African Journal of Health Sciences <p>The Journal of African Health Sciences has been in production and circulation since 1994.The Journal has been produced through the efforts of Kenya Medical Research Institute (KEMRI) and the African Forum for Health Sciences (AFHES).</p> <p>A lot of interest had been created in the Journal locally and internationally. The Journal was regularly patronized by scientist as one of the leading scientific publication in Africa.</p> <p>The Publications Committee, a committee comprised of the senior scientists that peruses all publications emanating from KEMRI, felt that it was essential to continue with the publication and circulation of the Journal as soon as possible. Therefore the Publications Committee formed a new team to revive the publication and circulation of the Journal and to ensure future sustainability of the Journal. The new team felt there is need for mechanism to fund the above activities towards revival of the Journal on behalf of the scientist.</p> <p>Other websites related to this journal: <a href="" target="_blank" rel="noopener"></a></p> Kenya Medical Research Institute en-US African Journal of Health Sciences 1022-9272 Editorial: Hepatitis E: An Emerging Viral Illness of the Liver <p>No Abstract</p> Dr Hudson A. Lodenyo Copyright (c) 2021-09-08 2021-09-08 34 4 421 421 Hepatitis E in Namibia: A Historical Review <p><strong>Background:</strong><br>Namibia has had three outbreaks of Hepatitis E Virus (HEV), in 1983, 1995 and 2017. HEV is particularly dangerous to pregnant women. The objective of this study was to present a thorough review of the history of HEV in Namibia; the genotypes which have appeared since 1983, and the possible reasons for the nationwide spread of HEV that has occurred since 2017.<br><strong>Materials and Methods:</strong><br>As this is a review article, no primary research data will be presented. However, an exhaustive literature study has been undertaken and there will be in-depth discussion of the findings of primary researchers in Namibia and elsewhere.<br><strong>Results</strong>:<br>The first two episodes were confined to the Rundu area. The 1983 outbreak may have been genotype 1; that of 1995 contained genotypes 1 and 2. The genotype of 2017 episode has not been clearly established. Increased road traffic may have spread HEV during 2017-2020. Lack of clean water and washing facilities, and lack of awareness of what causes HEV, are the main factors in spreading it.<br><strong>Conclusionsand Recommendations:</strong><br>There remain challenges to the containment of HEV. A recent government initiative to stop COVID-19 has helped slow its progress. Both infections are propagated by poor hygienic practice and lack of clean water</p> <p><strong>Keywords</strong>: Hepatitis E, Disease Control, Poor Hygiene, Namibia</p> T.J. Davies Rachel Freeman Judith Hall Frauke Stegmann Copyright (c) 2021-09-09 2021-09-09 34 4 422 436 Perinatal Outcomes of Newborns by Women Presenting with Maternal Complications in Pregnancy at a County Referral Hospital in Lower Eastern Kenya <p><strong>Background:</strong><br>Maternal complications during pregnancy and labor have been the leading cause of maternal and neonatal death globally. The aim of the study was to observe and compare the differences in the perinatal outcomes of newborns born to women with maternal complications to those born to women without complications.<br><strong>Materials and Methods:</strong><br>This was a prospective hospital-based paired cohort study. A total of 510 pregnant women were followed up and their newborns’ outcomes recorded. 102 had complications and 408 did not have complications.<br><strong>Results:</strong><br>Thirteen percent (n=17) of women with complications and 9% (n=34) of women without complications were aged between 13 to 19 years. Forty five percent n=45 of the respondents were followed for maternal care related to fetus and amniotic cavity and possible delivery-related complications.<br><strong>Conclusion:</strong><br>Teenagers and women aged above 34 years in pregnancy were at a higher risk of presenting with maternal complications. Women referred from hard to reach constituencies of the county were more likely to present with complications in pregnancy. Maternal care related to amniotic fluid cavity complications was the leading maternal complications in pregnancy followed by edema with proteinuria complications.<br><strong>Recommendations:</strong><br>Governments and non-governmental organizations should put more emphasis on youth friendly services to reduce maternal complications associated with teenage pregnancy. There should also be more investment on infrastructure to make referral systems easy and avoid the second delay among women with maternal complications. Moreover, women presenting with maternal complications in pregnancy at all levels of care should be closely followed up to avert cases of intra-uterine fetal deaths before and during labor</p> <p><strong>Keywords</strong>: Perinatal Newborn Outcomes, Maternal Complications in Pregnancy, Exposed Newborns, Unexposed Newborns</p> Joseph Kithokoo Mulwa Drusilla Makworo Mwangi Elijah Githinji Copyright (c) 2021-09-09 2021-09-09 34 4 437 450 Immediate Seven Day Outcomes and Risk Factors of Low Birth Weight Neonates at Referral Hospitals in Mwanza City, Tanzania in October 2020 <p><strong>Background:</strong><br>Every year more than 20 million neonates worldwide are born with low birth weight (LBW) per year. Ninety-five percent of LBW births occur in developing countries. The aim of this study was to determine Immediate Seven Day Outcomes and Risk Factors of Low Birth Weight Neonates at Referral Hospitals in Mwanza City.<br><strong>Materials and Methods:</strong><br>This was a hospital based observational prospective cohort study of neonates with LBW whom were followed up for seven days in the neonatal wards at referral hospitals in Mwanza city. Maternal social-demographic, newborns clinical data and vitality outcomes were collected. Categorical and continuous variables were summarized and presented in tables or bar charts. Any<em> p-value</em> of &lt; 0.05, at 95% confidence interval was regarded as statistically significant.<br><strong>Results:</strong><br>Total of 200 neonates with median age of 0.8 days at baseline were enrolled. Amongst 148 (74 %) had prolonged hospitalization; due to sickness 88 (59%), and 60 (40%) due to poor weight gain. Whereas, the remaining 42 (21%) were discharged and 10 (5%) died within seven days. Prolonged hospitalization was associated with family income (<em>p-value</em>= &lt;0.001) and place of delivery (<em>p-value</em> = &lt;0.001). Neonatal death was associated with family income (<em>p-value</em> =0.035) and birth weight (<em>p-value</em> = 0.019). Early discharge associated with gestational age at first antenatal visit, family income, mode of delivery, APGAR score at one minute, time interval between delivery and admission and timing of medication initiation.<br><strong>Conclusion:</strong><br>LBW neonates are at high risk of death and prolonged hospitalization due to sickness or due to poor weight gain. Associated factors of these outcomes were family income, place of delivery, birth weight, gestation age during first antenatal visit, mode of delivered and low APGAR score.</p> <p><strong>Keywords</strong>: Neonatal Outcomes, Low Birth Weight, Tanzania</p> Shangwe Ezekiel Kibona Edson Elias Sungwa Haruna Ismail Dika Rose Mjawa Laisser Tumaini Mhada Kija Nchambi Malale Ambroce Modest Stephen Helena Marco Gemuhay Copyright (c) 2021-09-09 2021-09-09 34 4 451 463 Predictors of Adherence to Highly Active Antiretroviral Therapy among HIV Patients attending Selected Comprehensive Care Centres in Kericho County, Kenya <p><strong>Background:</strong><br>Highly Active Antiretroviral Therapy (HAART) is undoubtedly the only proven remedy known to improve the health outcomes and reduce AIDS-related mortality. However, just like other chronic diseases, HIV presents significant challenges in achieving and maintaining adherence to medication. The effectiveness of HAART solely depends on adherence. For maximum medication benefits, a near-perfect adherence levels of &gt;95% is required yet data from different studies indicate that few, if any patients have achieved perfect adherence. The main objective of the study was to the determine predictors of adherence to Highly Active Antiretroviral Therapy among HIV patients attending selected comprehensive care centres in Kericho County.</p> <p><strong><em>Materials and Methods</em></strong>:<br>A descriptive cross-sectional study was adopted, involving 280 HIV patients (≥ 15 years) on HAART from three selected Comprehensive Care Centres in Kericho County, Kenya. Quantitative and qualitative data were collected using interviewer administered semi-structured questionnaires and key informant interviews, respectively. Purposive sampling was used to select the three health facilities while systematic sampling was used for participant selection. Adherence was measured using viral load. Data was analyzed using SPSS version 25. Logistic regression analysis was used to determine the association between adherence to HAART and various independent variables. Results were considered to be significant at p &lt; 0.05).</p> <p><strong>Results and conclusion:</strong><br>Seventy six percent (76%) of the respondents had optimal adherence while 24% had sub-optimal adherence. More females than males were on treatment. Use of HAART alternatives was a risk factor for sub-optimal adherence (p=0.011).<br>Having someone/tool to remind of when to take medication and disclosure of HIV positive status to spouse were found to significantly promote adherence to HAART with p=0.034) and p=0.048, respectively.</p> <p><strong>Recommendations:</strong><br>Several studies have been done on the socio-demographic and socio-economic factors associated with adherence to HAART. Findings from this study indicate that attitudes and practices towards HAART have significant effects on adherence hence more research should be done on attitudes and practice aspects of adherence</p> <p><strong>Keywords:</strong> Adherence, Highly Active Antiretroviral Therapy (HAART), Human Immunodeficiency Virus</p> Dennis Magu Collins Cheruiyot Eunice Chelogoi Copyright (c) 2021-09-09 2021-09-09 34 4 464 474 A Study of Bacteriological Quality of Street-Hawked Milk in Ilesha Metroplolis, Osun State, Nigeria <p><strong>Introduction:</strong><br>Milk, a nutrient-rich liquid food produced in the mammary glands of mammals, contains low bacterial counts when it leaves the udder, but it may get contaminated from the environment, exterior of udder, water, soil, milkers’ hands and utensils. Contamination can serve as a source of spread of certain harmful human bacterial diseases like tuberculosis, diphtheria, salmonellosis and food poisoning if consumed in raw form. This study, therefore, was designed to evaluate bacteriological quality of milk samples collected from various localities within Ilesha metropolis.</p> <p><strong>Materials and Methods:&nbsp;</strong><br>Twenty (20) samples of fresh raw milk were collected in sterilized bottles from various nomadic milk hawkers in Ilesha. Methylene blue reductase test, standard plate count on standard plate count agar and isolation of possible pathogens using selective culture media was carried out on the samples.</p> <p><strong>Results:</strong><br>Of the 20 samples of raw milk collected for bacteriological analysis, 3 samples were found to be of excellent quality, 5 were very good, 4 were good, 5 were fair and 3 were of poor quality. The actual standard plate count for excellent and very good quality ranged between 33-54 and 62 - 80 colony forming units (cfu). The organisms isolated and biochemically characterized from the raw milk samples were found contaminated with <em>Escherichia coli</em> (4 strains), <em>Staphylococcus aureus</em> (8 strains),<em> Streptococcus pyogenes</em> (5 strains), <em>Streptococcus agalactiae</em> (3 strains) and <em>Enterobacter aerogenes</em> (5 strains).</p> <p><strong>Conclusion</strong>:<br>The results obtained from this study showed that the milk sold in raw form could be hazardous to human health if sold without adopting hygienic measures.</p> <p><strong>Keywords:</strong> Bacteriological Evaluation, Street-Hawked Milk, Ilesa Metropolis, Osun State.</p> O.L Okunye P.A Idowu B.M Okanlawan W.A. Ojieabu E.M. Coker Copyright (c) 2021 2021-09-10 2021-09-10 34 4 475 481 COVID-19 Health Knowledge and Practices among Nigerian Residents during the Second Wave of the Pandemic: A quick online cross-sectional survey <p><strong>Background</strong>:<br>The COVID-19 pandemic has redefined life as a whole. The lack of knowledge about the safe practices needed to manage the spread of the global pandemic could be detrimental to public health. This dearth of knowledge and inappropriate practices could increase the spread of the coronavirus and lead to high mortality rates in a country like Nigeria where access to healthcare services is limited. The study’s objective was to assess the health knowledge and practices of Nigerian residents in the face of the second wave of the COVID-19 pandemic.<br><strong>Materials and Methods:</strong><br>The study adopted a cross-sectional online survey which was conducted from January 2 to February 1, 2021. A self-administered questionnaire was used to collect data on the socio-demographics characteristics of respondents, the knowledge of COVID-19 and health management practices related to the virus. The reliability of the instrument yielded 0.72 internal consistency and the data were analyzed using descriptive and logistic regression at p&lt;0.05.<br><strong>Results:</strong><br>A total of 1,988 respondents participated in the study; 49.3% of this number were urban residents, 63.0% were males, 58.1% were married, and 67.4% had tertiary education. Overall, the mean score was 9.44±1.8 (72.6%) for knowledge and 6.72±3.1 (56%) for appropriate practices. Rural residence (OR = 0.552, 95% CI 0.351–0.868), female gender (OR = 4.494, 95% CI 3.264–6.187), aged 50 years and above (OR = 0.137, 95% CI 0.071-0.261), married status (OR = 5.004, 95% CI 3.242–7.724), tertiary education (OR = 7.049, 95% CI 4.362–11.391), Yoruba ethnicity (OR = 2.828, 95% CI 1.292–6.187), and good knowledge of COVID-19 (OR = 1.905, 95% CI 1.376–2.637) significantly predict appropriate practices.<br><strong>Conclusion:</strong><br>A substantial number of our respondents had good knowledge but lacked appropriate practices towards COVID-19. The beliefs of the people influenced inappropriate practices just as adequate practice was associated with good knowledge. There is a need for adequate sensitization programmes which might require the use of local languages/dialects and Nigerian Pidgin English to reduce the misinformation surrounding the virus.</p> <p><strong>Keywords:</strong> COVID-19 Pandemic, Knowledge, Beliefs, Practices, Nigeria</p> Turnwait O. Michael Tolulope Funmilola Ojo Grace A. T. Scent Olasumbo B. Kukoyi Oluwaseun I. Alhassan Richard Dele Agbana Copyright (c) 2021-09-10 2021-09-10 34 4 482 497 Patterns of Influence of Diabetics’ Integrating Healthcare-Seeking Behaviours on Diabetes Management in Rongo Sub-County, Migori County, Kenya <p><strong>Introduction:</strong><br>Diabetes is a fast-growing socio-economic burden, highly prevalent in Kenya due to inadequacies of mitigation measures; though manageable through appropriate healthcare-seeking behaviours (HSBs). High malaria and HIV/AIDS prevalence in Migori County reveals high susceptibility; besides, Rongo Sub County recorded the highest increment in diabetes clinic attendance in 2019. Hence, the study sought to determine the patterns of influence of diabetics’ integrating HSBs on diabetes management.<br><strong>Materials and Methods:</strong><br>Health Belief Model guided the study by adopting a correlational study design and convergent mixed-method approach. Yamane’s formula was applied to select 257 respondents using cluster and simple random sampling, and 5 medical practitioners purposively sampled. Results were analysed using descriptive and inferential statistics through SPSS v.26.0 and presented in frequency tables and bar graphs.<br><strong>Results:</strong><br>Females were 55.2%, individuals aged&gt; 50 years 60.9%, contemporary religious affiliation 98.9%, monthly income&lt; Ksh. 20,000 46.0%, normal blood sugar levels 65.5%, raised blood sugar levels 22.9%, frequently integrating HSBs 86.2% and those satisfied integrating HSBs were 78.1%. Significant association and very strong positive correlation between diabetics’ integrating HSBs and diabetes management was obtained (at p-value= .01; rs= .850) using a 2-tailed Spearman’s correlation. HO was rejected and Ha accepted, showing that there was statistically significant pattern of influence of diabetics’ integrating HSBs on diabetes management.<br><strong>Conclusion and Recommendation:</strong><br>There were patterns of influence of diabetics’ integrating HSBs on diabetes management in the study area. We recommend that Migori County Government and Ministry of Health improve patient-healthcare worker relationships. Besides, they should identify and document acceptable informal therapies.</p> <p><strong>Keywords:</strong> Integrating, Healthcare-Seeking Behaviours, Diabetics, Diabetes Management</p> MacDonald Odhiambo Owuor Wilson A.P. Otengah Erick Ater Onyango Eliud Oure Oyoo Copyright (c) 2021-09-10 2021-09-10 34 4 498 511 Determinants of Adolescent and Youth Sexual and Reproductive Health Service Utilization in Hard-To-Reach Communities of Amudat District, Uganda <p><strong>Introduction:</strong><br>Uganda has one of the largest adolescent and youth populations globally and yet access and utilization of sexual and reproductive health services (SRH) among this population remains inadequate, especially in hard-to-reach communities. This study sought to establish the contextual determinants of service utilization in Amudat District, a hard-to-reach community in Karamoja, Uganda.<br><strong>Materials and Methods:</strong><br>A community based descriptive cross-sectional study was conducted using random sampling of 503 respondents recruited after informed consent. Data were collected using interviewer administered questionnaires, entered into epidata 3.1 and analysed using STATA version 12. For quantitative data, logistic regression analysis was used to determine factors associated with services utilization. Qualitative data were analysed by content analysis, for themes.<br><strong>Results:</strong><br>Older adolescents and youth out-of-school were more likely to utilise services, with religion and socially accepted norms additionally determining utilisation of services.<br><strong>Conclusion:</strong><br>Strengthening social services that keep adolescents in school; supporting community engagement through youth gatekeepers particularly youth champions, religious and cultural leaders; while fostering family values that favour SRH discussions will increase access to and use of SRH services in hard-to-reach communities.<br><strong>Recommendations:</strong><br>Promote culturally adapted sexuality education; prevent child marriage, and provide youth friendly SRH services aligned to need in Amudat and similar settings</p> <p><strong>Key Words:</strong> Adolescents and Youths, Sexual and Reproductive Health, Hard-To-Reach Communities, Youth Friendly Services</p> Bernadette Ssebadduka Miisa Nanyingi Copyright (c) 2021-09-10 2021-09-10 34 4 512 525 Hypertension: Predictors of Knowledge among Market Women in the Sub-Urban Town of Sagamu, South West Nigeria <p><strong>Introduction:</strong><br>Hypertension is a major public health problem. Based on prevalence of hypertension in Nigeria, only 1/3 of Nigerians are aware that they are hypertensive and of this, only two-third is on treatment for the hypertension. This may be because of inadequate provision of proper education and counseling by health care providers on the risks associated with high blood pressure. This study was to assess the knowledge of hypertension and the determinants among market women in Sagamu, South West Nigeria.</p> <p><strong>Materials and Methods:</strong><br>The study was a cross sectional study conducted among women in the four major markets in Sagamu. The participants were recruited using multistage technique, thereafter a pretested questionnaire was administered to obtained relevant information. Data obtained were entered and analyzed using IBM SPSS 21.</p> <p><strong>Results:</strong><br>All the participants had heard of hypertension. Regarding overall knowledge scores, two hundred and fifty-two (60%) had good knowledge, 128(30%) fair/average knowledge while 40(10%) had poor knowledge. Two hundred and fourteen (51%) of the respondents had been diagnosed of hypertension. Those with normal weight, those who were overweight, those who had spent less than 10 years in the market (less time spent in a sedentary occupation) and those with co-morbidities were more likely to have good knowledge of hypertension. Those with informal/primary education, family history of hypertension and co-morbidities had a higher likelihood of reporting a previous diagnosis of hypertension.</p> <p><strong> Conclusion and recommendation:</strong><br>This study revealed that women in Sagamu are aware of hypertension. About two-thirds of them have good knowledge of hypertension. Determinants of knowledge of hypertension include educational status, number of years spent in market business (sedentary occupation), BMI, family history of hypertension and presence of comorbidities. There remains a need for continued community education about hypertension.</p> <p><strong>Keywords</strong>: Hypertension, Knowledge Predictors, South West Nigeria</p> Oluwaseyi I. Odelola Akintunde Akinpelu Akolade O. Idowu Oluwaseyitan A. Adesegun Bamikole T. Osibowale Osaze Ehioghae Razaq O. Lateef Micheal O. Elegbede Oluwafemi Ajose Odedina Adetowobola B Copyright (c) 2021-09-10 2021-09-10 34 4 526 536 Effects of <i>Achyranthes Aspera, Bidens Pilosa </i> and <i>Ajuga Remota </i> Leaf Extracts on Serum Glucose and Electrolyte Levels in Alloxan Treated Male Goats <p><strong>Background:</strong><br>Diabetes mellitus (DM) is a metabolic disorder that causes a major health concern and whose prevalence has continuously increased globally over the past few decades. It has been considered as an incurable non-communicable metabolic disorder of multiple etiologies affecting about 2.8% of the population worldwide. Derangement of water and electrolyte balances was found to occur in subjects with diabetes mellitus, resulting from insulin deficiency, hyperglycemia, and hyperketonemia. Electrolytes imbalance contributes to complications observed in diabetes and pose a significant risk of contracting many diseases. In the present study, we compared the anti-diabetic activities of ethanolic leaf extracts of<em> A. aspera, B. pilosa</em> and<em> A. remota</em> and their influence on serum levels of glycemia, natremia, calcemia, kalemia, and chloremia in diabetic Small East African male goats.</p> <p><strong>Materials and Methods:</strong><br>Eighteen young goats aged between 10 and 16 months were divided into six groups comprising of three animals each and given oral treatments as follows: Group I healthy control that received 4ml normal saline/day; group II diabetic control that received 4ml normal saline/day; group III received conventional glibenclamide drug at 0.125mg/kg bw/day; group IV, V and VI received 250mg/kg bw/day of leaf extracts of A<em>. aspera, B. pilosa</em> and<em> A. remota</em> respectively. Serum electrolytes Na<sup>+</sup>, Cl<sup>-</sup>, Ca2<sup>+</sup> and K<sup>+</sup> levels were determined. Results obtained were tabulated, coded and processed using SPSS software.</p> <p><strong>Results:</strong><br>Data was summarized and analyzed using descriptive and inferential statistics respectively. The probability values (p-value) were determined using t-test and ANOVA at 5% level (P&lt;0.05) of significance. The results showed diabetic goats became hyperglycemic with significant increase in Na<sup>+</sup> (139.89±16.25), K<sup>+</sup> (9.16±3.01), Cl<sup>-</sup> (121.29±5.56) and a concomitant significant decrease in Ca2<sup>+</sup> (1.024±0.62). <em>B. pilosa</em> was able to restore almost all these aberrations to normal levels whereas <em>A. aspera</em> and <em>A. remota</em> moderately restored some parameters to normal levels</p> <p><strong>Conclusion:</strong><br>The results demonstrated antidiabetic activity of <em>B. pilosa</em> and moderately by<em> A. aspera</em> and<em> A. remota</em> crude leaf extracts in the management of diabetes mellitus in alloxan-induced diabetic goats and hence restoration of electrolytes balance.</p> <p><strong>Keywords</strong>: Electrolytes, Hyperglycemia, Na<sup>+</sup>, K<sup>+</sup>, Cl<sup>-</sup> Ca2<sup>+</sup>, Diabetes Mellitus</p> J.K. Lagat A.G.M Ng'wena D.M. Mwaniki Copyright (c) 2021-09-10 2021-09-10 34 4 537 549