https://www.ajol.info/index.php/ahs/issue/feedAfrican Health Sciences2023-12-29T07:09:52+00:00Dr James Tumwinejktumwine@kab.ac.ugOpen Journal Systems<p>African Health Sciences is an open access, free online, internationally refereed journal publishing original articles on research, clinical practice, public health, policy, planning, implementation and evaluation, in the health and related sciences relevant to Africa and the tropics. African Health Sciences acknowledges support provided by the African Health Journals Partnership Project that is funded by the US National Institutes of Health (through the National Library of Medicine and the Fogarty International Center) and facilitated by the Council of Science Editors.</p> <p>Indexed on MEDLINE/PUBMED; PUBMED CENTRAL; African Index Medicus; HINARI; Bioline; AJOL; Science Citation Index - Clarivate (Thompson Reuters) <strong>Impact factor (2021): 1.108. CiteScore (2018): 0.99.</strong></p> <p>Other websites related to this journal include: <a title="http://www.bioline.org.br/hs" href="http://www.bioline.org.br/hs" target="_blank" rel="noopener">http://www.bioline.org.br/hs</a></p> <p>And: <a title="https://africanhealthsciences.org/" href="https://africanhealthsciences.org/" target="_blank" rel="noopener">https://africanhealthsciences.org/</a></p> <p>African Health Sciences encourages authors to now submit their papers online to the following website: <a title="http://mc.manuscriptcentral.com/mums-ahs" href="http://mc.manuscriptcentral.com/mums-ahs" target="_blank" rel="noopener">http://mc.manuscriptcentral.com/mums-ahs</a></p>https://www.ajol.info/index.php/ahs/article/view/261295Editor’s choice: Infections, non-communicable diseases, and reproductive health issues in a world beset by conflict and climate change2023-12-21T07:18:10+00:00James K Tumwinekabaleimc@gmail.com<p>NIL</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261296Application of joint modelling on the determinants of TB Status and CD4 cell count among antiretroviral therapy attendants in Gondar teaching referral hospital, Gonder, Ethiopia2023-12-21T07:32:27+00:00Gebre Kindu Kebede m7.kebede@gmail.comHussen Nuru Mohammedm7.kebede@gmail.com<p><strong>Abstract</strong><br><strong>Background:</strong> East African regions were highly affected by tuberculosis and the human immunodeficiency virus. The main objective was to identifying the associated factors with tuberculosis and CD4 cell count of patients in Gonder teaching referral hospital, Gonder, Ethiopia.<br><strong>Methods:</strong> A retrospective cohort study was conducted on AIDS patients from 1st January 2018 - to 30th January 2020. This study used joint mixed model, and individual profile plot to identify factors and the changeability inside and between patients respectively.<br><strong>Results:</strong> The mean with a standard deviation of weight and a serum hemoglobin concentration of patients were 55.48 (10.21) kilograms and 18.25 (33.028) grams per decilitre respectively.<br>This study shows an opportunistic infection, weight, and serum hemoglobin concentration were significantly associated with the log CD4 cell count and tuberculosis status of patients.<br><strong>Conclusion:</strong> The patient who has other diseases is 5.04 more likely to be co-infected with HIV and TB diseases. And also, the estimated odds of being co-infected in both diseases were increased by 1.14 and 1.05 times when a unit change in weight and hemoglobin respectively. Moreover, the estimated odd of patients who have no other related disease were 51.13% less likely to be co-infected with both diseases.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261299A comparative analysis of two national tuberculosis reporting systems and their impact on tuberculosis case notification in Uganda2023-12-21T07:43:18+00:00Kiyemba Timothy makrita2@gmail.comMakabayi-Mugabe Rita makrita2@gmail.comKirirabwa Nicholas Sebulibamakrita2@gmail.comTumwesigye Philip makrita2@gmail.comZawedde-Muyanja Stella makrita2@gmail.comOcero Andrew makrita2@gmail.comNkolo Abel makrita2@gmail.comQuinto Ebony makrita2@gmail.comTuryahabwe Stavia makrita2@gmail.com<p><strong>Abstract</strong><br><strong>Background:</strong> Before 2018, the use of parallel tuberculosis (TB) reporting systems was resource intensive with duplication of efforts and hence the need to select one that contributed to better TB case notification at the National TB and Leprosy Program (NLTP) in Uganda. We sought to analyse the difference in reporting rates between the two systems in order to improve NTLP TB case notification rates, logistics management, and planning for better health service delivery initiatives.</p> <p><strong>Methods:</strong> We conducted a comparative study to assess TB case notification between the web-based DHIS2 and the district TB supervisor-led health management information system between January 2016 to December 2017. We used Poisson regression analysis to assess the statistical differences in reporting rates between the two reporting systems.</p> <p><strong>Results:</strong> The association between TB case notification and the type of reporting system was statistically significant (Prob > chi2 = 0.0000). The Incident Rate Ratio (IRR) for the web-enabled DHIS2 system versus the district TB supervisor-led health management information system was 1.106625.<br><strong>Conclusion:</strong> The web-based integrated DHIS2 system was more effective in reporting missing TB cases. It presents an opportunity for better planning and allocation of resources for improved service delivery in a low-income setting.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261303Acceptability of hair harvest as a method of tuberculosis therapeutic drug monitoring among adult pulmonary TB patients: a qualitative study2023-12-21T07:57:00+00:00Muzanyi Grace gxm62@case.eduMafigiri David.K gxm62@case.eduSalata Robert gxm62@case.eduJoloba Moses gxm62@case.eduMukonzo Jackson gxm62@case.eduNtale Mohammed gxm62@case.eduMubiri Paul gxm62@case.eduBbosa Godfrey gxm62@case.edu<p><strong>Background:</strong> The current six months regimen for drug-susceptible tuberculosis (TB) is long, complex, and requires adherence monitoring. TB hair drug level assay is one innovative approach to monitor TB treatment adherence however, its acceptability in the context of African multi-cultural settings is not known.<br><strong>Objective:</strong> To determine the acceptability of hair harvest and testing as a TB therapeutic drug monitoring method.<br><strong>Methods:</strong> The study explored perceptions, and lived experiences among TB patients with regard to using hair harvest and testing as a method of tuberculosis therapeutic drug monitoring in the context of their cultural beliefs, and faith. We used a descriptive phenomenological approach.<br><strong>Results:</strong> Four main themes emerged namely: participants’ perceptions about the cultural meaning of their body parts; perceptions about hair having any medical value or meaning; perceptions about hospitals starting to use hair harvest and testing for routine hospital TB treatment adherence monitoring; and perceived advantages and disadvantages of using hair for treatment adherence monitoring. Overall, we found that using hair to monitor adherence was acceptable to TB patients provided the hair was harvested and tested by a medical worker.<br><strong>Conclusion:</strong> Hair harvest for medical testing is acceptable to TB patients on the condition that it is conducted by a medical worker.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261305Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes and its acceptability in a multicultural setting. A narrative review2023-12-21T08:08:28+00:00Muzanyi Grace gxm62@case.eduNtale Muhammad gxm62@case.eduSalata Robert gxm62@case.eduJoloba Moses gxm62@case.eduMukonzo Jackson gxm62@case.eduMafigiri David K gxm62@case.eduMubiri Paul gxm62@case.eduBbosa Godfrey gxm62@case.edu<p><strong>Background:</strong> Accumulation of chemicals including drugs in hair has been used in forensic investigations. Studies have reported isoniazid drug levels in the hair of TB patients.<br><strong>Objective:</strong> To review literature for evidence on isoniazid hair drug levels as a tool to monitor adherence, exposure, and TB treatment outcomes and the acceptability of using human hair for medical testing.<br><strong>Methods:</strong> We reviewed literature through Pubmed, Embase, Medline, google scholar, and google grey literature. The search terms focused on isoniazid/TB hair drug levels, adherence, treatment outcomes, and acceptability of using hair for medical testing. We kept refining our search terms at each step of our search.<br><strong>Results:</strong> The initial search yielded 186859 articles, which dropped to 88 after removing duplicates and irrelevant articles and eventually to 14 on further refining our search terms. On full review,2 out of 14 and 1 out of 14 articles touched the area of Isoniazid hair drug levels; adherence, exposure, TB treatment outcomes, and acceptability respectively. Further scrutiny showed that none of the articles had addressed our research question.<br><strong>Conclusion:</strong> Literature on Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes, and its acceptability is limited and more research is needed.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261307Preferred techniques of hair harvest for medical testing among adult pulmonary TB patients2023-12-21T08:19:09+00:00Muzanyi Grace gxm62@case.eduMafigiri David K gxm62@case.eduSalata Robert gxm62@case.eduJoloba Moses gxm62@case.eduMukonzo Jackson gxm62@case.eduNtale Muhammad gxm62@case.eduMubiri Paul gxm62@case.eduBbosa Godfrey gxm62@case.edu<p><strong>Background:</strong> Antiretroviral hair drug levels are currently being used to monitor adherence to HIV treatment. There is currently a dearth of literature on the preferred technique(s) of hair harvest for medical testing in the context of African multicultural settings.<br><strong>Objective:</strong> To explore the preferred techniques(s) of hair harvest for medical testing among TB patients.<br><strong>Methods:</strong> We used a descriptive phenomenological approach to conduct interviews for 15 TB patients from the 06<sup>th</sup> through the 24<sup>th</sup> of June 2022. Data was organized by N-VIVO version 10 and analysed step by step using a thematic analytical approach.<br><strong>Results:</strong> Participants aged <30 years were more knowledgeable, positively perceived, and experienced about the salon-based hair cutting technique compared to those aged≥30 years old. Participants aged ≥30 had experience, flexibility to use, and were knowledgeable in all three techniques, Overall, for all age categories (<30,30-40 and >40 years), majority of the respondents were knowledgeable, flexible and experienced in using all the three techniques.<br><strong>Conclusion:</strong> The majority of TB patients were knowledgeable, experienced and flexible about the hair cutting techniques however, efforts are needed to educate the youth that hair for medical testing can be cut by any of the three techniques without changing their cosmetic look.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261308Treatment outcomes and challenges of treating tuberculosis in children in a nomadic pastoralist community in Kenya2023-12-21T08:31:44+00:00Limungi Godfrey M glimungi@kmtc.ac.keMburugu Patrick M glimungi@kmtc.ac.keKirigia Consolata glimungi@kmtc.ac.keOrsolya Maté glimungi@kmtc.ac.ke<p><strong>Background:</strong> Tuberculosis in children has remained a major cause of childhood morbidity and mortality, especially in the developing<br>countries where it has been associated with marginalization, vulnerability and poverty.<br><strong>Study objectives:</strong> To evaluate treatment outcomes and determine the challenges experienced by health providers while treating tuberculosis in children in a nomadic pastoralist community in Kenya.<br><strong>Methods:</strong> This was a descriptive cross sectional study design utilizing mixed methods, conducted at Lodwar County Referral Hospital in Turkana County- Kenya. We utilized census sampling method to get 59 medical records and 8 nurses. Data were collected using data abstraction form and in-depth interviews. Treatment outcomes were determined quantitatively while challenges were described qualitatively using thematic approach.<br><strong>Results:</strong> A total of 59 paediatric patients had been diagnosed with tuberculosis between the months of January 2021 and April 2021. Most of them were new cases. Children who were under five years constituted the highest proportion (61%). Most of the patients had completed their treatment (69.5%), loss to follow up 6.8%, transferred out 11.9%, died 8.5% while those who were not evaluated were 3.4%. Lifestyle and habit, lack of system support and lack of properly formulated dosage for children were the challenges experienced by the health care providers.<br><strong>Conclusion:</strong> Although, most of the patients (69.5%) had completed their treatment, treatment complete rate remained below the standard set by the World Health Organisation (90%). Health system posed most of the challenges experienced by the health care providers at the hospital.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261310 A plausible hypothesis for the higher Covid-19 mortality in Brazil2023-12-21T08:39:36+00:00Silva Heslley Machado heslley@uniformg.edu.br<p>Brazil has high Covid-19 mortality rates, especially among those patients who are intubated. It is hypothetically considered that these rates may be related to the abusive use of medicines by the population. These drugs without scientific evidence are indicated by President Bolsonaro and his supporters but are also prescribed by doctors who follow this line. The text draws attention to the risks of this phenomenon.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261311Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemic2023-12-21T08:44:29+00:00Arrais Margarete LT miguel.brito@estesl.ipl.ptDias Welwitschia A F miguel.brito@estesl.ipl.ptSilva Maura P A miguel.brito@estesl.ipl.ptNeto Luquenia E S miguel.brito@estesl.ipl.ptPedro Naiol M F miguel.brito@estesl.ipl.ptJungo Sónia F. I miguel.brito@estesl.ipl.ptMiguel Avelina R. C miguel.brito@estesl.ipl.ptFortes-Gabriel Elsa M. Vmiguel.brito@estesl.ipl.ptSebastião Cruz S miguel.brito@estesl.ipl.ptGama Jorge M. R miguel.brito@estesl.ipl.ptBrito Miguel D miguel.brito@estesl.ipl.pt<p><strong>Background:</strong> The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection and tuberculosis.<br><strong>Objectives:</strong> We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients.<br><strong>Methods:</strong> Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information.<br><strong>Results:</strong> The sample included 1,683 patients aged ≥18 years, 64% men, with mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years, with less education and unemployed. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death.<br><strong>Conclusions:</strong> We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261312Comparison between abdominal CT findings in intensive care unit (ICU) and non-ICU patients with Covid-19: experience from a tertiary care hospital2023-12-21T08:57:06+00:00Himanshu Goyal binitsurekapgi@gmail.comBinit Sureka binitsurekapgi@gmail.comNachiketa Mangaraj binitsurekapgi@gmail.comAshish Agarwal binitsurekapgi@gmail.comNikhil Kothari binitsurekapgi@gmail.comMK Garg binitsurekapgi@gmail.comMithu Banerjee binitsurekapgi@gmail.comAshwini Agarwal binitsurekapgi@gmail.comPawan Garg binitsurekapgi@gmail.comTaruna Yadav binitsurekapgi@gmail.comPushpinder Khera binitsurekapgi@gmail.com<p><strong>Background:</strong> 16-66% of COVID-19 positive patients may have abdominal symptoms and findings in abdominal CT. The yield of abdominal CT scan in patients having abdominal complaints is not known.<br><strong>Objectives:</strong> The aim of this study was to explore the various abdominal imaging manifestations of COVID-19 and COVID-19 associated Mucormycosis (CAM) and to identify the relevant clinical and laboratory features associated with severity of the symptoms.<br><strong>Methods:</strong> A retrospective single centre observational study was performed at a tertiary care hospital in Northwest India. All consecutive patients who had COVID positive RT-PCR report and had undergone abdominal Computed Tomography scan from March 2020 to November 2021 for various abdominal complaints were included. Demographic data, CT images and reports and all relevant lab parameters were collected.<br><strong>Results:</strong> Out of 75 patients, positive abdominal findings were seen in 65 patients. Hepatobiliary findings were seen in 41.3% (31 of 75; OR=1.9) and bowel abnormalities were found in 37.3% (28 of 75; OR=2.1) of COVID-19 patients. 7 patients who had renal infarcts or bowel ischemia were found to have COVID-19 associated Mucormycosis on histopathology.<br><strong>Conclusion:</strong> Chest CT severity score was positively correlated with most of the abdominal manifestations in patients requiring ICU admission. Elevated D-dimer levels were significantly associated with abdominal symptoms.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261314Healthcare professionals’ perceived stigmatization about direct care of COVID-19 Patients: development and validation of the discrimination about COVID-19 (DisCOV-19) instrument2023-12-21T09:13:20+00:00Isah Abdulmuminu chinelo.aguiyi@unn.edu.ngAguiyi-Ikeanyi Chinelo Nneka chinelo.aguiyi@unn.edu.ngEkwuofu Chibueze Anosike Azubuike chinelo.aguiyi@unn.edu.ngAluh Deborah Oyine chinelo.aguiyi@unn.edu.ngUkoha-kalu Blessing Onyinye chinelo.aguiyi@unn.edu.ngAdibe Maxwell Ogochukwu chinelo.aguiyi@unn.edu.ngUkwe Chinwe Victoria chinelo.aguiyi@unn.edu.ngAbdullahi Abubakar Sadiq chinelo.aguiyi@unn.edu.ng<p><strong>Background:</strong> The novel coronavirus disease 2019 (COVID-19) is a public health concern worldwide. Healthcare professionals are among the most vulnerable groups in the fight against COVID-19 because they are directly involved in the care of at-risk persons and patients with Covid-19.<br><strong>Objectives:</strong> This study aimed to measure the level to which healthcare workers feel that they can be discriminated due to their involvement in the direct care of COVID-19 patients.<br><strong>Methods:</strong> A cross-sectional online survey was conducted among healthcare professionals in Nigeria. A nineteen-item discrimination<br>against COVID-19 (DisCOV-19) questionnaire was developed and validated for the study. Descriptive statistics and One- Way Analysis of Variance were used for data analysis. <em>P</em><0.05 was considered statistically significant.<br><strong>Results:</strong> Out of the 286 healthcare practitioners that participated in the study, 58.4% and 30.1% were pharmacists and physicians,<br>respectively. The majority of the participants were at least "moderately concerned" about disability (60.9%), death (71.7%), unknown complications (65.1%), and risk of infecting family members and friends (83.2%) if asked to provide care for COVID-19 patients. The physicians had a significantly higher mean discrimination score compared to the pharmacists (p=0.041). Pharmacists had a significantly lower mean discrimination score than the nurses (<em>p</em>=0.011).<br><strong>Conclusions:</strong> Many of the healthcare professionals reported a certain level of concern and perceived that they could face some forms of discrimination for providing care to COVID-19 patients.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261316High resolution chest computed tomography findings in patients with clinically suspected COVID-19 pneumonia in Uganda: a cross-sectional study2023-12-21T09:23:21+00:00Nassanga Rita ritanassanga@gmail.comMubuuke Aloysius Gonzaga ritanassanga@gmail.comMangun Randhawa ritanassanga@gmail.comTumusiime Max Crescent ritanassanga@gmail.comGeoffrey Erem ritanassanga@gmail.comNabbosa Valeria ritanassanga@gmail.comOlweny Francis ritanassanga@gmail.comAmeda Faith ritanassanga@gmail.comBugeza Sam ritanassanga@gmail.com<p><strong>Background:</strong> The alarming spread of the COVID-19 pandemic has led to a shortage of RT-PCR kits in Uganda necessitating the use of high-resolution chest Computed Tomography to guide patient management and treatment.<br><strong>Main Objective:</strong> To describe the chest HRCT findings in patients with clinically suspected COVID-19 pneumonia and to compare its diagnostic accuracy to RT-PCR. .<br><strong>Methods:</strong> In this cross-sectional study, chest HRCT findings of 384 patients and available RT-PCR laboratory results were reviewed and recorded in the data collection form.<br><strong>Results:</strong> The commonest chest HRCT findings were bilateral ground glass opacities (78.2%). Out of the 31.7% patients that took the PCR test only 26.9% tested positive. 16 out of 17 patients who tested negative, were classified under CORADS 5.<br>The sensitivity of chest HRCT was 90.4%, 95% CI (82.6-95.5), positive predictive value of 84.2%, 95% CI (75.6-90.7), and accuracy of 77.5%, 95% CI (71.5-87.1).<br><strong>Conclusions:</strong> HRCT was found superior to RT-PCR in diagnosing COVID-19. A patient with positive HRCT findings should be treated as COVID 19 when RT-PCR is inaccessible or results are negative. A patient with negative HRCT requires complimentary RT-PCR and possibly follow up CT scans if symptoms persist before treating for COVID 19.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261317Morphological abnormalities of leukocytes in SARS-CoV-2 infection2023-12-21T09:34:56+00:00Amine Moueden a.moueden@gmail.comReda Messaoudi a.moueden@gmail.comMokhtar Derouiche a.moueden@gmail.com<p><strong>Introduction:</strong> The causative agent of COVID-19 (Coronavirus Disease 2019) is an enveloped RNA (ribonucleic acid) virus of the SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) family. The effects of SARS-CoV-2 on the differentiation and maturation of blood cells have been the subject of several studies, we report our experience of an investigation of the morphologic abnormalities of leukocytes observed during COVID-19.<br><strong>Patients and methods:</strong> This is a prospective study of 5 months, from February 2021 to June 2021. Forty COVID-19 patients and 20 healthy controls were included in this study. We performed complete blood count and peripheral blood smear of all patients and control samples. Leukocytes abnormalities were quantified as a percentage of 100 leukocytes of the same lineage.<br><strong>Results:</strong> The morphological abnormalities of the leukocytes found in percentage of patients have been mainly neutrophils bilobed 72,5%, hypogranulation 45%, acquired pseudo Pelger-Huet 35%, vacuolated neutrophils 42,5%, Apoptotic neutrophils 35,5 %, neutrophils with toxic granulations 30%, myelemia 45%, atypical lymphocytes 52,5%, lymphoplasmocytes 60% and vacuolated monocytes 27, 5%.<br><strong>Conclusion:</strong> Our study revealed several morphological abnormalities of the different cells of the leukocyte lineage. The presence of toxic granulations in the cytoplasm of the myelocytes was specific to this study.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261319Knowledge, attitudes and practices of Moroccan cancer patients and their relatives towards the COVID-19 pandemic2023-12-21T09:41:00+00:00Nouari Nadia saloualamtali@gmail.comLamtali Saloua saloualamtali@gmail.comSebbani Majda saloualamtali@gmail.comKhouchani Mouna saloualamtali@gmail.comAmine Mohamed saloualamtali@gmail.comAdarmouch Latifa saloualamtali@gmail.com<p><strong>Background:</strong> This study aims to describe the knowledge, attitudes, and practices of cancer patients and their relatives regarding the COVID-19 pandemic in Morocco.<br><strong>Methods:</strong> A self-administered online questionnaire was administrated to 133 adults aged 19 to 70 years old, including 32 cancer patients and 101 people from the relatives of cancer patients.<br><strong>Results:</strong> The participants showed a very good level of knowledge (cancer patients (84.6%), relatives (82.7%)) and practice (cancer patients (96.0%), relatives (85%)) regarding covid-19. . A very large proportion of cancer patients (84.4%) were very worried about the virus, compared with only 52.5% of relatives. They were concerned about the potential risk of infection and felt personally exposed (93.8%) to serious complications from COVID-19. The knowledge, attitudes and practices score were significantly associated with age (p=0,018), sex (p=0.002), professional activity (p=0,036), medical insurance (p=0,009), place of residence (p= 0,017), presence or absence of cancer (p=0,000), and perception of the danger of catching COVID-19 (p=0,041).<br><strong>Conclusions:</strong> Although the level of knowledge and practices of cancer patients and relatives was very satisfying, disparities between the two groups were still to be noted. Cancer patients go out less and practice more, despite the impact of confinement on their health.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261320Performance of two SARS-CoV-2 rapid antigen detection tests in resource limited settings, the case of Mali2023-12-21T09:51:11+00:00Fatimata Diallo bdiarra@icermali.orgBassirou Diarra bdiarra@icermali.orgSadio Sarro Yeya dit bdiarra@icermali.orgMohamed Tolofoudie bdiarra@icermali.orgMahamoudou Toure bdiarra@icermali.orgDramane Diallo bdiarra@icermali.orgGeorges Togo Antieme Combo bdiarra@icermali.orgSidy Bane bdiarra@icermali.orgMohamed Abdou bdiarra@icermali.orgSy Konate Mama bdiarra@icermali.orgRazakou Dicko Abdoul bdiarra@icermali.orgIbrehima Guindo bdiarra@icermali.orgShaw Saliba Katy bdiarra@icermali.orgAmadou Kone bdiarra@icermali.orgMahamadou Diakite bdiarra@icermali.orgSeydou Doumbia bdiarra@icermali.org<p><strong>Introduction:</strong> While real-time reverse transcription PCR (RT-PCR) is the recommended laboratory method to diagnose severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection, its use in resource limited settings can be difficult to maintain due to high testing demand and shortage of reagents. The aim of this study was to evaluate the performances of Realy Tech™ and Standard Q™ in comparison to RT-PCR in a relatively low COVID-19 prevalence setting, Mali.<br><strong>Methods:</strong> We conducted a cross-sectional study between January and April 2021 in Bamako and Kati regions to evaluate both rapid tests during a large SARS-CoV-2 prevalence study in Mali.<br><strong>Results:</strong> Of the 390 samples tested, the sensitivity and specificity of Realy Tech™ and Standard Q™ were 57.1% (95%CI: 44.1-69.2), 95.8% (95%CI: 93.1-97.5); 61.9% (95%CI: 46.8-75.0), and 94.1% (95%CI: 89.5-96.8) respectively. Using RT-PCR, the global prevalence of SARS-CoV-2 was 14.4% (56/390). In both rapid antigen tests, the performance was better when used in suspected patients compared to positive patients under treatment. Moreover, higher viral loads equivalent to Ct < 25 were associated with better detection rates.<br><strong>Conclusion:</strong> While waiting for more complete data, these preliminary studies suggest that Realy Tech™ and Standard Q™ should not be used alone for COVID-19 diagnosis in Mali.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261323Negative experiences and coping strategies to stressful situations by undergraduate University students during Covid- 19 lockdown period in Uganda2023-12-21T10:11:53+00:00Kisuza Ruth Ketty kruthketty@gmail.comKicaber Saviour kruthketty@gmail.comOlum Ronald kruthketty@gmail.comNassozi Dianah Rhoda kruthketty@gmail.comWembabazi Abel kruthketty@gmail.comNamagembe Jennifer kruthketty@gmail.comAkot Enid kruthketty@gmail.comAbila Derrick Bary kruthketty@gmail.comBongomin Felix kruthketty@gmail.comOrach Christopher Garimoi kruthketty@gmail.com<p><strong>Aim:</strong> To describe the negative experiences, coping strategies for stressful situations, and factors associated with COVID-19 worry among undergraduate students at Makerere University during the second COVID-19 lockdown in Uganda.<br><strong>Methods:</strong> Descriptive cross-sectional study at Makerere University. Negative experiences and coping strategies were measured using a semi-structured questionnaire formulated based on literature and findings from previous studies on mental health and COVID-19. Descriptive statistics and measures of association were done using Stata 13.<br><strong>Results:</strong> A total of 301 participants were enrolled. Their median age were 23 years. The majority were male (192, 64.0 %), single (269, 89.7 %,) and on normal academic progress (241, 80.3 %). 48.0 % of the participants were worried about COVID-19. Disruption of students' academics (277, 92.0 %) and financial problems (184, 61.1 %) were the most reported negative experiences. Coping strategies included listening to music (203, 67.4 %), talking to family and friends (191, 63.5 %,) and watching movies (174, 57.8 %). Female students than males (aOR: 2.0, 95% CI: 1.0— 45.0, p= 0.118) and students without paid employment than those with paid work (aOR: 2.2, 95% CI: 1.0 —5.0, p=0.109) were more worried about COVID-19.<br><strong>Conclusion:</strong> Nearly half of the students were worried about COVID-19, which disrupted their social and academic lives. The<br>students utilized a myriad of coping strategies.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261327Post-quarantine anxiety and depression levels of COVID-19 positive patients, Northern Cyprus2023-12-21T10:30:14+00:00Kaya Ufuk aykacasli@yahoo.comGüvenir Meryem aykacasli@yahoo.comAykac Asli aykacasli@yahoo.com<p><strong>Background:</strong> The COVID-19 Pandemic, which started to be seen in Northern Cyprus (NC) as of March 2020, has affected the psychological mood of many people in our country as well as all over the world.<br><strong>Objectives:</strong> It was aimed to evaluate the post-illness anxiety and depression levels of people who were diagnosed with COVID-19 positive, completed the quarantine period and then received a negative PCR report.<br><strong>Methods:</strong> Through the questionnaire used in the study carried out between 1-30 April 2021, the sociodemographic characteristics of the participants and their personal experiences about COVID-19 were questioned and they were asked to answer the questions about the hospital anxiety and depression (HAD) scale.<br><strong>Results:</strong> The average score of the participants (n=120) in the HAD scale was determined as 11.66±5.90. According to the average scores of the scale, the anxiety and depression levels of the patients fall into the category of ‘11 and above abnormal'. The patients' general average scores of anxieties were 6.20±3.48 (normal) and depression was 5.46±3.55 (normal).<br><strong>Conclusion:</strong> Although it was determined that the HAD scores of the individuals from NC infected with COVID-19 were not high, most of them needed psychological support as they stated in their own statements.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261328COVID-19 unanticipated benefits to hand washing coverage and practices in health care facilities in central Uganda2023-12-21T10:35:16+00:00Nassolo Noe noenassolo@gmail.comWalekhwa Abel Wilson noenassolo@gmail.comKizza Frank Gramsen noenassolo@gmail.comOsuret Jimmy noenassolo@gmail.com<p><strong>Introduction:</strong> Hand hygiene in health care facilities (HCFs) remains a significant public health challenge. Global baseline estimates on water, Sanitation, and Hygiene (WASH) in HCFs indicate that 26% of HCFs lack access to an improved water source on the premises. In this study, we sought to assess the proportion of handwashing coverage and the associated factors among healthcare workers in public and private healthcare facilities in Ndejje division, Makindye Ssabagabo municipality, Wakiso district.<br><strong>Methods:</strong> A descriptive cross-sectional study with both quantitative and qualitative methods of data collection was conducted.<br>A total of 350 healthcare workers were interviewed using a self-administered structured open-ended paper questionnaire and Focus Group Discussions (FGD) guide. Data was analysed using STATA 14.2 and ATLAS. ti version 8 software.<br><strong>Results:</strong> The majority of 350 (92.6%) of healthcare workers were from private health facilities. We found out that the proportion of handwashing facilities coverage was 97.7%. The proportion of handwashing was good coupled with a positive attitude towards handwashing. Being a nurse was highly associated with washing hands in both private and public health facilities.<br><strong>Conclusion:</strong> High hand washing proportion was attributed to the COVID-19 guidelines and enforcement which sparked adherence to the standard operating procedures.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261329Bolstering the willingness to uptake covid-19 vaccination through multidisciplinary health communication intervention: a cue for reaching herd immunity in Nigeria2023-12-21T10:43:18+00:00Ibenyenwa Ndidi C ndubuisi.ugwu@fuoye.edu.ngOnyekwere Ogechi K ndubuisi.ugwu@fuoye.edu.ngUgwu Ndubuisi F ndubuisi.ugwu@fuoye.edu.ngAdams Adijat B ndubuisi.ugwu@fuoye.edu.ngAjewole Philip I ndubuisi.ugwu@fuoye.edu.ngMakinde Veronica I ndubuisi.ugwu@fuoye.edu.ngOnyekachi Blessing N ndubuisi.ugwu@fuoye.edu.ngAnibueze Anselm U ndubuisi.ugwu@fuoye.edu.ngOpele J K ndubuisi.ugwu@fuoye.edu.ngNwogu Onyemaechi F ndubuisi.ugwu@fuoye.edu.ng<p><strong>Background:</strong> The prevailing unwillingness to accept COVID-19 vaccination among the eligible population has been a serious setback in Nigeria’s bid to reach herd immunity against the pandemic.<br><strong>Objective:</strong> We assessed the impact of a multidisciplinary health communication intervention (MHCI) on willingness to accept COVID-19 vaccination among eligible unvaccinated community dwellers (EUCD) in Nsukka Urban, Enugu State, Nigeria.<br><strong>Methods:</strong> Through a quasi-experiment that adopted a pre-test, post-test, non-control group design, we studied a total of 85 eligible<br>unvaccinated adults. A researcher-designed "Willingness to Accept COVID-19 Vaccination Questionnaire" was the instrument used for data collection. The data gathered was analysed by means of Statistical Package for Social Sciences (SPSS) version 23.0. Specifically, descriptive and inferential statistics were used to test the formulated research questions and the hypothesis at 0.05 level of significance.<br><strong>Results:</strong> We found that the mean scores of willingness to accept COVID-19 vaccination increased significantly after the treatment.<br>There was no significant interaction effect of gender, level of education, and age on the mean of willingness to accept COVID-19 vaccination scores of EUCD after MHCI.<br><strong>Conclusion:</strong> The study established that MHCI is impactful in bolstering the willingness to accept COVID-19 vaccination. The Nigerian government should adopt and implement this intervention in schools, communities, and other institutions in order to attain herd immunity in Nigeria.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261331Antibacterial susceptibility of Staphylococcus aureus, Salmonella typhi, Bacillus subtilis and Escherichia coli to snail slime2023-12-21T10:54:12+00:00Agada Dorcas E adole.ujoh@fuhso.edu.ngSar Terdzungwe T adole.ujoh@fuhso.edu.ngUjoh John Adole adole.ujoh@fuhso.edu.ngAmeh Linus O adole.ujoh@fuhso.edu.ng<p><strong>Background:</strong> The emanation of multi-drugs resistant microorganisms and the challenges faced in combating multi-drug resistant<br>infections is a public health issue and this has increased the search for effective antibiotics from natural sources.<br><strong>Objectives:</strong> This work aims to determine the susceptibility of some pathogenic bacterial species to snail slime.<br><strong>Methods:</strong> The antibacterial activity of aqueous and ethanolic snail slime extracts were investigated against <em>Staphylococcus aureus,</em><br><em>Salmonella typhi, Bacillus</em> <em>subtilis</em> and <em>Escherichia coli</em> using the agar well diffusion method.<br><strong>Results:</strong> The results showed that all the organisms were sensitive to both extracts but were more susceptible to aqueous extracts; the highest zone of inhibition for aqueous extracts was 27.33mm ± 2.51mm for <em>Staphylococcus aureus</em> at concentration of 1000μl/ml, while the lowest was 11.33mm ± 1.53mm against <em>Escherichia coli</em>. The highest zone of inhibition for ethanolic fraction was 15.67 ± 1.15mm for <em>Salmonella typhi</em>. The lowest inhibition was 9.33mm ± 0.58mm for <em>Escherichia coli</em>. The MIC was 3.125% for <em>Staphylococcus aureus, Bacillus subtilis</em> and <em>Escherichia coli</em> and 6.25% for <em>S. typhi</em>. The extracts were not cidal at the concentrations used. Statistical analysis revealed that the treatments between the aqueous and ethanolic extracts against <em>Staphylococcus aureus, Escherichia coli</em> and <em>Salmonella typhi</em> were significant (p ≤ 0.05). The treatment against B. subtilis showed no significant difference between the two extracts (p > 0.05).<br><strong>Conclusion:</strong> This study has revealed that snail slime possesses antibacterial properties which can be used as anti-microbial agents against infectious diseases.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261334Hand hygiene among oral health care providers in public institutions in Edo state even in the wake of Lassa fever2023-12-21T11:13:39+00:00Harrison Omokhua harrison.omokhua@uniben.eduJoan Enabulele harrison.omokhua@uniben.edu<p><strong>Background:</strong> Hand hygiene is recognized as the leading measure to prevent the cross-transmission of microorganisms and to reduce the incidence of healthcare-associated infections.<br><strong>Objectives:</strong> To assess the knowledge and practice of hygiene among dental health workers even in the wake of Lassa fever.<br><strong>Method:</strong> This questionnaire-based descriptive cross-sectional study was carried out in four public hospitals in Edo state. All data were collected using a self-administered structured questionnaire after obtaining ethical clearance.<br><strong>Results:</strong> 108 of the 120 questionnaires distributed were filled and returned giving a response rate of 90.0%. Overall assessment of respondents’ knowledge of hand hygiene revealed that 41.7% of the respondents possessed a good knowledge of hand hygiene, 37.0% had excellent knowledge, 17.6% had moderate and 3.7% had a weak knowledge of hand hygiene. Overall assessment of the practice of hand hygiene showed that the hand hygiene practice of 58.3% of respondents was fair while 37.0% practiced hand hygiene poorly. Only a few (5.6%) respondents had good hand hygiene practices.<br><strong>Conclusion:</strong> The outbreak of Lassa fever does not seem to positively influence the practice of hand hygiene among the respondents.<br>While knowledge of hand hygiene is satisfactory in this study, the practice still leaves much to be desired.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261338Knowledge and perception of antimicrobial resistance and antimicrobial stewardship among healthcare students in Nigeria2023-12-21T11:25:36+00:00Jackson Idongesit L idongesitjackson@uniuyo.edu.ngAkpan Mary R idongesitjackson@uniuyo.edu.ngAdebayo Grace O idongesitjackson@uniuyo.edu.ng<p><strong>Background:</strong> Assessment of knowledge and perception of healthcare students regarding antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) would facilitate more effective education of these future prescribers.<br><strong>Objectives:</strong> To assess knowledge and perception of AMR and AMS among healthcare students in Nigerian universities.<br><strong>Methods:</strong> This was a questionnaire-based, cross-sectional survey of medical, nursing and pharmacy undergraduate students from November 2019 to January 2020, using both paper and electronic modes of self-administration.<br><strong>Results:</strong> A total of 335 students participated in the survey. Mean age of respondents was 23±3 years; 114 (34.4%) were in their 5th year of study. Most (78.9%) of the respondents agreed that widespread use of antimicrobials promotes AMR. Only 70 (21.1%) were aware that poor hand hygiene promotes AMR; 45.9% (42.7%, 37.3% and 57.7% for medicine, nursing and pharmacy respectively, p = 0.007) agreed that AMR is promoted by substandard quality of antimicrobials. Majority (94.3%) perceived AMR as a worldwide problem. Over half (60.8%) were not familiar with the term ‘antimicrobial stewardship’. Eleven (3.3%) and 122 (36.9%) rated their AMS knowledge as ‘very good’ and ‘poor’ respectively.<br><strong>Conclusions:</strong> Nigerian healthcare students had suboptimal knowledge of AMR and AMS. Current undergraduate healthcare curriculum should be reviewed to incorporate AMS principles.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261339Rapid cholera outbreak control following catastrophic landslides and floods: A case study of Bududa district, Uganda2023-12-21T11:56:10+00:00Bwire Godfrey gbwire1@yahoo.comTumuhairwe Imelda gbwire1@yahoo.comKwagonza Leocadia gbwire1@yahoo.comWetaka Milton Makoba gbwire1@yahoo.comNakinsige Anne gbwire1@yahoo.comArinitwe Emmanuel Samuel gbwire1@yahoo.comKemirembe Julian gbwire1@yahoo.comMuruta Allan gbwire1@yahoo.comMugero Charles gbwire1@yahoo.comNalwadda Christine K gbwire1@yahoo.comOkware Samuel I gbwire1@yahoo.com<p><strong>Background:</strong> In June 2019, landslides and floods in Bududa district, eastern Uganda, claimed lives and led to a cholera outbreak. The affected communities had inadequate access to clean water and sanitation.<br><strong>Objective:</strong> To share the experience of controlling a cholera outbreak in Bududa district, after landslides and floods.<br><strong>Methods:</strong> A descriptive cross-sectional study was carried out in which outbreak investigation reports, weekly epidemiological data and disaster response reports were reviewed.<br><strong>Results:</strong> On 4 – 5th June 2019, heavy rainfall resulted in four landslides which caused six fatalities, 27 injuries, floods and displaced 480 persons. Two weeks later, a cholera outbreak was confirmed in Bududa district. The Ministry of Health (MoH) rapidly deployed oral cholera vaccine (OCV) from local reserves and mass vaccinated 93% of the target population in 22 affected parishes. The outbreak was controlled in 10 weeks with 67 cholera cases and 1 death reported. However, WaSH conditions remained poor, with only, 24.2 % (879/3,628) of the households with washable latrines, 26.8% (1,023/3,818) had hand-washing facilities with soap and 33.6% (1617/4807) used unsafe water.<br><strong>Conclusion:</strong> The OCV stockpile by the MoH helped Uganda to control cholera promptly in Bududa district. High-risk countries should keep OCV reserves for emergencies.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261342Nasopharyngeal carriage and antibiotic susceptibility patterns of Sstreptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis and Staphylococcus aureus among urban Ugandan children post-PCV10 introduction: a cross-sectional study2023-12-21T12:08:51+00:00Nshimiyimana Thaddée david.kateete@mak.ac.ugNajjuka Christine Florence david.kateete@mak.ac.ugNalwanga Winnie david.kateete@mak.ac.ugKatende George david.kateete@mak.ac.ugKateete David Patrick david.kateete@mak.ac.ug<p>In 2013, Uganda introduced the PCV10 pneumococcal vaccine and it is given to children at 6, 10 and 14 weeks after birth. Carriage prevalence studies post PCV10-introduction are necessary for monitoring the impact of vaccination and trends in antibiotic resistance. Here, we studied carriage/antibiotic resistance of Streptococcus pneumoniae (pneumococcus), <em>Haemophilus influenzae, Moraxella catarrhalis</em>, and <em>Staphylococcus aureus</em> isolated from 194 children at the Mulago Assessment Centre clinic in Kampala-Uganda, 5 years post-PCV10 introduction. Almost all the children were vaccinated with PCV10 (98.5%, 191/194). The overall carriage prevalence (any species) was 62% (120/194), and it was associated with a history of antibiotics use (p=0.0159) and having respiratory symptoms (p=0.0003). The pneumococcus, <em>H. influenzae, M. catarrhalis</em>, and <em>S. aureus</em> carriage prevalence was 46% (90/194), 21% (40/194), 7% (14/194), and 6% (12/194), respectively. Species co-carriage occurred in 32 children (17%, 32/194), predominantly multidrug resistant pneumococcus + <em>H. influenzae</em> (23 children). Furthermore, pneumococci were highly resistant to cotrimoxazole (100%), erythromycin (76%), and tetracycline (52%), 42% being multidrug-resistant. Overall, we note an increase in antibiotic resistance post-PCV10 introduction, and microbial shifts i.e., a decrease in pneumococcus,<em> M. catarrhalis</em> and<em> S. aureus</em> carriage and an increase in <em>H. influenzae</em> carriage suggesting vaccine-associated perturbation of the respiratory ecology.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261346Might the fungus Candida albicans be a risk factor for autism? A meta-analysis study2023-12-21T12:18:58+00:00Ozgur Emrah Gokay emrahgokayozgur@gmail.comBalci Sibel emrahgokayozgur@gmail.com<p><strong>Objective:</strong> Due to the high increase in rate of autism, it has gained great importance to determine the etiology of autism spectrum<br>disorder. The purpose of our study was to assess the role of Candida albicans as a risk factor to cause autism behavior.<br><strong>Methods:</strong> We searched Scopus, PubMed, Web of Science and PsycINFO for articles up to December, 2021. The studies involving children diagnosed with autism spectrum disorder were included. Children’ outcomes were selected as Candida albicans (positive) and Candida albicans (negative). Odds ratios were reported using fixed-effect and random-effect meta-analysis. The heterogeneity was assessed by the<em> Chi-square test and Higgins' I<sup>2</sup> test</em>. The publication bias was examined via funnel plot and <em>Hegger’s test</em>.<br><strong>Results:</strong> Our meta-analysis was conducted based on 254 diagnosed with Autism Spectrum Disease cases and 161 healthy cases from 4 studies. Compared to the healthy cases, the odds of presence of Candida albicans (OR=7.21; 95% CI: 3.75-13.85; p<0.001) were higher in those diagnosed with autism spectrum disorder.<br><strong>Conclusion:</strong> This study as a whole showed that children diagnosed with autism spectrum disorder have higher frequency of the presence of the fungus Candida albicans. Therefore, Candida albicans may be an etiological factor for the autistic behavior in children.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261348Socio-demographic and food insecurity associated with adherence to antiretroviral therapy among HIV adults in Ahmadu Bello University teaching hospital Zaria, Kaduna State Nigeria 2023-12-21T12:24:36+00:00Eze Rosemary Ada roseada93@gmail.comSulaiman Norhasmah roseada93@gmail.comDaud Zulfitri 'Azuan Mat roseada93@gmail.comBabadoko Aliyu roseada93@gmail.com<p><strong>Background:</strong> Socio-demographic characteristics may have an impact on HIV-positive people's prognosis and survival. In addition, food insecurity could make it harder for HIV patients to stick to their treatment plans as effectively as possible.<br><strong>Objective:</strong> This research aimed to determine the association between socio-demographic and food insecurity with adherence to antiretroviral therapy among people living with HIV on ART in Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria.<br><strong>Method:</strong> Using a cross-sectional design, a systematic random sampling method was used to select respondents aged 18–64 years on antiretroviral therapy for at least six months at Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria, outpatients of the President's Emergency Plan for AIDS Relief clinic. Socio-demographic, food insecurity status and adherence to ART was obtained using self-administered questionnaire. Descriptive statistics, chi-square test, and multiple logistic regression were used for data analysis.<br><strong>Results:</strong> Among the 385 people who took part in the study, about 67.5% of females and 32.5% of males took part in the survey, respectively. About 54% of adults adhered to ART. The majority of the respondents (87.0%) had a low level of food security. Food insecurity (OR = 1.2, <em>p</em> = <0.05), government employment (OR = 2.842, <em>p</em> = <0.01), self-employment (OR = 2.6, <em>p</em> = <0.001), and being divorced or widowed (OR = 2.0, <em>p</em> = <0.01) were all significantly associated with ART adherence.<br><strong>Conclusion:</strong> Food insecurity, employment, and marital status influenced adherence to ART. As a result, health care providers and HIV control programme implementers must continually emphasis and encourage strict adherence.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261353Patients’ perceived quality of the care provided during the management of HIV/AIDS in a tertiary care setting in Nigeria2023-12-21T12:38:52+00:00Eshiet Unyime Israel unyimeeshiet@uniuyo.edu.ngNjoku Chikosolu unyimeeshiet@uniuyo.edu.ngWogu Chidinma unyimeeshiet@uniuyo.edu.ng<p><strong>Background:</strong> The provision of patient-centred care by clinicians is believed to improve patient satisfaction with care as well as the outcome of treatment.<br><strong>Objective:</strong> To assess the quality of personalized care provided to people living with HIV/AIDS in a typical Nigerian health care setting and its association with patients’ knowledge and attitude towards HIV/AIDS and patients’ knowledge and attitude towards antiretroviral therapy.<br><strong>Methods:</strong> The study was a cross sectional study carried out in the HIV/AIDS clinic of the University of Uyo Teaching Hospital, Nigeria. Data on the demographic and clinical details of the patients were obtained from patients’ case notes using a suitably designed, pre-piloted data collection instrument. Furthermore, data on the quality of patient-centred care, patients’ knowledge and attitude towards HIV/AIDS, and patients’ knowledge and attitude towards antiretroviral therapy was obtained using ‘Patient Assessment of Quality of Individualized care for Chronic Illness Scale’, ‘Patient knowledge and attitude towards HIV/AIDS questionnaire; and ‘Patient knowledge and attitude towards antiretroviral therapy questionnaire’, respectively.<br>Quantitative data were analysed using Statistical Program and Service Solutions (SPSS) version 25.0 computer package. Descriptive<br>statistics were used to summarize data, while inferential statistics were used where applicable with statistical significance set at p<0.05.<br><strong>Results:</strong> The overall mean patients’ satisfaction with individualized care score was 3.54 (SD = ±0.86; Max. = 5). The mean scores of the patients’ knowledge and attitude towards HIV/AIDS were 6.80 (SD = ± 1.079; Max. = 8) and 5.5 (SD = ± 0.924; Max. = 7) respectively, while the mean scores of the patients’ knowledge and attitude toward antiretroviral therapy were 5.7 (SD = ± 1.103; Max. = 10) and 4.2 (SD = ± 0.874; Max. = 6). Multivariate linear regression revealed that the quality of patient centred care was a predictor of knowledge and attitude towards antiretroviral therapy (B=0.511; CI = 95%, p = 0.024).<br><strong>Conclusion:</strong> The quality of patient-centred care provided to persons living with HIV/AIDS in the facility is satisfactory. Patients perceived quality of care appear to be a predictor of knowledge and attitude towards antiretroviral therapy.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261354An investigation of the relationship between female university students’ breast cancer risk factors and their health beliefs about breast self-examination 2023-12-21T12:44:10+00:00Gölbaşı Zehra altunbas5858@gmail.comYeşildağ Birnur altunbas5858@gmail.comAltunbaş Nermin altunbas5858@gmail.com<p><strong>Purpose:</strong> The purpose of this study is to determine the relationship between female university students’ breast cancer risk factors and their health beliefs about breast self-examination (BSE).<br><strong>Methods:</strong> The sample of this descriptive and correlational study was 389 female students who were determined by stratified sampling method. Data were collected through the Socio-demographic Characteristics and Breast Cancer Risk Factors Determination Form and the Champion's Health Belief Model Scale (CHBMS). Data obtained from the study were analysed using SPSS for Windows 16.0 program. Data analysis was performed using percentage distributions, z test, and Spearman correlation analysis. Statistical significance was accepted p<0.05.<br><strong>Results:</strong> While a positive correlation was detected between students’ perceived breast cancer risk for themselves and perceived<br>susceptibility, severity, benefit, self-efficacy related to BSE and health motivation mean scores, a negative and significant correlation<br>was detected with perceived barriers to BSE mean score (p<0.05).<br><strong>Conclusion:</strong> Results showed that although female university students had some risk factors in terms of breast cancer, they have low levels of perceived risk factors for themselves.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261356Co expression of EGFR and CD10 in patients with phyllodes tumors of the breast: a single centre experience in North Western Algeria2023-12-21T12:49:50+00:00Belhadj Amina belhadj_ami@yahoo.frBrikci Samia Bekkal belhadj_ami@yahoo.frAkhrouf Chahinez belhadj_ami@yahoo.frBelhadj Adel belhadj_ami@yahoo.frMedjamia Miloud belhadj_ami@yahoo.frSahraoui Tewfik belhadj_ami@yahoo.fr<p><strong>Background:</strong> Breast phyllodes tumors (BPT) have variable malignant potential, their histological classification remains insufficient for an accurate diagnosis.<br><strong>Objectives:</strong> We attempted to investigate CD10 (Cluster of differentiation 10) and EGFR (Epidermal growth factor receptor) expression in BPT in order to highlight their diagnostic and prognostic values.<br><strong>Methods:</strong> Eight patients with BPT are recruited from January 2014 to December 2020 and immunohistochemical assessment of CD10 and EGFR is realized.<br><strong>Results:</strong> Median age was 27±15.2, the mean tumor size was 9.63±10.21. Only malignant tumours showed expression for EGFR. Borderline and malignant tumors were CD10 positive. Patients overexpressing CD10 were postmenopausal with great tumor size, 25% of these were sarcomatous. Coexistence of CD10 and EGFR overexpression was found in 25% of cases and was associated with age (P=0.008), tumor size (P=0.030) and hitologic types (P=0.014). PC1 and PC2, were extracted, they accounted cumulatively for 94.7% of the variance of the data analysed, it suggests that patient’s age and histological type of tumor have significant association with CD10 and EGFR expression in BPT.<br><strong>Conclusions:</strong> EGFR and CD10 overexpressed combined proteins in phyllode tumors constitute, with histopathological parameters, an important prognostic factor as well as a promising potential targets.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261358Predictive factors of axillary lymph node involvement in Tunisian women with early breast cancer2023-12-21T12:56:45+00:00Leila Achouri l.achouri1@gmail.comInes Zemni l.achouri1@gmail.comAmani Jallali l.achouri1@gmail.comHouyem Mansouri l.achouri1@gmail.comNajet Mahjoub l.achouri1@gmail.comHouda Henchiri l.achouri1@gmail.com<p><strong>Background:</strong> Axillary lymph node involvement (ALNI) is associated with an increased risk of local recurrence and poor prognosis in early breast cancer. The determination of the risk of positive axillary lymph node contributes to therapeutic decisions.<br><strong>Objectives:</strong> The aim of this study was to identify clinicopathological predictive factors of axillary lymph node metastases in patients with early breast cancer.<br><strong>Methods:</strong> We included patients with clinical T0, T1 andT2 invasive breast carcinoma who underwent resection of the primary tumor and axillary staging by sentinel lymph node biopsy and/or axillar lymph node dissection between 2012 and 2018.<br><strong>Results:</strong> Of the 135patients included, 41.5% had ALNI. Regarding univariate analysis, clinical factors correlated with positive ALNM were clinical tumour size>30mm, clinical tumour stage, clinical number of tumours, clinical axillary nodal status and nodal status on ultrasound. Pathologic factors associated with nodal involvement were pathologic tumour stage, tumour grade SBR, number of foci, lymphovascular invasion, perineural invasion and Ki67>20%.<br>In multivariate logistic regression, clinical axillary nodal status, pathologic tumour stage and lymphovascular invasion (LVI) remained as independent predictors of ALNI.<br><strong>Conclusions:</strong> Based on these results, we suggest that clinical axillary nodal status, pathologic tumour stage and LVI are predictive factors for ALNM in Tunisian women with early breast cancer.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261359Assessment of malnutrition in patients undergoing chemotherapy at the National Oncology Centre of the Korle-Bu Teaching Hospital, Accra, Ghana2023-12-21T13:03:36+00:00Akpah Makafui C I masante@ug.edu.ghKegey Olivera masante@ug.edu.ghKyei Kofi Adesi masante@ug.edu.ghNortey Eunice masante@ug.edu.ghAsante Matilda masante@ug.edu.gh<p><strong>Background:</strong> Globally, cancer is on the rise despite several interventions. The link between nutrition and cancer has long been<br>established with the consequences of poor nutrition on cancer pathway being dire. Early nutrition intervention is recommended for all cancer patients.<br><strong>Objective:</strong> To assess malnutrition among patients undergoing chemotherapy at the National Radiotherapy Oncology and Nuclear Medicine Centre of the Korle-Bu Teaching hospital (KBTH) in Accra, Ghana.<br><strong>Methods:</strong> A cross-sectional study was conducted among 123 patients with different types and stages of cancer who were undergoing<br>chemotherapy. Data was collected from December 2018 to January 2019. The PG-SGA tool was used to assess weight loss at one and six months, food intake and nutrition impact symptoms. A correlation test was used to test the association between PGSGA score and Nutritional triaging. A T-test was used to determine the association between chemotherapy cycles and nutrition. A p-value <0.05 was considered to be significant.<br><strong>Results:</strong> The results revealed that 5.7% (n= 7) of the patients were well nourished, 31.7% (n= 39) were suspected of being malnourished and 62.6% (n=77) were severely malnourished. About half of the participants (48%) had experienced weight loss ranging between 1-20kg with weight loss ≤5kg being most prevalent at both one month and six months prior to the study. More than half (56.9%, n=70) of the participants were consuming less than their usual intake. Majority of the participants had 4-6 nutritional symptoms (39.0%) with symptoms being mostly mild (39.1%). Poor nutritional status was positively correlated with nutritional symptoms (r=0.747, p<0.001).<br><strong>Conclusion:</strong> The PGSGA tool identified that more than half of the patients were severely malnourished hence the need for early nutrition intervention in cancer patients.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261370A systemic review and meta-analysis on the prevalence and associated factors of hypertension among adult clients in Ethiopia2023-12-22T05:53:56+00:00Ayalew Tadele Lankrew tadelelankrew@gmail.comWale Belete Gelaw tadelelankrew@gmail.comZewudie Bitew Tefera tadelelankrew@gmail.com<p><strong>Background:</strong> Hypertension is a major risk factor for premature mortality and excessive morbidity in the world. It is a growing public health problem in developing countries including Ethiopia. It is a silent killer. Information on the prevalence of hypertension and its associated factors is to be considered vital to focus on early diagnosis and improve prevention and control of cardiovascular diseases. However, on the prevalence and contributing factors of hypertension in Ethiopia, there is a dearth of information. Thus, this review aimed to estimate the pooled prevalence of hypertension and its contributing factors among Ethiopia's adult population.<br><strong>Objective:</strong> The main objective of this study was to provide pooled evidence on the prevalence of hypertension among the adult<br>population in Ethiopia.<br><strong>Methods and material:</strong> This systematic review and meta-analysis were searched through MEDLINE/ Pub Med, Cochrane Library, and Google Scholar by using different search terms on the prevalence of hypertension and Ethiopia. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument was used for critical appraisal of studies. The analysis was done using STATA 14 software. The Cochran Q test and I2 test statistics were used to test the heterogeneity of studies. Egger’s test was used to show the publication bias. The pooled prevalence of HDP and the odds ratio (OR) with 95% confidence interval were presented using forest plots.<br><strong>Results:</strong> A total of 22 studies with 14,202 participants were included in this review and the overall estimated prevalence of hypertension among the adult population in Ethiopia was 28.02% (95% CI (23.89%, 32.15%). Age 4.37(2.71, 6.04), sex (AOR=2.54,<br>95% CI: 1.00–4.09), family history of hypertension (AOR=3.05, 95% CI, 1.89, 4.21), inactive physical exercise (AOR=2.67, 95% CI: 1.38, 3.97), being obese (AOR=3.94, 95CI:2.83, 5.06), khat chewing (AOR=3.73, 95% CI: 2.65, 4.80), salt consumption (AOR=4.20, 95% CI: 1.55, 6.86) were significantly associated factors. Subgroup meta-analysis done by region showed that a higher in Tigray region 52.19(46.54, 57.66), and the lower was observed in Harare region1 2.71 (9.54, 15.87).<br><strong>Conclusion:</strong> The prevalence of hypertension among the adult population in Ethiopia is high. Healthcare professionals and other stakeholders should give attention to the early detection of hypertension in Ethiopia to reduce the burden of the disorder.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261371Hypertension: risk perception and health seeking behaviour of long-distance drivers in Port Harcourt2023-12-22T06:04:09+00:00Hart David david_hart@uniport.edu.ngMaduka Omosivie david_hart@uniport.edu.ngJohn Amarachi david_hart@uniport.edu.ngChinonye Kemdirim david_hart@uniport.edu.ngNdubuisi Opurum david_hart@uniport.edu.ngAbiasianam Uduak david_hart@uniport.edu.ng<p><strong>Background:</strong> Driving as an occupation is associated with the occurrence of heart-related diseases such as hypertension.<br><strong>Objectives:</strong> To assess the perception of modifiable risk factors of hypertension and the health seeking behaviour of long-distance<br>commercial bus drivers in Port Harcourt Metropolis.<br><strong>Methods:</strong> A cross-sectional study design was used to obtain data from 272 long distance commercial drivers. Data were analysed<br>descriptively using SPSS version 24.0. (p≤0.05).<br><strong>Results:</strong> A total of 272 questionnaires were completed and returned (100%). Respondents’ mean age was 43.4 ± 8.9. In scoring for perception of modifiable risk factors of hypertension among the drivers, (45.6%) respondents had a high perception score while 148 (54.4%) respondents had a low perception score. In assessing for health seeking behaviour, 190 (69.9%) had checked their blood pressure at least once in their lifetime, 80 (42.1%) of those who had checked, did so over a year ago. However, 18 (9.5%) respondents were on medication for hypertension in the last one month.<br><strong>Conclusion:</strong> This study showed that a greater number of the drivers had a low perception of modifiable risk factors of hypertension.<br>Regular health checks were also not observed among participants. There is need for targeted health education for this group.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261372Prevalence and associated factors of hypertension among type 2 diabetes mellitus patients in Lautech teaching hospital, Osogbo, Nigeria2023-12-22T06:11:41+00:00Adeniyi Opeyemi A eniadetreasure@gmail.comEniade Olanrewaju D eniadetreasure@gmail.comOlarinmoye Abayomi T eniadetreasure@gmail.comAbiodun Bukola A eniadetreasure@gmail.comOkedare Omowumi O eniadetreasure@gmail.comEniade Adenike A eniadetreasure@gmail.comAtolagbe James E eniadetreasure@gmail.com<p><strong>Background:</strong> We assessed the prevalence and risk factors of hypertension among type-2 Diabetes Mellitus (DM) patients attending<br>Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo, Osun State Nigeria.<br><strong>Methods and materials:</strong> A hospital-based retrospective study was conducted among 143 type-2 DM patients in LAUTECH Teaching Hospital. Hypertension was defined as systolic BP ≥140 and or diastolic BP ≥90. Data were analysed using descriptive statistics, chi-square, and binary logistic regression.<br><strong>Results:</strong> The mean age of the respondents was 56.2 ±15.79 years. Hypertension was common (32.1%) among type-2 DM participants.<br>Respondents aged 45-64 years (OR= 5.96, 95%CI= 1.60 – 19.12) had the likelihood of being hypertensive. Type-2 DM patients who were not in union (AOR=6.64, 95%CI=1.79 – 24.52) were more likely to be hypertensive. The likelihood of hypertension was lower (AOR= 0.28, 95%CI=0.11 – 0.66) among participants who engaged in moderate physical activity compared to those who engaged in low physical activity.<br><strong>Conclusion:</strong> This study identified the age group 45-64 years, not being in a union and engagement in low physical activity as associated factors for hypertension among Diabetes Mellitus participants. Hypertension prevention/treatment should be considered in type-2 Diabetes Mellitus routine treatment.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261374Platelet indices in children with type 1 diabetes mellitus: a simple glucoregulation monitoring tool2023-12-22T06:19:06+00:00Dobrijević Dejan dejan.dobrijevic@mf.uns.ac.rsAntić Jelena dejan.dobrijevic@mf.uns.ac.rsRakić Goran dejan.dobrijevic@mf.uns.ac.rsAndrijević Ljiljana dejan.dobrijevic@mf.uns.ac.rs<p><strong>Introduction:</strong> Long-term hyperglycemia can lead to changes in the function and morphology of platelets.<br><strong>Objective:</strong> This study aimed to test the potential glucoregulation monitoring properties of platelet indices, mean platelet volume (MPV) and platelet distribution width (PDW), in children with type 1 diabetes mellitus (T1DM).<br><strong>Methods:</strong> The study included 453 patients below the age of 18 with T1DM treated at the Institute for Child and Youth Health Care of Vojvodina. Children were divided into two groups, according to their glucoregulation quality, i.e., glycated hemoglobin (HbA1c) levels. Descriptive and inferential statistical analyses were performed.<br><strong>Results:</strong> MPV and PDW were found to be important in predicting poor glucoregulation, both in independent and conjoint analysis. Proposed cut-off values for MPV and PDW in the glucose control monitoring of children with T1DM were 7.6 fL and 14.4%, respectively.<br><strong>Conclusion:</strong> Our study showed that MPV and PDW have monitoring properties in terms of glucose control in children with T1DM. Additionally, our study emphasizes the importance of selecting the most convenient control group in order to avoid misleading conclusions.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261378Prevalence and determinants of poor glycaemic control in individuals aged between 18-60 years, at a regional hospital in KwaZulu-Natal Province, South Africa- a cross sectional study2023-12-22T06:25:01+00:00Zimu Lindelwa mahomedo@ukzn.ac.zaMahomed Ozayrmahomedo@ukzn.ac.za<p><strong>Background:</strong> Achieving optimal blood glucose control is imperative for preventing diabetes related complications and negative socio-economic consequences associated with them.<br><strong>Objectives:</strong> The aim of the study was to determine the prevalence and determinants of poor glycaemic control amongst type II diabetic outpatients presenting at a regional semi-rural hospital in eThekwini district, Kwa-Zulu Natal.<br><strong>Methods:</strong> An observational, analytic cross-sectional study was conducted amongst 384 systematically sampled type 2 diabetes patients. Data were collected by an interviewer administered questionnaire, clinical record review and anthropometric measurements. Bivariate and multivariate analyses were performed<br><strong>Results:</strong> Ninety one percent of the study population (349/384) had poorly controlled diabetes. Amongst uncontrolled diabetics, 80% (n=281) were older than 35 years’ age group; 58% (n= 203) were male; 85% (n=295) completed primary school education and 93% (n=324) were overweight. Patients that were 35 years and older, female, employed, had a high body mass index, were on oral hypoglycaemic and/or insulin in combination, and receiving treatment longer than 3 years, had an increased odd of uncontrolled diabetes. Being female and receiving oral hypoglycaemic and/or insulin were significantly associated with poor blood glucose control.<br><strong>Conclusion:</strong> Patient that were female overweight, having a lower level of education, and greater than three-year duration of medication and on oral hypoglycaemic agent and/or insulin were more likely to have poor blood glucose control. These factors should serve as early identifiers of potential poor control and an alert clinician to adopt a more active approach to optimize treatment.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261379Rising prevalence of gestational diabetes mellitus and its associated risk factors in Makurdi, North-Central Region of Nigeria2023-12-22T06:29:24+00:00Basil Bruno simeonadebisi2003@yahoo.comMba Izuchukwu Nsimeonadebisi2003@yahoo.comGav Terna A simeonadebisi2003@yahoo.comMyke-Mbata Blessing K simeonadebisi2003@yahoo.comSwende Terrumun Z simeonadebisi2003@yahoo.comAdebisi Simeon A simeonadebisi2003@yahoo.com<p><strong>Background:</strong> The disease burden of gestational diabetes mellitus (GDM) in sub-Saharan African region have been on the rise. Proper assessment of current prevalence of GDM may inform policy changes and management approach for improved care delivery.<br><strong>Objective:</strong> To determine the current prevalence of Gestational Diabetes Mellitus (GDM) and evaluate its major risk factors amongst pregnant women in Makurdi, North-Central Nigeria.<br><strong>Method:</strong> This was a multi-center hospital-based prospective observational study. Maternal characteristics and clinical risk factors for GDM in a cohort of 281 pregnant women at 9 to 16 weeks gestational age was evaluated. The one-step 75g oral glucose tolerance test (OGTT) was carried out at 24 to 28 weeks of gestation.<br><strong>Result:</strong> Of the 356 women recruited, 281 (79.8%) completed the study. The GDM prevalence in the cohort was 16.7%. Increased early pregnancy BMI (adjusted OR = 1.154, 95% CI = 1.080 – 1.233, p<0.001) and presence of family history of diabetes mellitus (adjusted OR = 0.482, 95% CI = 0.233 – 0.997, P<0.05) were independent risk factors for GDM in the cohort.<br><strong>Conclusion:</strong> Increasing maternal age and early pregnancy BMI amongst other possible reasons, may account for the rising prevalence of GDM in the region.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261380Evaluation of thoracic inlet view plain radiograph in the management of patients with goitre2023-12-22T06:36:07+00:00Afolabi Adefemi Oladiran ezemeconstantine@gmail.comEzeme Constantine ezemeconstantine@gmail.com<p><strong>Background:</strong> Thoracic inlet view radiograph is an investigation for assessing patients with goitre in many centres in the sub-Saharan-<br>region. However, there is paucity of information on its usefulness in the diagnosis of retrosternal goitre (RSG) and in planning for thyroidectomy.<br><strong>Method:</strong> A review of patients with goitre managed in the Division of Endocrine Surgery, University College Hospital, Ibadan, Nigeria, between 2002 and 2014 was done. Data were obtained from Operating Theatre Log and electronic data archive of the Division. Clinical RSG (CRSG) was taken as a gland that the examining fingers could not get below its lower margin and Radiological RSG (RRSG) on thoracic inlet view was any extension of the thyroid gland beyond the thoracic inlet. Intra-operatively, if any part of the gland extends beyond the thoracic inlet it was considered as an RSG.<br><strong>Results:</strong> 221 (96.5%) of the 229 patients who had thoracic inlet plain radiograph were included in this study. The Male to Female ratio was 1:5.5. WHO grade III goitre was seen in 56.1% of the patients and 43.9% had grade II goitre. The CRSG, RRSG and Intra-operative RSG were seen in 7.7%, 16.7% and 17.6% respectively. The specificity and sensitivity of clinical examination in determining RSG was 88.7% and 94.1% and that of Thoracic inlet radiograph was 97.8% and 94.6% respectively.</p> <p><strong>Conclusion:</strong> It is a useful study for screening patients with goitre for retrosternal extension, however it could not be used to determine the need for extra-cervical surgical access during thyroidectomy.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261382Frequency of red blood cell allo-immunization in patients undergoing blood transfusion at the Uganda Cancer Institute2023-12-22T06:41:22+00:00Okello Clement D okdclement@gmail.comShih Andrew W okdclement@gmail.comNabwana Martin okdclement@gmail.comKiwanuka Noah okdclement@gmail.comHeddle Nancy okdclement@gmail.comMayanja-Kizza Harriet okdclement@gmail.comOrem Jackson okdclement@gmail.com<p><strong>Background:</strong> There is limited data on red blood cell (RBC) alloimmunization in patients with cancer in sub-Saharan Africa (SSA). We examined the frequency of RBC alloimmunization in transfused patients with cancers in Uganda.<br><strong>Methods:</strong> A randomized control trial was conducted on participants at the Uganda Cancer Institute. Eligible participants were age ≥15 years and required blood transfusion. Participants were randomized to receive either leucoreduced or non-leucoreduced blood transfusion. Participants’ plasma samples were screened for RBC alloantibodies at enrolment and 3-4 weeks after blood transfusion using a 2-cell panel of reagent group O RBCs using the tube method. Antibody identification was performed using a 10-cell panels of reagent RBCs. Participants were considered alloimmunized if antibodies to RBC antigens were identified.<br><strong>Results:</strong> A total of 277 participants were randomized (leucoreduced blood, n=137; non-leucoreduced blood, n=140). Overall, the most represented diagnoses were gynaecological cancers (n=88, 31.8%), acute leukaemia (n=35, 12.6%), and gastrointestinal cancers (n=25, 9.0%). Concomitant HIV infection was present in 26 (9.4%) participants. Most participants received <5 units of blood during the study. No study participant developed allo-antibodies.<br><strong>Conclusion:</strong> There was no RBC alloimmunization in participants with cancers. Routine RBC allo-antibody screening in all patients with cancer in SSA requires further research.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261383The immune-modulatory role of MSCs exerted by PI3K/AKT signaling pathway in kidney tissue after cyclophosphamide2023-12-22T06:49:31+00:00Mohamed Saad eldien Heba hmabdelal@ju.edu.saJayed Mohammed Alenzi hmabdelal@ju.edu.saRoshdy Ahmad Ahmad hmabdelal@ju.edu.sa<p><strong>Background:</strong> Cyclophosphamide (CP) is one of the most effective immunosuppressive agents. To understand the mechanisms used by the CP and MSCs in the kidney, we investigated their effects on some pathways.<br><strong>Experimental animals and methods:</strong> 4 groups of female rats were used. GI: was the normal control group treated with saline solution. Groups G II, G III, and G IV were treated with CP. G I and G II groups were sacrificed on the fourth day after treatment., G III (Auto healing group) was left without treatment after the CP injection for six days. The G IV group was treated with MSCs on the fourth day after the CP injection. G III and G IV groups were sacrificed six days after treatment, and the kidney was removed and processed.<br><strong>Results:</strong> CP induced up-regulation in CD14 and CD21 positive cells and caspase. Significant down-regulation of previous markers in groups III and IV. CP exerted a downregulation effect on AKT/ PI3K, that were ameliorated in groups III and IV. A significant increase in P53, BCL2, as well as VEGF in Group IV (P < 0 05).<br><strong>Conclusion:</strong> MSCs play a vital function in the immune inhibition in CP-treated rats through PI3K/AKT pathway.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261384Maxillofacial trauma and cerebrospinal fluid leak: a retrospective clinical study2023-12-22T06:56:04+00:00Anyanechi Charles E ceanyanechi@gmail.comSaheeb Birch D ceanyanechi@gmail.com<p><strong>Objectives:</strong> To determine the prevalence of maxillofacial fractures associated with persistent CSF leak, and to assess its bearing on clinical outcomes of consecutive patients managed at our centre.<br><strong>Methods:</strong> This was a retrospective cross-sectional study. The medical records of patients over 11-year period were analysed for age, gender, etiology of injuries, duration between injury and presentation to the hospital, types of facial fracture and their treatments, treatment done to control CSF leak, and complication(s). Descriptive and bivariate statistics were computed.<br><strong>Results:</strong> Overall, 1473 patients were evaluated, 66 (4.5%) presented with craniofacial injuries associated with persistent CSF leak after 5 days of non-surgical treatment. Males (92.5%, P= 0.0000) and those in the 21 to 30 years age group (59.1 %, P= 0.01) were predominant. The most common (68.2%) type of fracture combination was Le Fort I, II and III, NOE, zygomatic complex and mandible. The commonest clinical presentation of CSF leak was rhinorrhea only, in 66.7% of patients (P= 0.001).<br><strong>Conclusions:</strong> This study shows that the prevalence of maxillofacial fractures associated with persistent CSF leak was low, which was 4.5% of patients that presented with persistent CSF leak and 84.9% of the cases resolved after treatment of the various maxillofacial fractures.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261385Associations between sexual violence and women's sexual self-consciousness2023-12-22T07:00:23+00:00Sara Ghaffarian Jafarzade z_bostani@yahoo.comZahra Bostani khalesi z_bostani@yahoo.comMaryam Niknami z_bostani@yahoo.comSaman Maroufizadeh z_bostani@yahoo.com<p><strong>Background:</strong> Sexual violence is a global public health problem that has serious and multiple consequences for the victims' health.<br><strong>Objective:</strong> This study was conducted to determine associations between sexual violence and women's sexual self-consciousness.<br><strong>Methods:</strong> In the analytical cross-sectional study, 340 eligible married women of reproductive age who have been referred to comprehensive health centers of Rasht, participated. Simple random sampling followed by cluster sampling was used to reach eligible study participants. The data collection tool was a three-part questionnaire including a demographic information form, sexual violence questionnaire, and sexual self-consciousness scale.<br><strong>Results:</strong> More than 66% of the participants in this study were exposed to sexual violence by their current spouses/partners. The highest prevalence of sexual violence was in the dimension of unwillingness to have sex (49%), and the lowest in the verbal dimension was 2.1%. Participants were 4.11 ± 5.18. There was a significant positive correlation between the total score of sexual violence and the total score of sexual self-consciousness of participants (P <0.001, r = 469).<br><strong>Conclusion:</strong> According to the findings, there is a significant positive correlation between SSC and sexual violence, so prevention policies for sexual violence should be focused on skill-based programs and empowering women.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261386Domestic violence against Iranian pregnant adolescents: protective and risk factors2023-12-22T07:07:01+00:00Rahnavardi Mona z_bostani@yahoo.comKhalesi Zahra Bostani z_bostani@yahoo.comHazrati Zahra z_bostani@yahoo.com<p><strong>Background:</strong> Domestic violence is an important health, which has serious impacts on women's health. The study aimed to discover the protective and risk factors of domestic violence among pregnant adolescents.<br><strong>Materials and Methods:</strong> In the analytical cross-sectional study, 255 eligible pregnant women aged 14-20 years who have been<br>referred to Al-Zahra Hospital, in northern Iran between September 2020 and March 2022 participated. Demographical characteristics<br>were recorded by a questionnaire. Domestic violence was assessed using the instrument of violence against women. Descriptive statistics were used to describe the basic features of the data.<br><strong>Results:</strong> The frequency of physical, emotional, and sexual violence was respectively 13.33%, 23.52%, and 9.01%. The risk factors included the spouse’s substance use (OR 2.41, 95% CI 1.25–4.62), spouse’s low education (OR 1.41, 95% CI 1.12–3.52), spouse’s unemployment (OR 1.14, 95% CI 1.03–1.57) and domestic violence exposure in childhood (OR 1.85, 95% CI 1.46–2.51). Higher education for women was a protective factor for domestic violence (OR 0.70, 95% CI 0.45–0.83).<br><strong>Conclusions:</strong> The education level is a protective factor against domestic violence among pregnant adolescents. These results can help to design the most appropriate prevention programs to reduce the risk factors for violence among pregnant adolescents.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261388Frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women2023-12-22T07:12:19+00:00Shahmir Hussain Sana samiahusain_scorpio@hotmail.comShafaq Makhdoom samiahusain_scorpio@hotmail.comSamia Husain samiahusain_scorpio@hotmail.comAruna Hira samiahusain_scorpio@hotmail.comKhadija Bano samiahusain_scorpio@hotmail.comHaleema Yasmin samiahusain_scorpio@hotmail.com<p><strong>Objective:</strong> To determine the frequency of domestic violence in pregnancy and its adverse maternal outcomes among Pakistani women.<br><strong>Material and methods:</strong> This was a prospective descriptive longitudinal study conducted at the Department of Obstetrics &<br>Gynecology of Jinnah Postgraduate Medical Center, Karachi from October 2021 to March 2022. The questionnaire was filled during an interview. First part included demographic profile, second part comprised of 5 items with ‘yes’ or ‘no’ options. Any positive answer meant woman was subjected to abuse. Adverse maternal outcome was also assessed.<br><strong>Results:</strong> Out of a total of 105 pregnant women, 43(41%) women suffered domestic violence. Verbal or emotional violence (39%) was the most common type of violence. In our study, anemia (71.4%) was the most common complication. Preterm labor (63.8%) was the second on the list. was significantly associated with domestic violence (P-value<0.05). Educational status, employment status, substance abuse, and household monthly income of spouse had a significant association (P-value<0.05) with domestic violence.<br><strong>Conclusion:</strong> Our study shows that high frequency of violence at the time of pregnancy is related to negative maternal outcomes.<br>Women should be screened for violence and support services for such women should be provided in the country.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261389Burden and factors for the early resumption of sexual intercourse in the puerperium among new mothers at Kawempe national referral hospital and Mengo hospital, Uganda2023-12-22T07:19:39+00:00Namulema Edith edith.namulema@mengohospital.orgNakubulwa Sarah edith.namulema@mengohospital.orgMuhamadi Lubega edith.namulema@mengohospital.org<p><strong>Background:</strong> Early resumption of sexual intercourse in the puerperium is a concern for couples because it is often not discussed<br>during pre-natal or postpartum care.<br><strong>Objective:</strong> This cross-sectional survey aimed to establish the current burden and factors associated with the early resumption of sexual intercourse within the puerperium at the National Referral Hospital and Mengo Hospital.<br><strong>Methods:</strong> We conducted a descriptive cross-sectional study among 445 parous women attending the six-week postpartum review<br>and the young child clinic at Kawempe National Referral and Mengo Hospitals between March and May 2021.<br><strong>Results:</strong> The prevalence of ERSP within the puerperium was 39%. This study's earliest time to resume sexual intercourse was one week; the majority had resumed by week four (9.2%). Factors associated with the early resumption of sexual relations were the person’s tribe, going to the husband’s home after birth, and parity. The prevalence of sexual morbidities was 13%. Seventy-five (75%) of mothers did not receive information from the health care workers on when they can resume sex following childbirth.<br><strong>Conclusion:</strong> Puerperal sexual intercourse is still prevalent in Uganda. Interventions to reduce the resumption of sexual intercourse<br>in the puerperium should focus on these determinants to delay puerperal sexual intercourse.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261391Risky sexual behaviour among students of a Nigerian tertiary institution2023-12-22T07:25:03+00:00Idoko Chinedu Achineduarthur@yahoo.comNympha Enebe O chineduarthur@yahoo.com<p><strong>Background:</strong> While initiation of sexual activity is a part of a normal behaviour and development, it may also be associated with negative outcomes when sexual activity is initiated at too early an age, or without due attention to involved risks. These risky<br>behaviours expose to different kinds of sexuality and reproductive health problems like STIs, HIV, unwanted and unplanned pregnancy, abortion and psychological distress.<br><strong>Objectives:</strong> to assess sexual risk behaviours among medical students of University of Nigeria.<br><strong>Methods:</strong> A descriptive cross-sectional study of sexual risk behavior of the tertiary institution students.<br><strong>Results:</strong> a statistical significance existed between certain socio-demographic characteristics and sexual intercourse; these characteristics are age, level of study and place of residence (p <0.05). Major reasons for sexual abstinence include ‘against my faith’,<br>66(37.9%), ‘waiting till marriage’, 56(32.2%), ‘not emotionally ready’, 54(31.0%) and fear of pregnancy, 10(5.7%).<br><strong>Conclusion:</strong> Risky sexual behaviour exist among the respondents though with varying patterns.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261393Dysmenorrhea severity in war refugees with hypertension: a cross-talk with antihypertensives and analgesics2023-12-22T07:29:38+00:00Gammoh Omar Salem omar.gammoh@yu.edu.jo<p><strong>Background:</strong> Dysmenorrhea is the most common gynecological condition among women of reproductive age. Investigating the cross-talk between hypertension and dysmenorrhea is attractive and understudied, moreover, menstrual health is poorly studied in refugees.<br><strong>Objectives:</strong> The present study aims at examining the association between dysmenorrhea severity and antihypertensives and analgesics namely acetaminophen and Non-Steroidal Anti-inflammatory Drugs (NSAIDs) used by traumatized Syrian war refugees<br>with hypertension<br><strong>Methods:</strong> This is a cross-sectional study recruiting Syrian female refugees with hypertension. A structured questionnaire probed<br>their demographics and clinical data. Dysmenorrhea severity was assessed using the WaLIDD (working ability, location, intensity,<br>days of pain, dysmenorrhea) self-report scale<br><strong>Results:</strong> Data were analysed from 125 patients, almost half were diabetic, 47 (37.6%) had dyslipidemia, 59 (47%) reported using<br>β-blockers, 56 (44.8%) reported using ACEIs/ARBs, 43 (34.2) reported using CCBs and 30 (25%) were using diuretics. According to the multivariate binary logistic regression, severe dysmenorrhea was associated with acetaminophen OR 6.5, 95%CI (1.39-30.55), p=0.02 and NSAIDs use OR 2.97, 95%CI (1.28-6.89), p=0.02. Antihypertensive drugs were not associated with dysmenorrhea severity.<br><strong>Conclusion:</strong> Determinants of severe dysmenorrhea in patients with hypertension need more study, herein we report that analgesics<br>but not antihypertensives are not associated with dysmenorrhea severity.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261394Evaluation of the anatomical locations and sizes of uterine fibroids from ultrasound examination in Ghana2023-12-22T07:33:45+00:00Edzie Emmanuel Kobina Mesi emmanuel.edzie@ucc.edu.ghDzefi-Tettey Klenam emmanuel.edzie@ucc.edu.ghBrakohiapa Edmund Kwakye emmanuel.edzie@ucc.edu.ghGorleku Philip Narteh emmanuel.edzie@ucc.edu.ghAidoo Eric emmanuel.edzie@ucc.edu.ghAmoah Stephen Kwaku emmanuel.edzie@ucc.edu.ghAsiamah Samuel emmanuel.edzie@ucc.edu.ghQuarshie Frank emmanuel.edzie@ucc.edu.ghNimo Obed emmanuel.edzie@ucc.edu.ghRaj Amrit emmanuel.edzie@ucc.edu.ghKpobi Joshua Mensah emmanuel.edzie@ucc.edu.ghBoadi Evans emmanuel.edzie@ucc.edu.ghEdzie Richard Ato emmanuel.edzie@ucc.edu.ghTurkson Veronica emmanuel.edzie@ucc.edu.ghKusodzi Henry emmanuel.edzie@ucc.edu.ghAsemah Abdul Raman emmanuel.edzie@ucc.edu.gh<p><strong>Background:</strong> Uterine fibroids locations and sizes, have significant influences on the quality of life of women especially pregnant<br>women and on live birth rate.<br><strong>Objectives:</strong> To determine the anatomical locations and sizes of uterine fibroids and assess any possible associations with age groups.<br><strong>Methods:</strong> This retrospective study reviewed the locations and sizes of a total of 3,542 patients who were ultrasonographically diagnosed with uterine fibroids from January 2019 to December 2021. The obtained data were analysed using GNU PSPP, and Python on Jupyter Notebook with statistical significance level set at p≤0.05.<br><strong>Results:</strong> The overall average diameter of uterine myoma was 5.50±2.60cm (95%CI=5.41–5.58, range=1.00cm–19.10cm) and the respective mean diameter of intramural, subserosal and submucosal fibroids were 5.53±2.60cm (95%CI=5.44–5.62), 5.50±2.27cm (95%CI=5.27–5.74) and 5.82±2.77cm (95%CI=5.49–6.14). Most of the fibroid nodules were small (48.36%, n=1713) and only 5.84% (n=207) were large (>10cm). Posterofundal fibroids and lower anterior myomas were mostly seen in the 35-44 years age class.<br><strong>Conclusion:</strong> The majority of the uterine fibroids were intramural and were mostly at the anterior uterine wall. The submucosal<br>fibroids, even though the rarest, were averagely larger than the other types of uterine myomas. The diameter of uterine fibroids<br>increased with age.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261396Fertility awareness and teenage pregnancy in rural western Uganda: a community-based cross-sectional study2023-12-22T07:47:11+00:00Birungi Lilian jonahzd@gmail.comIzudi Jonathan jonahzd@gmail.com<p><strong>Background:</strong> Teenage pregnancy (pregnancy among girls aged 13-19 years) is prevalent in Uganda but data about the associated<br>factors are limited.<br><strong>Objective:</strong> To determine the prevalence and factors associated with teenage pregnancy in Buliisa district, western Uganda. We<br>hypothesized that fertility awareness is associated with reduced likelihood of teenage pregnancy.<br><strong>Methods:</strong> In this cross-sectional study, we included girls aged 15-19 years and collected data using a structured questionnaire.<br>The modified Poisson regression analysis was used to determine the association between fertility awareness and teenage pregnancy,<br>adjusted for confounders, reported using adjusted prevalence risk ratio (aPR) and 95% confidence interval (CI).<br><strong>Results:</strong> Of 246 teenagers, the prevalence of teenage pregnancy was 41.5% while fertility awareness was 56.7%. The age category 18-19 years (aPR, 3.44; 95% CI, 2.16-5.47), fertility awareness (aPR, 1.80; 95%CI, 1.30-2.51) and Muslim faith (aPR, 1.37; 95%CI, 1.04-1.80) were associated with increased likelihood of teenage pregnancy. Living with a father (aPR, 0.61; 95%CI, 0.48-0.76), mother (aPR, 0.65; 95%CI, 0.524-0.81), or both parents (aPR, 0.57; 95% CI, 0.43-0.76) was associated with a reduced likelihood of teenage pregnancy.<br><strong>Conclusion:</strong> The prevalence of teenage pregnancy in Bulisa district is high. There is a need to target teenagers with correct<br>fertility information, including the engagement of parents and religious leaders.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261397Risk factors for infertility and barriers to treatment in Tanzania: a survey and medical records study2023-12-22T07:51:08+00:00Groene Emily A groe0074@umn.eduMutabuzi Cyrialis groe0074@umn.eduChinunje Dickson groe0074@umn.eduShango Ester groe0074@umn.eduMkhoi Mkhoi L groe0074@umn.eduMason Susan M groe0074@umn.eduKulasingam Shalini groe0074@umn.eduMajinge Charles R groe0074@umn.edu<p><strong>Background:</strong> The burden of infertility is serious for women in high-fertility countries.<br><strong>Objectives:</strong> We sought to identify demographic, behavioral/environmental, and reproductive risk factors for various infertility factors (i.e., ovarian, tubal, uterine/cervical, male/other) among women seeking infertility treatment in central Tanzania; to determine the association between pelvic inflammatory disease (PID) and tubal factor infertility (TFI); and to identify barriers to infertility treatment by women’s home regional zone.<br><strong>Methods:</strong> We conducted a cross-sectional survey of women seeking infertility treatment in Dodoma, Tanzania from January-March 2020. We surveyed 168 participants aged 18-49 years and reviewed their medical records to confirm infertility status and potential risk factors. We estimated prevalence ratios for factors associated with infertility using logistic regression. Treatment barriers were compared by women’s regional zone to see if barriers varied geographically.<br><strong>Results:</strong> The median age of participants was 32 years (range: 18-48). Infertility factors did not vary greatly by patient demographics, behavioral/environmental, or reproductive risk factors. Approximately 31.48% of women had PID diagnoses. Those with PID had 1.94 (95% CI: 1.30, 2.90) times the prevalence of TFI diagnosis as those with other infertility factors, after adjusting for age, pesticide use, alcohol use, age at sexual debut, prior obstetric events, and family history of infertility. Logistical barriers to treatment, such as time and cost, were more frequently reported than emotional, stigma, or other barriers, regardless of regional zone.<br><strong>Conclusions:</strong> PID was strongly associated with TFI after adjustment for confounders. Infertility treatment access due to cost remains a challenge in Tanzania.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261399A cross-sectional study design of risk factors related to antenatal care service use among pregnant women in Sinana district, Bale zone, Ethiopia2023-12-22T07:59:06+00:00Abebe Meskerem maskaabe@gmail.comLegesse Alemayehu maskaabe@gmail.comDida Getu maskaabe@gmail.comTedila Habtamu maskaabe@gmail.com<p><strong>Background:</strong> Maternal health refers to the well-being of women through pregnancy, childbirth and the postpartum period. Antenatal care refers to the care that is given to a pregnant woman from the time that conception is confirmed until the beginning of labour. Ethiopia was known in concert of the world’s nation with primary maternal mortality proportions. The major goal of this study was to survey risk factors related with antenatal care service use among pregnant ladies at regenerative age.<br><strong>Methods:</strong> Data were obtained from primary sources. To dissect the information, descriptive and Bayesian multilevel binary logistic regression of random coefficient model was utilized. The convergence of parameters was assessed by Monte carol Markova Chain utilizing Stata 16 and MLwiN 2.31 programming.<br><strong>Results:</strong> The descriptive result showed that out of the whole 636 pregnant women considered around 60.5%were obtained antenatal care benefits. The odds ratio of pregnant women living in the rural areas being receiving antenatal care services was 0.206(OR = 0.206, P ≤ 0.05). This indicates that the use of prenatal care by rural mothers has decreased by 79.4% compared to urban mothers. Similarly, the Odds ratio for Pregnant women with medium and rich wealth index are 1.571(OR = 1.571, P ≤ 0.05) and 1.90(OR = 1.90, P ≤ 0.05) respectively. This means that pregnant women who are with medium and rich wealth index level had 57.1% and 90% increased odds compared to those pregnant women with poor wealth index consecutively. Varieties between the kebeles in terms of antenatal care benefit utilize were lessening by 0.9 % in random coefficient model.<br><strong>Conclusion:</strong> Generally, the study showed that there was high variation among pregnant women not to utilize antenatal care benefits and the likelihoods of prenatal use were found to increase with the husband occupation, wealth index, age category 25-34, and husband education level.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261401Maternal inherited thrombophilia and recurrent pregnancy loss: a Tunisian study and review of the literature2023-12-22T08:06:00+00:00Frikha Rim frikha_rim@yahoo.frTurki Fatma frikha_rim@yahoo.frAbdelmoula Nouha frikha_rim@yahoo.frRebai Tarek frikha_rim@yahoo.fr<p><strong>Background:</strong> Inherited thrombophilia, mainly the Factor V Leiden (FVL) and Prothrombin mutation (PTM) are the most risk factors for venous thrombosis especially during pregnancy and was strongly associated with recurrent pregnancy loss (RPL), a devastating reproductive problem that affects more than 1% of couples who are trying to conceive. The frequencies also the correlation among these polymorphisms and RPL have been reported controversially in various populations.<br><strong>Objectives:</strong> In this study we evaluated the presence inherited thrombophilia amongst 35 Tunisian women with more than 2 miscarriages, referred to our genetic counseling.<br><strong>Methods:</strong> DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of<br>mutation.<br><strong>Results:</strong> FVL and PTM were detected in 5.7 % and 2.9% respectively; in women with a particular history of early fetal loss and<br>thrombotic events.<br><strong>Conclusion:</strong> This study emphasizes the importance of testing for FVL and FIIM in women with RPL; mainly in the context of thrombotic events. Multi-center collaboration is necessary to clarify the real impact of thrombotic molecular defects on the pregnancy outcome, to ascertain the effect of inherited thrombophilia on recurrent pregnancy loss and then to evaluate the appropriate therapeutic approach.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261403Knowledge, perception and cervical cancer screening practices among nurses and midwives: a case study of Our Lady of Grace Hospital in the Asikuma Odoben Brakwa district, Central region-Ghana2023-12-22T08:18:16+00:00Avinu Esther Selasi selasi.avinu@presbyuniveristy.edu.ghKutah Juliana selasi.avinu@presbyuniveristy.edu.ghAkumiah Prince Osei selasi.avinu@presbyuniveristy.edu.ghOpoku-Addai Kwabena selasi.avinu@presbyuniveristy.edu.gh<p><strong>Background:</strong> Cervical cancer prevention can be achieved through comprehensive programs involving education, awareness creation, vaccination, screening, and early treatment. Health workers have a vital role to play in achieving this. Hence, they must be adequately equipped with the requisite knowledge of the condition since they provide information to their clients.<br><strong>Objective:</strong> This study determined the knowledge, perception, and screening practices on cervical cancer among female nurses and midwives in the Central Region of Ghana.<br><strong>Method:</strong> A quantitative descriptive cross-sectional survey amongst nurses and midwives was used for the study. A convenience<br>sampling technique was applied to yield a representative sample of 130 female nurses and midwives working in Our Lady of Grace Hospital in the Central Region, Ghana. Data was collected from the participants using a self-administered questionnaire.<br>The data was analysed using SPSS version 20, and standard descriptive statistics such as proportions were used to summarize the survey data.<br><strong>Results:</strong> Almost all the nurses (99%) had heard of cervical cancer. Majority (97.1%) of the respondents believed cervical cancer is preventable however, 67.6% also believed that it is incurable. Almost half (42.2%) of the respondents did not perceive themselves as at risk of cervical cancer. Thus, only 11.8% of the nurses had ever screened for cervical cancer. However, majority (92.2%) were willing to recommend the screening to others.<br><strong>Conclusion:</strong> The respondents of this study had some knowledge of cervical cancer however had low patronage for recommended<br>screening practices. Therefore, strategies must be implemented to increase screening practices among female nurses.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261406A review of fermented milks: potential beneficial effects on human nutrition and health2023-12-22T08:25:00+00:00Yerlikaya Oktay oktay.yerlikaya@ege.edu.tr<p>Fermented dairy products are formed during the acidification of milk through fermentation by suitable microorganisms; it contains different microorganisms in sufficient numbers and in an active state. A wide range of fermented milk products are produced and consumed around the world, including yogurt, kefir, koumiss, and yogurt beverages. There are various health benefits associated with the consumption of fermented dairy. Many studies reported that some fermented milk products have antimicrobial, antimutagenic, anticarcinogenic, and antihypertensive properties as well as provide benefits on mineral metabolism, reduce lactose intolerance symptoms and cholesterol levels. In addition to these effects, it has many other beneficial effects such as positive effects on type 2 diabetes and hypertension, antimutagen and antioxidant effects, and reduction of allergic symptoms. Dairy products including fermented milk are known to be the main carrier of probiotic microorganisms, and many clinical studies show the effects of probiotic strains on health. In this study, the effects of fermented milks on human nutrition and health are mentioned.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261407Magnitude of stunting and its determinant factors among children age 6-59 months at Debre Tabor comprehensive specialized hospital, South Gondar zone, North central Ethiopia, 2020 2023-12-22T08:29:30+00:00Feleke Dejen Getaneh dejengetaneh38@gmail.comChanie Ermias Sisay dejengetaneh38@gmail.comWubet Gashaw Mehiret dejengetaneh38@gmail.comAmare Abrham Tsedalu dejengetaneh38@gmail.comDemelash Agimasie Tigabu dejengetaneh38@gmail.comDesale Aragaw Tesfaw dejengetaneh38@gmail.comYimer Reta Dewau dejengetaneh38@gmail.comTesema Ayechew Ademas dejengetaneh38@gmail.com<p><strong>Introduction:</strong> malnutrition continues to be a significant public health and development concern not only in the developing country but also in the world. It is a serious problem because it is causing the deaths of 3.5 million children under 5 years old per- year.<br><strong>Methods:</strong> Institution based cross-sectional study design was employed using sample of 342 children selected through systematic<br>simple random sampling technique from May 1st -July30 /2020. Bivariate and multivariate logistic regression analysis was used.<br>The variables which had significant association were identified on the bases of P value<0.05 and AOR 95% CI.<br><strong>Result:</strong> The analysis this study revealed that, 42.6% of children were stunted. The main associated factors of stunting were found to be birth order of the child, maternal occupation, frequency meal per day, mother who did not wash their hand before breastfeeding, (AOR=1.636:95%CI:1.00-2.674), children who were not vitamin A, supplemented (AOR=1.901, 95%CI: 1.162-3.109), and child whose mother were not use family planning (AOR=2.916, 95%CI: 1.064-7.989 were associated with outcome variable.<br><strong>Conclusion and recommendation:</strong> From the findings of this study, it is concluded that stunting is still an important problem among children aged 6-59 months. Especial attention should be given on intervention of malnutrition.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261408Nutrient, non-nutrient, antioxidant activity, and Fourier Transform Infrared analysis of Kenyan indigenous edible leafy vegetables from Launaea cornuta (Hochst Ex Oliv and Hiern)2023-12-22T08:38:05+00:00Onyancha Jared Misonge onyancha.jared@ku.ac.keMoriasi Gervason Apiri onyancha.jared@ku.ac.keMandela Elias Nelson onyancha.jared@ku.ac.ke<p><strong>Background:</strong> <em>Launaea cornuta</em> is a vegetable with therapeutic advantage for human diseases.<br><strong>Objective:</strong> Evaluate nutritive and non-nutritive components, antioxidant activity, and Fourier transform infrared spectroscopy<br>profile of <em>L. cornuta</em> leaves.<br><strong>Methods:</strong> Proximate, nutri, non-nutrient, percentage phenolic, flavonoid, alkaloid, and saponin contents were investigated using<br>standard procedures. Total phenolic and flavonoids of the extracts were determined spectroscopically. Antioxidant activity and<br>functional groups in the extracts were characterised by 2.2- diphenyl-2-picryl-hydrazyl radical and FTIR spectroscopy, respectively.<br><strong>Results:</strong> Carbohydrates were the most abundant (57.61±0.61 %), and crude lipids were the least abundant (4.26±0.20 %) in<em> L.</em><br><em>cornuta</em>. Essential amino acids were present in varying concentrations, and histidine was the most abundant (251.20±2.00 mg/100g dw). Calcium was the most abundant mineral element (820.49±1.05 μg/g dw). High concentrations of phenols (13.07±0.60<br>%) and low amounts of saponins (2.19±0.10 %) were recorded. Methanolic and aqueous leaf extracts revealed total phenols of 83.10±4.32 and 57.77 ±1.65 mgGAE/g dw, respectively, while total flavonoids were 8.00±0.01 and 7.99±0.03 mgCE/g of dry<br>weight, respectively. Aqueous extract had significant DPPH radical scavenging efficacy (IC50 =72.96± 0.32 μg/ml) compared to<br>681.57± 2.21 μg/ml for methanol extract.<br><strong>Conclusions:</strong><em> L. cornuta</em> contain phytochemicals with health benefits for averting oxidative stress related diseases.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261409The unique contributions of depression and anxiety to suicidal ideation among Nigerian secondary school students: a cross-sectional survey2023-12-22T08:44:55+00:00Chinawa Awoere T Josephat.chinawa@unn.edu.ngOssai Edmund N Josephat.chinawa@unn.edu.ngChinawa Josephat M Josephat.chinawa@unn.edu.ngOdinka Paul C Josephat.chinawa@unn.edu.ngNduagubam Obinna C Josephat.chinawa@unn.edu.ngOdinka Jaclyn I Josephat.chinawa@unn.edu.ngAronu Ann E Josephat.chinawa@unn.edu.ng<p><strong>Background:</strong> It is important to establish the pattern of suicidal ideation among adolescents with depression and anxiety. This will help the schools prevent possible complete suicide among these groups of adolescents’ trough counseling and education.<br><strong>Objectives:</strong> This work is therefore aimed at determining the effects of depression and anxiety on adolescent suicide ideation and factors that predict suicidal ideation among adolescents attending secondary school in southeast Nigeria.<br><strong>Methods:</strong> A cross-sectional study among 450 secondary school adolescents in Enugu state, Nigeria. Information was obtained using the Columbia suicide severity rating scale and the Hospital Anxiety and Depression Scale (HADS). Chi-square test, correlation analysis and Hierarchical logistic regression were used in the analysis, and the level of statistical significance was determined using a P-value of <0.05.<br><strong>Results:</strong> The prevalence of anxiety was 36.4% while that of depression was 30.7%. The prevalence of suicidal ideation was 8.4%. The prevalence of suicidal ideation among adolescents who were <15 years was 8.0% while those who were between 15 – 18 years was 13.5% and those more than 19 years of age was 22.5%. The prevalence of suicidal ideation among adolescents with depression is 21.7% and 78.3 % for those without depression while the prevalence of suicidal ideation among adolescents with anxiety is 20.1% and 79.9 % for those without anxiety. The prevalence of suicidal ideation among the poorest half was 16.4% and 10.2% in the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers (53.3%) than the rural dwellers (46.7%).<br>There was a positive correlation between suicide and age in years and this was found to be statistically significant, (n=450, r=0.107, p=0.023). A significantly higher proportion of respondents who had depression, 21.7% had suicidal ideation when compared with those who were not, (χ<sup>2</sup>=12.170, p<0.001). Similarly, a significantly higher proportion of respondents who had an anxiety disorder, (20.1%) had suicidal ideation when compared with those who were not, 9.4%, (χ<sup>2</sup>=10.291, p=0.001). The respondents who were 19 years and above had increased suicidal ideation, and the difference in proportions was found to be statistically significant, (χ<sup>2</sup>=6.440, p=0.040). A significantly higher proportion of females, 16.6% had suicidal intentions when compared with the males, 7.1%, (χ<sup>2</sup>=7.958, p=0.005).<br><strong>Conclusion:</strong> There is an increasing prevalence of suicidal ideation among adolescents with a preponderance of older age and female gender. There is a link between depression/anxiety and suicidal ideation. The prevalence of suicidal ideation among the poorest half was higher than that of the richer half. There was a higher prevalence of suicidal ideation among the urban dwellers than the rural dwellers.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261411Mobile phone intervention to reduce dropout from treatment at an outpatient mental health service for older people in Nigeria2023-12-22T08:54:41+00:00Elugbadebo Olufisayo fisayoelu08@yahoo.comOjagbemi Akinsola fisayoelu08@yahoo.comGureje Oye fisayoelu08@yahoo.com<p><strong>Background:</strong> Half of older Africans drop out of treatment after a single contact with biomedical mental health services.<br><strong>Objective: </strong>This study examined the effect of introducing a mobile phone reminder intervention delivered by volunteering health staff to reduce dropout from an outpatient mental health service for older people in Nigeria.<br><strong>Methods:</strong> 405 patients were studied using a quasi-experimental design: 169 who attended clinic pre-intervention (2016-2017) and 236 who attended during intervention (2018-2019). We estimated annual dropout rates, reasons for dropout and predictors of drop-out.<br><strong>Results:</strong> We found a trend for decreasing dropout rates during intervention (p<0.001). The most common reasons for dropout were distance to the clinic (19.5%) and unavailability of a caregiver (47.6%). Current single status (O.R =2.02, 95% C. I=1.02-3.99) and treatment without adjunctive pharmacotherapy (O. R=2.14, 95% CI; 1.07-4.26) predicted dropout.<br><strong>Conclusion:</strong> Mobile phone call reminders improved treatment engagement in this population. Findings are important for policy to improve access to mental healthcare in Africa.</p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261412Prevalence, pattern and determinants of substance abuse among youths in a rural community of Osun State, Southwest Nigeria2023-12-22T09:00:25+00:00Idowu Ajibola idajibola@yahoo.comAremu Ayodele Olatayo idajibola@yahoo.comAkanbi Ibukun Mary idajibola@yahoo.comEseigbe Gloria idajibola@yahoo.comAdewale Victoria idajibola@yahoo.comAwubite Loliya idajibola@yahoo.comAdebayo Olumide idajibola@yahoo.comArisa Daniella idajibola@yahoo.comAdetona Blessing idajibola@yahoo.comOlaniyan Ayomikun idajibola@yahoo.comOlafisoye Ebunoluwa idajibola@yahoo.comOlorunshola Oluwaseyi idajibola@yahoo.comEyitayo Jesulayomi idajibola@yahoo.comOgunlana Omotolani idajibola@yahoo.comAboloye Oluwaseye idajibola@yahoo.comMayor Anatasia idajibola@yahoo.comOlatunde Emmanuel idajibola@yahoo.com<p><strong>Study objectives:</strong> This study assessed the prevalence, patterns and factors associated with substance abuse among youths of<br>Ejigbo community, Osun State, Nigeria.<br><strong>Method:</strong> This was a descriptive cross–sectional study which employed cluster sampling method to select 420 consenting youths<br>(aged 15-24years). Data were collected using interviewer–administered, semi structured questionnaire. Descriptive and inferential<br>statistics were carried out at p < 0.05.<br><strong>Results:</strong> The mean age (±SD) of the respondents was 19 ± 4.18 years. Majority (89%) of the respondents possessed good knowledge of substance abuse while 4% of them had a positive attitude towards it. Above a quarter (29.8%) of respondents had ever consumed alcoholic beverages while 12.3% of them had engaged in substance abuse. Besides alcohol, Shisha and tramadol were the most commonly abused substances in the study setting. Respondents’ age (AOR=3.11;95%CI=1.67-5.24), gender (AOR=1.87;95%CI=1.53-9.25), attitude to substance use (AOR=5.90;95%3.45-10.23) and marital status (AOR=3.27;95%- CI=2.71-7.24) were the main determinants of substance abuse in the study setting.<br><strong>Conclusion:</strong> Respondents in the current study had good knowledge, predominantly negative attitude but a relatively high burden<br>of substance abuse. There is urgent need for policy makers to upscale fights against the menace of substance abuse among rural Nigerian youths.<br><br></p>2023-12-27T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261624Phenotypic and cytogenetic variability of patau syndrome in Morocco2023-12-29T06:39:04+00:00hammou Hanane Ait nisrineaboussair@gmail.comSennaoui Mariam nisrineaboussair@gmail.comBouzid Fatimazahra nisrineaboussair@gmail.comDafir Kenza nisrineaboussair@gmail.comQabli Meriem El nisrineaboussair@gmail.comAkallakh Hassan nisrineaboussair@gmail.comMansouri Maria nisrineaboussair@gmail.comMaoulainine Fadl Mrabih Rabou nisrineaboussair@gmail.comBouskraoui Mohammed nisrineaboussair@gmail.comAboussair Nisrine nisrineaboussair@gmail.com<p>The objective of this work was to identify phenotypic features and cytogenetic aspects of trisomy 13 in Moroccan population.<br>The retrospective study was conducted on a group of 9 cases diagnosed cytogenetically with trisomy 13.<br>The study of sex ratio showed a slight female dominance in our group of cases. The major clinical findings included: Holoprosencephaly, microphthalmia and anophthalmia, coloboma of iris, cleft lip and palate, nasal and ear abnormalities, retrognathism and sloping forehead, polydactyly, capillary hemangiomas, omphalocele, congenital heart defect, renal abnormalities, cryptorchidism, language delay.<br>The cytogenetic study showed the dominance of the free and homogeneous trisomy 13 (56%). Patients who have this formula are dead at an early age (does not exceed one month). However, each of the chromosomal formula, trisomy 13 by translocation and partial trisomy 13 t (13;18), was found in 20% of our patients.<br>The partial trisomy 13 t (13;18) is the only variant that is still alive and the patients with this anomaly suffer mainly from renal and cardiac anomalies with slight dysmorphia and psychomotor retardation.<br>Our study shows the interest of the cytogenetic analysis in the diagnosis accuracy and in the genetic counseling of patients with Patau syndrome and their parents.</p>2023-12-29T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261626Mothers/caregivers’ knowledge of routine childhood immunization and vaccination status in children aged, 12-23 months in Ilorin, Nigeria2023-12-29T06:52:59+00:00Ariyibi Solomon O Ariyibisolomon@Gmail.ComOjuawo Ayodele I Ariyibisolomon@Gmail.ComIbraheem Rasheedat M Ariyibisolomon@Gmail.ComAfolayan Folake M Ariyibisolomon@Gmail.ComIbrahim Olayinka RAriyibisolomon@Gmail.Com<p><strong>Background:</strong> Immunization has averted millions of hospitalizations and deaths from vaccine-preventable diseases. It is a strong public health tool for childhood infection control and prevention. Many mothers are aware of routine immunization but with doubtable knowledge.<br><strong>Objectives:</strong> This study determined the mothers/caregivers’ knowledge of routine childhood immunization and vaccination status of their children, aged 12-23 months in Ilorin East Area of Kwara State, Nigeria. It also identified some of the socio-demographic factors associated with good knowledge status of the mothers/caregivers.<br><strong>Methods:</strong> This was a community-based cross-sectional study, carried out between December, 2019 and January, 2020, among 456 mothers / caregivers-children’s pairs. Subjects were recruited using multistage cluster sampling technique. Data were collected using a pretested, semi-structured, interviewer-administered questionnaire.<br><strong>Results:</strong> Up to 98.0% of the respondents were aware of childhood immunization with healthcare providers (92.1%) being their major source of information. Majority of the respondents (85.3%) had good knowledge of immunization, defined by a score ≤6 out of the 10 questions tested. There was a significant relationship between respondents’ knowledge and full vaccination status of the children (p=0.001). The significant factors associated with good knowledge from binary logistic regression were mothers / caregivers’ age >30 years, antenatal clinic attendance and at least secondary education (OR, p value = 10.60, 0.013; 8.50, <0.001; and 3.98, <0.001 respectively).<br><strong>Conclusion:</strong> Mothers / caregivers’ knowledge on immunization was good and this positively affected the full vaccination status of their children. There is a need to sustain female education and encourage antenatal clinic attendance, as tools to improve childhood immunization.</p>2023-12-29T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261627Total intravenous anaesthesia in rural sub-Saharan Africa: report of 25 cases2023-12-29T07:01:58+00:00Ramses Marrero-Garcia rmarrero@clinic.catAleix Clusella rmarrero@clinic.catDiego Prendes rmarrero@clinic.catRamón Soliva-Domínguez rmarrero@clinic.catTeresa Vives rmarrero@clinic.cat<p>Total intravenous anesthesia (TIVA) is a potential solution for safe and effective anesthesia administration in rural regions of sub-Saharan Africa, where access to inhalational anesthesia may be limited. However, challenges such as equipment and medication availability, as well as a shortage of trained anesthesiologists, can limit the use of TIVA. In this study, the safety and efficacy of TIVA were evaluated in a case series of 25 female patients undergoing thyroid surgery in a rural area of sub-Saharan Africa. The TIVA protocol involved the use of propofol, fentanyl, rocuronium, and sugammadex. Results showed that TIVA was a safe and effective method of anesthesia administration in this setting, with no major adverse events reported. The use of TIVA may offer advantages such as faster recovery times, reduced incidence of postoperative nausea and vomiting, and reduced risk of environmental pollution compared to inhalational anesthesia. However, the cost and monitoring requirements of TIVA may pose challenges in resource-limited settings. Further research is needed to determine the optimal use of TIVA in this context.</p>2023-12-29T00:00:00+00:00Copyright (c) 2023 https://www.ajol.info/index.php/ahs/article/view/261628The reliability and validity of the isixhosa version of the euroqol toddler and infant populations (EQ-TIPS) health related quality of life instrument2023-12-29T07:09:52+00:00Verstraete Janine Janine.verstraete@uct.ac.zaAmien Razia Janine.verstraete@uct.ac.za<p><strong>Background:</strong> Considering the high burden of disease in young children measurement of Health-Related Quality of Life is needed to evaluate the burden of morbidity. This study aims to report on the validity and reliability of the isiXhosa EuroQol Toddler and Infant Populations (EQ-TIPS) measure for South Africa.<br><strong>Methods:</strong> A sample of 181 caregivers of children 0-36 months were recruited from a hospital in-patient (inpt) and outpatient (outpt) facility and crèches. The EQ-TIPS, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolability (FLACC) and dietary information were administered at baseline. EQ-TIPS was administered one week later in crèche children for test-retest reliability.<br><strong>Results:</strong> Known groups showed significant differences for pain (X2=37.21, p<0.001), and EQ-TIPS level sum score (KWH=25.9, p<0.001) between health groups. The Visual Analogue Scale was unable to discriminate general health between groups (KW-H=3.92, p=0.141). Concurrent validity was weak to moderate and significant for all dimensions hypothesised to correlate. There was significant fair to moderate test-retest reliability for EQ-TIPS dimensions of movement, play, pain and eating.<br><strong>Conclusion:</strong> The isiXhosa EQ-TIPS is valid and reliable for very young children in South Africa and we suggest that it be included in the assessment of children with health conditions within this context.</p>2023-12-29T00:00:00+00:00Copyright (c) 2023