African Health Sciences

Editor’s choice: Tackling infectious diseases, NCDs and sexual reproductive health issues as we enter our 24th year of remarkable growth

James K Tumwine — Mon, 01 Apr 2024 00:00:00 +0000

NIL.

Effects of SNPs on TNF-α and IL-10 cytokine expression in TB and HIV patients in the Capricorn district, Limpopo Province, South Africa

Mosebo A Manabile, Tibello C Maguga-Phasha, Marema E Makgatho — Mon, 01 Apr 2024 00:00:00 +0000

Background: The impact of Tuberculosis (TB) places an immense burden on the health care system. Infection with Human
Immunodeficiency Virus (HIV) is a significant risk factor in the development and progression of TB disease. Single Nucleotide
Polymorphisms (SNPs) in the promoter region of Interleukin-10 (IL-10) and Tumour Necrotic Factor-Alpha (TNF-α) may play
a major role in the disease mechanism and understanding these mechanisms might prove to be a useful diagnostic tool in evaluating
the immune regulation and progression of the disease.

Objective: This study aimed to determine the relationship between cytokine levels and gene variants of Interleukin-10 and Tumour
Necrotic Factor Alpha in TB and HIV-infected participants.

Methods: Cytokine levels were determined by ELISA, and SNPs were determined by MassArray®.

Results: The levels of TNF-α were higher in the TB group than the HIV (p < 0.001) and TB-HIV (p = 0.011) groups, but similar to the TNF-α levels in the control group. In the HIV group, IL-10 levels were higher than those of the TB (p < 0.001) and control groups (p = 0.039), whereas there was no difference between the IL-10 levels in the HIV and the TB-HIV infection groups. The ratio was determined and there were no differences between the four infection groups. In this study, no associations were detected between the circulating plasma levels of TNF-α and IL-10 and their genotypes.

Conclusion: Our data showed that the gene variants were not associated with circulating plasma levels of TNF-α and IL-10 in our study population. A pro-inflammatory environment was found in the TB and TB-HIV groups, which is suggesting of bacterial clearance, while an anti-inflammatory environment was found in the HIV group, which suggests the suppression of
viral replication.

Keywords: Tuberculosis; Human immunodeficiency virus; interleukin-10.

Haematological parameter among drug resistant tuberculosis patients in Ibadan

Mon, 01 Apr 2024 00:00:00 +0000

Background: Haematological abnormalities are common among tuberculosis patients but there is dearth of information on their value as prognostic markers in multidrug resistant tuberculosis patients. This study examined the association between complete blood count variables and drug resistant tuberculosis.

Materials and methods: Nighty (90) consenting adults comprising 30 Drug Resistant Tuberculosis patients (DR-TB), 30 Drug susceptible tuberculosis patients (DS-TB) and 30 healthy participants were recruited in this study. Ethical approval was obtained from Oyo State Ministry of Health Institutional Review Board while patients’ demographic data were collected using structured questionnaire. Five milliliters (5mL) of blood samples were collected in EDTA bottle. Haematological parameters were analysed using impedance technique and Mindary-BG5380 5-part automated system.

Result: The mean hemoglobin levels were significantly lower in DR-TB patients (11.70 ± 2.73 g/dL) than in DS-TB patients (8.33 ± 9.56 fL), with a mean difference of -3.37 ± 12.29 g/dL. The mean MCH and MCHC levels were also slightly lower in DR-TB patients (26.17 ± 3.44 pg and 30.41 ± 1.92 g/dL, respectively), but the differences were not statistically significant. The WBC count was similar in both groups (8.20 ± 3.80 × 10^9 /L and 8.45 ± 3.63 × 10^9 /L, respectively).

Conclusion: The mean hemoglobin levels were significantly lower in DR-TB patients than in DS-TB patients which may be due to the increased inflammation associated with DR-TB. The WBC count was similar in both groups, suggesting that the immune system is responding similarly to the infection in both DR-TB and DS-TB patients.
Recommendation: In the meantime, healthcare providers should be aware of these potential differences and use them to inform their diagnosis and treatment of patients with tuberculosis.

Keywords: Haematological parameters; drug resistant tuberculosis; Ibadan.

Prevalence of HIV, HBV and HCV among livestock merchants and slaughterhouse workers in Ibadan, Nigeria

Mon, 01 Apr 2024 00:00:00 +0000

Background: Most studies on viral infections among livestock handlers have focused on occupational exposure from inadvertent contact with infected animals. Consequently, little emphasis is given to the effect of their lifestyle on the acquisition of other blood-borne viruses.

Objectives: To determine the prevalence and assess risk factors for HIV, HBV and HCV infections among livestock handlers in Ibadan, Nigeria.

Methods: Blood samples were collected from 265 livestock handlers between October 2016 to April 2017 in Ibadan. The samples were tested for the presence of antibodies to HIV and HCV; and surface antigen to HBV using ELISA. Structured questionnaire was administered to collect information on risk factors associated with the transmission of these viruses. Data analysis was carried out using Chi-square test and logistic regression to determine the association between risk factors and predictors of infection (p < 0.05).

Results: Of 265 participants, 11 (4.2%), 29 (10.9%) and 13 (4.9%) individuals tested positive for HIV, HBV and HCV infections respectively. Two (0.8%) of the participants were coinfected with HIV and HBV while 1(0.4%) was coinfected with both HBV and HCV. Individuals who travelled frequently in the course of Livestock trades had a higher rate of HIV infection.

Conclusions: A high Infection with HIV, HBV and HCV is common among the study participants. There is a need for continued surveillance and awareness creation on preventive measures against these viruses.

Keywords: Human immunodeficiency virus; viral hepatitis; slaughterhouse workers.

Preconception and contraceptive care for women living with HIV/AIDS attending antiretroviral treatment clinics in Lagos State, Nigeria

Samuel Oyibo, Atariata Oghenewoke, Mary O Balogun, Ugbe Maurice-Joel Ugbe — Mon, 01 Apr 2024 00:00:00 +0000

Background: Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring.

Objective: The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria.

Methods: This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process.

Results: Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), p = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), p = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), p = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), p = 0.002] were significantly related to the utilization of contraceptives.

Conclusion: There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS.

Keywords: Preconception care; contraceptive care; HIV/AIDS; women.

Sociodemographic predictors of beliefs about getting HIV infection by witchcraft or supernatural means: A population-based study of 15335 Senegalese women

Amr Ehab El-Qushayri, Amira Yasmine Benmelouka — Mon, 01 Apr 2024 00:00:00 +0000

Aim: To provide more insights about beliefs of witchcraft and supernatural means as causes of human immunodeficiency virus
(HIV) among women in Senegal.

Method: We included eligible women from the demographic and health survey conducted in Senegal during the year 2017.

Results: We included 15335 women, of those 620 (4%) thought that they can get HIV through witchcraft or supernatural
means. After the adjustment of all available covariates, old age, receiving primary or secondary education, higher wealth index,
more frequency of listening to radio, watching television for less than once a week and reading newspaper or magazine for at
least once a week were significantly associated with a reduction in the witchcraft and supernatural means beliefs (p < 0.05).
Moreover, rural residence was associated with an increase in the wrong HIV beliefs (p < 0.05).

Conclusion: We demonstrated many predictors of the wrong beliefs about getting HIV infection by witchcraft or supernatural
means in the Senegalese women. Policymakers should initiate health educational programs in parallel with increasing the
socioeconomic status to limit the HIV transmission. In addition, continuous monitoring of the HIV knowledge in the endemic
countries is crucial to decrease HIV burden.

Keywords: HIV; infection; witchcraft; misconception; myths.

Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese District, Uganda

Kizito Omona, Alex Bwogi Kanyerezi — Mon, 08 Apr 2024 00:00:00 +0000

Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services.

Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda.

Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide.

Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 – 3.270)].

Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low.

Keywords: Community client led anti-retroviral therapy delivery (CCLAD); Enrolment; Health care and public health.

A retrospective study of Crimean-Congo hemorrhagic fever in Iraq

Mon, 01 Apr 2024 00:00:00 +0000

Background: CCHF is transmitted via ticks biting and directly by contact with tissue or blood of infected patients or viremic
animals. This study intends to determine the occurrence of CCHF in Iraq between 2015 and 2019.

Methods: This study was designed as a retrospective and descriptive cross-sectional study. It was approved the occurrence of
CCHF in Iraq with relation to some epidemiological and demographic data reported in the Iraqi Communicable Diseases Control
Center (CDC)/zoonotic diseases section between 2015-2019.

Results: Out of 206 suspected cases, only 17 were diagnosed as CCHF with a total fatality ratio of 52%, 25%, and 80% in 2015
and 2018 respectively. However, no mortality was reported during 2016, 2017, and 2019. The mean age of the patients was 33
years± 18 SD, in males mainly (76%). Moreover, the risk groups were 29 %, 23 %, 18 % 12 %, and 6 % for butchers, animal
dealers, gainers, both housewives and students and children respectively.

Conclusion: Strict precautions and precise surveillance should be implemented to control the disease and protect the community
by improving the diagnosis and treatment of CCHF. The authors recommend another future study to detect the genotyping
and sequencing of CCHFV in Iraq.

Keywords: Crimean–Congo hemorrhagic fever; Iraq; tick.

Clinicopathological study of otomycosis in a tertiary hospital in South-west Nigeria

Olusola A Sogebi, Emmanuel A Oyewole, Olubunmi A Osinupebi — Mon, 01 Apr 2024 00:00:00 +0000

Background: Otomycosis is common in environments with hot, humid weather, and it may be challenging to manage.

Objectives: To profile common clinical presentations, the pathogenic fungi, the treatment modalities with responses, and explore
clinical factors associated with having positive fungal culture in Otomycosis.

Methods: Retrospective review of patients with Otomycosis. Demographic and clinical parameters, otoscopic findings and
mycological study results were recorded. The treatment modalities used and treatment response were summarized. Comparative
statistical analyses of associated factors to positive fungal culture were performed with Chi square test, and Student’s t-test, using
SPSS version 22.0

Results: Total of 71 patients with M: F=1:1.8, mean age 38.5±19.8 years. Average duration of symptoms was 5.4 ±4.6 weeks;
common presenting complaint was itchy ear (33.8%). Majority of patients (85.9%) had unilateral ear involvement, 50.0% applied
ototopic medications before presentation, 8.5% had multiple co-morbidities. 20 patients had positive fungal culture results; common
fungal isolate was Aspergillus niger 9 (45.0%).
Clinical factors associated with positive culture of fungus were age, non-previous use of ototopic drugs, and presence of
co-morbidity. The most common treatment was local ear debridement and use of topical antifungal creams. Majority (91.5%)
of the patients responded with resolution of fungal infection. Complications rate was 8.4%.

Conclusions: Otomycosis commonly present with itchy ears, the pathogenic fungi commonly being Aspergillus species. The
factors associated with positive fungal culture were age, non-usage of ototopic agents and presence of co-morbidity. Treatment
modality used was local debridement and topical antifungal agents, which produced favourable response in most patients.

Keywords: Otomycosis; mycology; presentations; treatment; complications; associations.

The effect of midwifery students’ changing life conditions and e-learning experiences on the state of their anxiety and hopelessness during the Covid-19 pandemic

Uluşen Mesude, Aslantekin Özçoban Filiz, Çilesiz Elif — Mon, 01 Apr 2024 00:00:00 +0000

Background: Giving the existing formal education through the internet without a planned transition to distance education
negatively affected the learning processes of the students.

Objectives: The study aims to identify the midwifery students’ changing life conditions and e- learning experiences on the state
of their anxiety and hopelessness during the Covid-19 pandemic.

Methods: Designed as cross-sectional research, the study was performed with the participation of 1,296 midwifery undergraduate
students. The survey form comprised of questions that explored the students’ demographic characteristics, life conditions
changing during the Covid-19 pandemic and distance education experiences, the Generalized Anxiety Disorder Scale-7, and the
Beck Hopelessness Scale were used in the data collection.

Findings: It was discerned that, of the participant midwifery students, 55.2% spent the period of the pandemic in the province
center, 51.7% used smartphones to have access to the distance education, 50.3% had trouble in following up the courses
due to the limited computer and internet access, 63.5% failed to follow up the courses because of the infrastructure problems
related to the distance education. It was found that, of the participant midwifery students, 54.6% exhibited anxiety symptoms
and 26.3% had hopelessness symptoms. It was identified that having trouble in following up the courses increased anxiety by
1.438 times (CI:1.103-1.875) and hopelessness by 1.980 times (CI:1.459-2.687), having tensions in the family relations increased
anxiety by 2.362 times (CI:1.780-3.134) and hopelessness by 1.789 times (CI:1.235-2.594), and having psychological support for
anxiety and worry increased anxiety by 2.914 times (CI:2.208-3.8477) and hopelessness by 1.875 times (CI:1.083-3.247). It was
ascertained that hopelessness increased anxiety by 2.878 times (CI:2.075-3.991) whilst anxiety increased hopelessness by 2.755
times (CI:1.985-3.823) (p<0.05).

Conclusion: As well as the Covid-19 pandemic, health, social life, and economic changes; the digital separation that accompanies
distance education also affects the students’ mental health. Solving the technical problems experienced in distance education,
facilitating the follow-up of the courses, and equipping the midwifery students with problem-solving and coping skills will
be useful for reducing the midwifery students’ hopelessness and anxiety levels.

Keywords: Midwife; anxiety; pandemics.

A case report: recurrent anemia related to long term acyclovir use in a pregnant HIV infected Ugandan

Mariam Nambuya, Harriet Mayanja-Kizza — Mon, 01 Apr 2024 00:00:00 +0000

Abstract: This case report describes a pregnant patient with recent diagnosis of Human Immuno-Deficiency Virus (HIV) infection initiated on Anti-Retroviral Therapy (ART) in the second trimester, as well as high dose acyclovir high for large infected genital warts. She had no other HIV related opportunistic infections, and no prior anti tuberculosis treatment or preventive medication. Despite little response to acyclovir, patient was continuing on acyclovir for over 4 months. She subsequently developed recurrent anemia requiring frequent transfusion (14 units in total) over a 6-week period.

On stopping acyclovir, the anemia subsided, a few weeks later she had a normal delivery, followed by surgical removal of the warts. At a follow-up 8 months later, she was well, with a healthy baby, and reported no other episodes of blood transfusion.

Keywords: Recurrent anemia; acyclovir; herpes genitalis; HIV; ART.

Transfusion transmitted infections among blood donors of Kamenge Teaching Hospital blood bank in Burundi

Mon, 01 Apr 2024 00:00:00 +0000

Background: The current risk of contracting a transfusion transmitted infections (TTIs) is unknown in Burundi.

Objectives: The aim of this study was to assess sociodemographic profiles of blood bank donors at Kamenge Teaching Hospital, the prevalence and associated risk factors of HIV, syphilis, HBV and HCV from 2015 to 2020.

Methods: We conducted a cross-sectional study including all blood donors of Kamenge Teaching Hospital blood bank. During this study, 1370 blood samples were screened for HIV, Syphilis, HBV and HCV. We calculated prevalence of TTIs and performed logistic regression to know associated risk factors.

Results: Blood donors were males at 77% and 23% females. They were mostly students (54.2%). On screening, 83 blood samples (6.06%) were seropositive for at least one TTI. The overall prevalence rate of HIV, Syphilis, HBV and HCV among blood donors was 1.3%, 0.2% ,1.6%, 2.9% respectively. There was difference in distribution of the four TTIs among blood donors which is statistically significant (x2=33.997, ρ-value<0.001). Private donors were associated with a high risk of syphilis and being a first-time donor was associated with a high HBV risk factor.

Conclusion: The prevalence of TTIs found still to be high; mandatory and continuous screening is necessary.

Keyswords: Transfusion transmitted infections; prevalence; blood donors; blood bank; Burundi.

Can reproductive health services be used to screen for sexual and gender-based violence in post-conflict Northern Uganda? – a pilot study

Keneth Opiro, Francis Pebolo Pebalo, Neil J Scolding, Charlotte Hardy — Mon, 01 Apr 2024 00:00:00 +0000

Background: Sexual and gender-based violence (SGBV), including rape and child sexual abuse, remains a significant challenge
in post-conflict northern Uganda. Many victims have never sought help. Consequently, the scale of the problem is not known,
and SGBV victims’ injuries, both psychological and physical, remain hidden and unresolved.

Objectives: We aimed to explore whether health workers in rural Reproductive Health Services (RHS), following specific training,
could provide a valuable resource for SGBV screening and subsequent referral to targeted services.

Methods: Our project had three elements. First, RHS workers were trained to use a questionnaire to screen subjects for past
SGBV. Second, the screening questionnaire was used by RHS workers over a 3-month period, and the data collected were analysed
to explore whether the screening approach was an effective one in this setting, and to record the scale and nature of the
problem. Third, victims detected were offered referral as appropriate to hospital services or to a dedicated SGBV ActionAid
shelter.

Results: Of 1656 women screened, 778 (47%) had suffered SGBV: 123 rape, and 505 non-sexual violence. 1,254 (76%) had been
directly or indirectly affected by conflict experiences; 1066 had lived in internally displaced persons camps. 145 (9%) requested
referral to Gulu SGBV Shelter; 25 attended the shelter and received assistance, and 20 others received telephone counselling.

Conclusion: Undetected SGBV remains a significant problem in post-conflict northern Uganda. RHS workers, following specific
training, can effectively screen for and identify otherwise unrecognised survivors of SGBV. This matters because without
ongoing detection, survivors have no opportunity for resolution, healing or help.

Keywords: SGBV; resource-poor setting; Screening.

Physical and psychological health consequences of intimate partner violence among married primary school teachers in Delta South Senatorial Zone of Delta State, Nigeria: Implication for marital stability

Mon, 01 Apr 2024 00:00:00 +0000

Background: Intimate Partner Violence (IPV) is a serious health issue among couples which is recorded more among married partners. Dishearteningly, IPV among couples who are teachers is underreported due to shame, thereby increasing the prevalence of IPV in the area of the study.

Objectives: The study examined physical and psychological health consequences of IPV on married primary school teachers.

Methods: The design was a cross-sectional descriptive survey conducted on married primary school teachers in Delta South Senatorial zone of Delta State, Nigeria from 22nd February - 29th November, 2021. Three hundred and thirteen 313 (207 women and 106 men who have experienced various forms of IPV) who were identified as victims of IPV were used as participants in the study. Structured questionnaire was used to elicit information on physical and psychological health consequences of IPV on married teachers.

Conclusion: The researchers concluded that there are severe and serious physical and psychological health consequences associated with IPV among married primary school teachers in Delta South Senatorial zone of Delta State, Nigeria. Urgent interventions such as public enlightenment, campaigns, workshops, seminars, community health talk-shows should be organized by government stakeholders, non-governmental organizations, community leaders on the prevention of IPV and its dare consequences for marital stability.

Keywords: Intimate partner violence (IPV); physical; psychological health consequences, married primary school teachers

Factors influencing use of contraceptives among literate married women in Ogbomoso South Local Government Area, Oyo State

Lateef Omotosho Adegboyega, Adeola Abideen Adewusi — Mon, 01 Apr 2024 00:00:00 +0000

Background: Contraceptives uses are issues of concern around the world due to the adverse effects of unsafe sexual behaviours, such as unwanted pregnancies and sexually transmitted diseases among women.
Objective: To investigate the factors influencing use of contraceptives among literate married women in Ogbomoso South Local Government Area, Oyo State. The study also examined whether the variables of age, religion and educational qualification would influence the respondent’s view.
Methods: Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 210 respondents. A questionnaire was used to collect data for the study. Mean and rank order was used to answer the research question while Analysis of Variance was used to test the hypotheses at 0.05 level of significance.
Results: Findings revealed that factors influencing contraceptive use among literate married women are educational qualification, health condition and number of children among others. Findings also revealed that there were no significant differences in the factors influencing use of contraceptives among literate married women based on age and religious affiliation while significant difference was found in educational qualification.
Conclusion: Majority of the respondents attested to the factors influencing contraceptive use among literate married women. Based on the findings of the study, it was recommended that contextual and cultural considerations are recommended for comprehensive understanding of factors influencing contraceptive use among Nigerian women, educative interventions by service providers on the necessity of continuous contraception even at older age before menopause should be recommended.

Keywords: Factors; use of contraceptives; literate married women.

Attitude to cervical cancer screening and human papillomavirus testing experience in self-sampled Nigerian women

Mon, 01 Apr 2024 00:00:00 +0000

Background: Cervical cancer is a disease of major public health significance which can be prevented by adequate screening.

Objective: This study assessed the level of cervical cancer knowledge, attitude to screening and human papillomavirus testing
experience in women who self-sampled for cervical cancer screening.

Methods: A descriptive cross-sectional study involving 790 women that had human papilloma virus (HPV) testing at the gynae-
oncology unit of the Lagos State University Teaching Hospital. Participants were assessed of their cervical cancer screening
knowledge, attitude and HPV testing experience. High risk HPV (hr-HPV) nucleic acid testing was funded by the Clinton Health
Access Initiative.

Results: Majority (76.71%) of the respondents exhibited a high level of knowledge of cervical cancer, its causes, risk factors and
prevention; and a positive experience with HPV self-sampling reported in 98.1%. hr-HPV positive rate was 13.4%. The most
common reason (43%) for not having a cervical screening done was lack of a doctor’s request. The most commonly known
method of cervical screening by the respondents was Pap Smear test (55.31%).

Conclusion: There is need for more education to improve the level of awareness and uptake of hr-HPV testing for cervical
cancer in Lagos. Health care providers are not offering cervical cancer screening enough and this needs to be explored more in
future studies.

Keywords: Cervical cancer; screening test; cancer screening.

Effect of occupational exposure to vat-textile dyes on follicular and luteal hormones in female dye workers in Abeokuta, Nigeria

Mon, 01 Apr 2024 00:00:00 +0000

Background: Some synthetic dyes used mainly in textile industries have been associated with endocrine disruption, resulting in
infertility, among other disorders. It is unknown if occupational exposure to Vat textile dyes among premenopausal dyers alters
hormonal levels.

Objectives: We aimed at determining the probable effects of occupational exposure to Vat dyes on reproductive hormones of
female textile dyers in the follicular and luteal phases while relating this to age categories and duration of exposure.

Methods: Thirty-three premenopausal Vat textile dyers at “Itoku”, Abeokuta, Nigeria, among a population of about 80 female
dyers were age and sex-matched with 55 non-exposed (control) female participants. Using semi-structured questionnaires, socio-
demographic, occupational details and the LMP of participants were obtained. Serum samples were collected in follicular
and luteal phases and assayed for female sex hormones using Enzyme Immunoassay. Mann-Whitney U and Z- statistic were used
for comparison of the two groups. P-value < 0.05 was considered to be significant.

Results: In the follicular phase, the result showed a lower mean FSH ranking (in age category ≤20 years) and higher (p<0.05)
Estradiol ranking (in age category 31-40 years) in the exposed than the unexposed. Mean ranks of Progesterone and Estradiol in
the luteal phase (age category 31-40 years) were higher (p<0.05) in the exposed, while Estradiol (age category ≥41years) ranked
lower (p<0.05). Prolactin demonstrated a significant inverse relationship with the duration of exposure.

Conclusion: Occupational exposure to Vat dye among female dyers in Abeokuta is associated with some sex hormone disruption
which appears to be age and duration of exposure-related.

Keywords: Follicular phase; luteal phase; dye workers; sex hormone; premenopausal.

The use of antenatal corticosteroids in preterm labour for the prevention of perinatal mortality in hospitals in Tanzania

Stanley Mwita — Mon, 01 Apr 2024 00:00:00 +0000

Background: Antenatal corticosteroids (ACS) are given to pregnant women at risk of preterm delivery to hasten the maturation of the lungs, lowering the risk of newborn respiratory distress syndrome (RDS) and perinatal mortality.

Objective: The aim of this study was to determine whether exposure to ACS was associated with lower rates of perinatal mortality and RDS in preterm infants delivered by women with preterm labour.

Methods: This is a secondary analysis of data from four hospitals in Mwanza, Tanzania. All singletons and twins born to women who were in preterm labour between July 2019 and February 2020 and delivered in-hospital between 24 and 34 weeks of gestation were included. Data were recorded from participants’ medical records and analysed using STATA Version 14.

Results: Over an eight-month period, 588 preterm infants were delivered to 527 women. One hundred and ninety (36.1%) women were given ACS. Infants who were exposed to ACS in utero had a lower rate of perinatal mortality (6.8% vs 19.1%) and RDS (12.3% vs 25.9%) compared to those not exposed to ACS. In adjusted multivariable models, ACS exposure was related to a lower risk of perinatal mortality, aRR 0.23 (95% CI 0.13 - 0.39), and RDS, aRR 0.45 (95% CI 0.30 - 0.68).

Conclusion: ACS significantly reduced the risk of perinatal mortality and RDS among preterm infants exposed to ACS in utero and delivered by women in preterm labour. The use of ACS should be encouraged in low-resource settings where preterm birth is prevalent to improve perinatal outcomes.

Keywords: Antenatal corticosteroids; preterm labour; perinatal mortality.

Women’s experience of preterm birth in an East African context: A qualitative study

Mon, 01 Apr 2024 00:00:00 +0000

Background: Approximately 15 million children are born each year prematurely, representing more than 10 percent of all childbirths worldwide. Prematurity is an acute event and the leading cause of death among newborns and children under five. Sixty percent of these premature deaths occur in Sub-Saharan Africa and Southeast Asia.

Objective: The current study aimed to explore and understand women’s experiences and perceptions regarding giving birth prematurely at the National Hospital of Muhimbili in Dar es Salaam, Tanzania.

Method: A qualitative method, using Interpretive Phenomenological Analysis approach was chosen to understand and describe the women’s experiences. A semi-structured guide was used during the interviews. All interviews were audio-recorded and transcribed verbatim.

Findings: Eight in-depth interviews were conducted. The analysis revealed three superordinate themes: (a) Emotional turmoil: unmet expectations shattering maternal identity, emotional distress, and loss of hope; (b) Adapting to preterm birth and challenges: the unexpected situation, lack of proper care, strenuous breastfeeding routines, and socioeconomic challenges; (c) Significance of proper care and emotional support: good maternal care, mother-to-mother and family support.

Conclusion: This study provided a deeper understanding of women’s experiences and perceptions of premature childbirth. The current study indicated the importance of caregivers’ awareness of the women’s emotional distress, their need to adapt to a sudden unexpected situation, and the necessity of emotional support.

Keywords: Preterm birth; maternal experiences; Tanzania; Global health.

Kenyan adults with type 2 diabetes mellitus (T2DM): Increase diabetic knowledge and self-efficacy and decrease hemoglobina1c levels post-educational program

Sabina Jeruto Bet, Jochebed Bosede Ade-Oshifogun — Mon, 08 Apr 2024 00:00:00 +0000

Introduction: Literature supports the relationship between increased diabetic knowledge and improved health outcomes among
individuals with Type II diabetes mellitus (T2DM). In Kenya, knowledge gaps within the at-risk population still exist about the
symptoms, complications, and management strategies of T2DM, making it challenging to achieve the required personal and
community health levels. The project’s objective was to determine whether a structured educational intervention for patients in
Eldoret, Kenya, would increase diabetic knowledge and self-efficacy and reduce HbA1c levels.

Method: We utilized an experimental study with a convenience sample of 143 participants systematically grouped into control
and experimental. The experimental group only received a structured educational intervention based on the health belief model.
Pre- and post-intervention data for diabetic knowledge, self-efficacy, and HbA1c were analyzed using the independent T and
ANOVA tests.

Results: We observed significant between-group differences for diabetic knowledge (t (116) = 7.22, p<0.001), self-efficacy t (96)
=5.323, p<0.001; and HbA1c level t (121) =-2.87, p = .003. We also observed significant within-group differences for diabetic
knowledge, t (12.6), p<0.001); self-efficacy t (5.32), p<.001); and HbA1c, t (4.4), p<0.001, in the experimental group only.

Conclusions: This study reveals the effect of a structured education intervention in increasing diabetic knowledge and self-efficacy
while reducing HbA1c levels in T2DM patients in Eldoret, Kenya.

Keywords: Education program; type 2 diabetes; Kenya.

Knowledge, attitudes and practices towards glycemic control among persons with diabetes mellitus at two tertiary hospitals in Uganda

Mon, 08 Apr 2024 00:00:00 +0000

Background: Intensive glycaemic control reduces the risk of microvascular complications in persons with diabetes mellitus
(DM). Owing to limited data available, we aimed to determine the knowledge, attitude, and practices (KAPs) toward glycaemic
control among Ugandans with DM at two large tertiary healthcare facilities.

Methods: A cross-sectional study was conducted among persons with DM attending outpatient clinics at Kiruddu National
Referral Hospital (KNRH) and Mulago National Specialized Hospital (MNSH) between March and April 2022. Eligible participants
provided written informed consent and were recruited through a systematic sampling technique and relevant data was
collected using a pretested, interviewer-administered, semi-structured questionnaire.

Results: Of the 452 participants, 318 (70.4%) were females. The median age was 52 years (IQR: 45-60 years), with more than
two-thirds diagnosed with DM at ≥36 years (69.8%, n=310). Overall, 274 participants (60.6%) had good knowledge on glycemic
control. At multivariable logistic regression analysis, good knowledge about glycaemic control was significantly associated with
having received training on glycaemic control (aOR: 2.3, 95% CI: 1.4 – 3.7, p=0.002), level of education: diploma (aOR: 4.3, 95%
CI: 1.1 – 17.8, p=0.042), degree aOR: 4.9, 95% CI: 1.0 – 23.1, p=0.046) compared to informal education, and nearest distance
from the health facility (aOR: 3.1, 95% CI: 1.0 – 9.6, p=0.047)

Conclusions: More than half of the patients had good knowledge about glycaemic control and this was associated with level
of education, distance from the health facility and having received training. Further studies assessing the correlations between
actual level of glycaemic control and patient related KAPs are recommended.

Keywords: Diabetes mellitus; glycemic control; HbA1C; KAPs.

Glycemic control and its associated factors among adult diabetic patients in Southern Ethiopia: a cross-sectional study

Mon, 08 Apr 2024 00:00:00 +0000

Background: Diabetes mellitus is a group of common metabolic disorders that share the phenotype of hyperglycemia. Chronic hyperglycemia causes vascular complications, mortality, and life-threatening disabilities in low-income countries including Ethiopia. Glycemic control status in diabetic patients is crucial to maintain the blood glucose level at the optimal level and to reduce the risk of diabetes-related complications and mortality. However, there is limited data on poor glycemic control status and its associated factors among diabetic patients in southern Ethiopia, particularly in the study area. Thus, this study aimed to determine glycemic control status and its associated factors using glycated hemoglobin among adult diabetic patients at Nigist Elleni Mohammad Memorial Referral Hospital, Hossana, southern Ethiopia.

Materials and methods: A facility-based cross-sectional study was conducted from May 1 to June 30, 2020. A systematic random sampling technique was used to recruit 307 diabetic patients at follow-up. Interviewer administered questionnaire was used to collect data on sociodemographic, clinical, and behavioral characteristics. Five milliliters of venous blood samples were collected to determine lipid profiles and hemoglobin A1C. Lipid profiles and hemoglobin A1C were measured by Cobas c311 analyzer. The data were analyzed by SPSS version 20.
Bivariable and multivariable logistic regression were used to determine associated factors with poor glycemic control status. P-value <0.05 was considered statistically significant.

Result: The overall prevalence of poor glycemic control among the study participants based on hemoglobin A1C ≥7% was 82.4%. Having a history of diabetic complications (AOR: 7.09, 95%CI: 1.72-29.16), duration of diabetes ≥7 years (AOR: 4.09, 95%CI: 1.38-12.08), insulin and oral hypoglycemic agents (AOR: 0.106 95%CI: 0.02-0.44), lack of self-glucose monitoring (AOR: 8.27, 95%CI: 1.61-42.46), lack of physical exercise (AOR: 5.5, 95%CI: 1.6-18.9) and dyslipidemia (AOR: 2.74, 95%CI: 1.12-6.66) were significantly associated with poor glycemic control.

Conclusion: A high prevalence of poor glycemic control status (82.4%) was observed among diabetic patients in this study area, and disease-related factors like duration of diabetes, complication, treatment type and lack of self-glucose monitoring, physical exercise, and dyslipidemia were identified as factors significantly associated with poor glycemic control status. The finding of the current study should be taken into account to conduct a strategic and timely intervention on significantly associated factors to delay diabetic complications and to improve the health outcome of diabetic patients. Routine screening and monitoring of dyslipidemia and providing health education on behavioral factors were the necessary measures that should be conducted to reduce the burden of poor glycemic control status among diabetic patients.

Keywords: Diabetes mellitus; Glycemic control; Glycated hemoglobin; Hossana; Ethiopia.

The distribution of esophageal cancer patients enrolled in care at the Uganda Cancer Institute by sub-regions, districts and ethnicity

Mon, 08 Apr 2024 00:00:00 +0000

Background: There is limited published data regarding the distribution of esophageal cancer patients by sub-regions, districts
and ethnicity in Uganda.

Objectives: To study the distribution by sub-regions, districts, ethnicity and sub-regions post-care outcomes of esophageal
cancer patients in care over ten years at the Uganda Cancer Institute.

Methods: Patients’ charts with confirmed diagnoses of esophageal cancer for 2009-2019 were identified. Case information,
which included demographics, clinical presentation, distribution by sub-regions, districts, ethnicity and sub-regions post-care
outcomes, were retrospectively abstracted.

Results: Central 671(34.15%), Southwestern 308(15.67%), Elgon 176(8.95%) and East central 163(8.29%) sub-regions had most
patients. Mostly from administrative districts of Wakiso 167(8.50%), Mbarara 51(2.59%), Tororo 53(2.70%), Busia 33(1.68). Baganda,
Banyakole, Bagisu and Basoga ethnic groups predominate. Patients from neighbouring countries were mainly from Rwanda
56(2.85%), South Sudan 24(1.22%), then Kenya 21(1.07%), and Rwandese, Dinka and Luo by ethnicity, respectively. Central
and Southwestern sub-regions had the most post-care outcomes of the patients regarding living, death, and loss to follow-up.

Conclusion: Patients are commonly from the administrative districts of Central, Southwestern, Elgon and East Central sub-regions
and neighbouring countries of Rwanda, South Sudan and Kenya. Baganda, Banyakole, Bagisu and Basoga are the main
ethnic groups. Central and Southwestern sub-regions are with most post-care outcomes.

Keywords: Esophageal cancer; sub-regions; districts; ethnicity; Uganda.

Trazodone-induced parkinsonism in a middle-aged male: A case report

Mon, 08 Apr 2024 00:00:00 +0000

Introduction: Trazodone is an antidepressant agent approved for treating major depressive disorders and is also prescribed for
insomnia due to its sedative effect. In a few cases, trazodone was associated with parkinsonism. Herein, we describe a case of
parkinsonism after a brief exposure to a moderate dose of trazodone.

Objective: To describe a case of a patient with trazodone-induced parkinsonism in which the diagnosis was suspected after the
exclusion of other common and serious causes.

Methods: A case report of trazodone-induced parkinsonism.

Clinical Case: A 58-year-old male with sleeping problems was prescribed trazodone 50 mg daily at bedtime. The subject doubled
the dosage without medical advice a week later. After 14 days of trazodone treatment, he started to experience difficulty in
moving his upper limbs and recurrent falling. Neuroimaging, electrodiagnostic studies, and laboratory exams were unremarkable.
Trazodone was discontinued, and the patient fully recovered. Noteworthy, the patient developed a recurrence of the motor
symptoms with trazodone-rechallenge.

Conclusion: Our case showed reversibly induced parkinsonism after a short intake of a moderate dose of trazodone which was
prescribed for insomnia. The patient had a complete recovery after trazodone withdrawal. Noteworthy, the symptoms recurred
upon trazodone-rechallenge.

Keywords: Trazodone; triazolopyridine; parkinsonism; movement disorder; drug-induced.

Trends in childhood intussusception in a Nigerian tertiary hospital

Mon, 08 Apr 2024 00:00:00 +0000

Background: Early presentation, high rate of successful non-operative treatment, low morbidity and mortality in childhood intussusception is common in High and Upper Middle-Income Countries but not in many Lower middle- and Low-income countries.

Aim: To assess the trends in the profile, treatment modalities and outcomes of intussusception in our hospital.

Materials and methods: Retrospective study over a 12-year period divided into two 6-year periods. Data entry/analysis was done using SPSS and various indices were compared between these two periods. Two-tailed t-test for two independent means was used to compare means while two-tailed Fisher exact tests were used to compare categorical variables. Results were presented as tables, means, ranges, percentages and a p-value less than 0.05 was deemed statistically significant.

Results: There was a significant increase in the proportion of successful non-operative treatment (18.6% vs 34%, p=0.03), reduction in the incidence of operative manual reduction (27.1% vs 12.8%; p=0.026), reduction in operative treatment (78.5% vs 63.9%, p=0.034), increased utilization of pre-intervention ultrasound (75% vs96.7%, p<0.0001) and reduction in hospital stay duration (10.47 ±7.95days vs 7.24±4.86 days; p=0.004).

Conclusions: Contribution of successful non-operative treatment to the overall treatment of intussusception significantly increased while that of operative manual reduction significantly reduced and bowel resection showed no change. Preoperative utilization of ultrasonography significantly increased while mean duration of admission reduced significantly, but late presentation, morbidity and mortality rates had no significant changes.

Keywords: Trends; childhood; intussusception; Nigerian; tertiary hospital.

Curosurf surfactant application on preterm babies with respiratory complications-health-economic benefits

Mon, 08 Apr 2024 00:00:00 +0000

Background: The implementation of surfactant for respiratory syndrome approbates the therapy as a revolutionary method in
intensive neonatal therapy and respiratory resuscitation. It is important to investigate the costs of this treatment.

Objective: The aim of the study is to analyze the data by the application of the surfactant Curosurf to preterm babies with
respiratory complications and describe the treatment costs, healthcare resource utilization and evaluate economic benefits of
surfactant use in the treatment of neonates with respiratory distress syndrome (RDS) and hyaline-membrane disease (HDM).

Methods: A retrospective survey was performed covering 167 babies based on respiratory complications due to preterm birth
and the necessity to apply a surfactant therapy. A documentary method was implemented and for each patient, an individual
research protocol was filled out - a questionnaire created specifically for the purposes of the study.

Results and discussion: An analysis of the data from the application of CUROSURF was made and the obtained therapeutic
results were compared to expenditures for the therapy, short-term therapeutic effect, benefits and consequences of the therapy
of preterm newborns with respiratory complications. The application of CUROSURF to babies with RDS resulted in the realization
of net savings due to the elimination of the necessity of conducting several diagnostic and therapeutic procedures as well
as their duration reduction of hospital stay, thus defining its health-economic benefits.

Conclusions: The models of evaluation of cost effectiveness reveal that the medicinal product is expensive but effective from
the aspect of short-term therapeutic results.

Keywords: Surfactant; CUROSURF; preterm babies; respiratory complications; health-economic benefits.

Newborn and infant hearing screening for early detection of hearing loss in Nairobi, Kenya

Mon, 08 Apr 2024 00:00:00 +0000

Background: Early detection of hearing loss and subsequent intervention leads to better speech, language
and educational outcomes giving way to improved social economic prospects in adult life. This can be achieved through establishing newborn and infant hearing screening programs.

Objective: To determine the prevalence of hearing loss in newborns and infants in Nairobi, Kenya.

Methods: A cross-sectional pilot study was conducted at the National hospital and at a sub county hospital immunization clinic. A total of 9,963 babies aged 0-3 years, were enrolled in the hearing screening program through convenient sampling over a period of nine months. A case history was administered followed by Distortion Product Oto-acoustic emissions (DPOAEs) and automated auditory brainstem response (AABR) hearing screening.

Results: The screening coverage rate was 98.6% (9963/10,104). The referral rate for the initial screen was 3.6% (356/ 9,963), the return rate for follow-up rescreening was 72% (258 babies out of 356) with a lost to follow-up rate of 28% (98/356). The referral rate of the second screen was 10% (26/258). All the 26 babies referred from the second screen returned for diagnostic hearing evaluation and were confirmed with hearing loss, yielding a prevalence of 3/1000.

Conclusions: Establishing universal newborn and infant hearing screening programs is essential for early detection and intervention for hearing loss. Data management and efficient follow-up systems are an integral part of achieving diagnostic confirmation of hearing loss and early intervention.

Keywords: Hearing screening; newborn; infant; hearing loss; early detection; Kenya.

Nutritional status of school children in South-West Nigeria: Inferences from a national homegrown school feeding programme

Mon, 08 Apr 2024 00:00:00 +0000

Background: The School Feeding Programme if properly executed has the capacity to improve the nutritional status of the
school children.

Objective: To assess the nutritional status of school children in Ondo State Nigeria given that the National Home-Grown
School Feeding Programme (NHGSFP) has been operational in the state for over five years.

Methods: This was a descriptive cross-sectional study.

Results: A total of 234 subjects from public schools and 227 subjects from private schools were enrolled in the study. Their
mean age was 8.23 ± 1.92 years. Wasting, overweight, obesity, underweight, and stunting were noted in 19.4%, 11.4%, 0.4%,
5.0%, and 20.7% of the children, respectively. The prevalence of stunting (30.3%) and wasting (23.9%) was more among subjects
from the public schools. A significant association was found between Weight-for-Age Z-score, Height-for-Age Z-score, and
BMI-for-Age Z-score and the children’s school type (p < 0.005).

Conclusion: Majority of the children showed normal growth, the rest were in both extremes of malnutrition, the subjects from
private schools seem to present better nutritional status, although there is no baseline data to ratify this finding. A further study
on this subject using the current finding as a baseline data is recommended.

Keywords: School children; Nutritional assessment; Stunting; Underweight; Wasting; School feeding programme.

Knowledge, attitude and practices towards oral health among secondary school students in Huye district, Rwanda

John Bayingana M, Geofrey Shyaka, Japheths Ogendi — Mon, 08 Apr 2024 00:00:00 +0000

Background: Good oral health knowledge is considered to be crucial for health-related practices and better oral hygiene.

Objective: This study was aimed to assess knowledge, attitudes and practices towards oral health among secondary student in
Huye district.

Methods: A cross-sectional survey was conducted with 386 students from public secondary schools with advanced level. Boarding
secondary schools were excluded. Stratified Clustering sampling technique was used for selecting study participants. A closed
ended questionnaire was used for collecting data. Results were found on the basis of percentage and frequency using SPSS 21.0
version.

Results: The majority of participants, 222 (57.5%) were female and 164 (42.5%) were male. The majority of the participants,
168 (43.5%) were between 15-17 years old. Out of the total population of students 1.8% had good knowledge, 56.2% had
average knowledge and 42% had poor knowledge about oral health. Moreover, 56.2% had negative and 43.8% had positive oral
health attitudes and overall practice towards oral hygiene of students showed that 74.6 % had poor practice and 24.4% had good
practices.

Conclusion: Oral hygiene has to be long life practice and oral health education have to be included as part of the school environment.

Keywords: Knowledge; attitudes; practice; oral health.

Exploring patient referral practices of traditional healthcare practitioners in Soshanguve, Gauteng Province, South Africa

Eugene Musiiwa Makhavhu, Mmajapi Elizabeth Masala-Chokwe, Tendani Sara Ramukumba — Mon, 08 Apr 2024 00:00:00 +0000

Introduction: It may be necessary for healthcare professionals to refer patients to other professionals and institutions that are
able to provide the care needed by patients, depending on the severity each case presents, healthcare requirements, and resources
available to offer care. In healthcare generally, patient referral is standard procedure; however, in South Africa, referral patterns
between allopathic and traditional healthcare practitioners are unknown, and this is a problem yet to be addressed.

Objectives: The study objective was to explore patient referral practices from the perspectives of traditional healthcare practitioners
of South Africa.

Methods: A qualitative, exploratory and descriptive design was employed to collect data from 11 traditional healthcare practitioners
who were sampled using snowball sampling. An individual semi structured interview schedule was used to collect data.
Content analysis was used to analyze the data.

Results: Patient referral was common practice in traditional health practices, however not reciprocal between the traditional
and allopathic healthcare. Several indications for patient referral to allopathic healthcare practitioners included management of
chronic conditions amongst others.

Discussion: Patient referral being an important part of healthcare practices should be promoted and regulation and traditional
health practices improved to promote safe referral practices and curb unsafe self-referrals by patients.

Keywords: Referral system; patient referral; traditional healthcare; allopathic healthcare.

Elderly people’s perceptions on the use of mobile phones to support the self-management of long-term illnesses at Kiruddu National Referral Hospital

Peterson Mulinde — Mon, 08 Apr 2024 00:00:00 +0000

Introduction: The global estimate of the aging population is progressively increasing in low and middle-income countries and this is accompanied by the limitations associated with the need for equitable and efficient healthcare delivery among this dire population. Unfortunately, despite the increasing numbers, the adoption of mobile phones is not balanced in the different populations with research showing young persons’ adoption rate is higher than that of elderly persons.

Objective: This current study was conducted to identify elderly people’s perceptions of the use of mobile phones to support the self-management of long-term illnesses at Kiruddu National Referral Hospital.

Methods: This descriptive-cross-sectional design study was conducted on a sample population of 30 elderly individuals older than 60 years admitted at the outpatient department of Kiruddu National Referral Hospital, Kampala, Uganda. We conducted face-to-face interviews following an interview guide and one focus group discussion. We later used a feature mobile phone and a tablet mobile phone to assess the individual ease of use of each device. The audio recordings were professionally transcribed and transcripts were coded into NVIVO version 12 analysis software for thematic analysis

Results: Almost all of the respondents who visited the facility had an ailment that hindered their full utilization of the mobile phone to support their self-care. This together with other factors like financial constraints, lack of support from the health workers on how to use mobile phones to support health, inadequate support from the facility, and cost of mobile data among others.

Background and Conclusion: This study provides empirical evidence that there is hardly a known mobile phone adoption model to enable policymakers, systems developers, and health workers to promote the elderly population’s use of mobile phones to manage their long-term illnesses in Uganda.

Keywords: Healthcare technology; older persons; mobile phone.

Use of mobile hospitals to improve access to health services and promote primary health care: lessons from Zambia (2011-2018)

Kabaso Kabwe — Mon, 08 Apr 2024 00:00:00 +0000

Background: Mobile hospitals play a critical role in serving difficult to access populations. In 2011, they were introduced by
the Zambian government to improve access to health care. However, little is known about and/or documented about their use
in Zambia, and other similar settings where people rely on them to access critical health care, or have to travel long distances to
the nearest health centre.

Objective: To understand the use of mobile hospitals in Zambia and share lessons on their implementation that may be useful
for similar settings. It describes their design, implementation, and challenges.

Methods: The qualitative research employed document review, key informant interviews with 15 respondents, and observation
of the operations of the mobile hospitals in the field.

Results: The research finds that while they help to reduce inequities associated with accessing health services, there needs to be
careful resource planning and addressing of the major issues in health care such as human resources, infrastructure, and disease
prevention before long term use.

Conclusion: The research not only highlights conditions that must be considered for the effective implementation of mobile
hospitals, but also the need for engagement of various key stakeholders during agenda setting in order to build trust and buy in,
which contribute to smoother implementation.

Keywords: Access to health care; mobile health; policy implementation; primary health care; Zambia.

Deodorant use and related adverse effects: a cross-sectional survey among Palestinian students

Iyad Ali, Naser Shraim, Anwar Younes, Reem Sawafta, Asma Sbeih, Samar Khater — Mon, 08 Apr 2024 00:00:00 +0000

Background: Deodorants are widely used to mask unpleasant body odors. They are reported to cause some adverse effects
depending on the form and ingredients. The purpose of this study was to assess the prevalence of deodorant use and related
adverse effects among Palestinian students.

Methods: This cross-sectional study was carried out at An-Najah National University from Aug 2018 to Mar 2020. A questionnaire
was constructed using a Google survey form. All analyses were done using SPSS 21.0, Fisher test was used for comparative
analysis and the P-value < 0.05 was considered as statistically significant.

Results: A total of 554 students participated in the study. About 93% of the participants were using deodorants and adverse
effects were reported by 25% of the participants. The reported adverse effects were itching (26%), coloration (25%), sneezing
(21%), and eye redness (8%). Only 4.1% of the participants visited a physician for counselling regarding various adverse effects.

Conclusion: Deodorants were widely used by Palestinian students with reported adverse effects, but these side effects rarely
prompted the participants to seek medical advice.

Keywords: Deodorants; antiperspirants; adverse effects; skin; students; physician consultation.

The cytotoxic, genotoxic and mitotoxic effects of Atractylis gummifera extract in vitro

Awatif Boumaza, Ali Ergüç, Hilmi Orhan — Mon, 08 Apr 2024 00:00:00 +0000

Background: The Mediterranean thistle Atractylis gummifera L. (Asteraceae; AG) has diterpenoid glucosides; atractyloside and
carboxyatractyloside that interact with mitochondrial protein adenine nucleotide translocator (ANT) and resulted in ATP inhibition.
Despite its well-known toxicity, acute poisonings still occur with this plant. Although most symptoms are attributed to
ANT and diterpenoids interaction, in-depth investigation of the effects of AG extract on various cellular processes has not been
performed.

Objective/method: We tested in vitro induction of mitochondrial permeability transition pore (MPTP) opening in bovine liver
mitochondria and evaluated its cytotoxicity and genotoxicity using Allium cepa test. Cell division, mitotic index (MI) and total
chromosomal and mitotic aberrations (TAs), that all seem potentially affected by ATP shortage, were studied in root cells of
Allium cepa exposed to Atractylis gummifera extract.

Results: With the two different doses of two purified AG fractions, stronger induction of MPTP was observed compared to
the induction with the standard pure atracyloside. Aqueous AG extract exerted inhibition root growth in A. cepa at 6 different
doses. The TAs was increased in a dose-dependent manner too, while mitotic index was decreased at the same doses. Evaluation
of mitotic phases revealed mitodepressive effect of AG on A. cepa roots.

Conclusion: This work highlights cellular and mitochondrial adverse effects of Atractylis gummifera extracts. A purified fraction
that likely corresponds to ATR derivatives induces MPTP opening leading to swelling of mitochondria and its dysfunction. Allium
cepa test provides the evidence for A. gummifera genotoxicity and cytotoxicity.

Keywords: Atractylis gummifera; Allium cepa test; mitochondrial permeability transition pore; genotoxicity; cytotoxicity; chromosomal
aberration; mitotic index.

The frequencies distribution of CYP3A5 rs776746 and ABCB1 rs1045642 polymorphisms in the west Algerian population and relationships with pharmacogenetics

Mon, 08 Apr 2024 00:00:00 +0000

Introduction: Pharmacogenetic markers, such as the ATP Binding Cassette (ABCB1) and cytochrome P450 (CYP) 3A5 enzymes,
play a crucial role in personalized medicine by influencing drug efficacy and toxicity based on individuals' or populations'
genetic variations.
This study aims to investigate the genetic polymorphisms of CYP3A5 (rs776746) and ABCB1 (rs1045642) in the West Algerian
population and compare the genotypes and allelic distributions with those of various ethnic groups.

Methods: The study involved 472 unrelated healthy subjects from the Western Algerian population. DNA genotyping was
performed using TaqMan allelic discrimination assay. The variants in our population were compared to those in other ethnic
groups available in the 1000 Genomes Project. Genotype and allele frequencies were calculated using the chi-square test and the
Hardy–Weinberg equilibrium (HWE)

Results: The minor allele frequencies were found to be 0.21 for CYP3A5 6986A and 0.34 for ABCB1 3435T. These frequencies
were similar to those observed in North African populations, while notable differences were observed in comparison to certain
Caucasian and African populations.

Conclusion: The difference in the allelic and genotypic distribution of these polymorphisms emphasize the need for dose adjustments
in drugs metabolized by CYP3A5 and transported by ABCB1 to optimize treatments outcomes.

Keywords: CYP3A5; ABCB1; genetic polymorphism; pharmacogenetics; West Algeria.