African Journal of Health Sciences

Bullying in secondary schools

2023-01-18T10:28:26+00:00

No abstract

Factors associated with bullying victimization among adolescents joining public secondary schools in Nairobi county Kenya: A cross-sectional study

2023-01-18T10:36:08+00:00

BACKGROUND
Bullying victimization in adolescence exposes young people to both short- and long-term mental health problems. These include depression and suicidality, whose prevalence has been on the rise around the world. Bullying, though officially banned in Kenyan secondary schools since 2013, has remained ubiquitous to the present day. This study aimed to elucidate the factors associated with bullying victimization among adolescents joining Form one at public secondary schools in Nairobi County, Kenya.
METHODOLOGY
This was an analytical cross-sectional design. Data were collected one month after the adolescents had joined secondary school. Data was collected from 539 adolescents attending 5 schools using the self-reported Adolescent Peer Relations questionnaire to assess bullying victimization as well as socio-demographic characteristics. Prevalence rates were generated using a generalized linear model (GLM) customized with a log link and a Poisson distribution for a common binary outcome.
RESULTS
In the univariable analysis, 85.7% (n=462) reported experiencing any bullying victimization. Of those who had depression, 93.5% (n=220) had experienced bullying victimization. The difference in prevalence rates between those who were depressed and those who weren’t was statistically significant in the multivariable analysis (adjusted prevalence rate, aPR=1.33; 95%CI=1.05-1.68, p=0.033). Boys were more likely to experience physical victimization compared to girls (aPR=1.27; 95%CI=1.02-1.58, p=0.031).
CONCLUSION
The prevalence of bullying victimization is quite high, and the presence of depression and sex are significant factors associated with the risk of bullying victimization. Anti-bullying interventions in secondary schools should include a component of depression screening and treatment.

Accessibility of anal cleansing materials for public primary school pupils in Kajiado County, Kenya

2023-01-18T10:43:38+00:00

INTRODUCTION
Anal cleansing is the hygienic practice of cleaning the anal area after defecation. Inaccessibility to anal cleansing materials leads to inappropriate methods resulting in faecal hand contamination. This study assessed the accessibility of anal cleansing materials for public primary school pupils in Kajiado County, Kenya.
MATERIALS AND METHODS
The researchers used a descriptive cross-sectional study approach, applying a cluster sampling technique to sample eighteen (18) schools to the study. Three hundred and eighty-four (384) pupils were selected from the schools using simple random sampling. The Headteacher and a teacher in charge of school health were purposively sampled due to their knowledge of school resources about hygiene. A total of thirty-six teachers participated in the key informant interviews.
Data were analysed using SPSS version 21, and Chi-square was used to test the hypothesis at p<0.05 significance level.
RESULTS
Accessibility to anal cleansing materials was low at 22.9%. Pupils' class (p-value = 0.036) and level of material awareness (p-value <0.001) influenced accessibility. For Institutional factors, material sensitisation was associated with accessibility (p-value = 0.001). The following sustainability measures were proposed; sensitisation on anal cleansing materials, provision through cost sharing, management of the materials by class teachers and prefects, and continued support by government ministries of health and education.
CONCLUSION
Anal cleansing materials access was low; pupils' predisposing characteristics and institutional factors influenced access.
RECOMMENDATION
We recommend that school management and ministries of health and education improve access to anal cleansing materials in schools and develop sustainability measures.

Impact of water sources on Schistosomiasis transmission and urine indicators

2023-01-18T10:49:33+00:00

BACKGROUND
Schistosomiasis is a significant debilitating disease caused by Schistosoma species. Infection is acquired when people come into contact with fresh water infested with the larval forms (cercariae) of parasitic blood flukes, known as schistosomes. The study aimed to assess the impact of water sources on schistosomiasis transmission and potential urinary markers for diagnosis.
METHODOLOGY
In this cross-sectional study, a total of 230 pupils were examined. Stool and urine samples were collected from each of them. Stool samples were analysed using the Formal-ether concentration method, and urine samples using the centrifugation sedimentation method and reagent strip.
RESULTS
This study showed that out of 230 pupils examined, 7(3.0%) were infected with S. mansoni, and 4(1.7%) were infected with S. haematobium. Prevalence of Schistosomiasis according to a source of water contact; revealed a significant difference in infection level based on the source of drinking water at (P<0.05). Those whose source was Dam/River had the highest prevalence, 4(25.0%), followed by stream water 4(10.0%), and the least was well water 2(3.30%). The ability of microhaematuria and proteinuria to accurately identify all those with the disease (sensitivity) was 25.0% and 75.0%, respectively. In comparison, the ability to sort out all those without the disease (specificity) was 97.35% and 96.46%, respectively.
CONCLUSION
The presence of Schistosomiasis among school children is linked to the water sources. Hence, water treatment intervention must reduce the risk of Schistosomiasis among pupils in Kisayhip, Bassa Local Government Area, Plateau State.

Exercise efficacy in management of Cervical Spondylotic Myelopathy – A case report

2023-01-18T10:52:42+00:00

Cervical Spondylotic Myelopathy is an ageing, degenerative spinal condition and a common cause of myelopathy in adults, with the average age of presentation being 56 years. This case report was on a 63-year man who was apparently healthy until he was presented with grade v on Nurick Classification System for Myelopathy. Lhermitte Sign was present. The clinical presentations were motor deficit in the upper limbs (ULs), lower limbs (LLs) and hands; intermittent bouts of spasms in lower limbs; painfully reduced range of motion (ROM) in the shoulder, cervical and lumbosacral joints; impaired activity of daily living (ADL) including ambulation, and reduced sleeping hours. The treatment plan aimed to relieve pain at the affected joints; improve ROM in joints of ULs and LLs; strengthen weak muscles (ULs and LLs); improve trunk control; improve patella mobility and release of tight muscle/structures(hamstrings). The adopted Exercise protocols, which were done between 11 am-1 pm at thrice weekly appointments for four months, were Mobilization & Strengthening Exercises (all limbs); Back Flexibility Exercises; Quadriceps Strengthening Exercises both LLs and Neuromotor Exercises. The patient became stable on a tripod stand in the fourth month and was discharged on a home programme at the end of the fourth month. The observed improvement in the clinical condition of this Cervical Spondylotic Myelopathy patient lays credence to the efficacy of the use of exercise interventions in this condition.

Study of D-dimer, CRP & ferritin status as independent risk factors for severity of the clinical aspects in patients with COVID-19 in Erbil, Iraq

2023-01-18T10:59:13+00:00

BACKGROUND
Coronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory disease which can evolve into multi-organ failure (MOF), leading to death. Several biochemical alterations have been described in COVID-19 patients. This study aimed to look at the ratio of D-dimer, CRP (C- reactive protein), and ferritin as independent risk variables in COVID-19 illness patients in Erbil Governorate, Iraq.
MATERIALS AND METHODS
In this retrospective data collection study, we aimed to determine the number of patients diagnosed with COVID-19 who were admitted to Rizgary and Komary hospitals. Moreover, we collected data, including demographic features and laboratory analysis results regarding: D-dimer, Ferritin and CRP(C- reactive protein) extracted from the patient's medical records. Patients were Erbil residents admitted to Rizgary & Komary educational hospital from 1st April to 1st November 2020, with a confirmed diagnosis of COVID-19 infection using SARS-CoV-2 viral nucleic acid using RT-PCR. CRP, D-dimer, and ferritin levels had been routinely measured on admission.
RESULTS
CRP, D-dimer, and ferritin levels were measured in 234 individuals (115 men and 119 women). The group aged 15-25 was the least afflicted, while the age group 45-55 had the most COVID-19 patients. The frequency of this disorder did not differ statistically significantly between men and women. According to a massive increase in CRP, men showed a far higher risk than women. In the research groups, there were no statistically significant differences in ferritin changes between males and females. In terms of D-dimer, there was no statistically significant difference between males and females in either of the studied groups.
CONCLUSIONS
Higher CRP levels, indicating a higher risk of disease and predicting and measuring the onset of the disease in the first few days, are mandatory in tracking COVID-19 disease.

Does safe delivery depend on antenatal care in Cameroon

2023-01-18T11:22:26+00:00

BACKGROUND
Cameroon had 529 maternal deaths per 100,000 live births in 2017. This high maternal mortality rate (MMR) is likely to reduce if the health system identifies earlier the complications related to pregnancy and provides an adequate response. The perinatal period is appropriate to identify some of these complications through antenatal care (ANC). However, little is known about the contribution of the ANC consultation in the improvement of safe delivery. This study, therefore, aimed to determine the effect of ANC on the probability of safe delivery in Cameroon.
MATERIALS AND METHODS
The study used a cross-sectional Cameroon Demographic Health Survey (CDHS, 2018). This survey comprised women who gave birth in the 5 years preceding the survey aged 15 to 49 years (N = 6463). Women's ANC compliance was assessed by at least one clinic. Safe delivery was measured as whether the woman gave birth at a health facility or home attended to by a skilled health worker or not. The association between women's ANC and safe delivery was analysed using a probit regression model.
RESULTS
The results show that women of favoured regions have a comparative advantage to safe delivery compared to the North and extreme North regions of Cameroon. Among women who did not carry out ANC consultation, 81.24% did not use a Safe delivery mode whereas 79.67% of women who carried out ANC consultation used the Safe delivery mode. Finally, the econometrics estimations indicate a positive and significant effect of ANC consultation on the probability safe of delivery.
CONCLUSION
The study confirms a positive and significant dependence of safe delivery on ANC in Cameroon. The main control variables such as education, income levels, living environment and region of residence are also expected to affect the likelihood of safe delivery.
RECOMMENDATION
To increase safe delivery in Cameroon, public policymakers could put in place policies encouraging ANC consultation among pregnant women. These policies could include, improving maternal education and reducing the distance to health facilities.

Prevalence and factors of alcohol use among secondary school students in Ghana: A cross-sectional study

2023-01-19T06:08:36+00:00

BACKGROUND
Globally, the harmful use of alcohol is the cause of 3 million (5.3%) deaths. The prevalence of alcohol use among students has been increasing and there is, therefore, the need to explore the situation and solutions to tackle it. The study sought to determine the prevalence and predictors of alcohol use among public secondary school students.
METHODOLOGY
A cross-sectional study was carried out among 848 students from two districts in Ghana who completed a set of questionnaires on alcohol use. Chi-square tests were carried out to determine associations between demographic characteristics and alcohol usage; and gender and age of onset of alcohol use. Binary logistic regression was performed to determine predictors of alcohol use.
RESULTS
Of the 848 study participants, 437 (51.5%) were females. The prevalence of alcohol use was 22.2%. The mean (SD) age of first alcohol use was 13 (2.1) years. Predictors of alcohol use were male gender 3.561 (p=0.003), friends 4.435 (p<0.001) and parents’ 5.302 (p<0.001) use of alcohol.
CONCLUSION
The prevalence of alcohol use among students in this study was high, with many students consuming alcohol at an early age. There is a need for effective health education interventions targeted at secondary school students to reduce alcohol use.

Metabolic Profile as a Predictor of Ischaemic Stroke: The Experience of a Rural Hospital in Nigeria

2023-01-19T06:21:51+00:00

BACKGROUND
The metabolic profile which includes glycated haemoglobin, insulin resistance, pancreatic beta cell function and lipid profile is frequently deranged in acute ischaemic stroke. Stroke is a leading cause of death worldwide and an emerging cause of long-term disability and mortality in Africa. Our study aimed to determine the correlation between the metabolic profile and acute ischaemic stroke in a rural Hospital in Southern Nigeria.
METHODOLOGY
This was a prospective cross-sectional study. Fifty consecutive first-ever ischaemic stroke patients presenting within 72 hours of stroke were matched for age and sex with 3 control groups (49 persons with type 2 diabetes and hypertension, 49 persons with hypertension only and 57 apparently healthy individuals). Blood samples were obtained from all participants to determine glycated haemoglobin, fasting lipid profile, fasting plasma glucose, fasting insulin and C-peptide and random plasma glucose (in stroke cases at presentation). Insulin resistance and pancreatic beta-cell function were determined using the Homeostatic Model Assessment (HOMA). Data were analysed by multivariate and univariate statistics.
RESULTS
One hundred and two (49.8%) males and 103 (50.2%) females participated in the study. The overall mean age of the study participants was 61.6 ± 10.1 years. Compared with the control groups, predictors of acute ischaemic stroke were Fasting insulin (hyperinsulinaemia) [OR (95%CI) = 1.108 (1.043-1.178), p= 0.001], HOMA-β% [OR (95%CI) = 0.994 (0.990-1.001) p=0.006] and total cholesterol [OR (95%CI)= 0.009 (0.001-0.012) p=0.022].
CONCLUSION
In this study, hyperinsulinaemia, impaired beta-cell secretory function (HOMA-β) and elevated total cholesterol were found to be significant risk factors of ischaemic stroke. Hence, the need for regular screening to detect abnormal metabolic profiles and prompt treatment.

Knowledge of the administration of medications among undergraduate nursing students in selected clinical sites in Kenya

2023-01-19T06:30:30+00:00

BACKGROUND
Medication administration is one of the critical competencies in nursing to ensure patient safety. Globally, a lack of competence in medication administration has been associated with high morbidity and mortality rates and poor patient outcomes. This study focused on assessing knowledge of medication administration among undergraduate nursing students.
MATERIALS AND METHODS
This descriptive cross-sectional study was conducted between June and August 2021 in two County Referral Hospitals in Kenya. The study aimed to establish the level of knowledge on medication administration among second-year nursing students starting their clinical rotations, mainly in the medical/surgical wards. The census method was used to recruit 147 participants based on the pre-defined inclusion criteria. The data was collected using a pretested interviewer-administered knowledge questionnaire based on the World Health Organization (WHO) training curriculum on medication safety. The data was then cleaned, coded and analysed using SPSS version 26. Descriptive and inferential statistics were used to summarise and compare the results.
RESULTS
The average score for the medication administration knowledge was 64.8 %, S.D=5.8. The highest score was 79%, whereas the lowest was 43 %. Poor performance was noted in five of the six categories of medication administration, whereby the total number of participants who passed the knowledge assessment with a score of 70% and above was 43 (29.3%) per the international recommendations. The proportion of those who passed differed significantly from those who failed the knowledge assessment, χ² (1, n=147) =25.31, p<0.05. The results of one sample chi-square test indicated that most students failed the knowledge assessment in the various categories (p<0.05).
CONCLUSION AND RECOMMENDATIONS
The pass mark for high-risk skills such as medication administration is 70%. Therefore, the participants’ knowledge was below the recommended pass mark. Nurse educators must identify the gaps in teaching and consider including the WHO medication safety curriculum guidelines and teaching strategies in the existing institutional undergraduate nursing curriculums to enhance the medication administration process and patient safety.

Factors associated with health care seeking behaviour: A cross-sectional study at an emergency department in a teaching hospital

2023-01-19T06:40:07+00:00

BACKGROUND
Emergent conditions are time-sensitive and delays in receiving emergency care can cause mortality and morbidity. Different healthcare-seeking behaviours (HSB) are influenced by several factors which impact choices in seeking healthcare. This study aimed to determine the factors associated with HSB among patients admitted to the Emergency Department of Korle Bu Teaching Hospital (KBTH).
METHODOLOGY
This was a cross-sectional study among patients admitted at the Accident and Emergency Centre of KBTH from May to June 2020 using the quantitative approach in data collection. Simple random sampling was used to select 400 participants who met the inclusion criteria after which the questionnaires were administered. Participants were assessed on their HSB based on Andersen's Behavioural Model of Health. Pearson's chi-square test was used to assess the association between categorical independent variables and the HSB of patients while Welch’s t-test was used to compare means of triage vital signs at admission between patients who sought formal and informal care. All factors significant from Pearson's chi-square test were introduced into the binary logistic regression model. P-values less than 0.05 were considered statistically significant in this study.
RESULTS
Of the 400 respondents interviewed, the mean age was 51 years with 56.5% being women. The majority of respondents (61.50%) sought formal health care as their initial action when sick whiles the remaining sought informal care. The adjusted odds for seeking formal health care were higher among patients who self-rated their illness as severe, those who travelled more than 30 minutes to the nearest health facility and those who were classified as red according to South African Triage Scale (SATS).
CONCLUSION
Self-rating of the severity of illness, distance to health facility and patient classification as red by SATS were significant factors associated with healthcare-seeking behaviour. Knowledge about the factors associated with healthcare-seeking behaviour is vital for health education and health promotion campaigns towards appropriate health care seeking behaviour.

Corrigendum: Sexual behaviour and uptake of modern contraceptives among adolescents in public secondary schools in Lagos State, Nigeria

2023-01-19T07:06:06+00:00

BACKGROUND
Globally, more than 16 million adolescent girls give birth every year with additional 5 million abortions. Adolescent pregnancy has been associated with high maternal mortality rates in Nigeria. Therefore, this study was designed to assess sexual behaviour and contraceptive uptake among secondary school adolescents in an urban area in Nigeria.
MATERIALS AND METHODS
The study was a descriptive cross-sectional study of students from twelve senior secondary schools in 2018. Respondents were interviewed using self-administered structured questionnaires. The questionnaire was pretested and analysis was done using SPSS version 17.0; descriptive data were presented as simple frequencies and percentages. The chi-square test was used for associations and the level of significance was set at p≤5%.
RESULTS
The majority of the respondents (70.3 %) were within the age bracket of 13 to 16 years with a mean age of 15.95±1.43. Generally, there was 100% awareness of the methods of contraceptives by all, with 64.5% aware of condom usage as a method of contraception. The level of knowledge scored fairly (62.4%), and attitude was 48.9% amongst males and females who had responsibility for contraception. Peer pressure of 42.9% was stated as one of the major factors affecting the utilization of modern contraceptives.
CONCLUSION
Awareness of contraception amongst adolescents was high. But with the level of knowledge identified, the government should ensure proper measures to promote sexual behaviour and uptake of contraception among adolescents in Nigeria.