type, gender, and risk of posttraumatic stress disorder (PTSD) still remains unclear. The authors investigated the association among gender and trauma type and risk of PTSD among people living within an area of conflict. Traumatic experiences and PTSD symptoms among 708 participants were assessed. It was determined that more men (53%) were exposed to traumatic events than women (44%). They also found no difference in PTSD prevalence according to gender. However, the authors found that there was a different risk of PTSD among men and women who experienced similar traumatic events: the risk of PTSD for those who experienced military conflict was higher among men than it was among women.

Genetic characterization of measles viruses isolated in Turkey during 2000 and 2001.

BackgroundMolecular epidemiologic studies have made significant contributions to measles surveillance activities by helping to identify source and transmission pathways of the virus. This report describes the genetic characterization of wild-type measles viruses isolated in Turkey in 2000 and 2001.ResultsWild-type measles viruses were isolated from 24 cases from five provinces in Turkey during 2001. The viruses were analyzed using the standard genotyping protocols. All isolates were classified as genotype D6, the same genotype that was identified in Turkey in previous outbreaks during 1998.ConclusionTurkey has begun implementation of a national program to eliminate measles by 2010. Therefore, this baseline genotype data will provide a means to monitor the success of the elimination program.

Opinions on early-age marriage and marriage customs among Kurdish-speaking women in southeast Turkey

Objectives For women, marriage before the age of 18 years has adverse consequences for physical, mental and emotional well-being and constitutes a barrier for continued education. According to a national survey, about 50% of all women in Eastern Turkey were aged under 18 years at first marriage. Methods This study explored womens opinions and experiences of early marriage and culture-specific marriage customs in the province of Diyarbakir, a region of Turkey populated mostly by people of Kurdish ethnicity. A random sample of 966 women aged 15 years or older living in urban and rural areas of the province completed a questionnaire on age at marriage and social status. Qualitative data on womens opinions and experiences were also collected through focus group interviews with 90 women. Results The frequency of early marriage ranged from 19% in the youngest age group to 63% in women aged 60 years or older. Analysis of focus group interviews through a qualitative modified content method showed that girls were considered marriageable some years after the menarche and considerations regarding the protection of family honour were key factors leading parents to arrange the early marriage of their daughters, sometimes without their consent. Some culture-specific marriage customs included cradle betrothal, cousin marriage and berdel (exchange of brides between two families). Conclusion There is a need for public health and family planning workers to create greater awareness of the adverse consequences of early marriage through parental arrangements.

Infant Feeding Beliefs and Practices in Islamic Societies: Focusing on Rural Turkey

Culture profoundly influences health knowledge, attitudes and behaviour, and this is particularly true of infant feeding practices. The benefits of breastfeeding to mother and the health of infants have long been known and breastfeeding is practised in Turkey. In this chapter, infant feeding practices of women living in rural areas of Turkey is described in the context of beliefs, traditions and cultural values. In Turkey nearly 1.5 million new births take place in each year and 95 percent of newborns are breastfed. Turkish mothers both in rural and in urban areas have positive opinion on breast milk. They consider breast milk as the best nutrient for infants; and according to their opinions, it should be introduced without interruption. When a mother is away from her infant, so as not to interrupt breastfeeding, another breastfeeding mother (that they call wetnurse) may continue. However, there is a wide range of beliefs, perceptions and practices in infant feeding which negatively affect appropriate breastfeeding. For example, in rural Turkey colostrum is deemed unsuitable for babies. Some also believe that babies should not be fed anything before ‘three calls to prayer (ezan)’ or that sugar water should be introduced first, before breast milk, to ‘clean’ the stomach. Exclusive breastfeeding is very rare in Turkey. Mothers supplement breast milk before 6 months by introducing liquids or solid foods. Mothers are also well aware of the contraceptive effect of breastfeeding. Some mothers prolonged breastfeeding to avoid pregnancy, controversially some of them stop to have a new baby. In rural Turkey, mothers breastfeed their infants anywhere whenever the baby needs it. This is an accepted norm and men just turn their eyes away with respect and walk away from the area. The way that mothers obtain their health-related information also affects infant feeding practices. Most often, the source of the information is older people living in the same family, but health professionals do not have the desired influence on mothers’ behaviour on infant feeding practices. For example, in the rural area of southeastern region of Turkey, nearly 60 percent of mothers are illiterate and cannot speak the official language of Turkey. Those mothers have less chance to be informed about infant feeding. Certain beliefs centre surround mothers during postpartum periods. The new mothers and their infants are vulnerable to supernatural powers. Both the woman and her baby should not be left by themselves at home, and a needle, bread, knife and onion are put under their pillows to protect them against supernatural powers. Insufficient milk appears to be the major reason for the early introduction of weaning foods. If the baby cries after breastfeeding, or if they feel that their infant is small, mothers interpret that as a result of insufficient breast milk. Mothers’ nutrition, sadness, hereditary features are the reasons shown by mothers for having insufficient breast milk.

Influenza Surveillance in Diyarbakir Between 2006-2009 Years -

Aim: The aim of this study was the evaluation of the surveillance activities for seasonal influenza in one of a sentinel city of Diyarbakir-Turkey between the years 2006 to 2009. Methods: In Diyarbakir 10 primary health centre and 2 voluntary physician were involved to surveillance. Weekly Influenza Like Illness (ILI) were reported through Health Administration of city and each week unique nasopharyngeal swap sample were collected from one randomly selected ILI case. Nasopharyngeal swap samples were transported to Virology Laboratory of Ankara Refik Saydam Hifzissiha Institute and virologic investigations were performed in this centre. Monthly distribution, person, place and time properties of ILI cases were shown by graphics and tabulates. Beside this forms filled for surveillance were evaluated according to their sufficiency. Results: Five thousand five hundred thirty four ILI cases were reported during 2006-2007 season and 4541 cases during 2007-2008 season, 10350 cases during 208-2009 season were reported. According to monthly distribution it was determined that ILI cases apparent by the fall, increase during winter and decrease during spring. For all three seasons most of the ILI cases were aged between 1 to 4 years old. Results of virologic investigation of samples collected at 2006-2007 season were 16 Influenza B, 10 Influenza A H3, 6 adenovirus, 4 Influenza A H1, 2 Parainfluenza, and 1 RSV. At 2007-2008 season virologic results were 17 Influenza B, 3 Influenza A, 7 Influenza AH1, 10 Influenza AH3, 3 Parainfluenza. At 2008-2009 season 26 Inf B, 1 InfAH3ve 1 RSV were the viruses found from ILI cases’ samples. Conclusion: The contribution of surveillance conducted in Diyarbakir city which is one of a sentinel region of Turkey was found very prior and important for National Surveillance of Influenza.

Diyarbakır da 0 6 Yaş Grubu Çocuklarda Akut İshal

Akut ishaller cocuk olumlerinin en onemli nedenlerindendir Gelismekte olan ulkelerde ozellikle yaz aylarinda akut ishal onemli bir saglik problemidir Diyarbakir alt yapisi yetersiz halkin egitim duzeyi dusuk bir ilimizdir ve beklendigi gibi akut ishaller yaygin bir sorundur 0 6 yas grubu cocuklarda yaz aylarinda ishal sikliginin ve annelerin ishal hakkindaki bilgi ve tutumlarim arastirmak amaciyla kesitsel bir arastirma planlanmistir 1 7 Agustos tarihleri arasinda Diyarbakir il merkezi 5 bolgeye ayrilarak bolge nufuslarina orantili olarak secilen 3094 cocugun annesine cocugunun son 15 gun icinde ishal olup olmadigi sorulmustur Annelerin ishal hakkindaki bilgi tutum ve davranistan kaydedilmistir Sonuc olarak 0 6 yas grubu cocuklarda akut ishal sikligi 53 36 bulunmustur Akut ishalle anne egitimi baba meslegi oturulan yer arasinda anlamli iliski saptanmistir Ayrica cocuklarin cogunun ishalli donemde herhangi bir saglik kurulusuna gec getirildigi hatta bazen hic getirilmedigi belirlenmistir Calismada ayrica ORS kullanim orani 19 32 buna karsilik antibiyotik kullanimi 52 69 bulunmustur Anahtar kelimeler: Akut Ishal Siklik Anne Egitimi Baba Meslegi