African Journal of Health Sciences

A cross-sectional study of suicide literacy, attitudes towards suicide attempters and decriminalization of the anti-suicide law among lawyers in Nigeria

Oluyemi O. Akanni — 2025-05-23

BACKGROUND

Suicide literacy is suspected to be poor and attitudes towards suicide attempters are sometimes negative in Nigeria. Besides, a suicide attempt is a misdemeanour criminalized under Nigerian law and the attitude towards this legal provision is uncertain. This study aimed to investigate the knowledge of lawyers in Benin City about suicide, their attitudes towards suicide attempters and the anti-suicide law.

METHODOLOGY

It was a descriptive study. Lawyers were drawn into the study by a convenience sampling of the participants who attended a conference of lawyers in Benin City. An additional sample was obtained by a snowballing approach of the lawyers within the city. Participants filled out a paper questionnaire consisting of a socio-demographic section, the Suicide Knowledge Subscale (SKS), and eight other relevant questions designed to meet the study’s objectives.

RESULTS

Eighty-seven lawyers completely and correctly filled out the questionnaire. The participants were of equal male-to-female ratio and mostly private defence lawyers (74.4%). Suicide literacy was more than average in only four out of the nine items of the SKS. About one-half and one-fifth had accurate knowledge of the provision of the Criminal Code and the Penal Code respectively of the Nigerian anti-suicide laws. A majority (55.3%) opined that the current state of the law was good enough. About two-thirds of the participants (64%) agreed to defend rather than prosecute someone who has attempted suicide.

CONCLUSION AND RECOMMENDATIONS

Suicide literacy is low among lawyers. Further, many of the lawyers exhibited poor knowledge concerning the criminal provision of the laws on suicide. They also expressed a mixture of negative/positive attitudes towards those who attempt suicide. There is a need to train them on suicide and anti-suicide legislation.

Seroprevalence and genotypes of Hepatitis A virus among acute hepatitis patients and food handlers in Kenya

Benard Kibet Langat — 2025-05-23

BACKGROUND

Hepatitis A virus (HAV) is a common cause of acute hepatitis worldwide. The epidemiology of HAV is highly dynamic. This necessitates current epidemiological data that can inform actionable recommendations on HAV vaccination and other preventive measures. The study aimed to determine the seroprevalence and genotypes of HAV infections among acute viral hepatitis patients during the January to March 2016 Mombasa outbreak and Kenyan food handlers.

MATERIALS AND METHODS

The study involved 227 healthy food handlers from Bomet County and 43 acute hepatitis patients from Mombasa General Hospital during the 2015–2016 outbreak. This study was approved by the KEMRI Scientific and Ethics Review Unit (SERU No: 2209), and all respondents provided informed written consent. Samples were tested for anti-HAV IgM antibodies to confirm HAV infection. Positive cases underwent nested PCR, sequencing, and genotyping to identify HAV genotypes, providing insights into the genetic characteristics of the circulating strains in these populations.

RESULTS

The mean age of the study subjects was 34.9 years. 16 of 270 (5.93%) samples were positive for anti-HAV IgM antibodies. The HAV seroprevalence was higher among acute hepatitis patients in Mombasa (n=12/43; 27.9%) compared to the food handlers in Bomet (n=4/227; 1.76%). Of the 16 seropositive samples, only four collected from acute viral hepatitis patients were HAV RNA positive. RNA sequencing from these four samples demonstrated the presence of HAV genotype IB (GenBank accession numbers ON832830–832833).

CONCLUSION

The overall HAV seroprevalence rate in our studied populations was 5.93%, with a higher rate among the acute hepatitis patients in Mombasa. HAV genotype IB, associated with water contamination, was observed within the study population.

Hepatitis B and C virus: Current status among health professional students in Mwanza, Tanzania - A cross-sectional study

Betrand Msemwa — 2025-05-23

BACKGROUND

Hepatitis B and C viruses are recognized as major public health concerns, particularly among high-risk groups such as healthcare workers and students in related medical fields. Hepatitis infection can progress to serious liver diseases such as hepatocellular carcinoma and cirrhosis. However, there is a paucity of data on the magnitude of Hepatitis B and C among undergraduate students in clinical years in Mwanza hindering its control interventions. This study aimed to assess the current status of Hepatitis B and C infections and their associated factors among clinical students in Mwanza, Tanzania.

METHODOLOGY

This cross-sectional study involving 300 medical students was conducted between June and August 2023 in Mwanza city. Socio-demographic information and other relevant information of the study participants were collected using a structured pretested data collection tool. About 5 ml of blood for serum analysis was collected from each participant. Detection of HbsAg was by a one-step HbsAg rapid Test kit, and HCV SD Bio line was used for detection of HCV Antibodies finally data analysis was done using STATA version 15 software.

RESULTS

The median age for the study participants was 23 [interquartile range 18-46] years. The prevalence of HBV and HCV in this study was 2.7% (8/300) 95%CI [1.16 -5.19] and 1% (3/300)95%CI [0.21 -2.89], respectively and unprotected sex was significantly associated with HBV positivity with a p-value of 0.004.

CONCLUSION

In this study, we report a low intermediate prevalence of HBsAg (HBV infection) and moderate endemicity of HCV among clinical students in Mwanza, Tanzania. Moreover, unprotected sex was found to be significantly associated with HBV infection, while no factors showed a significant association with HCV infection.

Determinants of influenza, pneumococcal and varicella-zoster vaccine hesitancy in older adults attending a geriatric clinic in Nigeria

Adebusoye Lawrence Adekunle — 2025-05-23

BACKGROUND

Influenza, pneumococcal disease, and shingles are vaccine-preventable diseases with high morbidity and mortality in older adults. Nigeria lacks a national immunisation program for older adults as well as empirical evidence on the uptake and hesitancy to the vaccines for these diseases. This study determined the level and factors associated with the uptake and hesitancy to influenza, pneumococcal, and varicella zoster vaccines among older adults at the Geriatric Centre, University College Hospital, Ibadan, Nigeria.

METHODOLOGY

This was a cross-sectional hospital-based study of older adults (≥60 years). Data were obtained from 332 patients in the outpatient clinic of the Chief Tony Anenih Geriatric Centre (CTAGC) of the University College Hospital (UCH), Ibadan, Nigeria. Participants were selected using a systematic sampling method, collecting data from January to March of 2023. Univariate and multivariate analyses were carried out at 5% significance.

RESULTS

Out of the 332 participants recruited, mean age was 71.8±7.3 years and female-to-male ratio 1.24. Vaccination rates were low for influenza (2.7%), pneumococcal (2.4%), and varicella zoster (0.9%). Vaccine hesitancy rates were 79.2% (influenza), 78.6% (pneumococcal), and 81.6% (varicella zoster). Bivariate analysis revealed significant associations with vaccine hesitancy, including low education, low income, living with family, financial and social support, concerns over side effects, commercial profiteering, reliance on natural immunity, risk calculation, collective responsibility, and negative perceptions of vaccine safety and effectiveness. Multivariate logistic regression identified a preference for natural immunity, greater calculation of disease and vaccination risk, and vaccine safety concerns as predictors of hesitancy to influenza, pneumococcal, and varicella zoster vaccines.

CONCLUSION AND RECOMMENDATIONS

The uptake of influenza, pneumococcal, and varicella zoster vaccines was poor among older adults in our setting,while vaccine hesitancy was high indicating that a high proportion of older adults were unwilling and undecided to take the vaccines. Investigating and addressing vaccination concerns such as preference for natural immunity, greater calculation of disease and vaccination risk, and concerns about vaccine safety may improve vaccination coverage among older adults.

Factors associated with HIV self-testing among long-distance truck drivers along Uganda Road in Uasin Gishu County, Kenya

Dennis Kipkosgei Rotich — 2025-05-23

INTRODUCTION

HIV self-testing was introduced to increase the number of HIV testing rates among hard-to-reach populations such as long-distance truck drivers. However, little is known about its uptake in Kenya, where it has been available since 2017, or the factors influencing its utilisation. Therefore, this study aimed to assess the uptake and establish the sociodemographic and behavioural factors associated with HIV self-testing among truck drivers along Uganda Road in Uasin Gishu County, Kenya.

METHODOLOGY

This cross-sectional study recruited 287 participants using proportionate stratified and simple random sampling. Data were collected through a pretested, interviewer-administered questionnaire uploaded to KoboToolbox. Necessary research licences and permits were obtained. Data were analysed using SPSS version 28 for descriptive statistics including means, frequencies, and percentages. Bivariate analysis was used to determine associations between variables, while multivariate logistic regression using a generalised linear model identified true predictors of HIV self-testing at a 95% confidence interval (CI) at p < 0.05.

RESULTS

The majority (98.6%) of the 287 participants were male averaging 38.66 years and HIV self-testing uptake was 35.5%. Factors associated with HIV self-testing included the duration of driving specifically 6-10 years (Odds Ratio(OR)=3.0, 95% CI =1.3-6.9, p=0.008); moderate and high perceived risk of HIV infection (OR=4.1, 95% CI=1.9-9.1, p=<0.001 and OR=3.7, 95% CI=1.3-10.8, p=0.012); average and excellent HIV knowledge (OR=11.7, 95% CI =2.2-217.4, p=0.021 and OR=28.3, 95% CI =5.1-536, p=0.002).

CONCLUSION

HIV self-testing uptake remains low, highlighting the need for targeted educational campaigns. Peer-led programs and workplace sensitisation can help reinforce HIV risk perception and knowledge, while interventions should be tailored to meet the needs of drivers of varying degrees of experience.

Medication adherence and associated factors among adult patients with hypertension attending two county referral hospitals in Kenya

Stephen Kainga M’Kiunga — 2025-05-23

BACKGROUND

Inadequately controlled hypertension increases risks of morbidity and mortality associated with damage to cardiovascular, cerebrovascular or renal systems. Sub-optimal adherence to antihypertensive medications significantly contributes to inadequate hypertension control rates among the majority of the patients. This study assessed medication adherence (MA) and associated factors among adults with hypertension attending two county referral hospitals in Kenya.

METHODOLOGY

This was an analytical cross-sectional study that was part of a larger experimental study. A total of 328 adults with hypertension were recruited using simple random sampling. The Hill-Bone Medication Adherence Scale (HB-MAS) was used to measure antihypertensive MA while a researcher-developed questionnaire captured demographic and health-related data. Anthropometric variables were gathered using standard tools and standard procedures. The obtained data were analyzed using R software (v 4.1.2). Multiple linear regression analysis was done to identify determinants of adherence to antihypertensive medications. For all analyses, the level of statistical significance was set at P ˂ 0.05.

RESULTS

The participants attained a mean score of 33 with a minimum and maximum score of 27 and 36 respectively. The predictors of better MA included younger age (p=0.02), higher knowledge of medications (p=0.03), improved communication with doctors and other healthcare workers (p˂ 0.001), positive self-rating of BP status (p˂ 0.001) and lower BMI (p=0.01). Most participants considered forgetfulness (80.5%) and running out of medications (76.5%) the most significant factors in decreasing MA.

CONCLUSION

The level of MA was above average. The predictors of better MA included younger age, knowledge of medications, the individual perception that their BP status was better compared to the previous year, and having active and regular communication with doctors and other healthcare providers to address issues related to their disease and other personal problems.

The effectiveness of an education intervention based on self-care model on social support among adolescents with Type 1 diabetes mellitus

Sherry Oluchina — 2025-05-23

INTRODUCTION

The increasing prevalence rate has made diabetes mellitus a world epidemic. Type 1 diabetes mellitus (T1DM) demands are extensive. Self-care among adolescents with T1DM improves when social support is provided by parents, caregivers and peers. This intervention study among adolescents with T1DM evaluated the effectiveness of a self-care model education intervention on social support.

METHODOLOGY

We conducted a quasi-experimental non-equivalent study design utilizing pre-test and post-test at Thika Level 5 Hospital (TL5H) and Kiambu Level 5 Hospital (KL5H) diabetes clinics in Kenya from January to August 2021. Adolescents aged 10 to 19 years at the two clinics selected by stratified random sampling were the study population. Experimental and control arms had 48 adolescents with T1DM. The experimental arm received education intervention but the control arm did not. The Medical Outcomes Study (MOS) Social Support Survey (SSS) scale was used to assess social support in the first and seventh months. Data were analysed by the paired sample T-test and Independent T-test.

RESULTS

Paired sample T-test showed a significant increase in social support (p<0.05) before and after the intervention. Independent T-test showed a significant increase in social support (p<0.05) post-intervention.

CONCLUSION

Education intervention based on the self-care model is an effective program that could improve social support. In addition, the education intervention based on self-care model needs to be implemented continuously to prevent diabetes-related complications and improve social support for diabetic patients.

Health Management Information System and health products and technologies management in level four and five hospitals in Nyeri County, Kenya

Alice Muthoni Machanga — 2025-05-23

INTRODUCTION

An effective health system is based on well-managed health products and technologies. However, the efficient administration of medical supplies and equipment in Kenya's public hospitals faces several challenges. This research focused on Level Four and Five hospitals in Nyeri County, in Kenya, aiming to identify the factors influencing health product and technology (HPT) management in relation to health management practices.

METHODOLOGY

This study employed a cross-sectional research design with a mixed-methods approach. Six key informants were identified through purposive sampling, while 51 health professionals were selected using a census technique. Data were gathered using structured questionnaires, which were piloted in Laikipia County to ensure accuracy. Quantitative data were analyzed using SPSS version 25, employing hierarchical regression methods, descriptive statistics, and correlation analysis. Qualitative data were analyzed thematically and presented verbatim.

RESULTS

The Health Management Information Systems (HMIS) accounted for 43.3% of the variation in HPT management. The explanatory power slightly improved to 43.9% with the addition of the leadership style as the mediating variable, indicating its contribution to the model. The regression analysis revealed a positive and significant relationship between HMIS and HPT management (β = 0.331), suggesting that improvements in HMIS are associated with better management of HPTs.

CONCLUSION

Level Four and Five hospitals in Nyeri County rely heavily on the Health Management Information System (HMIS) for HPT management. Further research should explore additional factors—such as the regulatory environment, patient needs and preferences, healthcare provider adoption, healthcare infrastructure, and global health challenges—that account for the remaining 56.7% of the variation in HPT management, both in Nyeri County and beyond.

Determinants of nurses' ethical decision-making in acute care: A case study of Thika level V hospital

Rachael Nyarangi Simeka — 2025-05-23

BACKGROUND

Nurses in acute care settings often face complex ethical challenges, requiring them to make rapid and skilled decisions despite having limited clinical support. Moreover, novice nurses with limited experience frequently adopt linear decision-making approaches, which focus on single tasks and problems. However, in critical care environments, these decisions could significantly affect patient outcomes. Therefore, this study aimed to identify determinants influencing ethical decision-making among nurses working in the intensive care unit, renal unit, and emergency unit of Thika level V hospital, in Kiambu County, Kenya.

METHODOLOGY

Adopting an analytical cross-sectional design with quantitative and qualitative methods through a census approach, we recruited 36 registered nurses working in critical care settings of Thika Level V hospital. A self-administered questionnaire and a key informant interview guide were instruments used to collect quantitative and qualitative data, respectively. We analysed the quantitative data using SPSS version 26.0 for descriptive and inferential statistics and thematically analysed qualitative data using NVivo version 21.2. The Mantel-Haenszel chi-square test was used in the inferential analysis with P<0.05 considered statistically significant. The confidence interval was set at 95%.

RESULTS

The majority of nurses (75%) demonstrated low adherence to the ethical decision-making process. Work-related factors did not significantly influence adherence levels. Emerging thematic areas of ethical issues were three namely, resource allocation, paediatric care, and challenges affecting patient care in acute settings.

CONCLUSION AND RECOMMENDATIONS

Most nurses in Thika Level V Hospital’s acute care settings exhibited low adherence to ethical decision-making processes and work-related factors did not significantly affect their adherence. The ethical dilemmas the nurses faced were: the allocation of resources, handling of paediatric patients and ethical issues affecting care. To address these gaps, healthcare institutions should provide targeted support to nurses for navigating ethical challenges. We also recommend further research, inter-institutional collaborations, and dissemination of best practices to enhance ethical decision-making in critical care environments.

A comparative study of sexual and reproductive health knowledge among adolescents in rural and urban secondary schools of Ekitistate, Nigeria

Oluremi Olayinka Solomon — 2025-05-23

BACKGROUND

Adolescents without adequate knowledge of sexual reproductive health are predisposed to high-risk sexual behaviours. Knowledge of sexual and reproductive health among adolescents is generally low, especially in rural areas. This study aimed to compare sexual and reproductive health knowledge and likely disparities among adolescents in rural and urban secondary schools.

METHODOLOGY

The study was a comparative cross-sectional design. Pre-tested, semi-structured, adapted questionnaires were administered to 669 students selected through a multistage sampling technique. Univariate, bivariate and multivariate analyses were conducted after entering data using SPSS version 25. Descriptive statistics (percentages, the sample mean, and frequency tables) were computed. Chi-square was used to determine the association between socio-demographic characteristics and knowledge. Multivariate analyses were conducted using binary regression, considering a p-value threshold of < 0.05.

RESULTS

Overall knowledge was 257 (65.2%) and 207 (75.3%) in the urban and rural, respectively. In the urban area 72.5% (n=150) of the females had good knowledge compared to only 57.2% (n=107) of the boys (p=0.006). Sex of participant was associated with knowledge of sexual reproductive health (p < 0.05).

CONCLUSIONS

The knowledge of sexuality, reproductive anatomy, and physiology among adolescents in rural schools was better than in urban schools. Knowledge of female adolescents was better than that of male adolescents, and the differences were statistically significant.

RECOMMENDATIONS

Culturally gender-sensitive educational intervention should be employed by the government, teachers, and parents.

Association between knowledge levels and Menstrual Hygiene Management practices among adolescent girls with disabilities in selected schools in Wajir County, Kenya

Abdiwahit A. Jama — 2025-05-23

BACKGROUND

Menstruation marks a significant transition for adolescent girls, yet unhygienic practices and inadequate access to clean and supportive environments, like sanitation facilities, impact their social well-being and health. This issue is exacerbated for girls with disabilities due to the additional challenges they face. This study aimed to assess Menstrual Hygiene Management (MHM) practices among adolescent girls with disabilities in primary schools in Wajir County, Kenya, focusing on knowledge level.

METHODOLOGY

A descriptive cross-sectional study design was employed, using a census sampling technique to select 101 adolescent girls with disabilities from three primary schools. Data was collected through questionnaires and analyzed using descriptive and inferential statistics. Chi-square tests determined associations between variables, with significant results further examined through logistic regression analysis.

RESULTS

Only 11.9% of respondents practised MHM. Knowledge factors that were associated with Menstrual Hygiene Management practice were; normal for every girl to experience menstruation (p=0.013), Menstrual blood comes from the womb (p=0.042), Menstruation is an indication of fertility (p=0.008) and overall level of knowledge about menstruation (p=0.037). Predictors of Menstrual Hygiene Management practice were, believing it is normal for every girl to experience menstruation (AOR=7.417, p=0.001), menstruation is an indicator of fertility (AOR=6.800, p=0.045) and overall levels of menstrual knowledge (AOR=4.206, p=0.028).

CONCLUSION AND RECOMMENDATIONS

Menstrual Hygiene Management (MHM) practices among the study population were notably low. Overall level of knowledge predicted Menstrual Hygiene Management practice (AOR=4.206, p=0.028). We recommend providing free sanitary pads, improving sanitation facilities, addressing misconceptions, and increasing MHM education. Enhanced support from the government and NGOs is crucial to improve access to resources and services.

Child oral health: Practices among parents attending child welfare clinics in Murang’a County, Kenya

Kaguru George — 2025-05-23

BACKGROUND

Early childhood caries affects half of Kenya's under-five-year-old children. This high disease burden suggests possible gaps in child oral healthcare practices among their parents. To facilitate change in practice towards reducing early childhood caries, there was a need to identify current practice gaps. This study thus aimed at assessing child oral healthcare practices among parents attending child welfare clinics in Murang’a County, Kenya.

METHODOLOGY

This was a baseline cross-sectional study targeting 357 parents of children aged 6-18 months attending the child welfare clinics in Murang’a County, Kenya. An interviewer-administered questionnaire was used to collect data on child oral healthcare practices. The chi-square test and logistic regressions were used to determine the association between predictor variables and practices.

RESULTS

Fifty-one (14.3%) of the parents cleaned their children's teeth, majority brushed occasionally. Brushing was significantly (p<0.001) influenced by the child's age. Parents' age, sex or level of education did not influence teeth cleaning. Only 2.0% used toothbrush and toothpaste, while a piece of cloth was the preferred cleaning tool (10.9%) and only 1.1% used toothbrush only. Additionally, only 14.3% of participating parents referred to dental health notes in the mother-child booklet, none had filled the baby's teeth development chart. Notably, no parent had taken their child for an index dental visit, consumption of a cariogenic diet was prevalent (32.8%), and uvulectomy (6.7%) was practised among the study population.

CONCLUSION AND RECOMMENDATIONS

Parents visiting the child welfare clinics had poor child oral health practices, consequently, they should be educated on child oral health practices and how to utilize the mother-child booklet for oral health.

Nurses' knowledge of evidence-based preventive measures for catheter-associated urinary tract infections in Kiambu County referral hospitals, Kenya

Jocyline Mukiri — 2025-05-23

BACKGROUND

Catheter-associated urinary tract infections (CAUTIs) remain one of the most common healthcare-associated infections (HAIs) despite established preventive guidelines. Nurses play a key role in implementing prevention strategies, educating patients, and ensuring evidence-based practices. However, many lack sufficient expertise in this area. This study evaluated nurses' knowledge of evidence-based CAUTI prevention measures.

MATERIALS AND METHODS

This descriptive cross-sectional study was part of a larger quasi-experimental research. The setting was adult medical and surgical wards in Kiambu and Thika County Referral Hospitals in Kiambu County in Kenya. The census method was used to recruit 83 nurses from these wards based on pre-defined inclusion criteria. Data were collected using a pretested researcher-developed knowledge questionnaire. Data analysis was done using SPSS version 26. Descriptive and inferential statistics were used to summarize and compare the results.

RESULTS

Nurses in Kiambu and Thika county referral hospitals demonstrated poor knowledge of evidence-based measures to prevent CAUTIs. The mean knowledge scores were 57.52% (SD = 11.48) and 56.98% (SD = 10.80), respectively, with no significant difference between the two groups (χ²=0.002, p=0.968). Overall, 87.95% (73/83) of participants scored below the 70% pass mark, highlighting gaps across all four key areas of CAUTI prevention: appropriate catheter use, proper insertion techniques, catheter maintenance, and timely removal. Only 12.05% (10/83) met the recommended benchmark, as set by the Commission on Collegiate Nursing Education.

CONCLUSION AND RECOMMENDATION

Nurses’ knowledge was poor as it was below the pass mark recommended for high-risk skills such as indwelling urinary catheter maintenance. Medical-surgical nurses should be educated on current CAUTI evidence-based prevention measures to improve their knowledge and skills and ultimately reduce these infections.