Showing papers in "African Health Sciences in 2014"
TL;DR: The rapid spread in the acute phase of outbreak can be expected, and although the Ebola infection usually results in severe clinical presentation it can also be asymptomatic4 –5, which can be a difficulty for disease screening and control.
Abstract: Dear editor, we would like to discuss on the report on Ebola outbreak in west Africa [1]. Mbonye et al. noted that “several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda [1].” In fact, the widespread of Ebola infection is Africa is due to several reasons including to the limited medical facilities. Of interest, when any emerging infectious diseases occur in poor countries, the problem is usually difficult to control. As noted by Mbonye et al1, “political support” is an important thing that determines the success of the disease control. However, there are many factors that can make difficulty to disease control. First, at the early stage of infection, the practitioner usually lack for knowledge and there are extremely limited diagnostic tool and therapeutic facilities2,3. Hence, the rapid spread in the acute phase of outbreak can be expected. Second, although the Ebola infection usually results in severe clinical presentation it can also be asymptomatic4 –5. This can be a difficulty for disease screening and control.
Beuy Joob1, Viroj Wiwanitkit2
1. Sanitation 1 Medical Academic Center, Bangkok Thailand
2. Visiting professor, Hainan Medical University, China; adjunct professor, Joseph Ayobabalola University, Nigeria
140 citations
TL;DR: Unlike the practice in several other developing countries, small-scale farmers in Uganda do not use the most hazardous pesticides, however use of WHO class II pesticides and those of lower toxicity is seen in combination with inadequate knowledge and practice among the farmers.
Abstract: BACKGROUND: Over the past years there has been an increase in the use of pesticides in developing countries. This study describes pesticide use among small-scale farmers in Uganda and analyses predictors of pesticide poisoning (intoxication) symptoms. METHOD: A cross-sectional study was conducted using a standardized questionnaire. Some 317 small-scale farmers in two districts in Uganda were interviewed about pesticide use, knowledge and attitude, symptoms of intoxication, personal protective equipment (PPE) and hygiene. The risk of reporting symptoms was analysed using logistic regression analysis. RESULTS: The most frequently used pesticides belonged to WHO class II. The farmers had poor knowledge about pesticide toxicity, and the majority did not use appropriate PPE nor good hygiene when handling pesticides. There was no significant association between the number of times of spraying with pesticides and self-reported symptoms of pesticide poisoning. The only significant association was between blowing and sucking the nozzle of the knapsack sprayer and self-reported symptoms of pesticide intoxication (OR: 2.13. 95% CI: 1.09 - 4.18). CONCLUSION: Unlike the practice in several other developing countries, small-scale farmers in Uganda do not use the most hazardous pesticides (WHO class 1a and 1b). However use of WHO class II pesticides and those of lower toxicity is seen in combination with inadequate knowledge and practice among the farmers. This poses a danger of acute intoxications, chronic health problems and environmental pollution. Training of farmers in Integrated Pest Management (IPM) methods, use of proper hygiene and personal protective equipment when handling pesticides should be promoted. Language: en
91 citations
TL;DR: There was a moderate level of compliance towards IFA tablets with key social and demographic factors playing an important role.
Abstract: Background: Anaemia is highly prevalent among pregnant women and iron deficiency is the most important cause. Like many other countries, India has policies to give pregnant women iron supplements. Non-compliance is one important challenging factor in combating anaemia. Objective: To estimate the compliance for IFA tablets among pregnant women and to study the social factors influencing it. Methodology: This study included 190 pregnant women seeking ante-natal care in tertiary health Centres in the Mangalore city in South India. After Institutional Ethics Committee (IEC) approval, data was collected by personal interview. Missing ≥2 doses consecutively was considered non-compliance. The data was analyzed using SPSS (Statistical Package for Social Sciences) version 11.5. Results: The mean age of the study population was 25.8 years (SD: 4.1). Majority of the subjects consumed mixed diet and 72.1% belonged to lower socioeconomic status. Overall, compliance with IFA tablets was 64.7%. Compliance increased with the increase in age, birth order and single daily dose. Forgetfulness and both perceived as well as experienced side effects of IFA therapy were the important factors for non-compliance. Conclusion: There was a moderate level of Compliance towards IFA tablets with key social and demographic factors playing important role.
83 citations
TL;DR: The results did not reveal any decrease in the prevalence of consanguinity over a generation, which shows that the tradition of marrying within the family is a preferred practice, despite the awareness that certain genetic disorders occur at a higher frequency in cousin marriages.
Abstract: Background : Saudi population is unique in that there is a strong preference for cousin marriages in the general population. We studied the prevalence of consanguinity in educated Saudi females and compared the results with the results obtained in their parents, to access if a generation difference in which extensive educational activities have prevailed to inform the people of the influence of cousin marriages on health, has made any difference in prevalence of consanguineous marriages. Method : A total of 600 Saudi women (421 university students and 179 women attending outpatients’ clinics) were interviewed about their own and their parents’ consanguinity. Results : The total consanguinity (first and second cousins) was 29.7% in the parents. Consanguinity was significantly higher among the daughters than the parents, where 37.9% of the 293 married women had consanguineous marriages. The prevalence of consanguinity was studied in different age groups, though no significant pattern was observed. A strong correlation was found between consanguinity of parents and their daughters; consanguinity was highest (52.3%) in the daughters of parents who were themselves consanguineous. Conclusion : The results did not reveal any decrease in the prevalence of consanguinity over a generation. This shows that the tradition of marrying within the family is a preferred practice, despite the awareness that certain genetic disorders occur at a higher frequency in cousin marriages. There is a need at the primary health care level to inform the public of the consequences of this common practice. Key words : Consanguinity; Saudis; First cousin marriage; second cousin marriage; Middle East.
81 citations
TL;DR: There is still room for improving the low proportion of young people who test for HIV in South Africa, and specific attention needs to be paid to younger males, with lack of HIV knowledge, having never talked to the mother or female guardian about HIV and having never been pregnant or made someone pregnant were less likely to be tested.
Abstract: Background: Although recent estimates of the HIV/AIDS burden in South Africa show the particular vulnerability of youth to HIV, HIV testing and its determinants are largely understudied in this age group. Objective: To investigate the prevalence and determinants of HIV testing among young people aged 18 to 24 years, as part of an evaluation of the impact of loveLife. Methods: South Africa’s national HIV prevention campaign for young people, on HIV and related risk behaviours. A cross-sectional population-based household survey was conducted using a multistage stratified cluster sampling approach. The total sample included 3123 participants, aged 18-24, 54.6% men and 45.4% women, from four provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). Results: The results indicated that over half (52.2%) of the youth reported testing for HIV, with more young females (60.1%) testing for HIV compared to their male counterparts (39.9%). In the multivariate analysis, older age, being female, HIV knowledge, having ever talked to the mother or female guardian about HIV and having ever been pregnant or made someone pregnant were found to be associated with testing for HIV. Conclusion: There is still room for improving the low proportion of young people who test for HIV. Specific attention needs to be paid to younger males, with lack of HIV knowledge, having never talked to the mother or female guardian about HIV and having never been pregnant or made someone pregnant were less likely to be tested. Outreach at individual and community levels and public health messages targeting these youth should be implemented. Africa Health Sciences 2013; 13(4): 1006 - 1014
78 citations
TL;DR: Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.
Abstract: Background : Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. Objectives : The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization Method : A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. Results : The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Conclusion : Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people. Keywords/Phrases : Utilization, healthcare Delivery System, Planning, Model, Factor Analysis, Rural and Urban Areas.
68 citations
TL;DR: Uganda's experience in controlling similar Ebola outbreaks and some lessons that could inform the control of the Ebola outbreak in West Africa are shared to draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic.
Abstract: Background : There has been a rapid spread of Ebola Viral Hemorrhagic disease in Guinea, Liberia and Sierra Leone since March 2014. Since this is the first time of a major Ebola outbreak in West Africa; it is possible there is lack of understanding of the epidemic in the communities, lack of experience among the health workers to manage the cases and limited capacities for rapid response. The main objective of this article is to share Uganda’s experience in controlling similar Ebola outbreaks and to suggest some lessons that could inform the control of the Ebola outbreak in West Africa. Methods : The article is based on published papers, reports of previous Ebola outbreaks, response plans and experiences of individuals who have participated in the control of Ebola epidemics in Uganda. Lessons learnt : The success in the control of Ebola epidemics in Uganda has been due to high political support, effective coordination through national and district task forces. In addition there has been active surveillance, strong community mobilization using village health teams and other community resources persons, an efficient laboratory system that has capacity to provide timely results. These have coupled with effective case management and infection control and the involvement of development partners who commit resources with shared responsibility. Conclusion : Several factors have contributed to the successful quick containment of Ebola outbreaks in Uganda. West African countries experiencing Ebola outbreaks could draw some lessons from the Uganda experience and adapt them to contain the Ebola epidemic. Key words : Ebola, viral hemorrhagic fever, West Africa, lessons, Uganda
64 citations
TL;DR: AKI is common and associated with poorer outcomes in perinatal asphyxiated full-term infants and larger studies need to be done to correlate maternal factors and perinnatal asphyxia-associated AKI.
Abstract: Background: The kidney is the most damaged organ in asphyxiated full-term infants. The severity of its damage is correlated with the severity of neurological damage. We determined the prevalence of perinatal asphyxia-associated acute kidney injury (AKI). Methods: We conducted a prospective cohort study including 60 full-term neonates admitted at the Kenyatta National Hospital newborn unit (NBU) in Nairobi with hypoxic ischaemic encephalopathy (HIE) from June 2012 to November 2012. Renal function was assessed by measuring serum creatinine on day 3 of life. AKI was defined by a level of creatinine above 133 µmol/l. The degree of neurological impairment was determined daily until patient discharge, death or day 7 of life. Results: Of the 60 infants 36.6% had HIE I, 51.6% HIE II and 11.8% HIE III. The prevalence of AKI was 11.7 %. There was a 15 fold increase risk of developing AKI in HIE III versus HIE I, p=0.034. Mortality rate in perinatal asphyxia associated AKI was 71.4 % with a 24 fold increase risk of death in neonates with AKI, p=0.001. Conclusions: AKI is common and associated with poorer outcomes in perinatal asphyxia. Larger studies need to be done to correlate maternal factors and perinatal asphyxia-associated AKI.
61 citations
TL;DR: Prevalence of burnout and psychological distress is high among nurses in Nigeria, with high levels of burnouts identified in nurses working in Nigerian tertiary health institution.
Abstract: Background: The role of nurses in the health care delivery system cannot be overemphasized. Nurses are needed at all levels of healthcare and the profession requires a lot of dedication, time and energy with regards to patient management and service delivery. This time investment and dedication to duty is likely to lead to burnout and psychological distress among the nurses. Objective: This study assesses the prevalence of burnout and psychological distress among nurses working in Nigerian tertiary health institution. Method: The Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) were used to assess 210 nurses working in this health institution for symptoms of burnout and psychological distress. Results: High levels of burnout were identified in 42.9% of the respondents in the area of emotional exhaustion, 47.6% in the area of depersonalization and 53.8% in the area of reduced personal accomplishment, while 44.1% scored positive in the GHQ-12 indicating presence of psychological distress. Conclusion: Prevalence of burnout and psychological distress is high among nurses. Keywords: Burnout, psychological distress, stress management African Health sciences Vol 14 No. 1 March 2014
55 citations
TL;DR: The prevalence of NIHL among employees at the Mine of Zimbabwe of 37% is high and mine management should institute a hearing conservation program to protect employees against hazardous noise.
Abstract: Background: Noise induced hearing loss (NIHL) is within the top five occupational illnesses in Zimbabwe. Workers at a mining company complained about loss of hearing at the mine clinic. Objective: To determine the prevalence of NIHL among employees at the Mine. Methods: We conducted a descriptive cross sectional study at the mine. Workers were proportionally selected to represent all the mine departments or working areas. We measured noise levels at various mine sites, conducted a walk-through survey to observe noise related worker practices and conducted audiometric testing. Results: Mean age for workers was 34.8±7.6 years and the mean duration of exposure to noise was 7.5±1.2 years. All workers could define noise. Ninety (53%) workers attributed NIHL to noisy work environment. Excessive noise levels were in Plant Processing (94 dBA), Underground Mining (102 dBA) and (Underground Workshop (103 dBA). Sixty two (36.7%) workers had NIHL. NIHL increased as a function of age (chi square=30.99 df=3 p<0.01) and was associated with work area (chi square=24.96 df=5 p<0.01). Observed workers took heed of noise warnings. There was no documented hearing conservation program at the mine. Conclusion: The prevalence of NIHL of 37% is high. Age and work area were associated with NIHL. Studies reported that age tends to distort the relationship between noise exposure and NIHL. Mine management should institute a hearing conservation program to protect employees against hazardous noise. Management may meanwhile use administrative controls and adhere to permissible exposure limits according to the noise regulations. African Health Sciences 2013; 13(4): 899 - 906 http://dx.doi.org/10.4314/ahs.v13i4.6
51 citations
TL;DR: Serious efforts are needed to improve or review curriculum so that health sciences students' knowledge on infection prevention and control is imparted early before they are introduced to the wards.
Abstract: Background: Health Sciences students are exposed early to hospitals and to activities which increase their risk of acquiring infections. Infection control practices are geared towards reduction of occurrence and transmission of infectious diseases. Objective: To evaluate knowledge and attitudes of infection prevention and control among Health Science students at University of Namibia. Methods: To assess students’ knowledge and attitudes regarding infection prevention and control and their sources of information, a self-administered questionnaire was used to look at standard precautions especially hands hygiene. Results: One hundred sixty two students participated in this study of which 31 were medical, 17 were radiography and 114 were nursing students. Medical students had better overall scores (73%) compared to nursing students (66%) and radiology students (61%). There was no significant difference in scores between sexes or location of the high school being either in rural or urban setting. Conclusion: Serious efforts are needed to improve or review curriculum so that health sciences students’ knowledge on infection prevention and control is imparted early before they are introduced to the wards. Keywords: Infection Prevention and Control, Health Science students, Hand hygiene African Health Sciences 2013; 13(4): 1071 - 1078
TL;DR: The results of this study can be used to inform the development of culturally relevant cervical cancer education interventions aimed at addressing the psychological barriers to cervical cancer screening perceived by Ghanaian women.
Abstract: Background: Cervical cancer is the leading cause of cancer death among women in Ghana, West Africa. The cervical cancer mortality rate in Ghana is more than three times the global cervical cancer mortality rate. Pap tests and visual inspection with acetic acid wash are widely available throughout Ghana, yet less that 3% of Ghanaian women get a cervical cancer screening at regular intervals. Objective: This exploratory study was to identify psychological barriers to cervical cancer screening among Ghanaian women with and without cancer using a mixed methods approach. Methods: Semi-structured interviews were conducted with 49 Ghanaian women with cancer and 171 Ghanaian women who did not have cancer. Results: The results of the quantitative analysis indicated that cancer patients where not more likely to have greater knowledge of cancer signs and symptoms than women without cancer. Analysis of the qualitative data revealed several psychological barriers to cervical cancer screening including, common myths about cervical cancer, misconceptions about cervical cancer screening, the lack of spousal support for screening, cultural taboos regarding the gender of healthcare providers, and the stigmatization of women with cervical cancer. Conclusion: The results of this study can be used to inform the development of culturally relevant cervical cancer education interventions aimed at addressing the psychological barriers to cervical cancer screening perceived by Ghanaian women. Keywords: Cancer, developing countries, disease prevention, knowledge, qualitative methods br> African Health Sciences 2013; 13(4): 1054 - 1061
TL;DR: Qualitative findings show that poverty, refusal to use condoms by male partners, alcohol use before sex and beliefs that condoms 'kill the mood for sex' remain key barriers to consistent condom use.
Abstract: Background: There is limited documentation on knowledge, attitudes and barriers to condom use among female sex workers (FSWs) and truck drivers (truckers) Objective: To explore knowledge, attitudes and barriers to condom use among FSWs and truckers operating along major transport corridors in Uganda Methods: Structured questionnaires were administered to explore FSWs’ and truckers’ knowledge of and attitudes towards condom use among 259 FSWs and 261 truckers Qualitative data were collected on barriers to condom use using focus group discussions Quantitative data were analyzed using SPSS while qualitative data were audio-recorded, transcribed and thematically analyzed Results: Condom knowledge was high with 97% of FSWs and 95% of truckers agreeing with the statement, “using condoms properly and consistently reduces risk of HIV infection” Attitudes towards condom use were generally favorable with 91% of FSWs and 82% of truckers agreeing with the statement, “condom use is the best method of HIV prevention” Qualitative findings show that poverty, refusal to use condoms by male partners, alcohol use before sex and beliefs that condoms ‘kill the mood for sex’ remain key barriers to consistent condom use Conclusions: Consistent condom use among FSWs and truckers is still hampered by economic and relationship factors Keywords: knowledge, attitudes, barriers, condom use, FSWs, truckers African Health Sciences 2013; 13(4): 1027 - 1033
TL;DR: Moderate aerobic exercise training modulates inflammatory cytokines more than mild aerobic exerciseTraining in obese type 2 diabetic patients.
Abstract: Background: Recently some plasma biomarkers of inflammation have been recognized as important cardiovascular risk factors. There is little information about the effects of aerobic exercise training on these biomarkers and the risk of metabolic complications in obese type 2 diabetes patients. Objective: To compare the impact of moderate versus mild aerobic exercise training on the inflammatory cytokines in obese type 2 diabetic patients. Methods: Fifty obese type 2 diabetic patients of both sexes with body mass index (BMI) varying from 31 to 36 kg/m 2 , non smokers, free from respiratory, kidney, liver, metabolic and neurological disorders, participated in this study. Their age ranged from 40 to 55 years. The subjects were included into two equal groups; the first group (A) received moderate aerobic exercise training. The second group (B) received mild aerobic exercise training, three times / week for 3 months. Results: The mean values of leptin, TNF- alpha, IL2, IL4, IL6, HOMA-IR and HBA1c were significantly decreased in group (A) and group (B). Also, there were significant differences between both groups after treatment. Conclusion: Moderate aerobic exercise training modulates inflammatory cytokines more than mild aerobic exercise training in obese type 2 diabetic patients. Keywords : Aerobic exercise, inflammatory cytokines, obesity, non-insulin dependent diabetes African Health Sciences Vol 13 Issue 4 December 2013
TL;DR: Interventions that educate FSWs on their rights and enable them to avoid violence are urgently required to enable them avoid sex work.
Abstract: Background:. Few studies in Africa provide detailed descriptions of the vulnerabilities of female sex workers (FSWs) to violence. Objective: To document the prevalence and types of violence experienced by FSWs, identify the risk factors of experiencing violence to women (VAW) and the perpetrators of these acts. Methods: An analytical cross sectional survey of 305 brothel-based FSWs and in-depth interview of 20 chairpersons residing in brothels in Abuja, Nigeria was done. Results: The prevalence of VAW six months preceding the survey was 52.5%. Sexual violence was the commonest type (41.9%) of violence experienced, followed by economic (37.7%), physical violence (35.7%) and psychological (31.9%). The main perpetrators of sexual violence were clients (63.8%) and brothel management (18.7%). Sexual violence was significantly more experienced (aOR 2.23; 95%CI 1.15-4.36) by older FSWs than their younger counterparts, by permanent brothel residents (aOR 2.08; 95%CI 1.22-3.55) and among those who had been in the sex industry for more than five years (aOR 2.01; 95%CI 0.98-4.10). Respondents with good knowledge levels of types of violence were less vulnerable to physical violence (aOR 0.45; 95%CI 0.26-0.77). Psychological violence was more likely among FSWs who smoked (aOR 2.16; 95%CI 1.26-3.81). Risk of economic violence decreased with educational levels (aOR 0.54; 95%CI 0.30-0.99 and aOR 0.42; 95%CI 0.22-0.83 for secondary and post secondary respectively). Consequences of the violence included sexually transmitted infections (20%) and HIV (8.0%). Conclusion: Interventions that educate FSWs on their rights and enable them avoid violence are urgently required. Young women need economic and educational empowerments to enable them avoid sex work.
TL;DR: In this article, the relationship between neck circumferences and obesity was found to be positively associated with body weight, BMI, waist circumference, waist and hip circumference and waist/hip ratio for men and women.
Abstract: Background : Neck circumference (NC) measurement is one of the simple screening measurements which can be used as an index of upper body fat distribution to identify obesity Objectives: The aim of this study was to determine the relationship between neck circumferences and obesity Methods :A total 411 volunteer adults participated in this study (174 men, 237 women) A questionnaire which consisted of anthropometric measurements and demographic features was used Patients with NC ≥37 cm for men and ≥34 cm for women require evaluation of overweight status Results : The percentages of the men and women with BMI ≥ 25kg/m 2 were 552% and 270% respectively and with high neck circumferences were 851% and 388%, respectively The percentages of the men and women with high waist circumference were 316% and 793%, respectively In both gender there were positive significant correlations between neck circumference, body weight (men, r=0576; women, r=0702; p=0000), waist circumferences (men, r=0593; women r=0667; p=0000), hip circumferences (men, r=0568; women, r=0617; p=0000) and BMI (men, r=0587; women, r=0688; p=0000) Conclusions : This study indicates that NC was associated with body weight, BMI, waist and hip circumferences and waist/hip ratio for men and women A significant association was found between NC and conventional overweight and obesity indexes NC was associated with waist/hip ratio for men and women Key words : Neck circumference, obesity
TL;DR: The water sources were heavily contaminated which suggested poor protection and sanitation practice in the water sources and source protection strategies as well as monitoring are recommend for this community.
Abstract: Background: Accesses to safe water is a universal need however, many of the world’s population lack access to adequate and safe water. Consumption of water contaminated causes health risk to the public and the situation is serous in rural areas. Objectives: To assess the bacteriological and physico-chemical quality of drinking water sources in a rural community of Ethiopia. Methods: Water samples were collected from tap, open springs, open dug wells and protected springs for bacteriological analysis of total coliforms and thermotolerant coliforms. The turbidity, pH and temperature were measured immediately after collection. Results: Most drinking water sources were found to have coliform counts above the recommended national and international guidelines and had high sanitary risk scores. There was a statistically significant difference among water sources with respect to TC and TTC (p < 0.05) and there was a statistically significant positive correlation between coliform counts and sanitary risk scores (p < 0.01). Most water sources didn’t satisfy the turbidity values recommended by WHO. Conclusion: The water sources were heavily contaminated which suggested poor protection and sanitation practice in the water sources. Source protection strategies as well as monitoring are recommend for this community. Keywords : Coliforms; physico-chemical; rural community; water quality African Health Sciences 2013; 13(4): 1156- 1161
TL;DR: Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in the authors' environment and more awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers.
Abstract: Background: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population. Methods: A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant. Results: A total o:f 146 patients, aged 5-70 years (mean 30.5+ 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 +15.72) and this was not different for malignant or benign tumors (P=0.886). Conclusion:Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers.
TL;DR: There has been a steady decline of neonatal mortality since 2004 and Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of Neonatal deaths.
Abstract: Background : The fourth Millennium Development Goals targets reduction of the mortality rate of under-fives by 2/3 by the year 2015. This reduction starts with that of neonatal mortality representing 40% of childhood mortality. In Cameroon neonatal mortality was 31% in 2011. Objectives : We assessed the trends, associated factors and causes of neonatal deaths at the Yaounde Gynaeco-Obstetric and Pediatric Hospital. Methods : The study was a retrospective chart review. Data was collected from the hospital records, and included both maternal and neonatal variables from 1 st January 2004 to 31 st December 2010. Results : The neonatal mortality was 10%. Out-borns represented 49.3% of the deceased neonates with 11.3% born at home. The neonatal mortality rate followed a downward trend dropping from 12.4% in 2004 to 7.2% in 2010. The major causes of deaths were: neonatal sepsis (37.85%), prematurity (31.26%), birth asphyxia (16%), and congenital malformations (10.54%). Most (74.2%) of the deaths occurred within the first week with 35% occurring within 24hours of life. Mortality was higher in neonates with birth weight less than 2500g and a gestational age of less than 37 weeks. In the mothers, it was high in single parenthood , primiparous and in housewives and students.. Conclusion : There has been a steady decline of neonatal mortality since 2004. Neonatal sepsis, prematurity, birth asphyxia and congenital malformations were the major causes of neonatal deaths. Neonatal sepsis remained constant although at lower rates over the study period. Key words : mortality, neonates, referral hospital, Cameroon
TL;DR: The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-Adherence problems in routine clinical practice.
Abstract: Background: Poor adherence to prescribed therapy among patients with chronic diseases is a growing concern which undermines the benefits of current medical care. Objectives: To evaluate the pattern of treatment non-adherence among ambulatory patients with poorly controlled type 2 diabetes in southwestern Nigeria, and to determine the possible factor(s) that accounted for such non-adherence with a view to identifying areas of future intervention to improve outcome. Methods: A prospective cross-sectional interview using the concept of RIM (Recognize, Identify and Manage) model was used to evaluate adherence to treatment recommendations among 176 consented patients recruited from the endocrinology out-patient clinics of two teaching hospitals in southwestern Nigeria between November, 2010 and January, 2011. Results: Overlaps of non-adherence behavior were obtained. More than three-quarter (153; 88.4%) were not aware of indication for each of the prescribed medications, 26 (15.3%) correctly described regimen as prescribed. The factorsidentified as possible barriers to medication adherence include practical (145; 40.1%), knowledge (103; 28.5%), and attitudinal (114; 31.5%) barriers. Dietary non-adherence was mostly due to inappropriate guidance (62; 33.7%). Conclusions. The arrays of non-adherence behavior among the cohort further emphasize the need for patient-centered approach as a reasonable strategy in resolving non-adherence problems in routine clinical practice.
TL;DR: Identifying symptom clusters helped clarify possible inter-relationships which may lead to the establishment of more effective symptom management interventions for patients with lung cancer in order to improve the quality of life.
Abstract: Objective: To explore the symptom clusters and quality of life in patients with lung cancer undergoing chemotherapy. Methods: A cross-sectional survey was completed with 183 patients from three public hospitals in Xi’an, China. Patients completed a demographic questionnaire, the Functional Assessment of Cancer Therapy-Lung Cancer (FACT-L) and the M. D. Anderson Symptom Inventory (MDASI-C). Factor analysis was used to identify symptom clusters based on the severity of patients’ symptom experiences. The resulting clusters were correlated with quality-of-life measures. Results: The QOL scores of lung cancer patients on the functioning subscale were the lowest (9.70±5.30), while those of the family subscale were the highest (19.28±3.24). Three symptom clusters were identified: gastrointestinal, emotional and fatigue–related symptoms. There was a negative relationship between the symptom clusters and multiple dimensions of quality of life (r -0.178～-0.805, p< 0. 05). Females, especially those women with low education level /chronic diseases, were experienced greater symptom distress than others. Conclusions: The clusters had a negative relationship with QOL. Identifying symptom clusters helped clarify possible inter-relationships which may lead to the establishment of more effective symptom management interventions for patients with lung cancer in order to improve the quality of life. Keywords: symptom clusters, lung cancer, factor analysis, symptom management, quality of life African Health sciences Vol 14 No. 1 March 2014
TL;DR: Leaders in Gulu district should encourage pregnant woman to acquire and use ITN to reduce their vulnerability to malaria.
Abstract: Background : Malaria during pregnancy causes severe anaemia, placental malaria or death to the mother while the fetus may be aborted or stillborn. Objective: To establish the prevalence and factors associated with Insecticide Treated Net (ITN) utilisation among pregnant women in a post conflict Internally Displaced Persons (IDP) camps of Gulu district. Methods: We conducted cross-sectional study in 20 IDP camps in which 769 pregnant women were interviewed for ITN utilisation the night before the survey. The 20 IDP camps were selected using simple random sampling technique as clusters. Households that had pregnant women were then consecutively selected. Data were entered in EpiData 3.1 and analyzed using STATA11. Results: 35% of pregnant women (95% CI 31% - 38%) had utilised ITNs. Factors that promoted ITN utilisation includes: antenatal visit (AOR 1.90, p-value 0.000); ITN awareness (AOR 1.57, p-value 0.011), and willingness to purchase ITN (AOR 2.12, p-value 0.000). Factors which hinder ITN utilisation were: hours taken to reach health centre (AOR 0.64, p-value 0.050) and being single/widow/divorced (AOR 0.22, p-value 0.000). Conclusion: Majority of the respondents were not utilising ITN. Therefore, leaders in Gulu district should encourage pregnant woman to acquire and use ITN to reduce their vulnerability to malaria. Keywords: Utilisation, ITN, pregnant women, post conflicts, internally displaced persons African Health Sciences 2013; 13(4): 962 - 969
TL;DR: The methanolic fruit extract of M. charantia exhibits dose dependent hypoglycaemic activity in vivo in alloxan-induced diabetic albino rats.
Abstract: Background: Momordica charantia L. is a medicinal plant commonly used in the management of diabetes mellitus. Objectives: We investigated the blood glucose lowering effect of the methanolic fruit extract of the Ugandan variety of M. charantia L. in alloxan-induced diabetic albino rats. Methods: 500g of M. charantia powder were macerated in methanol and the extract administered to two groups of alloxaninduced diabetic rats. The first group received 125mg/kg, the second 375mg/kg and a third group 7mg/ kg of metformin. A fourth group received 1ml normal saline. Fasting blood glucose (FBG) levels were measured at 0.5,1,2,3,5,8 and 12 hours and compared using one-way ANOVA. Results: There was an initial rise in FBG for 1 hour after administration of extracts followed by steep reductions. Significant reduction in FBG occurred at 2 hours for 125mg/kg of extract (-3.2%, 313±25.9 to 303±25.0mg/dL, p = 0.049), 375mg/kg of extract (-3.9%, 356±19.7 to 342±20.3mg/dL, p = 0.001), and metformin (-2.6%, 344±21.7 to 335±21.1mg/dL, p = 0.003) when compared to normal saline. The maximum percentage reduction in FBG by both extracts occurred between 3 and 12 hours post dose. Conclusions: The methanolic fruit extract of M. charantia exhibits dose dependent hypoglycaemic activity in vivo. Keywords: Momordica charantia , methanolic extract, Diabetes Mellitus, hypoglycaemic effect, in vivo African Health Sciences 2013; 13(4): 933 - 939
TL;DR: Schistosomiasis is highly endemic in the study area and the use of microhaematuria and proteinuria for mapping the infected population prior treatment could be adopted.
Abstract: Background : Rapid and accurate diagnosis is necessary for the management of schistosomiasis in endemic areas. Objective : To assess the burden of urogenital schistosomiasis and the diagnostic efficiency of morbidity indicators of the disease in an endemic rural community of Nigeria. Methods : A cross-sectional school-based study was conducted. Urine samples of 487 pupils were screened microscopically for S. haematobium and tested for haematuria and proteinuria using chemical reagent strips. Results : The prevalence and intensity of infection were 57.1% and 45.0 eggs/10 mL urine respectively. Prevalence of infection in male (54.1%) and female (60.3%) individuals showed no significant variation (P>0.05). However, prevalence of infection was age dependent with those in age groups 3-5 and 12-14 years having the least and highest prevalence of infection respectively (P<0.05). Microhaematuria and proteinuria varied significantly with ages of the pupils with least (14.0, 40.0%) and highest (60.0, 80.0%) prevalence recorded in age groups 3-5 and 15-19 years respectively (P<0.05). Proteinuria showed higher sensitivity (80.3%) compared to microhaematuria (73.3%). Conclusion : Schistosomiasis is highly endemic in the study area and the use of microhaematuria and proteinuria for mapping the infected population prior treatment could be adopted. Key words : Schistosomaisis, haematuria, proteinuria, Nigeria
TL;DR: Current management of LBP at PHC level appears to be ineffective and not conform guidelines, and South African research should focus on barriers as well as measures to be taken for implementation of L BP guidelines.
Abstract: Background : Primary Health Care (PHC) is well suited for management of low back pain (LBP). Prevalence of (chronic) LBP is suspected to be high among visitors of the South African primary care centers, but currently no information exists on prevalence or guideline adherence. Objectives : To establish if treatment received for LBP in public PHC in the Cape Town area compares with international evidence based guidelines. Methods : Cluster randomization determined the 8 community health centres where the study took place. A measurement tool was developed and validated for this population. Descriptive analysis and logistic regression analytical techniques were applied. Results : 489 participants (mean age: 44.8) were included in this study. Lifetime prevalence was 73.2% and 26.3% suffered from chronic low back pain (CLBP) . Pain medication was the only form of treatment received by 90% of the sample. Interventions received seemed to be unrelated to type of LBP (acute, sub acute and chronic). Referral to physiotherapy, education and advice to stay active were rarely done. Participants expressed low satisfaction with treatment. Conclusions : Current management of LBP at PHC level appears to be ineffective and not conform guidelines. Further South African research should focus on barriers as well as measures to be taken for implementation of LBP guidelines. Keywords : Low back pain, management, guidelines, primary care, South Africa
TL;DR: C. trachomatis infection if unchecked will continue to pose a threat to reproductive life with its established complications and regular screening should be encouraged for every adult especially before commencement of marital life.
Abstract: Background : Chlamydia trachomatis is the most common bacterial sexually transmitted disease in the world with severe complications. The aim of this study was to determine the prevalence and possible risk factors of C. trachomatis in Kano. There is dearth of information on this subject in this locality. Method : Urine samples, Endocervical swabs and Urethral swab were collected from consecutive patients attending the Infertility and STD clinics in Aminu Kano Teaching Hospital (AKTH) between June and December 2012, after administering a questionnaire by the attending physician and also obtaining an informed consent.Samples were analyzed using Diaspot Chlamydia kit, a rapid immunoassay test for the detection of genital chlamydial antigen in urinogenital samples. Results : A total of 125 consecutive samples were collected, comprising 69 females and 56 males aged between 14 – 55 years. Twelve samples tested positive for C. trachomatis antigen giving a prevalence rate of 9.6%. The age group prevalence were as follows 25 – 29 yrs (17.1%), 20 – 24 (16.7%), 15 – 19 (12.5%), 30 – 34 (11.1%) and > 49 years (9.0%). Married patients were associated with higher infection rate than single (8.3%), and divorced patients (33.3%). A higher percentage of the patients (95.2%) were not aware of the existence of C. trachomatis infection and its complications. Previous STD exposure was associated with increased risk of Chlamydia infection. Conclusion : C. trachomatis infection if unchecked will continue to pose a threat to reproductive life with its established complications. Since asymptomatic cases are common in the population regular screening should be encouraged for every adult especially before commencement of marital life. Key words : Chlamydia trachomatis , Prevalence, risk factors, Infertility, STD, Kano.
TL;DR: MUAC and CC values of 33cm and 39cm respectively might be reliable cut off points for diagnoses of obesity throughout pregnancy in Enugu, Nigeria.
Abstract: Background: Obesity in pregnancy is a global health problem which is associated with poor pregnancy outcomes. The use of weight and height, measured at about ten weeks of gestation, to produce pre-gestational body mass index is recommended for the diagnoses of the condition but limitations abound in under resourced settings. Objectives : To measure anthropometric indices such as mid upper arm circumference, calf circumference, waist circumference and waist to hip ratio, for identification of obesity in pregnancy. Methods: Anthropometric measurements were carried out on cohorts of pregnant women from 4 hospitals in Enugu, South-eastern Nigeria. Results: There were no significant difference in the mean mid upper arm circumference (MUAC) and calf circumference (CC) across the trimester groups. The mean values of waist circumferences, hip circumference and waist to hip ratios changed significantly across the trimesters. The 75th percentile of MUAC (33 cm) and CC (39 cm) in all trimesters, had sensitivity and specificity of more than 70% for identifying obesity in pregnancy. Conclusion: MUAC and CC values of 33cm and 39cm respectively might be reliable cut off points for diagnoses of obesity throughout pregnancy in Enugu, Nigeria Keywords: Anthropometric indices, Body mass index, obesity, oregnancy, Nigeria African Health Sciences 2013; 13(4): 1034 - 1040
TL;DR: Psoralen and isopsoralen have growth inhibitory effects on transplanted tumor in nude rats with osteosarcoma, and can induce tumor cell apoptosis or necrosis, without significant toxic effects.
Abstract: Background : Modern studies have shown that psoralen has a significant inhibitory effect on tumor growth in a variety of animals and humans. Objective : To obtain coumarin compounds – psoralen and isopsoralen – from traditional Chinese medicine Psoralea corylifolia L. using chromatographic techniques and isolation and purification methods, and to observe the transplanted tumor growth inhibitory effects and adverse reactions of psoralen and isopsoralen in nude rats with osteosarcoma. Methods : Dried ripe fruits of Psoralea corylifolia L. were taken as the raw material to prepare crude extract of Psoralea corylifolia L. by ethanol reflux method. Column chromatography was used to isolate the crude extract; compounds were structurally identified based on 1 H-NMR, 13 C-NMR spectra, the two compounds were identified as psoralen andisopsoralen, and their contents were 99.7% and 99.6, respectively. Nude rat model of osteosarcoma was established; the rats were randomized into: normal saline group, psoralen low- and high-dose groups, isopsoralen low- and high-dose groups, and cisplatin group. Osteosarcoma volume and weight inhibition rates in nude rats in each group were observed; radioimmunoassay was used to determine the serum alkaline phosphatase activity; peripheral blood cell and bone marrow nucleated cell counts were determined; light microscopy was used to observe heart, liver, spleen, lung, kidney, and tumor histopathology; and electron microscopy was used to observe the fine structure of tumor cells. Results : Tumor volume inhibition rates were 43.75% and 40.18%, respectively, in the psoralen and isopsoralen low-dose groups, and tumor weight inhibition rates were 38.83% and 37.77%. Tumor volume inhibition rates were 67.86% and 66.96%, respectively, in the psoralen and isopsoralen high-dose groups, and tumor weight inhibition rates were 49.47% and 47.87%. Psoralen and ispsoralen markedly lowered serum AKP level. Psoralen and isopsoralen induced apoptosis or necrosis of osteosarcoma. After administration of high doses of psoralen and isopsoralen, toxic reactions such as writhing, lassitude, and hypoactivity were seen. Kidney histopathology showed tubulointerstitial dilatation and congestion, and inflammatory cell aggregation in the renal intercellular space. Psoralen and isopsoralen did not cause any significant toxic side effects to the bone marrow, or other organs such as heart, lung, liver, and spleen. Conclusion : Psoralen and isopsoralen have growth inhibitory effects on transplanted tumor in nude rats with osteosarcoma, and can induce tumor cell apoptosis or necrosis, without significant toxic effects. Key words : Psoralea corylifolia L., psoralen, isopsoralen, osteosarcoma
TL;DR: Sero-prevalence of 6.6% among pregnant women is reported in Nigeria and efforts to promote routine screening of pregnant women, immunization and vaccination of infants should be sustained.
Abstract: Background: Hepatitis B virus (HBV) infection is one of the most common public health problems worldwide. Over one million people die annually of HBV- related chronic liver disease. Maternal to fetal transmission from chronic carriers exceeds 90% and accounts for up to 40% of the world’s chronic carriers in endemic areas. Methods: This was a descriptive study which involved Serial recruitment of 836 women attending the antenatal clinic at a health facility in Cross-River State, Nigeria from 1st January to 30th June 2010. HBsAg screening was done using an ELISA test. Results: Fifty five (6.6%) of the 836 women screened tested positive for HBsAg. The mean age and parity of sero-positive subjects was 26.9 ±5.0 (range 18-38 years) and 2.2±1.2 (0 to 5) respectively. The prevalence was more in women who were farmers (29.1%) and those with either none or low level of formal education (67.2%). Conclusion: Sero-prevalence of 6.6% among pregnant women is reported. Women education, economic empowerment and public enlightenment programmes focused on modification of risky social lifestyle is recommended. Efforts to promote routine screening of pregnant women, immunization and vaccination of infants should be sustained. Keywords: Sero-prevalence, Hepatitis B virus, routine screening, immunization African Health Sciences 2013; 13(4): 1139 - 1143
TL;DR: Regular molecular surveillance of this form of ESBL is recommended due to the relationship between high molecular weight plasmids and multi-drug resistance, and the recent emergence of carbapenem resistant bacteria.
Abstract: Background: The increased reports of ESBL dissemination from various centres in south western, Nigeria and the recent emergence of carbapenem resistant bacteria prompted the conception of this study. Objectives: To demonstrate the relationship between high molecular weight plasmids and the expression of antibiotic multi-resistance including ESBL and carbapenemase. Methods: We investigated 97 isolates of selected organisms consisting of 67 E. coli and 30 Klebseilla spp for the presence of plasmids expressing ESBL including carbapenem-hydrolysing enzymes. Beta-lactamase was determined using acidometric method, while ESBL and carbapenemase activity was determined using the double-disk diffusion test as well as the Modified Hodge test (MHT). Plasmid profiles of ESBL and carbapenemase positive isolates were determined according to standard protocols. Results: An ESBL prevalence rate of 21.6% and carbapenem- resistance rate of 9.3% was recorded. Antibiotic susceptibility profile of ESBL isolates showed 100.0% resistance against Amoxicillin, Cotrimoxazole and Erythromycin. Moderate susceptibility was recorded against the Quinolone class of antibiotics; Meropenem remained the most active antibiotic against ESBL isolates with 62.5% against E. coli and 60% against K. pneumoniae. The plasmid profiles of our study isolates ranged from 11.8kbp to 35.5kbp. Conclusion: Due to the relationship between high molecular weight plasmids and multi-drug resistance, we hereby recommend regular molecular surveillance of this form in our study setting. Keywords: Carbapenem-resistance, ESBL isolates, Plasmid profile, Abeokuta African Health Sciences 2013; 13(4): 1091 - 1097