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(see <a href=""></a>)</p> (Dr James Tumwine) (Pauline Salamula) Tue, 03 Aug 2021 17:11:20 +0000 OJS 60 Editorial: Infectious diseases and NCDs persist despite concerted effort <p>Nil.</p> James K Tumwine Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Co-existence of NDM-1 and OXA-48 genes in Carbapenem Resistant Klebsiella pneumoniae clinical isolates in Kafrelsheikh, Egypt <p><strong>Background:</strong> The noteworthy spread of carbapenem-resistant <em>K. pneumoniae</em> (CR-KP) isolates represents a significant safety threat.</p> <p><strong> Objective:</strong> Determination of the carbapenemase genes incidence among CR-KP clinical isolates in Kafrelsheikh, Egypt.</p> <p><strong>Methods:</strong> A total of 230 <em>K. pneumoniae</em> isolates were recovered from four hospitals in Kafrelsheikh, Egypt. Susceptibility testing was conducted using Kirby-Bauer method and automated-Vitek2 system. CR-KP isolates were tested using modified Hodge test (MHT) and combined disk synergy test. PCR and DNA sequencing were conducted for CR-KP isolates to rec- ognize the included carbapenemase-genes.</p> <p><strong>Results:</strong> Out of 230 <em>K. pneumoniae</em> isolates, 50 isolates presented resistance to carbapenem (meropenem). All 50 CR-KP iso- lates were multidrug-resistant (MDR). Genes like blaNDM-1 and blaOXA-48 were the only detected genes among CR-KP with an incidence of 70.0% and 52.0%, respectively. Up to 74.0% of the tested isolates carried at least one of the two record- ed genes, among them 48.0% co-harbored both blaNDM-1 and blaOXA-48 genes. The accession-numbers of sequenced blaNDM-1 and blaOXA-48 genes were MG594615 and MG594616, respectively.</p> <p><strong>Conclusion:</strong> This study reported a high incidence of MDR profile with the emergence of blaNDM-1 and blaOXA-48 genes co-existence in CR-KP isolates in Kafrelsheikh, Egypt. Hence, more restrictions should be applied against the spread of such serious pathogens.</p> <p><strong>Keywords:</strong> <em>Klebsiella pneumoniae</em>; Egypt; carbapenem resistance; MDR; PCR; blaNDM-1; blaOXA-48; sequencing.&nbsp;</p> Ramadan Ahmed El-Domany, Tarek El-Banna, Fatma Sonbol, Samar Hamed Abu-Sayedahmed Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Phenotypic and genotypic detection of extended spectrum β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections <p><strong>Background:</strong> T2DM patients are more likely to have UTIs caused by resistant organisms such as ESBLs producing bacteria. Challenging reliable identification and prompt characterization of in-vitro susceptibilities of these bacteria are the first steps of deciding the appropriate antimicrobial therapy for UTIs caused by them.</p> <p><strong>Objectives:</strong> To isolate and identify <em>E. coli</em> and <em>K. pneumoniae</em> from urine of T2DM patients with UTIs, to determine antibiotic resistance pattern among isolates, and to identify ESBLs production phenotypically and genotypically.</p> <p><strong>Material and method:</strong> All samples were cultured on Cystine-Lactose-Electrolyte-Deficient Agar medium (CLED) by using calibrated loop. Growth of 100 colonies or more, i.e. 105 colony forming units (CFU)/mL urine was considered as signifi- cant bacteriuria. Isolation and identification were done according to standard method. All isolates were tested for antibiotic susceptibility testing by the disc diffusion method according to CLSI guidelines. Phenotypic detection of ESBLs was done by double-disk synergy test. Genotypic detection of blaTEM, blaSHV and blaCTX-M genes by using PCR.</p> <p><strong>Results:</strong> Results of this study showed that <em>E. coli</em> and <em>K. pneumoniae</em> were the dominant bacterial isolates, they constituted 103 (91.2%) out of 113 urine isolates. <em>E. coli</em> (58. 4%) <em>K. pneumoniae</em> (32.7%), <em>Enterococcus spp</em>. (4.4%), <em>Proteus spp</em>. (2.7%) and <em>Pseu- domonas spp</em>. (1.8%). About 25 (24.3%) out of 103 <em>E. coli</em> and <em>K. pneumoniae</em> isolates were ESBLs positive by DDST, and 22 (88.0%) out of them had ESBLs encoding genes by conventional PCR. The most common gene detected was blaTEM (59.1%), followed by blaSHV (27.3%). CTX-M had not been detected in any of testes isolates.</p> <p><strong>Conclusion:</strong> blaTEM and blaSHV genes were detected in 22 out of 25 ESBLs producing <em>E. coli</em> and <em>K. pneumoniae</em> isolates phenotypically detected by DDST. blaTEM was found to be the predominant gene (59.1%), while blaCTX-Mene was not detected in any of tested isolates.</p> <p><strong>Keywords:</strong> Extended Spectrum β-Lactamases; Type 2 diabetes mellitus; Urinary tract infections; Phenotypic; genotypic methods.</p> Souad Youssouf Kani Elmi, Medhat Saber Ashour, Fathy Zakaria Alsewy, Nashwa Fawzy Abd El Moez Azzam Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prevalence and antimicrobial susceptibility of extended-spectrum beta lactamases-producing Escherichia coli and Klebsiella pneumoniae isolated in selected hospitals of Anyigba, Nigeria <p><strong>Background:</strong> <em>Escherichia coli</em> and <em>Klebsiella pneumoniae</em> are commonly implicated in urinary tract infections accounting for majority of the antimicrobial resistance encountered in hospitals.</p> <p><strong>Objectives:</strong> To determine the prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamases (ESBLs) producing <em>E. coli</em> and <em>K. pneumoniae</em> among patients in Anyigba, Nigeria.</p> <p><strong>Methods:</strong> This hospital-based cross-sectional study was conducted using urine samples from 200 patients of Grimmard Catholic hospital and Maria Goretti hospital. Urine samples were processed to identify ESBL-producing <em>E. coli</em> and <em>K. pneu- moniae</em> using standard microbiological techniques. Isolates were then tested against antimicrobial agents.</p> <p><strong>Results:</strong> A total of 156 bacterial isolates were recovered consisting 128 of <em>E. coli</em> and 28 of <em>K. pneumoniae</em>. Extended spec- trum beta-lactamases production was observed in 69% of <em>E. coli</em> and 31% of <em>K. pneumoniae</em>. These pathogens were resistant to 3 or more antibiotics. Of the antimicrobials tested, cefotaxime demonstrated the highest rates of resistance (100%) for both ESBL-producing <em>E. coli</em> and <em>K. pneumoniae</em>. Fifty-four isolates of ESBL-producing <em>E. coli</em> showed a high level of resist- ance to amoxicillin clavulanic acid (83.3%), ciprofloxacin (83.3%), and ceftazidime (79.6%). ESBL-positive <em>K. pneumoniae</em> iso- lates were highly resistant to ciprofloxacin (75%), and amoxicillin clavulanic acid (83.3%). Cefoxitin (62.5%) and gentamicin (66.7%) showed substantially higher rates of resistance against these isolates while all 24 strains were resistant to imipenem.</p> <p><strong>Conclusion:</strong> This study indicated the prevalence of ESBL-positive Gram-negative pathogens in these study sites and also demonstrated their resistance to a few antibiotics. This highlights the need for new antimicrobials that are potent and im- proved policy on use of antibiotics.</p> <p><strong>Keywords:</strong> Antibiotic resistance; ESBLs; <em>Escherichia coli</em>; <em>Klebsiella pneumoniae</em>; Anyigba.</p> Kehinde C Mofolorunsho, Hannah O Ocheni, Ruth F Aminu, Cornelius A Omatola, Olabisi O Olowonibi Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Bacterial profile and their antimicrobial susceptibility patterns in patients admitted at MaddaWalabu University Goba Referral Hospital, Ethiopia: a cross sectional study <p><strong>Background:</strong> Hospital acquired infections (HAIs) are one of the global concerns in resource limited settings. The aim of the study was to determine bacteria profile and their antimicrobial susceptibility patterns among patients admitted at surgical and medical wards.</p> <p><strong>Methods:</strong> A hospital based cross-sectional study was conducted from November 2016 to July 2017 in MaddaWalabu Uni- versity Goba Referral Hospital. Urine and wound swabs were processed and standard disk diffusion test was done to assess susceptibility pattern. Association among variables was determined by Chi-square test.</p> <p><strong>Results:</strong> Among 207 patients enrolled, 24.6% developed HAI, of which, 62.7% and 37.3% were from surgical and medical wards, respectively. The male to female ratio was 1.5:1. The age ranged from 19 to 74 years with a mean of 41.65(±16.48) years. A total 62 bacteria were isolated in which majority of the isolates were gram negative bacteria. Most isolates were re- sistance to most of the antibiotics tested but sensitive to Ceftriaxone, Norfloxacin and Ciprofloxacin.</p> <p><strong>Conclusion:</strong> Due to the presence of high level drug resistant bacteria, empirical treatment to HAI may not be effective. Therefore, treatment should be based on the result of culture and sensitivity.</p> <p><strong>Keywords:</strong> Antimicrobial susceptibility patterns; bacterial profile; hospital acquired infections.</p> Meseret Mitiku Gemechu, Tesfaye Assefa Tadesse, Getahun Negash Takele, Fithamlak Solomon Bisetegn, Yonas Alem Gesese, Tizazu Zenebe Zelelie Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Brucellosis and its associated risk factors to humans and domestic ruminants in Kagera Ecosystem, Tanzania <p>Background: Brucellosis is an important disease for both veterinary and public health. A study was conducted to under- stand the seroprevalence of brucellosis and its associated risk factors in pastoral areas of Kagera, Tanzania. Methods: Sera from 156 patients with malaria-like symptoms were analyzed using the commercial rapid agglutination test (specific for B.abortus and B.melitensis detection) and Fluorescence Polarization Assay (FPA). Sera from 426 cattle, 206 goats and 197 sheep were analyzed using Rose Bengal Plate (RBPT) and Competitive ELISA (c-ELISA) tests. Results: In humans, overall brucellosis, B. abortus, and B. melitensis sero-prevalences were 7.7% (95%CI: 3.8-12.2%), 1.9% (95% CI: 0.4-4.5%), and 5.8 % (95%CI: 2.6-10.6%), respectively. At animal level, seropositivity was 5.9% (95%CI: 4.0-8.6%), 2.5% (95%CI: 0.8-5.7%) and 0.5% (95%CI: 0.01-2.8%) in cattle, goats and sheep, respectively. At herd level, seropositivity was 18.2% (95%CI: 12.0-25.8%) in cattle and 6.9% (95%CI: 2.2-15.3%) in small ruminants. Brucellosis was associated with assisting in parturition without wearing protective gears (OR= 5.6; p= 0.02) in humans, herds of 50-200 animals (OR= 4.2, p= 0.01) and cattle (OR=3.5; p=0.01). The knowledge of brucellosis among pastoralists (OR=0.1; p&lt;0.01) was a protective factor. Conclusion: Brucella infections could be occurring in pastoralists and domestic ruminants in Kagera. Community health education is necessary for the control of brucellosis in Tanzania.</p> <p><strong>Keywords:</strong> Brucellosis; pastoralists; risk factors; Tanzania.</p> Jean Bosco Ntirandekura, Lucas Eliaimringi Matemba, Sharadhuli Iddi Kimera, John Bwayla Muma, Esron Daniel Karimuribo Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Bacterial vaginosis, the leading cause of genital discharge among women presenting with vaginal infection in Dar es Salaam, Tanzania <p><strong>Background:</strong> Pathological vaginal discharge is a common complaint of women in reproductive age worldwide caused by various agents. The prevalence and etiologic agents vary depending on the population studied. Management of vaginal discharge in low-income countries, typically depend on the syndromic approach, which limits understanding the specific causative agents. We determined the proportion of bacterial vaginosis, candidiasis, and trichomoniasis among women with vaginal discharge at a regional referral hospital in Dar es Salaam, Tanzania.</p> <p><strong>Methods:</strong> We conducted a cross-sectional study between June and August of 2017 among nonpregnant women at Amana Regional Referral Hospital. Experienced staff performed physical examination to establish a clinical diagnosis, and collection of the high vaginal swab for microscopic examination. Descriptive statistics were performed to assess the characteristics of study participants and the proportion of vaginal infections.</p> <p><strong>Results:</strong> A total of 196 samples were collected, of all, 128 (65.3%) had either bacterial vaginosis, candidiasis, or trichomo- niasis. Bacterial vaginosis was the leading infection at 33.2%, followed by candidiasis (19.4%) and trichomoniasis (13.3%). Laboratory confirmed vaginal infection were generally found more in age below 25, unmarried, and those employed or petty business.</p> <p><strong>Conclusion:</strong> The proportion of bacterial vaginosis in women with vaginal discharge was relatively higher than others, and the presence of vaginal infection relate to socio-demographic characteristics. Further advanced studies are needed to understand the potential role of aetiologic agents in causing vaginal infections.</p> <p><strong>Keywords:</strong> Bacterial vaginosis; vaginal discharge; genital infection.</p> Mtebe V Majigo, Paschal Kashindye, Zachariah Mtulo, Agricola Joachim Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Application of Integrated Behavioral Model (IBM) to measure intention to get early screening and treatment of Sexually Transmitted Infections (STIs) among HIV at- risk sub-populations in Ethiopia <p><strong>Background:</strong> Sexually Transmitted Infections (STIs) increase the risk of contracting Human Immunodeficiency Virus (HIV). Hence, early screening and treatment of STIs as a behavioral practice will reduce the odds of HIV infection among at risk and vulnerable sub-populations. To that end, HIV prevention strategies need to design evidence-based interventions using behavioral models or theories to help at-risk individuals adopt early screening and treatment of STI as preventive health behavior. In this study, commercial sex workers were considered as HIV at-risk sub-populations.</p> <p><strong>Objective:</strong> Measuring to what extent that Integrated Behavioral Model constructs explain individuals’ intention to practice early screening and treatment of sexually transmitted infections as healthy behavior of interest in HIV prevention.</p> <p><strong>Design:</strong> Integrated Behavioral Model (IBM) measurement survey was conducted using Respondent Driven Sampling (RDS) in six towns located in the main transport corridors of Ethiopia. Respondents’ answers to model construct-based questions and intention to practice the health behavior of interest were measured using Likert Scale. Analysis was done to assess the correlation and level of association of model construct-based questions with intention to practice the preventive health behavior.</p> <p><strong>Results:</strong> Respondents’ attitude explained 32%, perceived control 2%, normative influence 21%, and self-efficacy 53 % of their intention to get early screening and treatment of sexually transmitted infections.</p> <p><strong>Conclusion:</strong> Self-efficacy explained the variability of respondents’ intention to get early screening and treatment of STIs most, while perceived control was the least. Hence, HIV prevention behavioral interventions targeting early screening and treatment of STIs should give high emphasis to self-efficacy.</p> <p><strong>Keywords:</strong> Behavior; integrated behavioral model; sexually transmitted infections; human immunodeficiency virus.</p> Wondwossen Asefa Alemayehu, Jeanitte Maritz, Lizeth Roets Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Exploring unsafe sexual practices among truck drivers at Meerut District, India: a cross-sectional study <p>Background: Despite implementation of HIV prevention programmes for truck drivers in India, unsafe sex behavior among truck drivers has been documented. Objective: The objective of this study was to assess knowledge about HIV Transmission and modes of prevention, pattern of condom use with high risk partners and explore the practice of unsafe sex and its risk factors among truck drivers. Methods: This exploratory cross-sectional study design was conducted on a recruited convenient sample of 100 truck drivers above 18 years from March to May 2015. Binary logistic regression was used to compute unadjusted odds ratio [95% Confidence Interval] for establishing association of risk factors with unsafe sex. Results: Overall, only 7% had complete knowledge about HIV/AIDS transmission and prevention. 54% of truck drivers have sex with a high risk partner (commercial sexual worker or men having sex with men) and thirty-eight percent reported unsafe sexual practices due to inconsistent condom use with them. The various risk factors found significantly associated with unsafe sex were mean age of first intercourse (OR= 0.92, 95% CI: 0.75 – 0.97), access to pornography (OR = 4.4, 95% CI: 1.8 – 10.7) and conuming psychoactive substance before sex (OR = 4.06, 95% CI: 1.09 – 15.02). Conclusion: Socio-demographic, occupational factors, pornography access and consuming psychoactive substances seems to influence the sexual behaviour of truckers.</p> <p><strong>Keywords:</strong> Unsafe sex; truck drivers; psychoactive substance; HIV; AIDS.</p> Ashish Pundhir, Arvind Shukla, Akhil Dhanesh Goel, Pooja Pundhir, Manoj Kumar Gupta, Pawan Parashar, Amit Mohan Varshney Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Evaluation of clinical, etiological and antimicrobial resistance profile of pediatric urinary tract infections in a secondary health care centre <p><strong>Background:</strong> Urinary tract infections are common during childhood. The etiologic agents and empirical antibiotics may vary due to age and geographic area.</p> <p><strong>Objectives:</strong> This study was designed to investigate the urinary tract infection pathogens, their antibiotic resistance profile and risk factors in a sample of well-child population.</p> <p><strong>Materials and Methods:</strong> This retrospective study was conducted in the pediatric clinics of a secondary health-care centre in a one-year period. The source of data was hospital and laboratory records. Toilet trained children and adolescents aged between 5-17 years old with positive urine culture were enrolled into the study. Microbiological studies were conducted ac- cording to international guidelines.</p> <p><strong>Results:</strong> During the study 3640 urine samples were analyzed and 342(9.4%) had significant growth. Gram negative en- terobacteria were the most common infectious agents. Antibiotic susceptibility tests showed low cephalosporine resistance unless ESBL was positive. Multi drug resistance was remarkable. Extended beta lactamase resistance rate was 17%. Previous history of antibiotic use before the present administration was the only significant risk factor for ESBL positivity.</p> <p><strong>Conclusion:</strong> Treating urinary tract infections may become an emerging problem soon. Unless there are risk factors, cepha- losporines are good options, but if so nitrofurantoin or carbapanems should be preferred for treatment in this population.</p> <p><strong>Keywords:</strong> Urinary tract infections; antibiotics; susceptibility.</p> Gökce Celep, Hüseyin Burak Özçelik Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Oral health related quality of life among HIV positive patients attending two HIV outpatient clinics in Nigeria - a cross sectional study <p><strong>Background:</strong> The human immunodeficiency virus infection remains a devastating disease of public health importance.</p> <p><strong>Objectives:</strong> To assess the association between oral health and quality of life and the factors affecting the oral health related quality of life among HIV positive patients in Nigeria.</p> <p><strong>Methods:</strong> This was a cross sectional study of HIV positive patients attending two HIV outpatient clinics in Nigeria. Impact of oral health on quality of life was assessed using the OHIP-14. Oral health status was assessed by the DMFT and Simpli- fied OHI indices. Level of significance was set at p&lt; 0.05.</p> <p><strong>Results:</strong> Three hundred and fifty-two patients were seen, 64.2% being females. Prevalence of impact was 8.5%; and the mean OHIP scores was 8.05±9.54. Highest impact was “painful aching” 67(19.1%) with the domain of physical pain scoring the highest mean impact of 2.32. Most patients (88.6%) were on HAART. Following logistic regression, after controlling for potential confounders, independent factors associated with poor OHRQoL were perceived need for dental treatment, HAART use, and higher DMFT (p&lt;0.05).</p> <p><strong>Conclusion:</strong> The domain of physical pain had the highest impact, while perceived need for dental treatment, HAART use and higher caries index were contributory to poor OHRQoL.</p> <p><strong>Keywords:</strong> HIV infection; Oral health; OHRQoL.</p> Kehinde Adesola Umeizudike, Babatope Bamidele Osagbemiro, Opeyemi Oluwayemisi Daramola, Titilope Adenike Adeyemo Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Community pharmacists’ management of self-limiting infections: a simulation study in Akwa Ibom State, South-South Nigeria <p><strong>Background:</strong> Inappropriate use of antibiotics, especially for treatment of self-limiting infections remains one of the major drivers of antibiotic resistance (ABR). Community pharmacists can contribute to reducing ABR by ensuring antibiotics are dispensed only when necessary.</p> <p><strong>Objective:</strong> To assess community pharmacists’ management of self-limiting infections.</p> <p><strong>Methods:</strong> A purposive sample of 75 pharmacies participated in the study. Each pharmacy was visited by an investigator and a trained simulated patient who mimicked symptoms of common cold and acute diarrhoea, respectively. Interactions between the simulated patient and pharmacist were recorded by the investigator in a data collection form after each visit. Descriptive statistical analysis was carried out. Ethics approval was obtained from the state Ministry of Health Research Ethics Committee.</p> <p><strong>Results:</strong> For common cold, 68% (51/75) of pharmacists recommended an antibiotic. Azithromycin, amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%, 24%, 20%, respectively) were the most frequently dispensed agents. For acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic, while 15% dispensed more than one antibiotic. The most frequently dispensed agent was metronidazole (82%), which was dispensed in addition to amoxicillin or tetracycline among pharmacists who dispensed more than one agent. In both infection scenarios, advice on dispensed antibiotics was ofered in 73% and 87% of the interactions, respectively.</p> <p><strong>Conclusion:</strong> This study shows high rate of inappropriate antibiotics dispensing among community pharmacists. There is need for improved awareness of antibiotic resistance through continuing education and training of community pharmacists. Furthermore, the inclusion of antibiotic resistance and stewardship in undergraduate pharmacy curriculum is needed.</p> <p><strong>Keywords:</strong> Antibiotics; pharmacists; common cold; acute diarrhoea; community pharmacy; patient simulation.</p> Richard Mary Akpan, Emmanuel Imo Udoh, Samuel Emediong Akpan, Chioma Cynthia Ozuluoha Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia <p><strong>Background:</strong> Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa.</p> <p><strong>Aim/Objective:</strong> To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia.</p> <p><strong>Materials and Methods:</strong> Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brika- ma District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify <em>C. albicans</em> and <em>Trichomonas vaginalis</em> while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test.</p> <p><strong>Results:</strong> The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Strep- tococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%).</p> <p><strong>Conclusion:</strong> A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia.</p> <p><strong>Keywords:</strong> Sexually transmitted infections; pregnant women; antenatal clinics; The Gambia.</p> Alphonsus Isara, Aru-Kumba Baldeh Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 The experiences of sex workers accessing HIV care services in Bulawayo, Zimbabwe <p><strong>Background:</strong> Although sub-Saharan African countries have rolled out massive HIV treatment and care programmes, there is little evidence of these having embraced key population groups particularly female sex workers. Due to the criminalisation of sex work in countries like Zimbabwe, research on HIV and its impact on this group is sparse. The absence of an enabling environment has hindered access to HIV care and treatment services for female sex workers.</p> <p><strong>Objectives:</strong> To gain an in-depth understanding of the experiences of female sex workers accessing HIV care and treatment services to enhance programming and planning for this key population group.</p> <p><strong>Methods:</strong> This study was qualitative and phenomenological. Data saturation determined the sample size of 20 participants. Data was collected using in-depth interviews that were audio recorded, transcribed, and subjected to thematic content anal- ysis.</p> <p><strong>Results:</strong> Our findings demonstrate varying dynamics between the private and public sector HIV care services for sex work- ers, with facilitators and barriers to access to care.</p> <p><strong>Conclusion:</strong> Health workers need sensitization and training in the provision of differentiated care. For effective linkage to and retention in care an enabling environment is critical.</p> <p><strong>Keywords:</strong> Linkage to care; retention in care; enabling environment; facilitators; barriers.</p> Idah Moyo, Margaret Macherera Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Virologic suppression and associated factors in HIV infected Ugandan female sex workers: a cross-sectional study <p><strong>Introduction:</strong> Key populations have disproportionately higher HIV prevalence rates than the general population.</p> <p><strong>Objective:</strong> To determine the level of virologic suppression and associated factors in female Commercial Sex Workers (CSW) who completed six months of ART and compare with the female general population (GP).</p> <p><strong>Methods:</strong> Clinical records of CSW and GPs who initiated ART between December 2014 to December 2016 from seven urban clinics were analyzed to determine virologic suppression (viral load &lt; 1000 copies/ml) and associated factors.</p> <p><strong>Results:</strong> We identified 218 CSW and 182 female GPs. CSW had median age of 28 (IQR 25-31) vs 31 (IQR 26-37); median baseline CD4 446 (IQR 308-696) vs 352 (IQR 164–493) cells/microL; and optimal ART adherence levels at 70.6% vs 92.8% respectively, compared to GP. Virologic suppression in CSW and GPs was 85.7% and 89.6% respectively, P=0.28. Overall virologic suppression in CSW was 55% while Retention in care after 6 months of ART was 77.5%. Immediate ART initiation (&lt;2weeks) and tuberculosis independently predicted virologic suppression in CSW with adjusted odds ratios 0.07 (95% C.I. 0.01-0.55, P=0.01) and 0.09 (95% C.I. 0.01-0.96, P=0.046) respectively.</p> <p><strong>Conclusion:</strong> Virologic suppression in both groups is similar, however, intensified follow-up is needed to improve treatment outcomes.</p> <p><strong>Keywoeds:</strong> HIV infected Ugandans; female sex workers.</p> Darius Owachi, Godwin Anguzu, Joanita Kigozi, Janneke Cox, Barbara Castelnuovo, Fred Semitala, David Meya Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prevalence and density of malaria parasitaemia amongst HIV Individuals in Warri, Nigeria <p><strong>Background:</strong> Malaria parasite has been observed to be a common infection in Human Immunodeficiency virus (HIV), an increase malaria infection in adults.</p> <p><strong>Objective:</strong> This experimental study is sets to determine the prevalence and density of malaria parasitaemia in Warri com- munity, South-Southern Nigeria.</p> <p><strong>Methods and Results:</strong> A total of 600 participants were screened for Human immunodeficiency virus and malaria parasite using WHO systems two and Geimsa staining technique for thick and thin blood films and absolute parasite counts done respectively. The prevalence rate of 38% and 39% were obtained for malaria parasite infection among HIVSP and HIV/ span&gt;SN respectively. The difference in malaria parasite infection was not statistically significant (P&gt;0.05) between HIVSP and HIVSN. However, the mean parasite density in HIVSP was significant (P&lt;0.05) when compared with HIVSN. The mean parasite densities of 2384 ± 747 and 1883 ± 645 were recorded for HIVSP and HIVSN respectively. The mean par- asite densities of 2385 ± 782 and 2383 ± 717 observed for males and females respectively showed no statistical significant difference (P&lt;0.05).</p> <p><strong>Conclusion:</strong> This study has shown a high prevalence of malaria parasite among the HIV infected subjects.</p> <p><strong>Keywords:</strong> Density; Malaria; HIV; prevalence; Nigeria.</p> Johnson Daniel Jemikalajah , Clement Oliseloke Anie, Felix Oghenemaro Enwa Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Evaluation of the postal service for referral of specimen of drug resistance tuberculosis in Amhara region, Ethiopia; mixed method <p><strong>Background:</strong> In Ethiopia, specimens of presumptive drug resistant tuberculosis cases are transported by courier system from district sample collection centers to reference laboratories. It is essential to track the effectiveness of the referral system and identify challenges in order to take timely and appropriate actions. We assessed turnaround time and quality of speci- mens, and explored challenges of the specimen referral system in Amhara region, Ethiopia, 2017.</p> <p><strong>Methods:</strong> With mixed methods, we retrospectively examined 385 randomly selected presumptive drug resistance TB speci- mens, and interviewed 53 purposively selected key informants from laboratories and post offices. We calculated median TAT and proportion of acceptable quality. We analyzed qualitative data thematically.</p> <p><strong>Results:</strong> Of the 385 specimens, 94.5% (364/385) had acceptable quality at arrival in the reference laboratories. All the 364 specimens had result. Three - fourth (76.1%) of results were dispatched to the referring health facilities within the recom- mended turnaround time. Ineffective communication and lack of feedback among institutions were mentioned as challenges.</p> <p><strong>Conclusion:</strong> The postal service was effective in keeping quality and majority of test results were timely delivered. Yet, there were operational challenges. Therefore, effective communication, using dedicated vehicle for specimen shipment and aware- ness creation on specimen collection and handling are recommended.</p> <p><strong>Keywords:</strong> Postal service; specimen referral; turnaround time; drug resistance tuberculosis.</p> Gebremedhin Berhe Gebregergs, Mulusew Alemneh Sinishaw, Melashu Balew Shiferaw, Tenagnework Antife, Melkie Assefa, Daniel Fiseha, Eveline Klinkenberg Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 The threat of persistent bacteria and fungi contamination in tuberculosis sputum cultures <p>Background: Tuberculosis (TB) sputum culture contaminants make it difficult to obtain pure TB isolates.We aimed to study and identify persistent TB sputum culture contaminants post the standard laboratory pre-culture sample decontamination techniques. Methods: This was a longitudinal study of TB sputum culture contamination for a cohort of TB patients on standard treatment at: baseline, during TB treatment and post TB treatment. Sputum samples were decontaminated with 1.5%NaOH and neutralized using 6.8 Phosphate buffer solution.Sputum was then inoculated into MGIT (mycobactrial growth indicator tube) supplemented with 0.8ml PANTA. A drop of each positive MGIT culture was sub cultured onto blood agar and incu- bated for 48 hours at 35 -37OC.Any growth was identified using growth characteristics and colony morphology. Results: From October 2017 through May 2019;we collected 8645 sputum samples of which 8624(99.8%) were eligible and inoculated into MGIT where 2444(28.3%)samples were TB culture positive and 255(10.4%)were positive for contam- inants:237 none-tuberculosis bacteria, 12 fungi and 6 mixed(none-tuberculous bacteria+fungi).There was no statistically significant difference between none tuberculosis bacteria and fungi in the treatment (OR=1.4,95%CI:0.26–7.47,p=0.690) and the post treatment TB phases(OR=2.02,95%CI:0.38–10.79,p=0.411)Vs baseline. Conclusion: None-tuberculous bacteria and fungi dominate the plethora of TB sputum culture contamination and persist beyond the standard laboratory pre-culture decontamination algorithm.</p> <p>Keywords: Bacteria; Fungi; Inoculation; PANTA (Polymyxin B; Amphotericin B; Nalidixic acid; Trimethoprim; Azlocillin).</p> Grace Muzanyi, Aber Peace, Bonny Wamuntu, Akol Joseph, Joanita Nassali Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prevalence and factors associated with self medication with antibiotics among University students in Moshi Kilimanjaro Tanzania <p><strong>Background:</strong> Self medication is a common practice of using medicines without a medical supervision by the people them- selves. Self medication is likely to happen when people feel unwell, it is worse in the population with poor helth seeking be- havior. Therefore it is important to assess the prevalence and factors associated with self medication with antibiotics among University students in Moshi, Kilimanjaro Tanzania.</p> <p><strong>Methods:</strong> A cross sectional study was conducted from April-August 2019 at two Universities in Moshi, including one med- ical and one non medical. The study population were undergraduate students aged 18 and above, A self-filled questionnaire was used for data collection and data analyzed using the SPSS version 16 and association was tested using chi square.</p> <p><strong>Results:</strong> Out 374 students enrolled 187 from each University, 126 were female and 248 were male with age ranging from 19 to 35 years with mean age of 23.91 years. The prevalence of self medication with antibiotics was 57% and the most com- mon used antibiotics was amoxicillin with prevalence of 32.08%. The common reported symptoms/diseases were headache (31.02%) followed by malaria and coughing with prevalence of 15.24% and 10.96% respectively. The commonest reasons of self medication reported to be emergency illness (38.77%) and delaying of hospital services (24.33%). The commonest effects reported among respondents which practiced self medication with antibiotics were worsening of the condition that they were suffering in (4.55%) and body rashes (2.67).There was no significant difference between self medication practices among medical and non medical students(p = 0.676).</p> <p><strong>Conclusion:</strong> The prevalence of self medication with antibiotics was high among University students and there is no signif- icant difference in both medical and non medical students. The most feared outcome on self medication with antibiotics is antibiotic drug resistance which leads to treatment failure along with high financial costs and increase mortality rate following microbial infections.</p> <p><strong>Keywords:</strong> Self-medication; antibiotics; University students; Moshi; Tanzania.</p> Bernard Baltazary Chuwa, Linna Abraham Njau, Kaizali Ivo Msigwa, Elichilia Shao Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 The role of body temperature on respiratory rate in children with acute respiratory infections <p><strong>Background:</strong> The World Health Organization (WHO) recommends the use of tachypnea as a proxy to the diagnosis of pneumonia.</p> <p><strong>Objective:</strong> The purpose of this study was to examine the relationship between body temperature alterations and respiratory rate (RR) difference (RRD) in children with acute respiratory infections(ARI).</p> <p><strong>Methods:</strong>This cross-sectional study included 297 children with age 2-60 months who presented with cough and fever at the pediatric emergency and outpatient clinics in the Department of Pediatrics, Baskent University Hospital, from January 2016 through June 2018. Each parent completed a structured questionnaire to collect background data. Weight and height were taken. Body temperature, respiratory rate, presence of the chest indrawing, rales, wheezing and laryngeal stridor were also recorded. RRD was defined as the differences in RR at admission and after 3 days of treatment.</p> <p><strong>Results:</strong> Both respiratory rate and RRD were moderately correlated with body temperature (r=0.71, p&lt;0.001 and r=0.65, p&lt;0.001; respectively). For every 1°C increase in temperature, RRD increased by 5.7/minutes in overall, 7.2/minute in the patients under 12 months of age, 6.4/minute in the female. The relationship between body temperature and RRD wasn’t statistically significant in patients with rhonchi, chest indrawing, and low oxygen saturation.</p> <p><strong>Conclusion:</strong> Respiratory rate should be evaluated according to the degree of body temperature in children with ARI. How- ever, the interaction between body temperature and respiratory rate could not be observed in cases with rhonchi and severe pneumonia.</p> <p><strong>Keywords:</strong> Fever; tachypnea; pneumonia; respiratory rate difference; children.</p> Beril Ozdemır, Sıddıka Songül Yalçın Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Rational and design of SATRACD study: detecting subclinical anthracycline therapy related cardiac dysfunction in low income country <p><strong>Background:</strong> Anthracycline therapy-related cardiac dysfunction (ATRCD) is the most notorious adverse side-effect of chemotherapy. It has become a significant cardiovascular health concern for long-term cancer survivors. With the emerging concept of subclinical ATRCD and newer diagnostictools (Speckle Tracking Echocardiography (STE) and biomarkers), detecting anthracycline cardiac toxicity at an early stage has become an important step to prevent severe cardiac dysfunction and improve the cardiovascular outcome in cancer survivors. Despite the increasing population at risk in sub-Saharan Africa (SSA), there is no contemporary data in Uganda to address the burden, pathogenesis and risk factors of subclinical ATRCD. This big gap in knowledge has led to a lack of local guidelines for monitoring and management of ATRCD.</p> <p><strong>Methods:</strong> SATRACD (Detecting Subclinical Anthracycline Therapy Related Cardiac Dysfunction In Low Income Country) study is an observational prospective cohort study. Three hundred and fifty-three anthracycline naïve cancer patients will be recruited at baseline. Patients are followed up on completion of anthracycline-based chemotherapy and at 6 months after completion of anthracycline therapy. Data on demographics, cancer profile and clinical presentation will be collected at baseline. Comprehensive cardiac assessment will be performed at each visit, including electrocardiogram, conventional echo- cardiography, STE, cardiac and oxidative stress markers. We will be able to determine the incidence of subclinical and clinical ATRCD at 6 months after completion of anthracycline therapy, determine whether hypertension is a major risk factor for ATRCD, evaluate the role of conventional echocardiography parameters, and biomarkers for detecting subclinical ATRCD.</p> <p><strong>Conclusion:</strong> This SATRACD study will provide contemporary data on Ugandan cancer patients who have subclinical and clinical ATRCD, help in the development of local strategies to prevent and manage ATRCD, and improve cardiovascular outcome for Ugandan cancer survivors.</p> <p><strong>Keywords:</strong> SATRACD study; subclinical anthracycline therapy; cardiac dysfunction; low income country.</p> Wanzhu Zhang, Feriel Azibani, Emmy Okello, James Kayima, Victoria Walusansa, Jackson Orem, Karen Sliwa Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Awareness and knowledge about prostate cancer among male teachers in the Sunyani Municipality, Ghana <p><strong>Objective:</strong> The study was aimed at assessing the awareness and knowledge of prostate cancer (PC) among male teachers in the Sunyani municipality of Ghana.</p> <p><strong>Methods:</strong> This was a cross-sectional study conducted using a structured questionnaire to collect data from 160 male teach- ers aged 45 years or more, randomly selected from public elementary and high schools in the Sunyani Municipality. Pearson’s Chi square and Fishers exact tests were used to examine the association between socio-demographic characteristics and knowledge of PC.</p> <p><strong>Results:</strong> On average, respondents were aged 50±3.95 years. There was a universal awareness of PC. Most of the respond- ents could identify at least one signs and symptoms of PC (88.1%), risk factors of PC (78.8%), and indicated that PC could be treated through surgery (70.6 %), but only 37.5% of respondents knew about screening tests for PC. The study found 57.5% of them had adequate knowledge about PC. Socio-demographics characteristics were not associated with knowledge about PC. Main sources of information were the television (68%) and radio (57 %).</p> <p><strong>Conclusion:</strong> The outcomes of the study suggest the need for general educational campaigns with emphasis on modalities for the screening of PC using the appropriate media channels for accessibility.</p> <p><strong>Keywords:</strong> Prostate cancer; awareness; knowledge; male teachers; Ghana.</p> Bernard Yeboah-Asiamah Asare, Mercy Mawufenya Ackumey Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Potential anticancer activity of Acetone extracts of Toona cilliata, Seriphium plumosum and Schkuhria pinnata on HeLa cervical cancer cells <p><strong>Background:</strong> Cervical cancer is common in women in less developed regions of the world. The plant biomolecules can be employed for synergistic activity with chemo- and radiotherapy. This combinations might result in reduced toxicity and increased efficacy of the treatment regimen.</p> <p><strong>Objectives:</strong> The anti-HeLa cells activity of the acetone extracts of <em>S. plumosum</em>, <em>T. cilliata</em> and <em>S. pinnata</em> was assessed using different parameters.</p> <p><strong>Methods:</strong> Secondary metabolite detection and antioxidant activity quantification were determined using the DPPH and ferric iron reducing assays. HeLa cell growth inhibition and mechanistics were assessed by employing MTT and Annexin-V flous assays.</p> <p><strong>Results:</strong> Observations revealed the presence of phenolic, flavonoids, tannins steroids and coumarins in all the plants ex- tracts. High amount of total phenolic and flavonoid content were detected in <em>S. plumosum</em> and <em>T. cilliata. S. plumosum</em> extract had the best DPPH scavenging activity and ferric reducing powers.</p> <p><strong>Conclusion:</strong> Observable concentration dependent cell proliferation inhibition by test materials was exhibited. The leaf ex- tracts from <em>T. cilliata</em>, <em>S. plumosum</em> and <em>S. pinnata</em> contain compounds of various polarities with free-radical, antioxidant and anti-cancerous activities that may play a beneficial role in treatment.</p> <p><strong>Keywords:</strong> Medicinal plants; anticancer activity; antioxidant activity.</p> Mxolisi Justice Ndlovu, Victor Patrick Bagla, Matlou Phenius Mokgotho, Marema Ephraim Makgatho, Thabe Moss Matsebatlela Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Allium sativum aqueous extract does not have chemo-protective effect on etoposide induced therapy-related DNA damage leading to Acute Myeloid Leukemia in albino-wistar rats <p><strong>Background:</strong> Therapy-related acute myeloid leukemia (t-AML) is a well-recognized clinical syndrome occurring in a signif- icant fraction of patients who have undergone previous chemotherapy for a solid tumour.</p> <p><strong>Objectives:</strong> We aim to evaluate the effect of aqueous extract of fresh Allium sativum cloves on haematological parameters, bone marrow and DNA of etoposide treated albino wistar rats. Decoction method was used to prepare plant extracts and the rats were weighed and divided into experimental and control groups. Blood and bone marrow sample were analysed and DNA fragment analysis was carried out.</p> <p><strong>Results:</strong> There was progressive increase in the weight of animals that received distilled water only for the duration of the experiment while those that received etoposide only showed a sharp decrease in weight by the end of week 3. There was no significant difference in the mean of the haematological parameters in the test and control groups except for platelet count. The bone marrow smears showed no prevention of erythroblast fragmentation by the extract, in the same vein, DNA dam- age was not abated.</p> <p><strong>Conclusion:</strong> Aqueous extract of fresh Allium sativum cloves may not be the option for the prevention of etoposide induced acute myeloid leukemia.</p> <p><strong>Keywords:</strong> <em>Allium sativum</em> aqueous; chemo-protective effect; acute myeloid leukemia; albino-wistar rats.</p> Ugochi F Ndiokwelu, Liasu A Ogunkanmi, Joseph B Minari, Ijeoma C Uzoma Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Transient bone marrow hypoplasia preceding T-Cell acute lymphoblastic leukemia: a case report <p><strong>Background:</strong> Acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and is characterised by hy- perproliferation of malignant lymphocytes in the bone marrow. Rarely, ALL may be preceded by a period of pancytopenia and bone marrow hypoplasia which spontaneously recovers. This phenomenon, which has not before been described in T-cell ALL, is referred to as transient bone marrow hypoplasia.</p> <p><strong>Case presentation:</strong> A 5-year-old boy who presented with high-grade fever and generalised lymphadenopathy, was found to have pancytopenia on peripheral blood count and bone marrow hypoplasia. He was observed over a one-month period during which his bone marrow and peripheral blood counts recovered spontaneously. Symptoms recurred after 4 months and he was found to have blast infiltration of the bone marrow and diagnosed with T-cell ALL.</p> <p><strong>Conclusion:</strong> Cases of transient bone marrow hypoplasia or overt aplastic anemia with spontaneous recovery and then followed by B-cell ALL or Acute Myeloid Leukemia have been described previously in the medical literature. This is the first case of transient bone marrow hypoplasia resulting into ALL of T-cell immunophenotype. While marrow hypoplasia preceding ALL remains poorly understood, it suggests an antecedent environmental insult to lymphoid progenitors or a germline abnormality that predisposes to lymphoid dysplasia. This may provide clues to the hitherto unknown pathophysi- ological process and etiological factors that precede the majority of childhood ALL cases. This case enlightens pediatricians about the existence of such rare cases so as to periodically follow up children with pancytopenia and/or bone marrow hy- poplasia for prolonged periods even after apparent recovery.</p> <p><strong>Keywords:</strong> Pancytopenia, hypoplasia; aplastic anemia; T-cell acute lymphoblastic leukemia; case report.</p> Ernest Naturinda, Paul George, Joseph Ssenyondwa, Deogratias Bakulumpagi, Joseph Lubega, Peter Wasswa Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Molecular study of Nucleophosmin 1(NPM1) gene in acute myeloid leukemia in Kurdish population <p><strong>Background:</strong> In patients with Acute Myeloid Leukemia (AML) the most frequent acquired molecular abnormalities and important prognostic indicators is nucleophosmin-1 (NPM1) mutations. Our study aims was molecular study of Nucleop- hosmin -1 gene in Acute Myeloid Leukemia in Kurdish population.</p> <p><strong>Patients &amp;Methods:</strong> A total of 50 patients with AML, (36) of them attended Nanakaly Hospital and (14) attended Hiwa Hospital and 30 healthy subjects as control were selected randomly, all were matched of age and gender. Polymerase chain reaction (PCR) was used for detection of NPM1 gene mutation. Three samples of PCR product for NPM1 gene mutations were sequenced, and mutations were determined by comparison with the normal NPM1 sequence NCBI (GenBank acces- sion number NM_002520).</p> <p><strong>Results:</strong> Out of 50 patients with AML, 5 (10%) of them were NPM1 gene mutation positive, and 45 (90%) were negative. The mutation were a base substitution (C to A), (G to C), (G to T), transversion mutation in addition of frame shift mutation and all mutated cases were heterozygous and retained a wild type allele.</p> <p><strong>Conclusion:</strong> Identification of NPM1 mutations in AML are important for prognostication, treatment decision and optimi- zation of patient care.</p> <p><strong>Keywords:</strong> Acute myeloid leukemia; Nucleophosmin-1 (NPM-1) gene mutation; PCR.</p> Galawezh Obaid Othman, Nawsherwan Sadiq Mohammad, Chiman Hameed Saeed Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Evaluation of predominant risk factors for type 2 diabetes mellitus among out-patients in two Nigerian secondary health facilities <p><strong>Background:</strong> Prevention of type 2 diabetes is enabled by identification and effective management of risk factors.</p> <p><strong>Objectives:</strong> To evaluate the predominant risks for type 2 diabetes and identify persons at highest risk in a population; to facilitate the understanding of implications for practice.</p> <p><strong>Methods:</strong> Cross-sectional survey using Canadian diabetes risk assessment questionnaire was conducted among non-diabetic persons who visited two secondary hospitals. SPSS version 18 was used for data analysis.</p> <p><strong>Results:</strong> A total of 300 respondents participated in the study, with 25.7% having family history of type 2 diabetes, while 160 (53.3%) were at high risk of developing the disease. Males (62.5%), overweight (65.1%) and obese (82.6%) participants, were at higher risk. Others found to be at high risk were respondents with high waist circumference (55.6%), respondents who did not exercise (77.0%), those who did not eat fruits/vegetable daily (54.4% ), those with high blood pressure (67.5%) and those who have had raised blood sugar in the past (71.0% ).</p> <p><strong>Conclusion:</strong> Majority of the study participants was at high risk for type 2 diabetes, male participants had higher risks and lifestyles/habits were the major risks for developing the disease.</p> <p><strong>Keywords:</strong> Evaluation; type 2 diabetes; risk factors; Nigeria; primary prevention.</p> Chinonyerem O Iheanacho, Doyin O Osoba, Uchenna IH Eze Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prediction of prevalence of type 2 diabetes in Rwanda using the metropolis-hasting sampling <p>In this work, we predict the prevalence of type 2 diabetes among adult Rwandan people. We used the Metropolis-Hasting method that involved calculating the metropolis ratio. The data are those reported by World Health Organiation in 2015. Considering Suffering from diabetes, Overweight, Obesity, Dead and other subject as states of mathematical model, the transition matrix whose elements are probabilities is generated using Metropolis-Hasting sampling. The numerical results show that the prevalence of type 2 diabetes increases from 2.8% in 2015 to reach 12.65% in 2020 and to 22.59% in 2025. Therefore, this indicates the urgent need of prevention by Rwandan health decision makers who have to play their crucial role in encouraging for example physical activity, regular checkups and sensitization of the masses.</p> <p><strong>Keywords:</strong> Non communicable diseases; type 2 diabetes; Markov Chain Monte Carlo method; Metropolis-Hasting method; Transition probabilities.rds:&nbsp;</p> Angelique Dukunde, Jean Marie Ntaganda, Juma Kasozi, Joseph Nzabanita Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Glycemic index values of traditional Kenyan foods: the missing link in the effectiveness of dietary approach in the prevention and management of diabetes mellitus in Kenya <p><strong>Background:</strong> Glycemic index (GI) measures postprandial blood sugar after consumption of carbohydrate-rich foodstuff. Kenya is yet to fully embrace this concept in prevention and management of diabetes mellitus.</p> <p><strong>Objective:</strong> To review and tabulate GIs of locally consumed foods in order to improve dietary management of diabetes mellitus.</p> <p><strong>Methodology:</strong> A literature search was conducted using Google scholar and PubMed databases which identified 7 articles on glycemic index values of Kenyan foods published between 2002 and 2020. Two articles failed to meet the inclusion criteria and five proceeded for review. Key search words used included GI, glycemic load and glycemic response combined with Kenya. The data was reported depending on whether the testing involved healthy individuals or patients suffering from diabetes mellitus.</p> <p><strong>Results:</strong> Nine individual foods and 7 mixed meals were identified. Low GI foods included beans and whole maize ugali consumed alongside cowpea leaves. High GI foods included whole maize <em>ugali</em> eaten with beef, boiled rice, boiled cassava and cassava-sorghum <em>ugali</em> eaten with silver fish.</p> <p><strong>Conclusion:</strong> Proper meal mixing is important in diabetes management. Cowpea leaves and beans possess GI lowering po- tential. This information can be used to improve guidance on food choices for diabetes patients.</p> <p><strong>Keywords:</strong> Glycemic index; glycemic load and glycemic response; Kenya.</p> Rebecca Ebere, Jasper Imungi, Violet Kimani Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Streptozotocin-induced type 1 and 2 diabetes in rodents: a model for studying diabetic cardiac autonomic neuropathy <p>Background: Several animal models are continually being developed to study diabetic complication. Several conflicting regimen for diabetes induction exist in the literature with varying dose strength and regimen for different study interest in diabetes. This study aims to show the effect of high dose streptozotocin (STZ) on the one hand compared with multiple low doses after high fat diet induction on diabetic cardiac autonomic neuropathy (DCAN). Methodology: Eighty-four Wistar rats were used to demonstrate DCAN induction using 2 approaches one for T1DM (STZ 50mg/kg) and the other for T2DM (HFD for 8 weeks with STZ 25mg/Kg daily for five days). DCAN features were assessed using invasive biomarkers, histology patterns and cardiac nerve densities. Results: Diabetes induction rate was 76% and 89% in T1DM and T2DM model respectively. T1DM group had significant weight loss, reduced c-peptide, and insulin level post induction. The T2DM additionally showed significantly higher total cholesterol and Homeostatic model assessment (HOMA) compared with control. Serum levels of catecholamine, choactase, nerve growth factor and cardiac nerve density confirms development of DCAN. Conclusion: High single dose of STZ and HFD with multiple low doses of STZ may be recommended for DCAN study in T1DM and T2DM rat model respectively.</p> <p>Keywords: Diabetic cardiac autonomic neuropathy; Diabetes mellitus; Heart rate variability; Streptozotocin.</p> Olawale Mathias Akinlade, Bamidele Victor Owoyele, Ayodele Olufemi Soladoye Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Circulatory microRNA expression profile for coronary artery calcification in chronic kidney disease patients <p><strong>Background &amp; Aim:</strong> Coronary artery disease (CAD) is the primary cause of mortality in patients with end stage renal disease (ESRD). MicroRNA profiling is proven as a powerful tool in the diagnosis of any disease at the molecular level. Hence, the present study aimed to profile the microRNA expression for CAD especially coronary artery calcification in CKD patients.</p> <p><strong>Materials and Methods:</strong> Two hundread patients with CKD stages 3 to 5 without dialysis and healthy controls were includ- ed in this study. All two hundred patients underwent 1024 multi sliceardiac computed tomography (CT) scan for calcium scoring. The calcium scoring more than 100 have been included in the study. We performed miRNA microarray analysis from serum samples of seven high calcium scored with CKD patients and one control patients.</p> <p><strong>Results:</strong> Seven patients have observed circulating miRNAs has significantly upregulated and downregulated when compared with control patients. mir21, mir 67, mir 390, mir 56, mir 250, mir 65 and mir 13 were up regulated and mir235, mir256, mir226, mir207, mir255, mir193 were downregulated. There was no significant difference in left ventricle function.</p> <p><strong>Conclusion:</strong> 13 microRNAs play a potential role in coronary artery calcification in CKD patients.</p> <p><strong>Keywords:</strong> CKD; CAD; microRNA; coronary artery calcification.</p> Bhooma Vijayaraghavan, Sridharan Jeyamohan, Giri Padmanabhan, Antony Joseph Velangann, Kumaresan Ramanathan Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Evaluation of three different laboratory methods to detect preformed human leukocyte antigen antibodies in a South African kidney transplant population <p><strong>Background:</strong> Anti-human leukocyte antigen antibodies (anti-HLA) play a crucial role in graft. Detection of anti-HLA, both pre- and post-transplant is a crucial investigation in clinical organ transplantation.</p> <p><strong>Objectives:</strong> Three methodologies for the detection of lymphocytotoxic antibodies were compared to establish which of these is best suited to optimise pre-transplant donor-recipient matching.</p> <p><strong>Methods:</strong> Serum samples from 15 renal transplant patients were tested for the presence of anti-HLA by i) cytotoxic-de- pendent cross-match (CDCXM), ii) flow cytometric cross-match (FCXM) and iii) Luminex-based donor specific antibody cross-match (DSAXM) method, Confirmatory tests for the presence of preformed HLA antibodies were tested using Lu- minex methodology.</p> <p><strong>Results:</strong> Two (13%) of the 15 patients had positive HLA Class I antibodies (Ab) using all 3 methods. An additional 2 HLA Class I Ab were identified with FCXM/CDCXM. DSAXM identified 1 HLA Class I positive, not indicated by CDCXM/ FCXM. High HLA Class II positivity (40%), identified by CDCXM, while DSAXM and FCXM identified two and one patients, respectively. CDCXM produced 4 false-positive results confirmed by lymphocyte single antigen (LSA) assay.</p> <p><strong>Conclusions:</strong> The DSAXM method appears to add value in pre-transplantation screening to identify pre-sensitised patients that may not reject the donor graft due to the absence of donor-specific antibodies.</p> <p><strong>Keywords:</strong> Preformed human leukocyte; antigen antibodies; kidney transplant; population; South Africa.</p> Luyanda Kwofie, Ronald Anderson, Helen Steel, Pieter Meyer WA Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Relationships between cardiovascular signs and neurological signs in asphyxiated neonates in Ilorin, North Central Nigeria <p><strong>Background:</strong> Perinatal asphyxia is a condition associated with multiple organ dysfunctions inclusive of cardiovascular dys- function. Neurologic predictors of survival have been studied, but little has been reported regarding cardiovascular signs and their role in determining outcome in asphyxia.</p> <p><strong>Objective:</strong> The study aimed to determine the relationship between cardiovascular signs and outcomes in asphyxiated new- borns with hypoxic ischaemic encephalopathy.</p> <p><strong>Methods:</strong> This was a cross sectional study involving asphyxiated new-born babies recruited within the first 24 hours of life. Hypoxic ischaemic encephalopathy staging was done using Sarnat and Sarnat staging. All patients had a detailed cardi- ovascular examination on admission, after initial resuscitation (30 – 60 minutes) into admission, and were followed till final outcome: discharge or death.</p> <p><strong>Results:</strong> Eighty-five asphyxiated new-borns with HIE were studied over seven months. Abnormal cardiovascular-related signs identified in the patients included respiratory distress (64.7%), small volume pulse (57.6%), hypotension (52.9%), hy- poxemia (48.2%) and shock (32.9%). Five babies died. None of the clinical signs had a significant relationship with mortality.</p> <p><strong>Conclusion:</strong> Abnormal cardiovascular signs increased with the progression of HIE staging but had no relationship with mortality.</p> <p><strong>Keywords:</strong> Cardiovascular signs; Neurological outcomes; Mortality; Perinatal asphyxia.</p> Amudalat Issa, Mohammed Baba Abdulkadir, Omotayo Olukemi Adesiyun, Bilkis Owolabi, Habibat Suberu, Kayode Olusegun Alabi, Ruqayat Ronke Bakare Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Burden of iron overload among non-chronically blood transfused preschool children with sickle cell anaemia <p><strong>Background:</strong> Sickle cell disease is the commonest genetic disorder of haemoglobin due to inheritance of mutant haemo- globin genes from both parents. The disorder is characterized by chronic haemolysis which results in increased availability of iron from red blood cell destructions.</p> <p><strong>Objective:</strong> To determine the prevalence of iron overload among non-chronically blood transfused preschool children with sickle cell anaemia.</p> <p><strong>Methods:</strong> Serum ferritin was assayed and transferrin saturation derived in 97 steady state sickle cell anaemia children. Ele- vated iron stores were defined as serum ferritin level &gt;300ng/ml, and transferrin saturation &gt;45%. .</p> <p><strong>Results:</strong> Serum ferritin level was greater than 300 mg/ml in 14 (14.4%) subjects and transferrin saturation &gt;45% in six (6.2%) subjects with sickle cell anaemia. The prevalence of iron overload was 20.6%. The prevalence of iron overload was higher among subjects in older age group, female, with history of blood transfusion, and with single blood transfusion ses- sion.</p> <p><strong>Conclusion:</strong> Iron overload is prevalent in older children; the number of blood transfusion sessions notwithstanding. Regu- lar assessment of serum ferritin is recommended.</p> <p><strong>Keywords:</strong> Sickle cell anemia; iron overload; serum ferritin; transferrin saturation; elevated iron.</p> Akodu Samuel Olufemi, Adekanmbi Abiodun Folashade, Ogunlesi Tinuade Adetutu Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Relationship between disease severity and folate status of children with sickle cell anaemia in Enugu, South East Nigeria <p><strong>Background:</strong> Repeated crises in children with sickle cell anaemia (SCA), which is a manifestation of disease severity, results in depletion of their minimal tissue folate stores, with higher likelihood of folate deficiency. The study aimed to determine the relationship between disease severity and the folate status of children with SCA attending University of Nigeria Teaching Hospital (UNTH), Enugu.</p> <p><strong>Methods:</strong> This was a hospital based, cross-sectional study conducted between September 2018 and March 2019. One hundred participants were recruited, consisting of 50 children having sickle cell crisis and 50 age and gender matched hae- moglobin AA genotype controls. Relevant information was documented using a pretested questionnaire. Sickle cell severity score was determined using frequency of crisis, admissions and transfusions in the preceding one year, degree of liver and splenic enlargement, life-time cummulative frequency of specific complications of SCA, leucocyte count and haematocrit.</p> <p><strong>Results:</strong> Folate deficiency was observed in eight percent of the subjects and none of the controls. The difference was not significant (Fisher’s exact = 4.167, p=0.117). The odds of being folate deficient was 8.5 times more likely during anaemic crisis than in vaso-occlusive crisis, though not significant (95% C.I 0.05 – 89.750, p = 0.075). The mean SCA severity score was 8.06 ± 3.64, signifying a moderate SCA severity in the study population. There was a no relationship between folate status and severity of SCA (Fisher’s exact = 0.054, p = 0.949)</p> <p><strong>Conclusion:</strong> Folate status in children with SCA is not affected by their disease severity. Therefore, there may be no need for additional folate supplementation with increasing severity of sickle cell anaemia.</p> <p><strong>Keywords:</strong> Sickle cell anaemia; disease severity; folate status; children; Enugu.</p> Uchenna C Nnajekwu, Chukwubike O Nnajekwu, Vivian O Onukwuli, Ndubuisi A Uwaezuoke, Osita U Ezenwosu, Anthony N Ikefuna, Ifeoma J Emodi Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Level of utilization and provider-related barriers to the use of hydroxyurea in the treatment of sickle cell disease patients in Jos, North-Central Nigeria <p><strong>Background:</strong> Hydroxyurea is underutilized by sickle cell health-care providers in Nigeria despite available evidence of its effectiveness in reducing the manifestations and complications of sickle cell disease (SCD).</p> <p><strong>Objectives:</strong> To assess the level of utilization and provider-related barriers to the use of hydroxyurea in SCD therapy in Jos, Nigeria.</p> <p><strong>Methods:</strong> A cross-sectional study conducted among 132 medical doctors providing care for SCD patients. Data on so- cio-demographics, utilization and barriers to hydroxyurea use were obtained. The barriers were fed cumulatively into the logistic regression model as predictors of utilization.</p> <p><strong>Results:</strong> Of the 132 care providers, 88 (67%) had been in medical practice for ≥6years. The level of utilization of hy- droxyurea was 24.2%. The significant barriers that predicted the non-utilization of hydroxyurea included lack of expertise (OR=5.1; 95% CI=2.65–9.05), lack of clinical guidelines (OR=3.84; 95% CI=2.37-14.33), fear of side-effects (OR=0.50; 95% CI=0.22–0.68) and doubt about its effectiveness (OR=0.30; 95% CI=0.20–0.90).</p> <p><strong>Conclusion:</strong> The level of utilization of hydroxyurea in the treatment of SCD among the care providers is sub-optimal with the lack of expertise in its use identified as the most prominent barrier. There is an urgent need for the training of sickle cell care-providers and the development of clinical guidelines on hydroxyurea use.</p> <p><strong>Keywords:</strong> Hydroxyurea utilization; barriers to hydroxyurea; sickle cell disease; Nigeria.</p> Akinyemi OD Ofakunrin, Edache S Okpe, Tolulope O Afolaranmi, Rasaq R Olaosebikan, Patience U Kanhu, Kehinde Adekola, Nantok Dami, Atiene S Sagay Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State, Nigeria <p><strong>Background:</strong> Sickle-cell disease comprises a group of genetic disorders characterized by the inheritance of sickle haemo- globin from both parents. Sickle-cell disease carries a huge psycho-social burden which has impacts on the physical, psycho- logical, social and occupational well-being as well as levels of independence on adolescents.</p> <p><strong>Objective:</strong> To investigate the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State. The study also examined whether the variables of age and educational level would influence the psycho-social problems of adolescents with sickle-cell anaemia in Ekiti State.</p> <p><strong>Methods:</strong> Descriptive survey design was adopted for the study. Purposive sampling technique was adopted to draw a total of 121 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.</p> <p><strong>Results:</strong> Findings revealed that psycho-social problems of adolescents with sickle-cell anaemia are limited in the choice of career, find it difficult to get suitable partner in marriage and SCD adolescents usually manifest emotional upset, misbehav- iour, and have learning problems. Findings also revealed that there were significant differences in the psycho-social problems of adolescents with sickle-cell anaemia based on age and educational level.</p> <p><strong>Conclusion:</strong> Majority of the respondents attested to the psycho-social problems facing adolescents with sickle-cell anaemia. Based on the findings of the study, it was recommended that social workers should be employed in health sectors; govern- ment should offered standard health care for all adolescents with sickle cell disease.</p> <p><strong>Keywords:</strong> Psycho-social problems; sickle-cell anaemia; adolescents.</p> Lateef Omotosho Adegboyega Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 The utility of ‘home-made’ reagent red blood cells for antibody screening during pre-transfusion compatibility testing in Uganda <p><strong>Background:</strong> The WHO recommends that pre-transfusion testing should include ABO/RhD grouping followed by screen- ing for red blood cell (RBC) alloantibodies using the indirect antiglobulin test (IAT). However, in Uganda, current practice does not include RBC alloantibody screening.</p> <p><strong>Objective:</strong> To assess the utility of ‘home-made’ reagent RBCs in alloantibody screening.</p> <p><strong>Materials and methods:</strong> In a laboratory-based study, group O RhD positive volunteer donors were recruited and their extended phenotype performed for C, c, E, e, K, Fya, Fyb Jkb, S and s antigens. These ‘home-made’ reagent RBCs were preserved using Alsever’s solution and alloantibody detection tests performed. For quality assurance, repeat alloantibody screening of patients’ samples was done at Bloodworks Northwest Laboratory in Seattle, United States.</p> <p><strong>Results:</strong> A total of 36 group O RhD positive individuals were recruited as reagent RBC donors (median age, 25 years; range, 21 – 58 years; male-to-female ratio, 1.6:1). Out of the 311 IATs performed, 32 (10.3%) were positive. Confirmatory IAT testing in the United States was in agreement with the findings in Uganda.</p> <p><strong>Conclusion:</strong> Use of ‘home-made’ reagent RBCs during pre-transfusion testing in Uganda is feasible. We recommend the introduction of pre-transfusion IAT alloantibody screening in Uganda using ‘home-made’ reagent RBCs to improve trans- fusion safety.</p> <p><strong>Keywords:</strong> Blood transfusion; ‘Home-made’ reagent RBCs; Pre-transfusion testing; RBC alloantibody screening; Uganda.</p> Bernard Natukunda, Robert Wagubi, Ivan Taremwa, Benson Okongo, Yona Mbalibulha, Gayle Teramura, Meghan Delaney Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 A one-year prospective study on the occurrence of traumatic spinal cord injury and clinical complications during hospitalisation in North-East Tanzania <p><strong>Background:</strong> Clinical complications following spinal cord injury are a big concern as they account for increased cost of rehabilitation, poor outcomes and mortality.</p> <p><strong>Objective:</strong> To describe the occurrence of traumatic spinal cord injury and associated clinical complications during hospi- talisation in North-East Tanzania.</p> <p><strong>Method:</strong> Prospective data were collected from all persons with traumatic spinal cord injury from North-East Tanzania from their admission to discharge from the hospital. Neurological progress and complications were assessed routinely. Data were captured using a form that incorporated the components of the core data set of the International Spinal Cord Society and were analysed descriptively.</p> <p><strong>Results:</strong> A total of 87 persons with traumatic spinal cord injury were admitted at the hospital with a mean age of 40.2 ± 15.8 years. There were 69 (79.3%) males, and 58 (66.6%) of the injuries resulted from falls. Spasms (41 patients, 47.1%), neuropathic pain (40 patients, 46%), and constipation (35 patients, 40.2%) were the most commonly reported complications. The annual incidence rate in the Kilimanjaro region was at least 38 cases per million.</p> <p><strong>Conclusion:</strong> The incidence of traumatic spinal cord injury in the Kilimanjaro region is relatively high. In-hospital compli- cations are prevalent and are worth addressing for successful rehabilitation.</p> <p><strong>Keywords:</strong> Rehabilitation; pressure ulcer; spasm; urinary tract infections; low income countries.</p> Haleluya I Moshi, Gunnevi G Sundelin, Klas G Sahlen, Ann VM Sörlin Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Acute kidney injury among medical and surgical in-patients in the Cape Coast Teaching Hospital, Cape Coast, Ghana: a prospective cross-sectional study <p><strong>Background:</strong> Acute kidney injury (AKI) is a syndrome associated with high morbidity, mortality and high hospital costs. Despite its adverse clinical and economic effects, only a few studies have reported reliable estimates on the incidence of AKI in sub-Sahara Africa. We assessed the incidence and associated factors of AKI among medical and surgical patients admitted to a tertiary hospital in Ghana.</p> <p><strong>Methods:</strong> A prospective cross-sectional study was conducted among one hundred and forty-five (145) consecutive patients admitted to the medical and the surgical wards at the Cape Coast Teaching Hospital (CCTH), Cape Coast, Ghana from April 2017 to April 2018. Socio-demographic and clinical information were collected using structured questionnaires. AKI was diagnosed and staged with the KDIGO guideline, using admission serum creatinine as baseline kidney function.</p> <p><strong>Results:</strong> The mean age of the study participants was 46.6±17.7 years, whilst the male:female ratio was 68:77. The overall incidence of AKI among the participants was 15.9% (95% CI: 10.33 – 22.84%). Stage 1 AKI occurred in 56.5% of the par- ticipants, whilst stages 2 and 3 AKI respectively occurred among 4.1% and 2.8% of respondents. About 20% of the partic- ipants in the medical ward developed AKI (n= 15) whilst 12% of those in surgical ward developed AKI (n= 8). Among the participants admitted to the medical ward, 60.0%, 26.7% and 13.3% had stages 1, 2 and 3 AKI respectively. Whilst 50.0%, 25.0% and 25.0% respectively developed stages 1, 2 and 3 AKI in the surgical ward. Medical patients with AKI had hyper- tension (40%), followed by liver disease (33.3%); 37.5% of surgical inpatients had gastrointestinal (GI) disorders.</p> <p><strong>Conclusion:</strong> The incidence of AKI is high among medical and surgical patients in-patients in the CCTH, Ghana, with hy- pertension and liver disease as major comorbidities.</p> <p><strong>Keywords:</strong> Acute kidney injury; KDIGO; medical; surgical; hypertension; liver disease.</p> Richard KD Ephraim, Yaw A Awuku, Ignatious Tetteh-Ameh, Charles Baffe, Godsway Aglagoh, Victor A Ogunajo, Kizito Owusu-Ansah, Prince Adoba, Samuel Kumordzi, Joshua Quarshie Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Mortality incidence and its determinants after fragility hip fractures: a prospective cohort study from an Egyptian level one trauma center <p><strong>Background:</strong> Fragility hip fracture is a common condition with serious consequences. Most outcomes data come from Western and Asian populations. There are few data from African and Middle Eastern countries.</p> <p><strong>Objective:</strong> The primary objective was to describe mortality rates after fragility hip fracture in a Level-1 trauma centre in Egypt. The secondary objective was to study the causes of re-admissions, complications, and mortality.</p> <p><strong>Methods:</strong> A prospective cohort study of 301 patients, aged &gt; 65 years, with fragility hip fractures. Data collected included sociodemographic, co-morbidities, timing of admission, and intraoperative,ostoperative, and post-discharge data as mortal- ity, complications, hospital stay, reoperation, and re-admission. Cox regression analysis was conducted to investigate factors associated with 1-year mortality.</p> <p><strong>Results:</strong> In-hospital mortality was 8.3% (25 patients) which increased to 52.8% (159 patients) after one year; 58.5% of the deaths occurred in the first 3-months. One-year mortality was independently associated with increasing age, ASA 3-4, cardiac or hepatic co-morbidities, trochanteric fractures, total hospital stay, and postoperative ifection and metal failure.</p> <p><strong>Conclusion:</strong> Our in-hospital mortality rate resembles developed countries reports, reflecting good initial geriatric health- care. However, our 3- and 12-months mortality rates are unexpectedly high. The implementation of orthogeriatric care after discharge is mandatory to decrease mortality rates.</p> <p><strong>Keywords:</strong> Fragility hip fractures; trochanteric fractures; mortality rate.</p> Mohammad K Abdelnasser, Ahmed A Khalifa, Khaled G Amir, Mohammad A Hassan, Amr A Eisa, Wael Y El-Adly, Ahmed K Ibrahim, Osama A Farouk, Hossam A Abubeih Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Pattern and risk factors for childhood injuries in Dar es Salaam, Tanzania <p><strong>Background:</strong> Injuries contribute to morbidity and mortality in children. This study was carried out to describe the pattern of childhood injuries and associated risk factors in Dar es Salaam, Tanzania.</p> <p><strong>Methods:</strong> This case control study was conducted in six selected health facilities in Dar es Salaam, Tanzania. Data were col- lected using a structured questionnaire. Cases and controls were children below 18 years who had suffered injuries and those without injury associated condition respectively.</p> <p><strong>Results:</strong> A total of 492 cases and 492 controls were included in the study, falls (32%), burns (26%), Road Traffic Injuries (14%) and cuts (10%) were the major types of injuries identified. Younger parents/guardians {Adjusted odds ratio (AOR)= 1.4; 95% CI: 1.4 -3.6}, more than six people in the same house (AOR= 1.8; 95% CI: 1.3-2.6), more than three children in the house {AOR= 1.4; 95% CI (1.0-2.0)}, absence of parent/guardian at time of injury occurrence (AOR= 1.6; 95% CI: 1.1-2.3), middle socio-economic (AOR=1.6; 95%CI: 1.1-2.4) and low socio-economic status (AOR= 1.5; 95% CI: 1.0-2.1) were independent risk factors for childhood injury.</p> <p><strong>Conclusion:</strong> Falls, burns and road traffic injuries were the main injury types in this study. Inadequate supervision, over- crowding, lower socio-economic status and low maternal age were significant risk factors for childhood injuries.</p> <p><strong>Keywords:</strong> Childhood injuries; risk factors; Dar es Salaam; Tanzania.</p> Robert Moshiro, Francis F Furia, Augustine Massawe, Elia John Mmbaga Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 A descriptive prospective study of sports medicine practices for athletes in Uganda <p><strong>Background:</strong> Many international sporting organizations have recommended practices to reduce the risk of injury. These practices include screening for injury, having appropriate emergency medical care, and protocols for managing injury before return-to-play. The extent of the uptake of these practices in a developing country such as Uganda, is unknown.</p> <p><strong>Methodology:</strong> Using a descriptive case study approach, this investigation focused on a sample of injured athletes (n = 75) in Uganda from four main sports associations (football, athletics, basketball and rugby). The data were collected through observations and interviews after the injury. Using a best medical practice framework the phases of emergency, intermediate, rehabilitative, and return-to-sports participation were described.</p> <p><strong>Result:</strong> Nine conditions/types of injury were included. The results revealed a lack of specific pre-season screening or re- turn-to-play readiness for all the injured athletes. Further, there was a lack of application of best practice principles for most of the injury types. For athletes who received medical care, the results show inconsistencies and inadequacies from the acute stage of the injury to return-to-sports participation.</p> <p><strong>Conclusion:</strong> This study identified barriers such as up-to-date knowledge among the sports resource providers; the gaps for appropriate and adequate specific facilities for managing injured athletes, and policies to mandate care of injured athletes. These barriers detract from applying best medical practices.</p> <p><strong>Keywords:</strong> Injuries; medical; Uganda; emergency; intermediate; rehabilitation; return-to-sports.</p> Samuel K Lubega, Timothy Makubuya, Haruna Muwonge, Mike Lambert Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 A new grading system for female sexual dysfunction based on the female sexual function index in Egyptian women: a cross-sectional study <p><strong>Objective:</strong> To provide a grading system that accurately reflects the grades of female sexual dysfunction (FSD) severity.</p> <p><strong>Patients and methods:</strong> A cross-sectional study was conducted in Assiut University Hospital. It included 500 women who answered the Arabic version of the Female Sexual Function Index (FSFI) after getting their consent. A gradient of FSD severity was created, classifying FSD into five grades: severe, moderate, mild to moderate, mild, and no FSD.</p> <p><strong>Results:</strong> According to our grading system, FSD was detected in 339 women (67.8 %); Mild FSD in 20.4%, mild to moderate in 41.6%, moderate in 15.3%, and severe in 22.7%. Mean scores of desire show a linear trend of reduction from 3.8 in mild to 3.36 in mild to moderate to 2.25 in moderate and markedly reduced to 2.1 in severe grade. This difference was highly statistically significant (p= 0.002). The same was reported in arousal, orgasm, and satisfaction domains, while in lubrication and pain domains, the difference was not statistically significant.</p> <p><strong>Conclusion:</strong> In this study, our grading system was complementary to the FSFI. Moreover, it seems to be more practical and useful in grading the severity of FSD.</p> <p><strong>Keywords:</strong> Female sexual dysfunction; FSFI; grading; sexual function.</p> Sahar A Ismail, Nagwa E Abdel-Azim, Medhat A Saleh, Ahmed A Mohamed, Ali H Yosef, Ahmad M Abbas Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Menstrual hygiene management among adolescent school girls in Taraba State, Nigeria <p><strong>Background:</strong> The onset of menstruation denotes a landmark event in pubertal development of the adolescent girl. Lack of adequate knowledge and good menstrual hygiene management can have far reaching consequences on the girl’s wellbeing, dignity and reproductive health.</p> <p><strong>Objectives:</strong> This study assessed the menstrual knowledge and hygiene practices of adolescent school girls in Taraba State, Nigeria.</p> <p><strong>Methods:</strong> A descriptive cross sectional study conducted among 297 adolescent school girls. Participants were selected using multistage sampling technique. A self-administered, structured questionnaire was used for data collection. The Statistical Package for Social Sciences (SPSS) version 22.0 was used for the analysis of data.</p> <p><strong>Results:</strong> The mean age at menarche was 13.7 years (± 6.7). Over three-quarter (76.1%) of the girls knew about menstruation before experiencing it. Mothers (48.1%) were the leading source of information about menstruation to the students. The study found that 207 (69.7%) of respondents had good knowledge about menstruation while 171 (57.58%) had good men- strual hygiene management. Knowledge was significantly associated with good menstrual hygiene management (p&lt;0.001).</p> <p><strong>Conclusion:</strong> Knowledge of menstruation and hygienic practices during menstruation among the participants in the study was encouraging. Every adolescent girl should be equipped with the right knowledge and support for good menstrual hy- giene management.</p> <p><strong>Keywords:</strong> Menstrual hygiene; adolescents; Taraba; Nigeria.</p> Esther Umahi Nnennaya, Sonnen Atinge, Somterimmam Paul Dogara, Rimande Joel Ubandoma Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Refractory convulsive syncope in pregnancy: a rare presentation of Takayasu’s arteritis - a case report and literature review <p><strong>Background:</strong> Neurological manifestation of Takayasu’s Arteritis (TA) in pregnancy presenting as convulsive syncope is extremely rare, and poses a serious diagnostic dilemma due to other vast causes of fits in pregnancy.</p> <p><strong>Objective:</strong> We aimed to present and shed more light on a case of TA with convulsive syncope in pregnancy refractory to anticonvulsants for seven weeks, and review the literature on the management of TA in pregnancy.</p> <p><strong>Case presentation:</strong> A gravida 4 para 3+0 at 28 weeks of amenorrhea presented with repeated episodes of the sudden loss of consciousness, followed by a fall and jerking of the limbs. These were refractory to anticonvulsants that she had used for seven weeks. Physical examination revealed undetectable pulse and blood pressure (BP) in the upper limbs but elevated BP in the lower limbs. Further investigations confirmed TA and she improved on steroids and antihypertensives.</p> <p><strong>Conclusion:</strong> This case typically describes the unexpected presentation of TA with convulsive syncope. It calls for meticu- lous clinical assessment of epileptic seizures in pregnancy to avoid a late diagnosis of TA and its potential poor outcomes.</p> <p><strong>Keywords:</strong> Takayasu’s Arteritis in pregnancy; convulsive syncope; case report.</p> Gasthony Alobo, Violah Nahurira, Venice Omona, Pontius Bayo, Sam Olum Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Effects of black tea consumption and caffeine intake on depression risk in black tea consumers <p><strong>Background:</strong> The aim of this study was to compare black tea consumption and caffeine intake with depression status.</p> <p><strong>Subjects and Methods:</strong> This study was conducted on 491 adults (M:169, F:322). The average daily caffeine intake of individuals was calculated using the amounts of caffeinated beverages they consumed daily and the caffeine contents of these beverages. The participants’ depression status was determined using the Beck Depression Inventory (BDI). All of the research data were evaluated using STATA.</p> <p><strong>Results:</strong> According to BDI scores, 30.1% of participants had depression. Black tea was consumed by all of the partici- pants and also had the highest consumption level of 620.1±90.4mL and the mean caffeine intake of the participants was 629.5±418.8 mg. Multivariate regression analyses showed that consuming more than 1 cup was protective against depression up to 4 cups. Moreover, a 450-600 mg caffeine intake also reduces the risk of depression than lower or higher intake levels.</p> <p><strong>Conclusion:</strong> Our study suggests that black tea consumption up to 4 cups and caffeine intake between 450-600 mg can help protect against depression. Further studies are needed to better understand the protective effects of black tea and caffeine on depression.</p> <p><strong>Keywords:</strong> Caffeine; black tea; beck depression inventory; depression.</p> Esma Asil, Mustafa Volkan Yılmaz, Hulya Yardimci Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Genetic influence of Apolipoprotein E gene ε2/ε3/ε4 isoforms on odds of mesial temporal lobe epilepsy <p><strong>Objective:</strong> The potential correlation between the ε2/ε3/ε4 variants of the ApoE (Apolipoprotein E) gene and the odds of mesial temporal lobe epilepsy was investigated.</p> <p><strong>Methods:</strong> The database searching for eligible studies was performed in October 2020. A series of pooling analyses were conducted.</p> <p><strong>Results:</strong> We enrolled a total of twelve case-control studies for pooling. Within the pooling analysis of ε4, there was an in- creased risk of mesial temporal lobe epilepsy in cases under the models of carrier ε4 vs. ε3, ε3ε4 vs. ε3ε3, and ε3ε4+ε4ε4 vs. ε3ε3 [P &lt; 0.05, odds ratio (OR) &gt; 1], compared with controls. Moreover, we observed similar positive results in the subgroup analyses of “China” and “Population-based control” under the genetic models of ε4 (P &lt; 0.05, OR &gt; 1). Nevertheless, we did not detect the significant difference between the mesial temporal lobe epilepsy cases and controls in the pooling analyses of ε2 (all P &gt; 0.05).</p> <p><strong>Conclusion:</strong> The ε3ε4 genotype of ApoE seems to be linked to the risk of mesial temporal lobe epilepsy for patients in China. More sample sizes are required to confirm the potential role of ApoE isoforms in the susceptibility to diverse types of epilepsy from different origins.</p> <p><strong>Keywords:</strong> Epilepsy; ApoE; isoforms; susceptibility.</p> Tao Xu, Hui Zhang, Xueliang Qiu, Yuping Meng Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Prevalence and correlates of substance use among undergraduates in a developing country <p><strong>Background:</strong> Psychoactive substance use is a major global public health issue. Use of psychoactive substances has been associated with negative consequences among students.</p> <p><strong>Objective:</strong> The study assessed the prevalence and socio-demographic correlates of psychoactive substance use among un- dergraduate students in a Nigerian university.</p> <p><strong>Materials and Methods:</strong> This was a cross-sectional descriptive study of 763 undergraduate students of Imo State Uni- versity, Owerri, Nigeria, recruited using multi-stage sampling technique. Data on the socio-demographic characteristics and pattern of psychoactive substance use were collected using a structured questionnaire.</p> <p><strong>Results:</strong> The lifetime rate of psychoactive substance use was 84.5%. Alcohol had the highest rate of lifetime (82.5%) and 12-month (61.1%) use. There was a similar rate of lifetime use of psychoactive substances among males (86.1%) and females (83.4%). Age (p&lt;0.05) and place of residence (p&lt;0.05) were significantly associated with lifetime psychoactive substance use. Catholics (OR:1.43; 1.03 – 1.99), whose friend (OR:1.94; 1.39 – 2.71), roommate (OR:3.06; (1.62 – 5.78) or broth- er (OR:1.22; 0.77 – 1.93) uses psychoactive substances were significantly more likely to have used substances in the past 12-months.</p> <p><strong>Conclusion:</strong> There is a high rate of psychoactive substance use among the students. Age, religion, place of residence, family and peer use of substances are important determinants of psychoactive substance use.</p> <p><strong>Keywords:</strong> Substance use; undergraduates; Nigeria.</p> Chinyere Mirian Aguocha, Emeka Nwefoh Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Psychological ailments and their treatment protocols: a case study of Swati traditional healers in Mpumalanga Province, South Africa <p><strong>Background:</strong> Evidence suggests that South African traditional healers (THs) treat various mental complaints. However, there is little literature on Swati THs’ accounts on this subject. The current study therefore, sought to address this gap.</p> <p><strong>Methods:</strong> Data was gathered using qualitative research methods, namely semi-structured interviews with 10 purposely sampled Swati THs practicing in the Kanyamazane peri-urban township (Mpumalanga Province, South Africa). Data was thematically analysed.</p> <p><strong>Results:</strong> Results showed that THs treat seven psychological aliments, viz. adjustment disorders, depression, mental illness due to ancestral calling, mental illness due to bewitchment, mental illness due to breaking of taboos, psychotic disturbance and substance induced mental illness. Generally, an integrated treatment protocol was utilised by THs to treat and manage these disorders. Most of these procedures are acceptable from either folkloric or scientific viewpoint, and have demonstrat- ed certain level of efficacy in treating mental illness.</p> <p><strong>Conclusion:</strong> Taken together, the evidence presented indicates that Swati THs use different traditional methods to manage various mental complaints. In doing so, they carry a large share of the community caseload for mental health, whilst admit- ting patients in their homes for extended periods of time, and also referring some (patients) for additional care within the Western health sector.</p> <p><strong>Keywords:</strong> Mental illness; Mpumalanga; Swati; traditional healers; treatment methods; psychological ailments.</p> Anastasia Ngobe, Sebua Semenya, Tholene Sodi Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Availability of low vision services and barriers to their provision and uptake in Ghana: practitioners’ perspectives <p><strong>Background:</strong> Provision and uptake of low vision services are essential.</p> <p><strong>Objective:</strong> To assess the availability of low vision services and barriers to their provision and uptake in the Ashanti and Brong Ahafo regions of Ghana from the perspective of eye care practitioners.</p> <p><strong>Methods:</strong> A descriptive, quantitative, cross-sectional study design using semi-structured questionnaires was used to collect information from eye care practitioners selected from 58 eye care facilities in the Ashanti and Brong Ahafo regions of Ghana.</p> <p><strong>Results:</strong> Forty-four eye care practitioners from Ashanti region and 10 from Brong Ahafo region responded to the question- naire. Seventeen (34%) of the 50 eye care facilities who reported having patients seeking low vision services in their facilities provided such services. Lack of low vision devices (94.4%) and equipment (87%) were reported to be the main barriers to the provision of low vision services. Major barriers to low vision services uptake were lack of awareness (88.7%), high cost (70.4%) and social unacceptability of low vision assistive devices (59.3%).</p> <p><strong>Conclusion:</strong> Lack of adequate low vision services and barriers to their provision and uptake impact negatively on efforts to prevent visual impairment and blindness in Ghana.</p> <p><strong>Keywords:</strong> Low vision services; provision; barriers.</p> Sylvester Kyeremeh, Khathutshelo P Mashige Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Utilization and uptake of the UpToDate clinical decision support tool at the Makerere University College of Health Sciences (MakCHS), Uganda <p><strong>Background:</strong> The use of point-of-care, evidence-based tools is becoming increasingly popular. They can provide easy-to- use, high-quality information which is regularly updated and has been shown to improve clinical outcomes. Integrating such tools into clinical practice is an important component of improving the quality of health care. However, because such tools are rarely used in resource-limited settings, there is limited research on uptake especially among medical students.</p> <p><strong>Objective:</strong> This paper explores the uptake of one such tool, Up-To-Date, when provided free of cost at a medical school in Africa.</p> <p><strong>Methods:</strong> In partnership with the Better Evidence at Ariadne Labs free access to UpToDate was granted through the MakCHS IP address. On-site librarians facilitated training sessions and spread awareness of the tool. Usage data was aggre- gated, based on log ins and content views, presented and analyzed using Excel tables and graphs.</p> <p><strong>Results:</strong> The data shows evidence of meaningful usage, with 43,043 log ins and 15,591 registrations between August 2019 and August 2020. The most common topics viewed were in obstetrics and gynecology, pediatrics, drug information, and infectious diseases. Access occurred mainly through the mobile phone app.</p> <p><strong>Conclusion:</strong> Findings show usage by various user categories, but with inconsistent uptake and low usage. Librarians can draw upon these results to encourage institutions to support uptake of point-of-care tools in clinical practice.</p> <p><strong>Keywords:</strong> UpToDate clinical decision support tool; Makerere University College of Health Sciences; Uganda.</p> Alison Annet Kinengyere, Julie Rosenberg, Olivia Pickard, Moses Kamya Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Hearing healthcare gaps in LMICS: snapshot from a semi-urban community in Nigeria <p><strong>Background:</strong> Low and middle-income countries (LMICs) have high prevalence of hearing loss which are mainly due to pre- ventable causes. While urban communities in LMICs are likely to have functional hearing healthcare delivery infrastructure, rural and semi-urban communities may have different reality.</p> <p><strong>Objectives:</strong> This study aimed to provide: (i) a snapshot of the burden of ear diseases and (ii) a description of available hearing healthcare resources in a semi-urban Nigerian community.</p> <p><strong>Methods:</strong> A cross-sectional study of households selected by multistage random sampling technique. Seventy-four partici- pants: 39 males and 35 females with mean age of 34 years ± 5.24 were recruited and answered a structured questionnaire. In addition, the availability of hearing healthcare services in 15 health centers within the community were determined.</p> <p><strong>Results:</strong> All participants reported recent occurrence of ear complaints or gave similar history in a household member. Com- mon complaints were ear discharge, ear pain and hearing loss. Medical intervention was sought from patent medicine stores, hospitals and traditional healers. None of the assessed hospitals within the study site was manned by an ENT surgeon or ENT trained nurse.</p> <p><strong>Conclusion:</strong> Despite the heavy burden of ear complaints there is inadequate hearing healthcare delivery in a typical LMIC community. This highlights the need for urgent improvement of hearing healthcare.</p> <p><strong>Keywords:</strong> Hearing loss; healthcare delivery; disease burden; ear diseases; developing countries.</p> Adebolajo Adeyemo, Segun Ogunkeyede, Oluyinka Dania Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Upper gastrointestinal endoscopy findings in Mbale Regional Referral Hospital, Eastern Uganda: a 10-year retrospective analysis <p><strong>Background:</strong> Endoscopy is required for formal diagnosis of many upper gastrointestinal (UGI) conditions including oe- sophageal cancer (OC). There is a paucity of data on endoscopy findings in East Africa as access to testing is challeng- ing for patients. We describe the findings of 10 years of UGI endoscopy in Mbale Regional Referral Hospital (MRRH).</p> <p><strong>Method:</strong> Records of patients that underwent UGI endoscopy in MRRH, November 2009 – March 2019 were retrospective- ly analysed. Indication, macroscopic findings, histology and patient demographics were retrieved. Sub-group analyses were performed on those with a histological diagnosis of oesophageal cancer.</p> <p><strong>Results:</strong> 833 eligible patients received single UGI procedures during the study period. Mean age was 54.8 years, range 16-93 years and 56.9% of patients were male. The main indication was dysphagia (42%) and the most common findings OC (34%) and gastritis (28%). 151 patients had histologically proven OC with a median age of 60 years and a 2:1 male to female ratio. 145/151 (96%) of samples tested revealed squamous cell carcinoma (SCC).</p> <p><strong>Conclusion:</strong> Those undergoing endoscopy in MRRH are most commonly male patients presenting in their 5th decade with dysphagia. There is a high proportion of significant findings including gastritis, peptic ulcer disease, and oesophageal cancer.</p> <p><strong>Keywords:</strong> Gastrointestinal; OGD; LMIC; oesophageal cancer.</p> Matthew J Doe, Emmanuel Bua, John SO Obbo, Fred Bisso, Peter Olupot-Olupot Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Nutrition education improves knowledge and BMI-for-age in Ghanaian school-aged children <p><strong>Background:</strong> Adequate nutrition is required for growth and development in children. This study tested the effectiveness of nutrition education on knowledge and BMI-for-age (BFA) of school-aged children in the Kumasi Metropolis.</p> <p><strong>Methods:</strong> Children, aged 9-13 years old were recruited from ten randomly selected primary schools in the Metropolis. The schools were randomly allocated into 3 groups: nutrition education (3 schools), physical activity (PA) education (3 schools), both interventions (2 schools), or control (2 schools). Following a baseline nutrition and PA knowledge and status assess- ment in 433 children, twice-monthly nutrition and PA education and demonstrations were carried out for 6 months, followed by a post-intervention assessment.</p> <p><strong>Results:</strong> PA and nutrition knowledge improved in all groups (P&lt;0.001); the highest improvement was among those who received both interventions (31.0%), followed by the nutrition education group (29.8%), and the least, the control group (19.1%). Overall, BFA improved by +0.36, from baseline (-0.26) to end of the intervention (+0.10, P&lt;0.001). Within the groups, the nutrition group (+0.65, P&lt;.001) had the highest improvement, then, both the intervention group (+0.27, P&lt;0.001), the PA group (+0.23, P&lt;0.001) and lastly, the control group (+0.18, P=0.001).</p> <p><strong>Conclusion:</strong> Nutrition education could improve knowledge and BMI-for-age in school-aged children in Ghana.</p> <p><strong>Keywords:</strong> School-aged children; nutrition education; BMI-for-age; nutrition knowledge; basic school.</p> Reginald A Annan, Charles Apprey, Godwin O Agyemang, Diane M Tuekpe, Odeafo Asamoah-Boakye, Satoru Okonogi, Taro Yamauchi, Takeshi Sakurai Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 University students' perceptions and factors contributing to obesity and overweigh in Southern of Morocco <p><strong>Background:</strong> Weight load is a cosmopolitan health problem. In Morocco, women are the most affected by the phenomenon since obesity has risen from 26.8% to 29.0%.</p> <p><strong>Objective:</strong> To determine the prevalence of weight load and associated factors among female students in higher education.</p> <p><strong>Methods:</strong> Data were collected by a questionnaire. Anthropometric measurements were made using a scale and a wall-mount- ed scale. Data were analysed by the statistical software SPSS version 13.0. Quantitative variables were described in mean ± standard deviation. Factors associated with obesity were determined by binary logistic regression.</p> <p><strong>Results:</strong> About two-thirds of the students had a normal weight, 21% were overweight and 3% were obese. In addition, 58% of students were physically inactive and 77% ate cake and fast food. In addition, 63% of students were dissatisfied with their weight. A significant relationship is found between level of primary education, type of establishment, cake and fast food consumption and weight load.</p> <p><strong>Conclusion:</strong> The results revealed that 24% of participants were weight load and had behavioral risk factors such as a sed- entary lifestyle and an unbalanced diet, which requires the promotion of a healthy lifestyle among these students as well as psychological support for those dissatisfied with their body image.</p> <p><strong>Keywords:</strong> Weight load; obesity; overweight; perception; female students; higher education; Morocco.</p> Mohamed Boukrim, Majdouline Obtel, Laila Lahlou, Rachid Razine Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Effects of call reminders, short message services (SMS) reminders, and SMS immunization facts on childhood routine vaccination timing and completion in Ilorin, Nigeria <p><strong>Background:</strong> Reminders via mobile devices deployed as short message services (SMS) or calls have been identified to be a useful strategy in improving routine immunization uptake in several countries.</p> <p><strong>Objective:</strong> To identify the timeliness of appointments with reminders (calls or SMS), SMS health education and the routine care, and the vaccination completion rates in Ilorin, Nigeria.</p> <p><strong>Method:</strong> Mother-infant pairs presenting for the first vaccination appointment were randomized into four (three inter- ventions, one control) groups, each consisting of 140 participants. Intervention groups were reminders via calls (A), SMS reminders (B), immunization fact SMS messages (C) and controls on usual care (D). Reminders were made a day before the appointment while SMS immunization facts were sent at five weeks, nine weeks and eight months. Appropriate timing was defined as the scheduled visit ±3 days.</p> <p><strong>Results:</strong> The immunization completion rates after the nine months’ visit were 99.2%, 99.3%, 97% and 90.4% for Groups A, B, C and D respectively. Compared with controls, Group A had the highest odds [AOR 8.78 (6.10, 12.63)] of presenting at an appropriate time, followed by Group B [AOR 2.56 (1.96, 3.35)], then Group C [AOR 2.44 (1.87, 3.18)].</p> <p><strong>Conclusion:</strong> Reminders/SMS immunization facts improve vaccination completion rates.</p> <p><strong>Keywords:</strong> Call reminders; short message services (SMS) reminders; SMS immunization; vaccination timing; Nigeria.</p> Rasheedat Ibraheem, Moshood Akintola, Mohammed Abdulkadir, Hafsat Ameen, Oladimeji Bolarinwa, Muhammed Adeboye Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000 Clinical description and mutational profile of a Moroccan series of patients with Rubinstein Taybi syndrome <p><strong>Background:</strong> Rubinstein-Taybi syndrome (RSTS; OMIM 180849) is a rare autosomal dominant developmental disorder with an estimated prevalence of one case per 125,000 live births. RSTS is characterized by typical face, broad thumbs and halluces, short stature, and intellectual disability. Facial dysmorphy is characteristic with microcephaly, low frontal hairline, arched eyebrows, long eyelashes, convex profile of nose, narrow palate, and micrognathia. RSTS is mainly due to mutations or microdeletions of the CREBBP gene (about 60%) and more rarely of the EP300 gene (8%).</p> <p><strong>Objective:</strong> Clinical description and identification of mutations of patients with Rubinstein Taybi syndrome.</p> <p><strong>Methods:</strong> PCR and direct sequencing of CREBBP gene.</p> <p><strong>Results:</strong> We report here, the clinical and molecular data of a series of six Moroccan patients with a phenotype of RSTS. The molecular study of the major gene CREBBP (by Sanger Sequencing followed by CGH array, if sequence normal) revealed point mutations in five patients. For the sixth patient, CGH array revealed a microdeletion carrying the CREBBP gene. Through this work, we emphasize the importance of clinical expertise in the diagnosis, management and genetic counseling in Rubinstein Taybi syndrome.</p> <p><strong>Keywords:</strong> Rubinstein Taybi syndrome; CREBBP gene; mutation; Moroccan.</p> Siham Chafai Elalaoui, Wiam Smaili, Julien Van-Gils, Patricia Fergelot, Ilham Ratbi, Mariam Tajir, Benoit Arveiler, Didier Lacombe, Abdelaziz Sefiani Copyright (c) Mon, 02 Aug 2021 00:00:00 +0000