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Öğe Breastfeeding beliefs and practices among migrant mothers in slums of Diyarbakir, Turkey, 2001(Oxford Univ Press, 2006) Ergenekon-Ozelci, P; Elmaci, N; Ertem, M; Saka, GBackground: A qualitative investigation and a population survey were conducted to explore the breastfeeding beliefs and practices of mothers who were forced to migrate from their original villages and were currently living in the slums of Diyarbakir in Turkey. Methods: Qualitative data collection on breast-feeding beliefs was conducted using in-depth interviews. In-depth interviews were tape-recorded. Quantitative data on breastfeeding practices were collected using a structured questionnaire. Results: Mothers generally have a positive attitude towards breastfeeding, but colostrum is usually perceived negatively. No woman was found to feed her infant exclusively by breastfeeding. Only 9.9% of mothers initiated breastfeeding within the first hour of birth. Forty per cent of mothers started solid foods before 4 months. Mother's education appeared as a significant factor influencing the introduction of colostrum to the newborn. Mothers with lower education generally believed that the colostrum should not be fed to the infant and that a pregnant woman's milk is unhealthy for the baby. There was also a belief that 'working under the sun' decreased the quality of milk of a mother. Conclusion: Cultural beliefs have a significant influence on breastfeeding practices. Some of these practices are potentially harmful to newborns. Health education programmes should address these beliefs and practices in culture sensitive ways.Öğe Breastfeeding patterns, beliefs and attitudes among Kurdish mothers in Diyarbakir, Turkey(Wiley, 2005) Saka, G; Ertem, M; Musayeva, A; Ceylan, A; Kocturk, TAim: 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. Conclusion: The attitude to breastfeeding was highly positive, but more information is needed to encourage the use of colostrum, discourage early supplementation and promote exclusive breastfeeding during the first 6 mo of life.Öğe An epidemic caused by measles virus type D6 in Turkey(Turkish J Pediatrics, 2005) Ceylan, A; Ertem, M; Korukluoglu, G; Acemoglu, H; Kara, IH; Erten, PG; Arslan, CIn this study, the extent of measles outbreak was investigated in the Idil and Cizre counties of Sirnak Province. New cases determined in patients who applied to primary care clinics and those detected during home visits were evaluated. In 2001, a total of 2,143 cases reported in Sirnak Province were signified as a probable outbreak. Three hundred and thirty-three patients in Cizre and 219 patients in Idil applied to the primary care clinics. Of the cases, in Cizre 8.4% (n=28) and in Idil 6.4% (n=14) were infants aged nine months and younger who had not yet been vaccinated. Totally, 17 new cases (8 in Cizre and 9 in Idil) in the exanthema phase were determined during home visits and these were considered as outbreak cases. Virus isolation was achieved in 12 cases. All isolates were sent to the Centers for Disease Control (CDC) for genotyping and classified as D6 group. In conclusion, measles epidemics are still seen in our country. Therefore, measles outbreaks necessitate intensive intervention by physicians who are employed in primary health care services.Öğe The epidemiological aspects of irritable bowel syndrome in Southeastern Anatolia: a stratified randomised community-based study(Wiley, 2005) Yilmaz, S; Dursun, M; Ertem, M; Canoruc, F; Turhanoglu, AEven 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. The total population in the target region is approximately 6 million. A total of 3000 people (1521 females and 1479 males) randomly selected by stratified cluster sampling were interviewed face-to-face by using a questionnaire comprising demographic features and the Rome 11 criteria which also included probable risk factors and questions related with Bristol scale stool form. The statistical analysis was performed by using a package program called FPI INFO 2000. IBS prevalence was 10.2% according to the Rome TI criteria in our region. Six hundred and twenty-five of 3000 subjects had gastrointestinal symptoms in the last 3 months. IBS rate was higher in women (12.4%) than in men (8.0%), and married subjects had higher IBS rates (11.6%) than singles (6.7%). Those differences were statistically significant (p = 0.000 for both). It was most common in the 35-54-year age group. No difference was observed in terms of settlement (rural/urban), age group, education and occupation. History of abortion in women increased the IBS risk by 1.8 times (p = 0.000 Crude odds ratios = 1.8 (1.3-2.6) 95% confidence intervals). Of the IBS patients, 48.1% had characteristics of diarrhoea-predominance, 38.9% constipation-predominance while 13.0% had none. There was a significant relation between dominant stool form and Bristol scale stool form. IBS prevalence is 10.2% in the first community-based study carried out in this specific subject in Southeastern Anatolia. The dominance of middle age and females remained significant.Öğe Family planning in grand multiparous women in Diyarbakir, Turkey, 1998: the factors affecting contraceptive use and choice of method(Parthenon Publishing Group, 2001) Ertem, M; Ergenekon, P; Elmaci, N; Ilcin, EFamily planning is an important service for preventing maternal deaths. A 3-year project on children and maternal health was conducted in suburban areas of the Diyarbakir province of Turkey. In this project, volunteer women told women resident in the area about family planning as well as other maternal and child health-related subjects. Within 3 years, all women were visited at least five times and changes in contraceptive use were recorded. A cross-sectional study was planned to understand the factors affecting contraceptive use in grand multiparous women. A total of 200 grand multiparous women were selected from visit cards and various characteristics of these women were evaluated. Odds ratios and 95% confidence intervals were calculated using logistic regression analyses. The use of contraceptives had increased from 33.5% to 59.5% by the end of the 3 years in the 200 women. The main factors affecting contraceptive use were misconceptions and concerns about health-related risks, having a child younger than 14 years working outside the home to contribute to the household income, religious opposition, a gap between the desired and actual number of sons, number of previous deaths of children and discussion with the husband about family planning.Öğe Mitomycin C primary trabeculectomy with releasable sutures in primary glaucoma(Elsevier Science Inc, 2000) Ünlü, K; Aksünger, A; Söker, S; Ertem, MPurpose: To evaluate the effects of mitomycin C and a releasable suture technique on outcomes of primary trabeculectomy in primary glaucoma patients. Methods: A prospective analysis of patients who underwent primary trabeculectomy with a mitomycin C concentration of 0.2 mg/mL for 2 minutes. For closing the scleral flap, releasable sutures were used in 18 patients (17 eyes), Group 1, or permanent sutures in 18 patients (20 eyes), Group 2. Clinical outcome factors including postoperative intraocular pressure (IOP), visual acuity, and incidence of complications were determined. Results: The mean follow-up periods were 8.1 +/- 1.3 months in Group 1 and 8.3 +/- 1.3 months in Group 2. The postoperative reduction in IOP was highly significant (P < .0001) at all time intervals in both groups. In all measurement of IOP before the second week, mean IOP in Group 2 was found significantly lower than the mean IOP in Group 1 (P = .01). No statistically significant differences were found between the groups at later mean IOP measurements. At the last visit, the complete success rate was 88.8% in Group 1 and 85.0% in Group 2. No serious complications such as hypotonous maculopathy were observed in ally patient. Conclusion: Primary trabeculectomy with mitomycin C in eyes with primary glaucoma showed effective IOP pressure reduction. There were no cases of serious complications. In the early postoperative period IOP was controlled better in the releasable suture group. (C) 2000 Japanese Ophthalmological Society.Öğe Neonatal tetanus in the south-eastern region of Turkey(Oxford Univ Press, 2004) Ertem, M; Çakmak, A; Saka, G; Ceylan, ANeonatal 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.Öğe Poliomyelitis eradication programme: acute flaccid paralysis surveillance in Mardin and five other provinces around Mardin, Turkey 1998(W B Saunders Co Ltd, 2000) Ertem, M; Sarac, A; Tumay, SAfter the successful eradication of small pox, the eradication of poliomyelitis was planned. In the poliomyelitis eradication programmer conducted since 1989, routine vaccination, supplemental immunisation activities and acute flaccid paralysis (AFP) surveillance were the main strategies. In 1997, in Mardin provinces six poliomyelitis cases were reported. Therefore it was planned to strengthen the eradication programme in this province and those around it. In 1998 in Mardin and five neighboring provinces, a study was conducted that included monthly visits, educational activities, etc. At the result of this study, 64 AFP cases (22 of them poliomyelitis) were reported. Non-poliomyelitis AFP rate had increased from 0.9 in 1997 to 2.8 in 1998. An adequate two specimen ratio was 72%. We recognised that more poliomyelitis cases were reported in hot seasons when compared with non-poliomyelitis cases reported throughout the year. This difference was statistically significant (P < 0.001). Most AFP cases were aged under 35 months. At the 60th day follow-up visits of the patients, we found 90.9% of the the poliomyelitis cases but only 19.0% of the non-poliomyelitis case had residual paralysis. Presence of prodromal fever was another finding that distinguished poliomyelitis cases from non-poliomyelitis AFP cases. 90.9% of the poliomyelitis cases but only 64.3% of the non-poliomyelitis cases had fever at onset. This finding was also statistically significant (P < 0.05).Öğe Prevalence of Hepatitis C in adults in the south-eastern region of Anatolia(Wiley, 2004) Dursun, M; Özekinci, T; Ertem, M; Saka, G; Yilmaz, S; Canoruc, F; Çelenk, SAim: There is a limited number of studies on the general population about prevalence of Hepatitis C virus (HCV) in Turkey. The estimated prevalence of HCV in the Southeastern region of the country was obtained from the data of the blood donors. There is no study reflecting the general population of this region, leading us to plan this study. Material and method: Four provinces in the Southeastern Anatolia were randomly selected and sample sizes were determined by Epi Info Programme, and blood samples were collected from 2888 individuals. Questionnaires in which demographic information and probable risk factors for Hepatitis C were investigated and were applied on subjects who gave their consent to participate in the study. Anti-HCV was examined by using Cobas Core II immunochemistry system (Roche). All positive samples were further tested for the presence of HCV RNA by RT-PCR. Crude odds ratios (OR) and 95% confidence intervals (CI) were calculated and Chi-square analyses were performed. Epi Info 2000 Programme was used to perform the analysis. Results: Of the 2888 individuals, 17 (0.6%) were anti-HCV positive and 13 (82%) of them were confirmed as positive for HCV-RNA. No difference was found between rural and urban regions with respect to HCV prevalence (P = 0.51). The prevalence of HCV in 35-44 years of age group was found to be different from those of the other age groups (P = 0.02). It was determined that the risk for HCV in this age group was 4.23 times (P = 0.02; OR = 4.23;1.02-20.15; CI 95%:) higher with a prevalence rate of 1.6%. In this age group, anti-HCV was positive in 6 male (2.4%) and 2 female (0.8%), of whom 7 were living in urban (2.2%) and 1 in rural area (0.5%). The overall prevalence of HCV was not found to be different for sex (P = 0.75). Similarly, there was no difference between the married and single individuals for the prevalence (P = 0.38). Anti-HCV positivity did not change for the level of education. We could not determine any factor that might play a role in transmission of HCV. Conclusion: This is the first population-based study to be performed in order to determine the prevalence of HCV in the south-eastern region of Anatolia (Turkey). This region has a low prevalence of HCV. The extremely rare prevalence of homosexuality and intravenous drug addiction might have a role in this low prevalence. (C) 2004 Elsevier B.V. All rights reserved.Öğe A special risk group for hepatitis E infection: Turkish agricultural workers who use untreated waste water for irrigation(Cambridge Univ Press, 2003) Ceylan, A; Ertem, M; Ilcin, E; Ozekinci, TUntreated waste water usage in agriculture is an important health-threatening issue which could affect both workers' and the public's health. In this study we researched hepatitis E infection in 46 of 57 farmers who used untreated waste water in agriculture. We compared them with 45 persons of the same socio-economic status and age. Anti-HEV seropositivity was 34.8% in the workers and 4.4% in the control group. We suggest that this type of irrigation is an important potential risk for hepatitis E infection.
