African Journal of Health Sciences https://www.ajol.info/index.php/ajhs <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="https://www.ajhsjournal.org/" target="_blank" rel="noopener">https://www.ajhsjournal.org/</a></p> en-US africanjournal@kemri.org (Dr. Peter Wanzala) africanjournal@kemri.org (Website Administrator) Wed, 18 May 2022 13:06:09 +0000 OJS 3.1.2.4 http://blogs.law.harvard.edu/tech/rss 60 Malnutrition among hospitalized patients and in the home https://www.ajol.info/index.php/ajhs/article/view/225356 <p>No Abstract.</p> Hudson A. Lodenyo Copyright (c) 2022 https://www.ajol.info/index.php/ajhs/article/view/225356 Wed, 18 May 2022 00:00:00 +0000 Risks of infections among HIV exposed infants during the first 18 months of life in Western Kenya https://www.ajol.info/index.php/ajhs/article/view/225357 <p><strong>BACKGROUND</strong><br>Infants exposed to HIV are more vulnerable to infections compared to those not HIV exposed. The occurrence and risks of infections among these infants are less understood. High maternal viral load can result in advanced disease, low maternal survival rates and puts the infant at higher risk of having early T- cell abnormality [24].</p> <p><strong>AIM</strong><br>This study aimed at characterizing the infections among HIV Exposed Infants (HEI) and establishing the risk factors associated with infections for interventions that will improve their health outcomes.</p> <p><strong>METHODOLOGY</strong><br>A cohort study was conducted using records of HEI enrolled at the PMTCT program in Kisumu County Referral Hospital (KCRH) in western Kenya, between January 2015 and December 2017. Using a simple random sampling technique, 260 records were obtained and a structured checklist resembling HEI follow-up cards was developed for quality assurance in data abstraction. Targeting those who had completed the 18 months follow-up, died or confirmed HIV positive during the process. Excluded were transfers, loss to follow-up and infants who had incomplete records. Data entry was done using Microsoft Excel then exported to SPSS version 20 for data analysis.</p> <p><strong>RESULTS</strong><br>A total of 46 infants reported different infections with an incidence rate of 17.3 new cases per 100 persons. Respiratory tract infections were the leading cause of infections contributing to 34.6% (18) of the infections. Other infections were malaria 17.4% (9), gastroenteritis 8 15.4% (8), oral thrush 11.5% (6), measles 9.6% (5), UTIs 5.8% (3). The risks to infections were high maternal viral load (OR 8.20 CI 3.32-20.25, p≤ 0.001), incomplete Co-trimoxazole prophylaxis (OR 2.23 CI 0.91- 5.50, p≤0.050) and mixed feeding (OR 2.59 CI 1.05 -6.36, p≤0.040). High burden of gastroenteritis peaking at around the 7 th month of the 18 month was recorded.</p> <p><strong>CONCLUSION</strong><br>High maternal viral load, incomplete Co-trimoxazole prophylaxis dosage and mixed feeding are a risk to infections among HEI. These findings provide critical information for health promotion and improvement of PMTCT interventions. Lifespan approach in understanding and protecting these infants from risks and infections, pneumonia in particular is crucial.</p> <p><strong>RECOMENDATIONS</strong><br>Home delivery and breastfeeding for only 1 year compared to the recommended breastfeeding duration of 2 years should be discouraged. Future studies be conducted in multiple sites involving HIV infant comparator to enrich the findings.</p> Winnie A. Majanga, Daniel Onguru, Lorine K. Kangwana, George Ayodo Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225357 Wed, 18 May 2022 00:00:00 +0000 Institutional factors associated with effective cardiopulmonary resuscitation among health workers at a County Referral Hospital in Kenya https://www.ajol.info/index.php/ajhs/article/view/225358 <p><strong>BACKGROUND</strong><br>Cardiopulmonary resuscitation (CPR) is a very critical practise in the healthcare setting. WHO recommends CPR be initiated within the first three(3) minutes of an arrest. By 2015, mortalities related to cardiac arrest were estimated to be 300, 000 to 370 000 annually[1].</p> <p><strong>AIM</strong><br>This study aimed to assess the above factors at a County Referral Hospital in Kenya.</p> <p><strong>METHODOLOGY</strong><br>A descriptive cross-sectional design was adopted with a permission from the Institution to collect data. A total of 175 health care providers aged between 18-39 years and had served at the Nakuru County Referral Hospital for more than 6 months participated in the study. Students and staff on internship were excluded. Self- administered questionnaires were used. To gurantee their validity and checklists were practical, a pre-test was done at Thika Level 5 hospital since it shared the same characteristics. Ambiguous questions were rephrased. Data analysis was done using SPSS computer software, version 24 while demographic data were analysed by descriptive statistics.</p> <p><strong>RESULTS</strong><br>The study reported inadequate staffing. The response was 92.5% with a majority 69.1 %( n=112) being females. Basically (89.5%) of them were nurses, a profession where females are the majority. Respondents 18-29 years were 36.4% (n=59) while those aged between 30 and 39 years accounted for 32.1%(n=52). The mean age was 32 years. The vast majority of respondents were young (&lt;40 years). Some respondents (51.9% (N=81), indicated that, they did not have all the necessary resources for CPR. Having a BLS/ACLS certificate (p=0.042), a refresher course in the last 2 years (p=0.029) and necessary resources (p=0.034) was significant. All respondents had the minimum required level of education for their profession, ie, 52.8% (n=85) had acquired a diploma in nursing while 31.7% (n=51) had a bachelor's degree. All cadres of health workers participated spreading out across the various departments at the study site. The medical ward had 25.9% (n=42) while 24.7% (n=40) worked in the surgical ward.</p> <p><strong>CONCLUSION</strong><br>The study Confirmed that, institutional factors influence effective Cardiopulmonary Resuscitation. Effective CPR improves the patients' outcomes reducing mortality related to cardiac arrest (CA). Early detection of cardiopulmonary arrest and initiation of CPR greatly influence the outcomes of CPR. Lack of debriefing following CPR among Health workers contribute to ineffective and repeated mistakes when conducting CPR. Understaffing in the hospital setting limits the number of personnel who assist in the practice. The fatigue experienced by the rescuer prevents optimal chest compression. The sub-Saharan region lack documented information to enlighten the public about the problem.</p> <p><strong>RECOMMENDATION</strong><br>Hospital administrators should guarantee the provision of both human and material resources. Policy makers aught come up with policies to ensure that, all staff members are trained on CPR protocols.</p> Betty Kwamboka Manono, Albanus Kyalo Mutisya, Jackson Tsimba Chakaya Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225358 Wed, 18 May 2022 00:00:00 +0000 Knowledge, beliefs and attitude towards malaria control and prevention among students in tertiary institutions in the Gambia https://www.ajol.info/index.php/ajhs/article/view/225359 <p><strong>BACKGROUND</strong><br>Even though Malaria caused by five parasite species, two of which – <em>Plasmodium falciparum</em> and <em>Plasmodium vivax</em> is preventable, curable and treatable, it continues to pose a significant health threat to many communities around the world. Particularly in Sub-Saharan Africa, The Gambia is one of the African countries that has seen a significant reduction in malaria cases. Malaria cases in The Gambia had decreased gradually from 346.9 per 100,000 persons in 2004 to 66 per 100,000 people in 2018. The fight against malaria is great progress for the future.</p> <p><strong>AIM</strong><br>This study aimed at assessing the knowledge, attitude and practice of students attending tertiary institutions in The Gambia in regard to Malaria prevention and control.</p> <p><strong>METHODOLOGY</strong><br>From May to June 2021, a standardized pre-tested semi-structured questionnaire was used to obtain information from 431 students in four public institutions in The Gambia. The University of The Gambia (UTG) Brikama Campus, The Gambia College-Brikama Campus, Management Development Institution (MDI) and The Gambia Technical Training Institution (GTTI. Respondents were chosen using a random sampling approach of students who were found on campuses and consented to participate. Sample size was determined using the formula described by Thrusfield (2007) based on a 95% confidence interval. It was first entered into excel and then exported to SPSS version 22 (SPSS Inc., Chicago, Ill., USA) for data analyses.</p> <p><strong>RESULT</strong><br>The aetiology, symptoms and therapy of malaria were all well-understood by the respondents. Age (P-value=0.005) and program of study (P-value=0.014) were highly significant with students’ knowledge on the mode of transmission of malaria as for students belief of the disease. Institution of learning Odd ratio (1.385, P value=0.003) was the only factor which affected students perception of malaria. Gender (Odd ratio=2.491, P-value=0.005) and the institution of learning (Odd ratio=1.506, P-value=0.003) were factors which had a high statistical significance with students practice of sleep under an ITNs.</p> <p><strong>CONCLUSION</strong><br>This study reported a high level of knowledge, poor attitude and practice towards malaria control interventions among students attending tertiary institutions in The Gambia. Students from the UTG and GTTI showed a better positive knowledge than those from the other participants. Their curriculum studies and social activities (individual students’ unions) exposed them to a higher level of awareness.</p> <p><strong>RECOMMENDATIONS</strong><br>Health-related programs on malaria prevention and control should be organized to raise awareness in through television and radio or any other media. Health education should be a compulsory topic or module in institutions.</p> Edrisa Jawo, Alpha Kargbo, Pierre A. Mendy, Edward Mendy, Matty Kah, Bakanding Sanyang Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225359 Wed, 18 May 2022 00:00:00 +0000 Perceptions of male partner involvement in antenatal care among pregnant women and nurses at a Sub-county Referral Hospital in Kenya https://www.ajol.info/index.php/ajhs/article/view/225360 <p><strong>BACKGROUND</strong><br>Men are important personalities in the family. They play great roles such as being breadwinners and decision- makers.They influence greatly on women's access to maternal health services. The study sought to gain an understanding of male involvement in that study area through focused group discussions among the pregnant women who attended the antenatal clinic.</p> <p><strong>AIM</strong><br>To determine the perception of pregnant women and nurses on male partner involvement in antenatal care.</p> <p><strong>METHODOLOGY</strong><br>The study was facility- based and adopted an exploratory qualitative approach. Three focus group discussions (FGDs) were conducted consisting of 6-8 participants each and lasting 20-30 minutes. Three key informant interviews (KIIs) were conducted among three nurses working at the antenatal clinic, each lasting for 20-30 minutes. The data was audio-recorded in Kiswahili and later transcribed verbatim then translated to English.</p> <p><strong>RESULTS</strong><br>The following themes emerged from the FGDs: low male involvement, positive view of men involved and being busy at work as the main factor for non-accompaniment. The themes emerging from the KIIs were; positive attitude towards male involvement, long waiting time at the antenatal clinic as the main reason for low male involvement.</p> <p><strong>CONCLUSION</strong><br>Most men were not involved in antenatal care. They cited unfriendly antenatal clinic environment such as crowded facilities with limited seats. Being busy at work and the long waiting hours at the centres was a major concern.</p> <p><strong>RECOMMENDATION</strong><br>Motivate more men to participate in antenatal care by prioritizing couples attending the<br>clinic. Educate both women and men on the need for male partner involvement in antenatal care.</p> Pauline Kavindu Muia, Grace Mbuthia, Rosemary Mugambi Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225360 Wed, 18 May 2022 00:00:00 +0000 Nutritional status and associated factors among hospitalised Zambian adult patients receiving hospital prepared total nasogastric tube feeds https://www.ajol.info/index.php/ajhs/article/view/225361 <p><strong>BACKGROUND</strong><br>Under-nutrition which attributed by inadequate energy and micronutrient intake, chronic and acute illnesses as well as altered immunological function is linked to nutrition. Identification of factors associated with malnutrition among hospitalized adults is important for policy and practices. In settings similar to sub -Saharan Africa, under-nutrition among hospitalized patients was reported to be higher [5] than the 45% to 70% in developed countries. Several studies have shown significant benefits of NGTF.</p> <p><strong>AIM</strong><br>To establish the prevalence of under-nutrition and associated factors among adults on hospital prepared total Nasogastric Tube Feeding (NGTF) in Zambia.</p> <p><strong>METHODOLOGY</strong><br>A total of 113 patients on total NGTF admitted in a Zambian referral hospital's intensive care unit (ICU) and four medical wards constituted the study population. A researcher-administered questionnaire was used to collect data on socio-economic and medical characteristics. Mid upper arm circumference (MUAC), subjective global assessment (SGA) and body mass index (BMI) were used to establish nutrition status.</p> <p><strong>RESULTS</strong><br>Under-nutrition prevalence rates were 62.0%, 64.6% and 36.3% as determined by MUAC, SGA and BMI respectively. Participants’ HIV-reactive status was significantly associated with under-nutrition (MUAC, SGA, and BMI) (Odds ratio [OR]: 301.20; 95% C.I. [8.66 - 466.48] p=0.002), (OR: 34.03; 95% C.I. [0.002 – 0.319], p=0.004), (OR: 100.00; 95% C.I. [0.00 - 112.72], p=0.003) respectively. Participants’ energy intake, age, length of hospital stay, monthly income and place of residence were not associated with under-nutrition.</p> <p><strong>CONCLUSIONS</strong><br>Malnutrition was regular as HIV positive status was significantly associated with under-nutrition. The hospital administration have consider routine screening for malnutrition in all hospital admissions.</p> Ogada Irene, Nyati Murambiwa Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225361 Wed, 18 May 2022 00:00:00 +0000 Assessment of extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, federal capital territory, Nigeria https://www.ajol.info/index.php/ajhs/article/view/225362 <p><strong>BACKGROUND</strong><br>Physical inactivity, a phenomenon that cuts across age groups, is increasingly becoming a menace among children globally. With a rise in the obesity rates among children in the last three decades, lack of physical activity is a cause for major concern among school-aged children.</p> <p><strong>AIM</strong><br>This study aimed to assess extracurricular activities relating to physical activities in primary schools in Gwagwalada Area Council, of the Nigerian capital</p> <p><strong>METHODOLOGY</strong><br>A cross-sectional study was conducted among 146 primary schools. Respondents’ interviews and direct observations were used. The findings were entered into a questionnaire adapted from School Health Program Evaluation questionnaire.</p> <p><strong>RESULT</strong><br>While 5 (3.4%) of the schools surveyed allotted three periods a week for physical activities/ health education, 106 (72.6%) assigned two periods per week for this. All the schools surveyed observed break periods/ recess. A total of 39(36.8%) private schools, compared with 33(82.5%) public schools, had sports fields (p&lt;0.001). Within the preceding year of the study, one hundred and seventeen (80.1%) of the schools staged drama as a form of periodic extracurricular activity. Inter-house sports was organized by 22(55.0%) public and 19(17.9%) private schools (p&lt;0.001).</p> <p><strong>CONCLUSION</strong><br>Most of the schools carried out varying forms of extracurricular activities on a daily, weekly or annual basis. Physical activities were more commonly undertaken in public schools. Private schools should be compelled by the appropriate authorities to provide adequate space for sporting and other physical activities. The schools should be made to adopt the recommendations of the World Health Organization</p> Usman Abiola Sanni, Uduak Mayen Offiong, Raheem Oladeji Quadri, Aliu Rasaki Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225362 Wed, 18 May 2022 00:00:00 +0000 The economic cost of treatment for patients with severe COVID-19 in Maputo Province, Mozambique https://www.ajol.info/index.php/ajhs/article/view/225363 <p><strong>BACKGROUND</strong><br>Mozambique has an under-resourced and fragile healthcare system that is already facing a high burden of comorbidities. Determining the cost of COVID-19 treatment is therefore an early priority to inform the resource-constrained pandemic response. This study aimed to estimate the economic cost of treating patients with severe COVID-19 in Mozambique.</p> <p><strong>METHODOLOGY</strong><br>Cost data were collected retrospectively from the provider perspective. A “one-way” deterministic sensitivity analysis was performed to test the robustness of the assumptions.</p> <p><strong>RESULTS</strong><br>The total economic cost of treatment for inpatients with severe COVID-19 at Centro da Matola 1 (CM1) was 21,157,159 MZN, corresponding to US$334,501. The economic cost per capita per day was 22,039 MZN, corresponding to US$348. The costs of treatment for patients with tuberculosis and patients with pneumonia did not vary considerably, ranging between 176,122 MZN (US$2,785) and 176,113 MZN (US$2,784) for the affected comorbidities; without co-morbidities, 176,105 MZN (US$2,784) to 176,087 MZN (US $2,784), respectively. COVID-19 patients co- infected with bronchopneumonia and HIV were the ones with the least costly morbidities, ranging from 88,085 MZN (US$1,393) to 88,053 MZN (US$1,392).</p> <p><strong>CONCLUSION</strong><br>The results show a substantial cost to treat COVID-19 inpatients in a resource-constrained context. The course of the pandemic substantially impacted the total costs and consequently, there has been an increase in the demand for resources. Revising priority setting values and resource allocation shall be taken into consideration for timely adjustments to save lives, considering the scenario of a high burden of commodities versus resource constraints in Mozambican public health services. Additionally, it is highly recommended that the cost analysis be regularly updated to illustrate the current cost and contribute to informing the efficient allocation of resources.</p> Neide Canana, Janet Dula, Nelmo Manjate, Igor Capitine, Ana Olga Mocumbi, Sérgio Chicumbe Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225363 Wed, 18 May 2022 00:00:00 +0000 Spatial analysis of tuberculosis and risk factors at the lowest administrative level in Nigeria https://www.ajol.info/index.php/ajhs/article/view/225365 <p><strong>BACKGROUND</strong><br>Few studies have utilized modern techniques of spatial data analysis to understand the distribution of tuberculosis (TB) and its possible predictors. In 2013, an estimated 9 million new TB cases and 1.5 million deaths occurred worldwide, out of which 360,000 deaths were HIV related.</p> <p><strong>AIM</strong><br>To assist in planning key interventions for the control of TB at a sub-national level, the studysought to explore the spatial distribution of TB and associated risk factors at the lowest administrative level in Nigeria.</p> <p><strong>METHODOLOGY</strong><br>This was an ecological study carried out using number of notified TB cases for the 774 Local Government Areas (LGAs) in 2013. Bayesian spatial regression analysis was conducted to identify high-risk clusters of the disease and to assess associated factors .</p> <p><strong>RESULTS</strong><br>Analysis revealed that TB was significantly clustered in 138 (17%) LGAs. Significant associations were found with household size, urban residence, access to transportation, population density, number of TB diagnostic services. Other predictors, including a composite index of socioeconomic status, living in a single room, number of TB treatment centres, and total health facilities in the LGA were not significantly associated with TB incidence.</p> <p><strong>CONCLUSION</strong><br>The study identified LGAs with elevated risk as well as significant factors associated with TB. This information can assist policymakers in rationally planning targeted specific interventions with the potential to effectively control TB in the country.</p> Olusoji J. Daniel, Olusola A. Adejumo, Adekunle D. Alabi, Janet O. Bamidele, Kolawole S. Oritogun Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225365 Wed, 18 May 2022 00:00:00 +0000 Socio-economic determinants of maternal services uptake in Kenya https://www.ajol.info/index.php/ajhs/article/view/225366 <p><strong>BACKGROUND</strong><br>Kenya had relatively high early childhood and maternal mortality. Maternal health care services have shown to be an effective strategy for reducing early childhood and maternal mortality. A worldwide study carried out in 2014 found about 73% of all the 2,443,000 maternal deaths between 2003 and 2009 were due to direct obstetric causes and almost half of them occurred in Africa [5]. Infant and under-five mortality were 65 and 141 deaths per 1000 live births, respectively [12] in Kenya.</p> <p><strong>AIM</strong><br>This study sought to establish the effects of socio-economic factors on the uptake of maternal health care services in Kenya.</p> <p><strong>METHODOLOGY</strong><br>The study used data drawn from the 2014 Kenya Demography and Health Survey (KDHS) which was a nationwide survey that used a cross-sectional research design. The survey interviewed 31,000 women of reproductive age. However, this study focused on a nationwide sample of 14,398 women aged 15-49 years who had carried a live birth within five years preceding the survey. It was guided by <em>Andersen behavioural model</em>. Descriptive statistics and logistic regression were used to analyse the data.</p> <p><strong>RESULTS</strong><br>Nearly all 14,398 women who were included in the study sought antenatal care during their most recent pregnancy. The majority of the women (67%) initiated antenatal visits during the second trimester. Region of residence, household wealth status, education, type of place of residence, and age were to be determinants of early initiation of antenatal visits. Slightly over half of the women made at least 4 antenatal visits and about 40% made between 1 and 3 visits. Education, household wealth index, and region of residence were found to be strongly associated with making at least 4 antenatal visits. About sixty per cent of all the women delivered in a health facility. Delivering in a health facility was found to be strongly associated with the mother’s education, type of place of residence, region of residence, household wealth index, maternal age, and whether or not the woman had made at least 4 antenatal visits.</p> <p><strong>CONCLUSION</strong><br>There is need for concerted efforts to have the majority of women in the country initiate antenatal visits early, make at least four antenatal visits and deliver in health facilities. A statistical percentage of women were partaking antenatal care services during their last trimester.</p> Lawrence Ikamari Copyright (c) https://www.ajol.info/index.php/ajhs/article/view/225366 Wed, 18 May 2022 00:00:00 +0000