Journal of Preventive Medicine and Hygiene https://www.jpmh.org/index.php/jpmh <p>The Journal of Preventive Medicine and Hygiene (JPMH) is an international, multidisciplinary, open-access, peer-reviewed journal published on a three-monthly basis and covers the fields of Hygiene, Preventive Medicine and Public Health. The Journal has been publishing original articles, reviews, editorials, letters and proceedings of symposia and conferences since 1960. Systematic reviews of topics relevant to the journal’s aim are highly welcome. Scientific validity, methodological soundness, originality and advances in the field of Hygiene, Preventive Medicine and Public Health are a key acceptance criterion. For further information, please check our Section Policies.</p> <p>The JPMH is currently abstracted and indexed in PubMed, PubMed Central, Scopus, Web of Science, and Google Scholar. The JPMH currently has no article-processing charges.</p> Department of Health Science - University of Genoa en-US Journal of Preventive Medicine and Hygiene 1121-2233 Effectiveness of Theory Based Educational Intervention on Health Literacy, Medication Adherence and Self-Management Behaviors of Patients with Type 2 Diabetes: Applying Extended Theory of Planned Behavior https://www.jpmh.org/index.php/jpmh/article/view/3149 <p><strong>Introduction:</strong> <em>Theory-based educational interventions can play an important role in improving health literacy and promoting self-care behaviors and preventing diabetes complications. </em><em>This study was conducted with the aim of investigating the effectiveness of the educational intervention based on the extended theory of planned behavior on health literacy, medication adherence, self-care behaviors and metabolic indicators in T2D patients.</em></p> <p><strong>Methods:</strong> <em>The present research was a</em><em> Quasi-experimental study with a control group and measuring outcome variables at baseline and 3 months after the theory based intervention. With multi-stage sampling, 112 patients with T2D referred to health care centers of Qazvin city were equally assigned to experimental and control groups. The intervention included 6 online group education along with educational video, pamphlets and 60 SMS reminders using strategies as role-playing, lecture, and scenario presentation. The data collection tools were: Demographic items, summary of diabetes self-care activities scale, short test of functional health literacy in adults, The Morisky 8-item medication adherence scale, Sub-Scales of extended TPB (36 items). Paired &amp; independent t-test, chi-square, ANOVA and ANCOVA were used to data analysis.</em></p> <p><strong>Results:</strong> <em>T</em><em>he mean of attitude, subjective norms, perceived behavioral control, action planning, coping planning, trust and the intention associated with health literacy and medication adherence increased significantly in the experimental group in the post-test by controlling the effect of the pre-test variable (P&lt;0.001). In addition, the results of ANCOVA showed the improvement in the total mean score of self-care and its dimension along with the mean of </em><em>FBS and HbA1c in the experimental group in the post-test (P&lt;0.001). </em></p> <p><strong>Conclusion:</strong> <em>The focus of nurses and other medical staffs on improving health literacy, action &amp; coping planning and psychological variables in the design of cognitive behavioral interventions can lead to improving self-care and medication adherence in T2D patients.</em></p> Fatemeh Shabani Bazneshin Isa Mohammadi Zeidi Hadi Morshedi Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E236 E236 10.15167/2421-4248/jpmh2025.66.2.3149 Barriers to Breast Cancer Screening tools in a Cohort of Urban Indian Women https://www.jpmh.org/index.php/jpmh/article/view/3410 <p><span style="font-weight: 400;">Introduction:</span><span style="font-weight: 400;"> Breast cancer has the highest incidence and mortality rate in India. Early detection of Breast cancer has better survival chances and reduces treatment costs. Breast cancer screening involves Breast Self-Examination (BSE), Clinical Breast Examination (CBE), and Mammography. The highest burden of breast cancer has been observed in metropolitan cities. So it becomes crucial to assess breast cancer awareness and screening practices among urban women. Moreover, currently, there is a significant gap in the literature concerning the barriers that affect screening practices amongst Indian women.</span></p> <p><span style="font-weight: 400;">Methods:</span><span style="font-weight: 400;"> We conducted a survey-based, cross-sectional study on urban Indian women living in Uttar Pradesh. Women for this study were selected based on predefined inclusion and exclusion criteria. The data were collected using a self-administered questionnaire which included the socio-demographic variables (address, age, occupation, education level, marital status) of the participants and cancer and cancer screening-related questions.&nbsp;</span></p> <p><span style="font-weight: 400;">Results:</span><span style="font-weight: 400;"> 612 urban women in Uttar Pradesh, India participated in our study. Most were married (96%) and unemployed (59%). Approximately 76% had received education at the high school level or higher, while only 19% had health insurance. The participants' ages ranged from 30 to 70 years, with a mean age of 41 years ± 8.25 years).</span></p> <p><span style="font-weight: 400;">Conclusions:</span><span style="font-weight: 400;"> Our study revealed high breast cancer awareness among participants but disparities in screening awareness based on age, marital status, insurance, and education. Most women have a positive attitude towards breast cancer screening, recognizing its importance for early detection. This attitude can drive participation if barriers are addressed, including knowledge gaps, symptom ignorance, shyness, financial constraints, and a lack of female doctors.</span></p> Vaibhav Singh Mehul Saxena Gitika Nanda Parijat Suryavanshi Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E249 E249 10.15167/2421-4248/jpmh2025.66.2.3410 Historical Perspectives on Scrofula: Competing Medical Discourses and Public Health Implications at the Turn of the 20th Century https://www.jpmh.org/index.php/jpmh/article/view/3517 <p>This article examines how scrofula was classified as a distinct disease in Danish medical history around the turn of the 20<sup>th</sup> century. Dr. Niemeyer, a naturopathic advocate, attributed scrofula to an unhealthy composition of bodily fluids, whereas Dr. Geill viewed it as a tuberculous condition and a precursor to pulmonary tuberculosis. While they differed on causation – particularly regarding heredity – they agreed on prevention strategies, emphasizing fresh air, skin care, nutrition, and physical activity to reduce contagion and improve children’s resilience. Physicians advocated guiding children in dietary and hygienic practices to fortify their resistance against the tubercle bacillus. The article highlights how naturopathic discourses were challenged by emerging claims that scrofula was an infectious disease. Expanding clinical assessments to include home hygiene and working conditions reflected broader shifts in societal health rationales. Public health measures required coordinated efforts between physicians and municipal authorities rather than being solely an individual responsibility. Finally, this historical perspective is framed within a modern public health context, emphasizing the bio-psycho-social model of health and disease. It underscores the lasting relevance of interconnected health approaches, drawing parallels between past strategies against scrofula and contemporary public health efforts to address infectious and non-communicable diseases. Integrating historical insights into modern policy and practice can enhance health equity and prevention strategies.</p> Ulrik Bak Kirk Christian Wejse Per Kallestrup Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E263 E263 10.15167/2421-4248/jpmh2025.66.2.3517 Investigating the Theoretical Possibility of Dengue Fever in Ancient Egypt https://www.jpmh.org/index.php/jpmh/article/view/3601 <div> <p><span lang="EN-GB">Dengue fever, a mosquito-borne viral disease transmitted primarily by the mosquito species</span><span class="apple-converted-space"><span lang="EN-GB">&nbsp;</span></span><em><span lang="EN-GB">Aedes aegypti</span></em><span lang="EN-GB">, has become a significant global health concern, with cases surging in recent years. While no explicit records of dengue exist from ancient Egypt, this study explores the theoretical possibility of its presence during that era. By integrating contemporary epidemiological data, historical medical texts, entomological studies, and palaeoclimatic analyses, the problem of whether ancient Egyptians could have encountered a disease resembling dengue is assessed.</span></p> </div> Francesco Maria Galassi Michael Eduard Habicht Mariano Martini Mauro Vaccarezza Donatella Lippi Giorgia Cafici Francesco Baldanzi Elena Varotto Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E257 E257 10.15167/2421-4248/jpmh2025.66.2.3601 The penicillin revolution and the role of the forgotten pioneer Vincenzo Tiberio (1869-1915): discovery, development and legacy. https://www.jpmh.org/index.php/jpmh/article/view/3647 <p style="font-weight: 400;"><em>Penicillin’s discovery is widely attributed to Alexander Fleming (1881-1955) Professor of Bacteriology at St. Mary's Hospital in London in 1928, who observed the antibacterial effects of Penicillium mold. Fleming found that his "mold juice" was capable of killing a wide range of harmful bacteria, such as streptococcus, meningococcus and the diphtheria bacillus.</em></p> <p style="font-weight: 400;"><em>He then set his assistants, Stuart Craddock and Frederick Ridley, the challenging mission of isolating pure penicillin from the mold juice. It shown to be very unstable, and they were only able to prepare solutions of crude material to work with. Fleming published his findings in the British Journal of Experimental Pathology in June 1929, with only a passing reference to penicillin's potential therapeutic benefits. </em></p> <p style="font-weight: 400;"><em>&nbsp;However, over 30 years earlier, Italian physician Vincenzo Tiberio (1869-1915) had conducted controlled studies on the bactericidal effects of mold extracts, publishing results that went largely unnoticed by the scientific community.</em></p> <p style="font-weight: 400;"><em>This article runs through </em><em>a work plan timeline and significance of early antimicrobial discoveries, tracing the overlooked work of Tiberio, Fleming’s breakthrough, the biochemical properties of penicillin, and the wartime efforts that enabled its mass production.</em></p> <p style="font-weight: 400;"><em>The story of penicillin is not only one of scientific innovation but also of missed recognition, collaboration, and the complex interplay of chance and preparedness.</em></p> Elena Varotto Francesco Maria Galassi Mariano Martini Ludovica Gallitto Luigi Ingaliso Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E270 E270 10.15167/2421-4248/jpmh2025.66.2.3647 The effects of social isolation and problematic social media use on well-being in a sample of young Italian gamblers https://www.jpmh.org/index.php/jpmh/article/view/3581 <p><strong>Background</strong>: Gambling especially when problematic, has been observed to have a significant impact on mental health, social relationships, and well-being in general. Social isolation and problematic social media use (PSMU) have also been identified as risk factors affecting psychological well-being, with a potential link to gambling that may intensify the impact on well-being, especially among adolescents. However, the interaction between these factors remains poorly explored, especially in younger populations.</p> <p><strong>Objective</strong>: This study aims to investigate the effects of social isolation and problematic social media use on psychological well-being in a sample of adolescents, focusing on how these factors interact and influence well-being according to different engagement in gambling.</p> <p><strong>Methods</strong>: We analyzed data from the 2021/2022 Italian Health Behaviour in School-aged Children study in Tuscany Region. A cross-sectional study was conducted on 1,265 Tuscan adolescents aged 15-17 years, divided into three groups according to gambling behavior: non-gamblers, occasional gamblers and problem gamblers. Participants completed self-report questionnaires to assess well-being, social isolation, and PSMU. Data were analyzed using clustering methods, descriptive statistics, and path analysis to explore the relationships among these variables.</p> <p><strong>Results</strong>: The study identified three distinct groups of gamblers: non-gamblers (74.5%), casual gamblers (14.9%) and problem gamblers (10.6%). Contrary to expectations, problem gamblers reported the highest well-being scores, suggesting potential compensatory mechanisms or subjective perceptions masking underlying vulnerabilities. Social isolation had a negative impact on well-being in all groups, with the strongest effects observed in casual gamers. Problematic social media use did not show significant differences between groups, but was associated with lower well-being in all groups. An unexpected positive interaction between social isolation and PSMU was found in problem gamblers, indicating a unique reinforcing relationship in this group.</p> <p><strong>Conclusions</strong>: The results highlight the complex interaction between gambling behavior, social isolation, and problematic social media use in influencing adolescents' well-being. While social isolation consistently reduced well-being, problematic gamblers showed higher well-being scores, potentially due to developmental factors or maladaptive coping mechanisms. The study emphasizes the need for further research to better understand these relationships, particularly in the context of online gambling and social media use, to provide targeted interventions for at-risk adolescents</p> Marta Floridi Fabio Ferretti Natale Canale Claudia Marino Allison Uvelli Giacomo Lazzeri Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E153 E153 10.15167/2421-4248/jpmh2025.66.2.3581 Assessment of Knowledge and Practices Related to Children's Physical Fitness and Health Among French PE Teachers. https://www.jpmh.org/index.php/jpmh/article/view/3524 <p><strong>Objectives: </strong>To assess PE teachers' knowledge of physical fitness and its link to children's health and identify barriers and facilitators for its management in schools.</p> <p><strong>Methods: </strong>A total of 2,378 PE teachers (56% men) completed an online questionnaire on their knowledge, perceived barriers, and facilitators regarding physical fitness.</p> <p><strong>Results: </strong>Most of teachers reported being aware of the associations between cardiorespiratory fitness (CRF) (96%) and muscular strength (MS) (88%) with current health in youth. A smaller proportion of teachers acknowledged knowing the potential associations of these fitness components with future health in adulthood, specifically 40% for CRF and 22% for MS. The majority of teachers (80%) reported being sufficiently trained during their training courses to assess and develop the CRF. Only 50% of teachers reported feeling sufficiently trained to assess MS, while 58% reported being adequately trained to develop this component. Among the teachers, 82% reported that insufficient practice time, large class sizes, and high heterogeneity are key obstacles. Less than 50% identified other prioritized objectives as barriers, while 30% reported a lack of material resources as a significant limitation. Then, 84% of teachers reported being interested in participating in continued professional development focused on the promotion of physical fitness in youth through PE.</p> <p><strong>Conclusions: </strong>Barriers such as limited training, structural constraints, and low awareness of MS recommendations hinder effective fitness management. Addressing these through improved curricula, teacher training, and resources is crucial to enhancing youth fitness and health in France.</p> David Matelot Laurent Béghin François Carré Jérémy Vanhelst Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E170 E170 10.15167/2421-4248/jpmh2025.66.2.3524 A Snapshot Investigation on Assessment of Role of Dietary Diversity in Healthy Ageing among Elderly Living at Ahmedabad City, India https://www.jpmh.org/index.php/jpmh/article/view/3568 <p><strong>Background:</strong> Dietary Diversity (DD) is one of the crucial determinants to address Healthy ageing among elderly people. <strong>Objectives:</strong> To estimate prevalence with concerned determinants of Dietary Diversity, to assess intake-pattern of various nutrients and correlation of dietary diversity with healthy ageing among study participants. <strong>Methodology:</strong> A cross-sectional study was conducted among 192 Elderly people (≥ 60 years of age) residing at Ahmedabad city, India, selected by two-stage Cluster sampling [As per Rapid Assessment Method for Older People (RAM-OP) survey sampling technique]. A pretested, semi-structured questionnaire including Socio-Demographic and Dietary-Diversity related details was utilised as survey-instrument. Healthy ageing was assessed with selected General Health status using two domains of total five; namely general Activity of Daily Living and Instrumental Activity of Daily Living (IADL) were applied to collect relevant data. <strong>Results:</strong> Prevalence of Dietary-Diversity was 44.27% among study-participants. Various determinants such as living alone, socio-economic-class, co-morbidities, type of diet, oral health and meal-frequency revealed statistically significant association with Dietary Diversity. Cereals (96.9%), roots and tubers (91.7%), and condiments and mushrooms (90.1%) were the most common food-groups consumed by study participants. Of 85 participants with positive dietary diversity, more than two-thirds (67, 78.82%) were able to manage activities of daily living independently whereas approximately three-fifth (66, 61.68%) of sub-cohort of counterpart could manage the same independently. Predictors of IADL like use of telephone, practice of taking medications and managing their own money showed statistically significant association with presence of dietary-diversity. <strong>Conclusion:</strong> Dietary diversity was prevalent among less than half of study-participants. A diverse diet showed statistical significant role in ensuring independence in general activities of daily living while gender-specific variations for instrumental activities of daily living.</p> Viral R Dave Kalgi A Patel Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E171 E171 10.15167/2421-4248/jpmh2025.66.2.3568 Comparing vape use and perceptions among pharmacy and non-pharmacy students from two universities in the US and UK https://www.jpmh.org/index.php/jpmh/article/view/3605 <p><strong>Introduction</strong><strong>:</strong> Little research exists regarding pharmacy student vaping habits or differences among students from different countries.</p> <p><strong>Methods:</strong> A novel 19-item questionnaire was distributed in November 2023 to students at The University of Bath (United Kingdom) and The University of Texas at Austin (United States) to compare vape use and perceptions among pharmacy and non-pharmacy students from the two universities. All pharmacy students at both institutions were invited to complete the survey. A non-pharmacy student control group was identified through snowball sampling (i.e., the survey was distributed to a convenience sample of non-pharmacy students at each school, asking them to complete and distribute to peers). To incentivize participation, one respondent received a $100 reward. Data was analyzed using descriptive statistics. Chi-square and Wilcoxon Rank Sum tests were used to compare answers between pharmacy and non-pharmacy and UK and US participants. A p-value &lt;0.05 was deemed significant.</p> <p><strong>Results:</strong> Overall, 372 students completed the survey (25% pharmacy student response rate). Vape use significantly differed between pharmacy and non-pharmacy students (p=0.03). Among 212 pharmacy students, 49% reported vape ever-use versus 59% of the 158 non-pharmacy students. Significant differences were found in harm perceptions; more pharmacy students believed vapes are cancer-causing, affect the health of others nearby, should be banned in public, and are ineffective for quitting cigarettes. Few differences were observed between UK and US students.</p> <p><strong>Conclusion: </strong>Pharmacy students were less likely to vape and exhibited heightened awareness of associated risks than non-pharmacy students. Few differences were observed between UK and US students surveyed.</p> Sophie Milne Henry Ogbeifun Chris Frei Kirk Evoy Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E179 E179 10.15167/2421-4248/jpmh2025.66.2.3605 The responsibilities of commercial intermediation company as new food business: the case of a typical regional Italian food https://www.jpmh.org/index.php/jpmh/article/view/3472 <p>According to Regulation (EC) 178/2002, “any undertaking, whether for profit or not and whether public or private, carrying out any of the activities related to any stage of production, processing and distribution of food” must be classified as a “food business”. A food business operator (FBO) is defined as “the natural or legal person responsible for ensuring that the requirements of food law are met within the food business under their control”. We analyzed the particular case of an Italian wholesale commercial intermediation company, purchasing a typically carbohydrate-rich local product from producers and reselling it to retailers, although never taking physically possession of it. In the marketing process the company abnormally emphasized the food protein content of the product, providing false nutritional information on the label, thus committing food fraud. Moreover, sanitary guarantees on the operating methods and traceability were not provided, as required by the European law. In fact, to ensure food safety, every food business is subject obligation of registration (Regulation EC 852/2004), preparation of the self-control plan according to the principles of the HACCP system and traceability obligations (Regulation EC 178/2002).&nbsp; This case highlights the current general poor culture in food safety and shows the urgent need for awareness-raising and training interventions aimed at improving behaviors and clarifying the qualifications and the responsibilities of all parties involved, including FBOs and competent authorities, to prevent health risks and food frauds.</p> Cecilia Trucchi Marco Roveta Erica Baldoni Fabio Romairone Carolina Piccinini Elisa Schinca Marina Sartini Maria Luisa Cristina Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E187 E187 10.15167/2421-4248/jpmh2025.66.2.3472 Giovanni Battista Grassi (1854-1925): a forgotten Italian scholar and his fundamental studies on malaria https://www.jpmh.org/index.php/jpmh/article/view/3642 <p>A century ago, on May 4, 1925, an Italian doctor, zoologist, botanist, and entomologist called Giovanni Battista Grassi (1854-1925) died in Rome. Grassi was known especially for his studies on malaria, and he was one of the scholars who created the “Italian school of malariology” which played a critical role in the study and prevention of malaria. At that time malaria was a main problem in the colonies for the military. In the tropics malaria is a common disease that causes high fever and other symptoms. When the French chemist Louis Pasteur published his germ theory in the 1860s, scientists began to consider that an organism, might be responsible for the malaria disease and the breakthrough came in 1880 with a French army surgeon called Alphonse Laveran (1845-1922). By the middle of the 19th century, it was therefore clear that many diseases are caused by microorganisms, and several scholars began to assume that also malaria was caused by a bacterium. Laveran recognized the parasite group that caused the infection in human beings, however his studies were challenged. He after examining blood from people infected with malaria, (1889) was able to absolutely show that malaria is caused by another type of single-celled organism, a protozoan of the Plasmodium family, which attacks red blood cells. Laveran also identified other single-celled parasites that cause other diseases. In fact, there are four types of malarial infection caused by four species of parasite plasmodium. In 1898 Grassi began a large study that represented a turning point in the study and treatment of the disease. With the current manuscript, in addition to recalling some of the main and well-known steps in the historical evolution of this fearsome, dangerous, and insidious infectious disease, we believe it’s important to remember the scientific personality of this Italian scholar. The scientist Grassi is to be noted among the protagonists in the view of history of medicine and zoology between the 19th and 20th centuries, mainly because of his famous research, developed by a group of scholars, which led to the exact identification of the vector of human malaria.</p> Mariano Martini Davide Orsini Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E194 E194 10.15167/2421-4248/jpmh2025.66.2.3642 Delivering physical rehabilitation services during the COVID-19 pandemic in Iran: Common challenges and potential solutions for future pandemics https://www.jpmh.org/index.php/jpmh/article/view/3587 <p><em>The COVID-19 pandemic affected people with disabilities in different aspects, including their access to rehabilitation. Despite a significant global surge in the need for physical rehabilitation, it has not been prioritized and is under-resourced, even in the non-COVID era, in many countries. This study aimed to explore the challenges of delivering physical rehabilitation services during the COVID-19 pandemic in Iran and potential solutions to these challenges</em><em>. This qualitative study was done using a thematic approach from November 2023 to March 2024 in Iran. 45 rehabilitation professionals and faculty members from three fields—physiotherapy, occupational therapy, and orthotics and prosthetics—were interviewed in a semi-structured fashion. Data analysis was done using Braun and Clarke’s thematic analysis approach. The five control knobs (organization, regulation, financing, payment, and behavior) were used to study the challenges and proposed solutions. The main identified challenges included Iran's healthcare system's lack of preparedness, deficient infrastructure, limited remote rehabilitation options, restriction of in-person visits, lack of clinical guidelines, ambiguous pricing for telerehabilitation, financial hardships stemming from the pandemic, insufficient government support, reliance on out-of-pocket, patients' reluctance to pay for online services, delayed compensation for rehabilitation professionals, mental distress experienced by patients and service providers, resistance to new service modalities, and inadequate digital literacy. The key solutions included strengthening telerehabilitation infrastructure, developing clear clinical guidelines, increasing government financial support, improving payment structures, and fostering behavioral changes through increased awareness. </em><em>The findings of this study underscore the importance of proactive planning, intersectoral collaboration, and the integration of rehabilitation services within the healthcare framework. The suggested solutions can inform policymakers to enhance the preparedness and responsiveness of health systems to future crises.</em></p> Parnian Mansouri Tahereh Alavi Parviz Mojgani Naghmeh Ebrahimi Atefeh Taheri Masoud Behzadifar AmirHossein KamaliNia Mariano Martini Saeed Shahabi Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E202 E202 10.15167/2421-4248/jpmh2025.66.2.3587 Zika Virus Disease in India https://www.jpmh.org/index.php/jpmh/article/view/3600 <p>In 2024, a total of 151 Zika virus disease (ZVD) cases were reported in India (from Maharashtra, Karnataka, and Gujarat States). Maharashtra reported 140 cases (125 cases from Pune), Karnataka 10 cases (7 cases from Bengaluru) and Gujarat 1 case (1 case from Gandhinagar) respectively. No case of microcephaly or Guillain-Barre syndrome (GBS) associated with this outbreak was reported.<sup>1</sup></p> <p>India reported its first Zika case from Gujarat State in 2016. Since then, many other States namely Tamil Nadu, Madhya Pradesh, Rajasthan, Kerala, Maharashtra, Uttar Pradesh, Delhi, and Karnataka have reported cases subsequently, but no ZIKV-associated microcephaly has been reported. Aedes mosquito density in India varies by season and location, with the highest densities occurring during the monsoon and post-monsoon seasons.<sup>1</sup></p> <p>The Zika virus disease is usually mild and requires no specific treatment. The most common symptoms are mild fever, skin rash, headache, muscle and joint pain and inflammation of the underside of the eyelid. These symptoms normally last for 2-7 days.<sup>2</sup></p> <p>In India, Zika outbreak occurred in 2017 and in July 2021 one laboratory-confirmed case was also reported in Kerala state. One study was conducted to assess any positivity in field-collected mosquitoes for ZIKV and DENV during 2016–2021. Mosquito samples were received from 4 Zika affected citites, whereas samples were collected from Delhi. Out of 2346 pools, 4 pools for ZIKV, and 23 pools for DENV were found positive. ZIKV positive pools were from Jaipur (3 pools) and Kanpur (1 pool). 10 localities of Delhi were found positive for DENV. It was observed that the maximum positivity rate for both viruses were found in September–October.<sup>3</sup></p> <p>Another study showed that the lower attack rate of ZIKV in children than in adults will hasten the emergence of a population that will be fully susceptible to infection. Even with lifelong immunity, children aged 0–14 years will become entirely susceptible by 2031 and 15–29 year olds by 2046. In future outbreaks, the attack rate will then be highest amongst 15–29 year olds, including women who will be at risk of ZIKV infection in pregnancy.<sup>4</sup></p> <p>With the limited data available, it is seen that ZVD cases are rising and vary regionally across different states. The difference can be due to variation in number of tests done in all regions (state and city) due to different reasons. Hence, samples should be homogenously taken from different region including from hard to reach areas for understanding better picture. The case load appears to be underreported because asymptomatic infection and unreported illness are generally not taken into consideration, overlapping symptomatology of ZVD with dengue and chikungunya, and different level of health care providers’ awareness about the disease. Rising number of ZVD in India and future possibility of increased susceptibility among children and young adults mandates continuous monitoring, surveillance and use of preventive measures.</p> Dheeraj Sharma Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E220 E220 10.15167/2421-4248/jpmh2025.66.2.3600 Hepatitis C Virus Antibodies and HCV-RNA Detection in Hemodialysis Centres in Cameroon: Prevalence and Incidence Rate. https://www.jpmh.org/index.php/jpmh/article/view/3417 <p><strong>Background:</strong> Hemodialysis (HD) is the world's most prevalent kidney replacement therapy for end-stage renal disease patients. Hepatitis C virus infection (HCV) is highly prevalent in patients undergoing HD. There are no reports of the epidemiology of HCV viremia and HCV incidence rate based on prospective studies in HD units in Cameroon. This study evaluated the prevalence and incidence rate of HCV based on anti-HCV antibody (Ab) and HCV-RNA detection.</p> <p><strong>Methods:</strong> We conducted a controlled prospective study in three hemodialysis centers in Cameroon, from October 2021 to January 2023. The HEXAGON HCV rapid kit was used to detect anti-HCV Ab, and HCV-RNA was searched using the Xpert® HCV Viral Load technology. We performed a Wilcoxon test and the chi-square or Fisher exact test in statistical analyses.</p> <p><strong>Results:</strong> A total of 205 HD patients were enrolled with a mean age of 47.7±14.5 years and median hemodialysis duration of 36 months (IQR: 12-72). Anti-HCV Ab was positive in 59 [28.8% (95% CI: 22.7–35.5)] patients, and in 42 [71.2% (95% CI: 57.9–82.2)] of them, HCV-RNA was detected. A total of 125 patients with a negative status at the start of the study (M0) were prospectively followed-up. After seven months (M7), 15 [12%; 95% CI: 06.9–19.)] became HCV positive, with an incidence rate of 20.6 cases per 100 patients-years.</p> <p><strong>Conclusion:</strong> There is a high prevalence of HCV infection and HCV incidence rate in this study. Strategies aimed at decreasing HCV infection in HD centers in Cameroon are urgently needed.</p> Raoul Kenfack-Momo Marceline Djuidje Ngounoue Maimouna Mahamat Vanessa Sylvia Santerre Alida Kouojip Mabou Sylvie Wouatedem Marguerite Martin Zekeng Mekontchou Simon Frederick Lissock Gloria Enow Ashuntantang Njouom Richard Njouom Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E222 E222 10.15167/2421-4248/jpmh2025.66.2.3417 Integration of the fundamental of care framework into the clinic (the CONFORM study): A quasi -experimental pre-post implementation study protocol https://www.jpmh.org/index.php/jpmh/article/view/3666 <p><strong>Introduction</strong>: Fundamental care addresses the essential physical and psychosocial needs of patients and is critical for safe, high-quality nursing practice. Despite growing awareness of its value, it remains one of the most neglected areas in clinical care. The Fundamentals of Care (FoC) Framework provides a structured approach to support its delivery, yet its practical implementation remains limited and underexplored. This study aims to evaluate the effectiveness of integrating the FoC Framework into nursing practice to reduce patient length of stay in medical and surgical wards.</p> <p><strong>Methods</strong>: A quasi-experimental pre-post implementation study will be conducted over 15 months in one medical and two surgical wards. The FoC Framework will guide interventions targeting key needs (nutrition, elimination, mobility, and education) identified through focus groups with nurses, patients, and caregivers. Following framework introduction, a six-month phase of individualised care will be implemented. Data on interventions and outcomes will be collected daily via the Electronic Health Record, both before and after implementation. The primary outcome is length of stay; secondary outcomes include adverse events, readmissions, patient and nurse satisfaction, turnover intentions, complaints, discharge rates, needs assessments, frequency of interventions, and goal achievement. Analyses will use t-tests or Mann-Whitney tests.</p> <p><strong>Conclusion</strong>: This study represents the first international systematic evaluation of the FoC Framework in clinical practice. Findings will contribute robust evidence on its potential to improve care quality, meet essential patient needs, enhance satisfaction among patients and staff, and reduce adverse outcomes.</p> Annamaria Bagnasco Graziella Costamagna Silvia Bagnato Alexandra Do Nascimento Elga Ghironi Oscar Testa Maddalena Stuardi Andrea Ricotti Riccardo Sperlinga Marco Di Nitto Gianluca Catania Loredana Sasso Copyright (c) 2025 Journal of Preventive Medicine and Hygiene 2025-07-25 2025-07-25 66 2 E228 E228 10.15167/2421-4248/jpmh2025.66.2.3666