Showing papers in "Journal of Public Health in Africa in 2017"
TL;DR: The authors have sought to highlight the pitfalls researchers sometimes entangle themselves within an act of compromise thereby impinging on the ethical and professional responsibilities for the content of a paper under consideration.
Abstract: Dissemination of research findings through the publication of one’s work or a group of contributors is an important part of the research process, as this allows the passing on of benefits to a much wider community. In whatever evocative form this dissemination may take, the onus lies on the author(s) to ensure adherence to the code of ethics as it pertains to the integrity of the information being put out. We publish because we want our findings to be adapted into practice and application, or in some cases may be relevant to policy makers in decision-making. To a large extent in the field of academia, successful publication improves opportunities for academic funding and promotion whilst enhancing scientific and scholarly achievement and repute. A situation may be compromised where intellectual contributions to a scientific investigation do not adhere to the four key guidelines of scholarship, authorship, approval and agreement as well as the protocols of ensuring good publication ethics. The objective of this review is to lay emphasis on universal standards for manuscript authorship and to fostering good practices. This in our view will bring authorship credit and accountability to the attention of our colleagues and readers at large. To achieve this, a systematic and critical review of the literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to responsible authorship, common authorship malpractices, conflict of interest, universal publication guidelines and other authorship related issues, were used. Only references deemed useful from relevant texts and journal articles were included. In this paper, the authors have sought to highlight the pitfalls researchers sometimes entangle themselves within an act of compromise thereby impinging on the ethical and professional responsibilities for the content of a paper under consideration. This article presents the case that authorship has a strong currency that brings not only personal satisfaction but also career rewards based on publication counting. In all cases described here, a universal standard for manuscript authorship will be critical in fostering good practices. As you write and review manuscripts, keep these good practices in mind, and consider ways to bring authorship credit and accountability to the attention of your colleagues and readers.
47 citations
TL;DR: Both the parents and adolescents had good knowledge of adolescent reproductive health but practice and quality of communication was poor, therefore, training intervention to improve the adolescent- parent communication is recommended for the parents.
Abstract: Communication between parents and adolescents on Adolescent Reproductive Health (ARH) issues are emerging public health concerns in Nigeria; yet they can be tackled through parents’ intervention. This study was designed to document the parents’ knowledge and quality of communication relating to ARH between parents and their adolescents in Ibadan, Oyo State, Nigeria.A descriptive cross-sectional study was conducted in two Local Government Areas in the state. Interviewer-administered instruments were used to collect data from the parents and adolescents pair. Both instruments included a 28-point knowledge scale and questions on ARH practices. The instrument for adolescents contained an additional 15-point Perceived Quality of ARH Communication (PQARHC). Knowledge scores ≤9, ≤10-18 and ≥20 were categorized as poor, fair and good, respectively for both parents and adolescents. Data were analyzed using descriptive statistics and Chisquare tests at P=0.05. Ages of adolescents were 13.9±2.4 years while parents’ ages was 42.6±8.5 years. Parent’s and adolescents knowledge scores 22.6±3.4 and 19.4±5.9, respectively with no significant difference. Adolescents whose parents ever discussed ARH issues with them were 20.9% as against 72.1% by the parents. The proportion of parents and adolescents with good knowledge of ARH were 89.4% and 64.7% with no significant difference while the proportion of Adolescents’ PQARHC with their parents was adjudged to be of good quality communication was 82.2% with P>0.05. Both the parents and adolescents had good knowledge of adolescent reproductive health but practice and quality of communication was poor. Therefore, training intervention to improve the adolescent- parent communication is recommended for the parents.
19 citations
TL;DR: The high numbers of women requesting caesarean section without medical indication should be investigated and the motivation factors identified so as to curb the practice.
Abstract: There is great concern about the increasing rise in the rate of caesarean section in both developed and developing countries. This study was to ascertain the prevalence and compare outcomes of elective and emergency caesarean sections among women who deliver at the University of Cape Coast Hospital, Ghana. This retrospective study reviewed records of 645 women who delivered through caesarean sections during the period of January 2014 and December 2015. The prevalence of caesarean section was 26.9%. There was a significantly higher rate of adverse fetal outcomes (P=0.016) among babies born through emergency caesarean section. There were 12 (1.9%) women who had caesarean section done based on maternal request. The caesarean section rate found in this study was high. The lack of availability of technology for diagnosing fetal distress found in this study could possibly lead to over diagnosis of fetal distress. Thus availability of such diagnostic technology could reduce the high caesarean section rate. The high numbers of women requesting caesarean section without medical indication should be investigated and the motivation factors identified so as to curb the practice.
16 citations
TL;DR: Although pregnant women positively rated the clinical aspects of care, as confirmed by the survey, satisfaction gaps remained in the areas of service delivery, care organization and responsiveness, which would ensure that every woman can access and use quality EmOC that is sufficiently available.
Abstract: Globally, Nigeria is the second most unsafe country to be pregnant, with Lagos, its economic nerve center having disproportionately higher maternal deaths than the national average. Emergency obstetric care (EmOC) is effective in reducing pregnancyrelated morbidities and mortalities. This mixed-methods study quantitatively assessed women’s satisfaction with EmOC received and qualitatively engaged multiple key stakeholders to better understand issues around EmOC access, availability and utilization in Lagos. Qualitative interviews revealed that regarding access, while government opined that EmOC facilities have been strategically built across Lagos, women flagged issues with difficulty in access, compounded by perceived high EmOC cost. For availability, though health workers were judged competent, they appeared insufficient, overworked and felt poorly remunerated. Infrastructure was considered inadequate and paucity of blood and blood products remained commonplace. Although pregnant women positively rated the clinical aspects of care, as confirmed by the survey, satisfaction gaps remained in the areas of service delivery, care organization and responsiveness. These areas of discordance offer insight to opportunities for improvements, which would ensure that every woman can access and use quality EmOC that is sufficiently available.
16 citations
TL;DR: Lack of three way interaction of stunting, wasting and underweight means that childhood undernutrition multidimensional nature is still valid, and no each indicator can represent the other.
Abstract: Childhood undernutrition is an important public health problem. Many studies have investigated the factors of childhood undernutrition, but not the association between the undernutrition indicators. This study aimed at investigating the association between the childhood undernutrition indicators. A loglinear model of cell counts of a three way table of stunting, wasting, and underweight was fitted based on the 2010 Malawi demographic health survey data. Interaction terms in the model depicted deviations from independence. A multiple correspondence analysis of undernutrition indicators was also plotted to have a visual impression of association of the undernutrition variables. A loglinear model showed that underweight was associated with both stunting (P<0.001), and wasting (P<0.001). There was no association between stunting and wasting (P=1). Furthermore there was no three way association of stunting, wasting and underweight (P=1). Lack of three way interaction of stunting, wasting and underweight means that childhood undernutrition multidimensional nature is still valid, and no each indicator can represent the other.
15 citations
TL;DR: The prevalence of HBsAg among the pregnant women can be classified as Low Intermediate; therefore there is still the need for routine screening of pregnant women during antenatal visits, and HBeAg positivity was significantly high, which suggests high chances of carrier and vertical transmission state.
Abstract: Hepatitis B virus (HBV) infection remains a global challenge, although there is currently a safe and effective vaccine available. HBV prevalence in Ghana is not well documented, but vary regionally from 4.8% to 12.3% in the general population, 10.8% to 12.7% in blood donors and about 10.6% in pregnant women. This puts Ghana among the high endemic countries in Africa. The study objective was to determine the sero-prevalence of HBs antigen (Ag) and HBeAg among pregnant women in the Ho municipality. Two hundred and eight participants (pregnant women), attending Ho Municipal antenatal clinic were enrolled into the study. This study recorded a HBsAg seroprevalence rate of 2.4% among the pregnant women, with primigravida pregnant women recording (0.98%) and multigravida (1.42%). The prevalence of HBsAg among the pregnant women can be classified as Low Intermediate; therefore there is still the need for routine screening of pregnant women during antenatal visits. Amongst HBsAg positives, HBeAg positivity was significantly high (40% of all HBsAg positive women), which suggests high chances of carrier and vertical transmission (mother to child) state.
13 citations
TL;DR: The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts and demonstrates that experienced facility managers who timeously receive customised reports of their clinic’s performance are more likely to implement changes that positively impact on reducing WT.
Abstract: A waiting time survey (WTS) conducted in several clinics in Cape Town, South Africa provided recommendations on how to shorten waiting times (WT) A follow-up study was conducted to assess whether WT had reduced Using a stratified sample of 22 clinics, a before and after study design assessed changes in WT The WT was measured and perceptions of clinic managers were elicited, about the previous survey's recommendations The overall median WT decreased by 21 minutes (95%CI: 1177-3023), a 28% decrease from the previous WTS Although no specific factor was associated with decreases in WT, implementation of recommendations to reduce WT was 267 times (95%CI: 133-540) more likely amongst those who received written recommendations and 23 times (95%CI: 128-419) more likely amongst managers with 5 or more years' experience The decrease in WT found demonstrates the utility of a WTS in busy urban clinics in developing country contexts Experienced facility managers who timeously receive customised reports of their clinic's performance are more likely to implement changes that positively impact on reducing WT
12 citations
TL;DR: Although the respondents had good knowledge and positive attitude, their lack of observance of safety practices brings to fore the need for direct safety instruction and training and retraining of textile dye workers on workplace hazards and safety practices.
Abstract: Textile dye workers are subject to occupational hazards on a daily basis due to exposure to precarious conditions in the workplace. This study aimed to assess the knowledge, attitude and safety practices and its determinants among textile dye workers in Sokoto metropolis, Nigeria. This is a descriptive cross-sectional study conducted among 200 textile dye workers and the respondents were selected by multi stage sampling technique. Data was collected using an interviewer administered questionnaire. Data was processed using SPSS IBM version 20 and analyzed using descriptive and inferential statistics. Majority of the respondents (74.0%) had good knowledge of workplace hazards; (81.0%) had positive attitude and only 20% observed all the safety practices. Formal education (P=0.047); working less than 5 days a week (P=0.001) and permanent employment (P=0.013) were found to be determinants of respondents’ knowledge and attitude towards workplace hazards. Although the respondents had good knowledge and positive attitude, their lack of observance of safety practices brings to fore the need for direct safety instruction and training and retraining of textile dye workers on workplace hazards and safety practices.
12 citations
TL;DR: Choosing a FBD is a complex decision and education around the benefits of FBD should be combined with interventions designed to remove barriers to FBD, according to women in rural Uganda.
Abstract: The aim of the paper is to explore factors associated with home or hospital delivery in rural Uganda. Qualitative interviews with recently-delivered women in rural Uganda and statistical analysis of data from the 2011 Ugandan Demographic and Health Survey (DHS) to assess the association between socio-demographic and cultural factors and delivery location in multivariable regression models. In the DHS, 61.7% (of 4907) women had a facility-based delivery (FBD); in adjusted analyses, FBD was associated with an urban setting [adjusted odds ratio (aOR) 3.38, 95% confidence interval (CI) 2.66 to 4.28)], the upper wealth quintile (aOR: 3.69, 95%CI 2.79 to 3.87) and with secondary education (aOR: 3.07, 95%CI 2.37 to 3.96). In interviews women quoted costs and distance as barriers to FBD. Other factors reported in interviews to be associated with FBD included family influence, perceived necessity of care (weak women needed FBD), and the reputation of the facility (women bypassed local facilities to deliver at better hospitals). Choosing a FBD is a complex decision and education around the benefits of FBD should be combined with interventions designed to remove barriers to FBD.
11 citations
TL;DR: Although the mothers had an average knowledge about risk factors, two thirds did not know which professional to seek help from and cultural beliefs were associated with hearing loss, there is a need to create awareness amongst mothers regarding the risk factors of infant hearing loss as well as audiology services in order to facilitate early detection and intervention.
Abstract: The aim of the paper is to describe the knowledge of mothers in Durban, South Africa, regarding risk factors of hearing loss in infants and their awareness of audiology services, and to describe their cultural beliefs about the risk factors for hearing loss in infants. A descriptive survey design with quantitative methods of analysis were used. Conveniently sampled mothers (n=102) receiving postnatal care for their infants from eight provincial clinics within Durban consented to participate, yielding a response rate of 48%. A questionnaire was used to collect the data and the Cronbach α was calculated yielding a score of 0.835, indicating good internal consistency and reliability of the questionnaire. Sixty percent of the mothers were aware of risk factors, such as middle ear infections, ototoxic medication and consumption of alcohol during pregnancy. Seventy percent were unaware that NICU/mechanical ventilation for more than 5 days, prematurity, rubella and jaundice are considered risk factors for hearing loss, implying a need to create awareness amongst mothers regarding such risk factors. Sixty percent (n=62) believed that bewitchment and ancestral curses can cause hearing loss. Cultural beliefs were associated with hearing loss, therefore, health professionals need to demonstrate cultural competence when providing audiology services, especially in a culturally and linguistically diverse countries such as South Africa. Although the mothers had an average knowledge about risk factors, two thirds did not know which professional to seek help from. There is a need to create awareness amongst mothers regarding the risk factors of infant hearing loss as well as audiology services in order to facilitate early detection and intervention. There is a need for health professionals to demonstrate cultural competence when working with their patients.
11 citations
TL;DR: As seen in this study, community understanding of ASD is poor in such locations, in which many persons with other neurodevelopmental disorders are often presented as having autism.
Abstract: Autism Spectrum Disorder (ASD) is a globally prevalent neurodevelopmental disorder for which early diagnosis and intervention is the mainstay of management. In the African continent, limited data is available regarding the non-clinic based samples. Lack of information available to caregivers and inadequate skilled manpower often limit early detection and access to the few available though under resourced services in the community. Community based screening can be an important drive to create awareness and improve information dissemination regarding services available for those living with this disorder. This is a descriptive cross-sectional study utilizing data obtained from participants of a community-based autism screening exercise. The surveillance exercise was part of the annual Orange Ribbon initiative for autism awareness and screening held in 2014. Data was obtained from 85 participants involved in the Autism Surveillance screening exercise within the Lagos community. Community public service radio announcements state wide and word of mouth were used to invite and enroll eligible participants to the screening and consultation exercise. A second stage screening and a brief sociodemographic questionnaire followed by a third stage clinical interview and evaluation using the Diagnostic and Statistical Manual of Mental Disorders - 5 Edition (DSM 5) were used. Appropriate consultation and referrals to services in the community were given. Participants had a mean age of 7.53 years (SD 4.35). Twenty-nine (34.5%) met the diagnosis of ASD. Other diagnosis included attention deficit hyperactivity disorder (ADHD), language and speech disorder, intellectual disability (8.3%) and learning disorders (9.5%). Main health concerns to caregivers were poor language development in all (100%), of which 11 (40.7%) were non-verbal; gaze avoidance was seen in 14 (48.3%) and challenging behavior in 12 (42.9%). Comorbidities included seizure disorders (3.4%) and ADHD (6.9%). Persons with autism had history of ASD behavior more often when compared to the other neurodevelopmental disorders and these findings were statistically significant. Referrals were given to caregivers to engage in services within the community. As seen in this study, community understanding of ASD is poor in such locations, in which many persons with other neurodevelopmental disorders are often presented as having autism. Caregivers in the study location are distressed by many symptoms associated with autism and their comorbid conditions. Currently there is an evident role for frequent large scale community based screening and autism awareness exercises possibly using inter-sectoral collaboration as a strategy.
TL;DR: Until a malaria vaccine becomes available, the deleterious effects of malaria in pregnancy can be avoided by protection against infection and prompt treatment with safe, effective antimalarial agents; however, concurrent infections such as with HIV and helminths during pregnancy are jeopardizing malaria control in sub-Saharan Africa.
Abstract: Malaria in pregnancy is a serious public health problem in tropical areas. Frequently, the placenta is infected by accumulation of Plasmodium falciparum-infected erythrocytes in the intervillous space. Falciparum malaria acts during pregnancy by a range of mechanisms, and chronic or repeated infection and co-infections have insidious effects. The susceptibility of pregnant women to malaria is due to both immunological and humoral changes. Until a malaria vaccine becomes available, the deleterious effects of malaria in pregnancy can be avoided by protection against infection and prompt treatment with safe, effective antimalarial agents; however, concurrent infections such as with HIV and helminths during pregnancy are jeopardizing malaria control in sub-Saharan Africa.
TL;DR: The data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response.
Abstract: A serosurvey of anti-Ebola Zaire virus nucleoprotein IgG prevalence was carried out among Ebola virus disease survivors and their Community Contacts in Bombali District, Sierra Leone. Our data suggest that the specie of Ebola virus (Zaire) responsible of the 2013-2016 epidemic in West Africa may cause mild or asymptomatic infection in a proportion of cases, possibly due to an efficient immune response.
TL;DR: This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smeartest remained low even after intervention, highlighting the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice.
Abstract: Cervical cancer is the most common female genital tract carcinoma worldwide. It is increasingly becoming the leading carcinoma seen among women in the developing world. The aim of our study was to showcase the effect of educational intervention on the knowledge of cervical cancer and subsequently the uptake of Pap smear test amongst market women in Niger state, Nigeria. The state has a rich network of markets in all the local government areas because of the fishing activities, bountiful agricultural produce yearly and its situation to the North of the national capital, Abuja. This was a quasi-experimental study conducted in two groups with pre and post intervention data collection. Sample size was determined based on a previous similar study done in Nigeria. Multi stage sampling technique was used for recruiting the study participants. SPSS statistical software was used for data entry, editing and analysis. Respondents’ knowledge of cervical cancer were comparable at pre-intervention but were statistically significantly better (P<0.0001) at post-intervention in the intervention group compared to the control group for every variable measured. However, there was only a (Fisher’s exact, P=0.621) compared to the control group. This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smear test remained low even after intervention. This underscores the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice.
TL;DR: Most adolescents interviewed did not perceive HIV testing to be important to HIV prevention and reported low perception of susceptibility to HIV infection, which is important in improving uptake of HIV services.
Abstract: The purpose of this paper is to explore the perceptions of self-reported HIV testing and risk behavior among sexually active adolescents and youth in secondary schools in Kampala Uganda. This was a cross-sectional survey conducted between June and October 2010 among secondary school students in Kampala, Uganda. Forty eight (48) students across the 54 schools were purposively selected for the qualitative sub-study based on their responses to particular questions. We thematically analyzed 28 interviews for our qualitative study using Nvivo software. Drug and alcohol use coupled with peers pressure impaired students’ perceptions towards HIV risk and therefore increased their susceptibility to HIV risk behaviors. Of the 28 scripts analyzed, 82% (23/28) had ever had sexual partners, 79% (22/28) were currently sexually active, and 57% (16/28) had ever been tested for HIV. In conclusion, most adolescents interviewed did not perceive HIV testing to be important to HIV prevention and reported low perception of susceptibility to HIV infection. Development of an adolescent HIV prevention model is important in improving uptake of HIV services.
TL;DR: The complications indicate that self-ear cleaning does pose a risk for injury, necessitating more community information and education.
Abstract: Self-ear cleaning is the insertion of objects into the ear canal to clean it, a widespread practice that has the potential to compromise its integrity as a natural, selfcleansing mechanism, and a risk factor for possible injuries. The practice is common among young adults and highest in university than any other graduates. This study aimed to determine the self-ear cleaning practices and associated risk of injury and related symptoms in undergraduate students at KwaZulu-Natal University. The descriptive survey utilized a self-administered questionnaire. Of the 206 participants that responded, 98% engaged in self-ear cleaning, with 75% indicating that it was beneficial. The commonest method (79.6%) being the use of cotton buds, with an associated injury rate of 2.4%. There was no statistically significant associations between those who used or did not use cotton buds and the symptoms experienced. The complications indicate that self-ear cleaning does pose a risk for injury, necessitating more community information and education.
TL;DR: The prevalence of squamous cell carcinoma of the esophagus in this single center study is 0.96%, 95% confidence interval and is a disease of black elderly males as seen elsewhere.
Abstract: The incidence of esophageal cancer varies widely in the world. In the Middle East, Africa, and Asia and parts of Europe, squamous cell carcinoma of the esophagus dominates the esophageal cancer landscape. Worldwide the rates are highest in Northern China, South Africa, Turkey and Iran. In the United States, the black population has a five-fold higher incidence of esophageal squamous cell carcinoma than the white population. To determine the prevalence of squamous cell carcinoma of the esophagus in a single tertiary center in South Africa. Patients referred to Gastroenterology Division of Steve Biko Academic Hospital for upper gastrointestinal endoscopy were recruited. Those with a known diagnoses of squamous cell carcinoma of the esophagus were recorded and those with suspicious lesions had biopsies done. These were then evaluated by an experienced histopathologist. 6118 patients were recruited. Squamous cell carcinoma was found in 59 patients giving us a prevalence of 0.96% 95%CI. The cancer was found mainly in back elderly males. The prevalence of squamous cell carcinoma of the esophagus in this single center study is 0.96%, 95% confidence interval and is a disease of black elderly males as seen elsewhere. Bigger multicenter studies are needed to further clarify this findings.
TL;DR: The application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa has proved that this method could be very helpful to monitor water safety before and after various purification treatments.
Abstract: Water monitoring requires expensive instrumentations and skilled technicians. In developing Countries as Africa, the severe economic restrictions and lack of technology make water safety monitoring approaches applied in developed Countries, still not sustainable. The need to develop new methods that are suitable, affordable, and sustainable in the African context is urgent. The simple, economic and rapid Micro Biological Survey (MBS) method does not require an equipped laboratory nor special instruments and skilled technicians, but it can be very useful for routine water analysis. The aim of this work was the application of the MBS method to evaluate the microbiological safety of different water sources and the effectiveness of different drinking water treatments in the Horn of Africa. The obtained results have proved that this method could be very helpful to monitor water safety before and after various purification treatments, with the aim to control waterborne diseases especially in developing Countries, whose population is the most exposed to these diseases. In addition, it has been proved that Moringa oleifera water treatment is ineffective in decreasing bacterial load of Eritrea water samples.
TL;DR: The most studied gene was the C CR5 promoter, followed by the CCR2-64I found to reduce MTCT; then SDF1-3’A shown to have no effect on MTCT and others like the DC-SIGNR, CD4, CCL3 and IP-10.
Abstract: Maternal viral load and immune status, timing and route of delivery, viral subtype, and host genetics are known to influence the transmission, acquisition and disease progression of human immunodeficiency virus-1 (HIV-1) infection. This review summarizes the findings from published works on host molecular factors and virus genotypes affecting mother to child transmission (MTCT) in Africa and identifies the gaps that need to be addressed in future research. Articles in PubMed, Google and AIDSearch and relevant conference abstracts publications were searched. Accessible articles on host factors and viral genetics impacting the MTCT of HIV, done on African populations till 2015 were downloaded. Forty-six articles were found and accessed; 70% described host genes impacting the transmission. The most studied gene was the CCR5 promoter, followed by the CCR2-64I found to reduce MTCT; then SDF1-3’A shown to have no effect on MTCT and others like the DC-SIGNR, CD4, CCL3 and IP- 10. The HLA class I was most studied and was generally linked to the protective effect on MTCT. Breast milk constituents were associated to protection against MTCT. However, existing studies in Sub Saharan Africa were done just in few countries and some done without control groups. Contradictory results obtained may be due to different genetic background, type of controls, different socio-cultural and economic environment and population size. More studies are thus needed to better understand the mechanism of transmission or prevention.
TL;DR: Generally speaking, publications describing research on the frequency and occurrence of important zoonotic bacterial organisms of public health concern from underdeveloped regions, such as Libya, are few and epidemiological information remains scarce.
Abstract: Diarrheal pathogens persist as a primary cause of high morbidity − and mortality − gastrointestinal illnesses worldwide particularly in the developing world.1,2 Rotaviruses are a major cause of diarrheal illnesses, and a seasonal infection transmitted by the fecal-oral route. The increased incidence of rotavirus infection among human populations has been attributed to its wide-range presence in animals and ability to exchange genetic determinants between strains affecting animal and human hosts.3 Bacteria pathogens are also a leading cause of diarrhea, especially among children, and are reported to be responsible for significant morbidity, mortality, and economic losses, particularly in underdeveloped countries.2 In Libya, for instance, research studies of diarrheagenic agents have focused on bacteria and the pediatric population and different serogroups of Escherichia coli have been reported as a major cause of childhood diarrhoea.4-11 Entero-hemorrhagic E. coli [EHEC; also known by the acronyms Shiga toxinproducing E. coli (STEC), or verocytotoxin-producing E. coli (VTEC)] is one of the most common of the serogroups associated with gastroenteric illnesses and foodborne outbreaks.12 The Shiga toxins produced by this group of E. coli cause an array of complications in humans, ranging from uncomplicated diarrhea to life-threatening conditions such as hemorrhagic colitis, which can progress into hemolytic uremic syndrome (HUS) and severe acute renal failure. The STEC/VTEC encompass hundreds of serotypes capable of causing severe illnesses in humans, among which O157, O26, O111, O103 and O145 (the so-called top five) are the most frequently reported serogroups associated with human disease.13 The O157 serogroup is the most commonly reported and has been the main cause of serious outbreaks, especially of foodborne infections.12 As such, E. coli O157 has emerged as a particular public health concern. Ruminants, particularly cattle, are the natural reservoir of E. coli 0157, which inhabit the intestinal tract of healthy animals. Infection of humans is typically acquired through contaminated food and drink (i.e. undercooked ground meat, raw milk, dairy products, raw vegetables, contaminated fruits) or through direct contact with animals.12,14 Generally speaking, publications describing research on the frequency and occurrence of important zoonotic bacterial organisms of public health concern from underdeveloped regions, such as Libya, are few and epidemiological information remains scarce.5,14 However, researchers in Libya have begun reporting on the isolation of E. coli 0157 from a range of animals and animal products. Herein, we summarize the recent peer-reviewed articles on this topic and provide commentary to promote interest in this important public health concern and highlight the research opportunities (Table 1). In Libya, 24-33% of pediatric diarrheal cases are caused by rotavirus rotavirus.4,15,16 In addition, a recent study uncovered an alarming trend in increasing incidence, with these cases estimated to represent up to 57%.17 Bacterial pathogens are also reported to be a major cause of diarrhea in children and are responsible for an approximate 27% of the clinical samples examined. Several genogroups of E. coli have been characterized (i.e. EPEC, ETEC, EHEC, EIHC, EAEC) and found to express multidrug-resistant phenotypes.4,5,11 However, the epidemiology, phylogenetic relation and zoonotic features of the reported strains isolated from pediatric human cases, and at population level, are largely unknown. In Libya, the recently reported E. coli 0157 isolates from food-producing animals and most recently from animal products underscore the serious health concern facing this region (Table 1). Garbage et al., for instance, have reported the isolation of E. coli 0157 from raw milk and dairy products collected from different animals, with cow origin being predominant (7/11 of total isolates).18 This particular study has reported raw goat milk as the most contaminated source (i.e. 2/7 samples; 28.6%). On the other hand, Abujnah et al. have reported a high isolation rate for E. coli 0157 from fresh white cheese samples (35.6% of tested samples) collected from local factories around Tripoli; however, the animal origin of the samples was not clear.19 The consumption of raw or undercooked meat of bovine origin has been frequently reported to be the most common source of E. coli 0157 contamination and infection. A study of raw sausage specimens (locally known as almergaz) that had been collected from local markets in Tripoli isolated E. coli 0157 from 48%, with 60% genopositivity for stx genes among the isolated strains; however, the animal source of meat samples was not stated.20 Previously, studies have reported the isolation of this pathogen from burger meat specimens of beef and chicken origins. Considering the collective findings from these studies, the rates of isolation/contamination was found to range between 4-5% in cooked meat and from 20-27% in uncooked meat specimens of burgers (Table 1).21,22 Unfortunately, most of the previous studies have not determined the possible sources of these contaminant bacteria or the epidemiologic and phylogenetic relation among these strains and/or toward humans (either humans-incontact or the consumers). Prevalence of E. coli 0157 in healthy dairy cows has been studied as well. In suburban areas of Tripoli, the reported rates range from 6-9%.14,23 Shedding of E. coli 0157 from healthy cattle was reported to be significantly associated with signs of diarrhea and source of water-intake (identifying these parameters as risk factors of shedding). Surprisingly, age which is frequently associated with shedding of E. coli 0157, was not found to be a significant risk factor. Ultimately, healthy dairy cows have been posited as a natural reservoir of E. coli 0157 in Libya. A regional study from Egypt identified E. coli O157 isolates from marine life (seafood and animals from coastal water; 48% of tested samples).24 Thus, there is a Journal of Public Health in Africa 2017 ; volume 8:685
TL;DR: The Journal of Public Health in Africa responds to the need for a communication system aimed at reaching the widest audience of professionals worldwide in a shorter time than traditional publishing.
Abstract: The population of sub-Saharan Africa faces global health challenges more than any other part of the world, bearing the brunt of tuberculosis, malaria and HIV/AIDS. This region already carries 24% of the global disease burden and the situation is made worst by the advent of noncommunicable diseases, such as coronary heart disease, hypertension, cancer and diabetes (just to name a few). Thus the need for African scientists to disseminate research data in order to alleviate the continent’s huge disease burden and help the frail health systems affected by poverty, underdevelopment, conflicts and poorly managed government agencies. In our opinion, the Journal of Public Health in Africa responds to the need for a communication system aimed at reaching the widest audience of professionals worldwide in a shorter time than traditional publishing [...]
TL;DR: The perception of health workers on vaccination and the immunization of their patients and the vaccination status of the 291 health care workers for the hepatitis B virus was determined to be dependent on the promotion among HCWs.
Abstract: Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouake, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P<0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P<0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs.
TL;DR: The FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE- infants, and there was a significant difference in the portion of infants that received antibiotics, and fluid bolus.
Abstract: False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE-) was 14% (P=0.22). The FTE+ study group, and FTE- comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE- infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE- infants.
TL;DR: The caravan project has greatly contributed to improving young peoples’ awareness on STI/HIV/AIDS in Dschang Municipality within three years.
Abstract: Awareness is a preventive action to instill in individuals certain concepts to improve their health. It is an essential element in the prevention of sexually transmitted infection (STI)/HIV and early pregnancies among adolescents. In 2012, the prevalence of HIVin Cameroon was estimated at 4.3%. The young population appear to be the most affected (3.2%); very close to that of the Dschang Health District (Cameroon; 3.1%) in the 15-19 years age group. Theaimof this study was to evaluate the contribution of the Mobile Caravan project on the preventive aspect of STI/HIV/AIDS among youths of Dschang in 10 secondary schools within three years. 2029 students joined the project’s activities and 58.55% of them belonged to the age group of 16-21 years. Most students attended private schools. Nearly 3/4 of students (1515/2029) had an acceptable level of knowledge regarding STI/HIV/AIDS, which increased in number each year (from 641 to 716 students between 2012 and 2014). The Level of knowledge was significantly determinedby the study cycle (P=0.0004), the type of school (P=0.0027) and the year ofimplementation of activities (P=0.0026). The caravan project has greatly contributed to improving young peoples’ awareness on STI/HIV/AIDS in Dschang Municipality.
TL;DR: It is indicated that the length of detention and gender are factors that influence HIV status, however, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates.
Abstract: Cases of HIV are common in Benin, with infection rates varying according to socioeconomic and cultural factors, and by region. Certain segments of the population, such as prison inmates, sex worker clients and truck drivers are at high risk for HIV/AIDS. The aim of this study is to identify which behavioral and serological indicators contribute to the spread of HIV among prisoners. A total of 496 inmates from prisons located in all major cities in Benin were surveyed. Data was collected through interview sessions carried out using a questionnaire and through blood samples. The results show that most inmates are Beninese (83.5%), and the average age is 33 years (range: 14-80 years). No prisoner reported using a condom the last time they engaged in sexual intercourse. Blood exposure was found in 14.6% of inmates and HIV was detected in 1.4% of cases. Our analysis indicates that the length of detention and gender are factors that influence HIV status. However, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates. The results highlight the need to raise awareness in prisons about HIV. This can be achieved by strengthening communication strategies and by organizing HIV and sexually transmitted diseases information sessions for both prison officers and inmates.
TL;DR: It is confirmed that improving the survival of PLWHA receiving ART requires enhanced adherence, and the main predictor of two-year mortality was poor adherence.
Abstract: The benefits of antiretroviral therapy (ART) for treating human immunodeficiency virus (HIV) infection have been well described The objective of this study was to identify the predictors of two-year survival in persons living with HIV/AIDS (PLWHA) in Benin This retrospective transversal study included all patients from 46 HIV/AIDS therapy sites across Benin who started ART between July 1st, 2011 and June 30th, 2012 The independent variables were patients’ sociodemographic, clinical, biological and therapeutic characteristics and their ART regimen The main dependent variable was the time of death Data were collected from medical records, using documentary review Cox proportional hazards regression models were used to investigate factors associated with survival Among the 771 PLWHA participants of the study, 18 (23%) died within the two-year period The estimated mortality of the 771 PLWHA was 3% at 24 months Among the sociodemographic, lifestyle and therapeutic characteristics studied, the main predictor of two-year mortality was poor adherence [odds ratio = 415, 95% confidence interval (155- 1128)] This study confirms that improving the survival of PLWHA receiving ART requires enhanced adherence
TL;DR: The study sought to determine clientlevel and facility-level factors that affect perinatal outcomes among women attending comparable public and non-public health facilities in Kisii County-Kenya in the context of free maternity care and found a significant relationship between a mother’s knowledge of pregnancy-related issues and the baby's weight.
Abstract: The study sought to determine clientlevel and facility-level factors that affect perinatal outcomes among women attending comparable public (government owned) and non-public health facilities (non-government owned) in Kisii County-Kenya in the context of free maternity care. A total of 365 pregnant mothers recruited in 4 health facilities during their ANC visit and followed up to 2 weeks post-delivery but only 287 attended all follow-up visits. Study subjects were recruited proportionate to number of deliveries each of the facilities had conducted in the preceding 6 months. The dependent variable was perinatal outcome; independent variables were demographic and clinical factors. Analysis was done using χ2, logistic regression, paired t and McNemar’s tests. Maternal BMI and a mother’s parity were statistically correlated with perinatal outcome (χ2= 8.900, d.f =3, P=0.031 and (χ2= 13.232, d.f =4, P=0.039) respectively. Mothers with 1 parity were 4.5 times more likely to have normal perinatal outcomes (OR =4.5, 95% CI 2.25-14.29, P=0.012). There was a significant relationship between a mother’s knowledge of pregnancy-related issues and the baby’s weight (t=-67.8 d.f. 213 P<0.001). Mothers’ knowledge on pregnancy issues and spousal involvement influences perinatal outcomes. Dietary Diversity Score (DDS) of a mother does not have a direct influence on the outcome of a pregnancy. There is need to focus on maternal factors that affect perinatal outcomes besides free maternity care.
TL;DR: In this paper, a descriptive cross-sectional study was carried out in Soba locality, Khartoum, Sudan to determine the health hazards acquired by the residents nearby Soba sewage treatment plant.
Abstract: The aim of this study was to determine the health hazards acquired by the residents nearby Soba sewage treatment plant. A descriptive cross-sectional study was carried out in Soba locality, Khartoum, Sudan. An interviewer-administrated questionnaire was assigned to 462 residents of the area living in four geographically distributed squares around the sewage plant. The data was analyzed in SPSS; Cronbach’s alpha reliability scale of measurement was used to check the internal validity of six variables related to the quality of life. A logistic regression analysis was used to assess the relationship between the health hazards and the quality of life. Among the 462 residents, difficulty in breathing (37.9%) and nausea (37.2) were the principal health hazards. Moreover, the residents had a satisfactory level of awareness (88.7%) about the health hazards. The utmost impact on the quality of life was psychological (97.2%). It was statistically correlated with the reported factors, which impacted the quality of life in the district as revealed by the Cronbach’s alpha reliability test with absenteeism (P=0.026), disability (P=0.014), socialization (P=0.032) and death (P=0.016). A logistic regression analysis revealed chemical hazards had a statistically significant association (P<0.05) with quality of life of the residents of Soba district. The study strongly entails the fact that sewage treatment plants crave exceptional consideration from the concerned responsible authorities, together with the fact that the evolved health threats should be confronted with immense responsibility as soon as possible.
TL;DR: This study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance to avoid wastage of time, blood, resources and reduce undesirable experiences.
Abstract: The existence and sustenance of the blood bank depends on blood donors. It is imperative that the donation experience is satisfactory for the donors. Therefore this study was carried out to determine the frequency of undesirable events experienced by the blood donor as part of donor haemovigilance. This was a retrospective descriptive study of the events that occurred amongst the blood donors of the blood bank of a tertiary institution. The blood donor incident book was reviewed for the period of six months. Negative undesirable events occurred in 2% of the donor populations, of which 45.8% could not complete the blood donation process while only 16.7% completed the blood donation process. Mild vasovagal attack occurred in 0.2% of the donor population. Undisclosed deferrable risk factors/ behaviours were identified by the phlebotomist in the bleeding room which made donors unfit for donation even though they had passed the donor screening criteria. This accounted for 20.8% of those with negative experience. Guidelines are required to identify donors that are not likely to complete donation to avoid wastage of time, blood, resources and reduce undesirable experiences.