Abstract:

The combined effects of limited time to the deadline of the UNAIDS 95-95-95 by 2020 for the epidemic control of HIV, need for early HIV case detection and decline in funding for HIV services necessitated partners in the HIV response to seek cost effective but smarter and result oriented methods of reaching the HIV testing targets which is the gateway to prevention and treatment of HIV, using the partner notification services (PNS) as a key approach.

A descriptive cross-sectional quantitative method was employed to review the performance of PNS after eight months of implementation. A multi staged random sampling was employed to select six health facilities providing comprehensive HIV services. Data from HIV testing services registers utilized within the period were reviewed for testing approaches, gender of clients, and linkage status. The anti-retroviral therapy registers were accessed for confirmation of linkages. Data was collected in excel sheet and transferred to SPSS version 21 for statistical analysis.

A significantly higher positivity rate and linkage from PNS though low coverage was observed. More women were reached than men. PNS needs to be optimized and also prioritized while challenges such as stigma, disclosure and gender issues should be addressed.

Keywords: Index case testing for HIV, provider-initiated testing and counseling, formative evaluation, innovative testing for HIV.

References:

[1].   Garcia de Olalla P, Mollas E, Barbera MJ, Martin S, Arellano E, Gosch M, et al. Effectivenesss of a pilot partner notification program for new HIV cases in Barcelona, Spain. PLos one. 2015;10(4), e0121536.

[2].   Mahachi, N., Muchedzi, A., Tafuma, T., Mawora, P., Kariuki, L., Semo, B., Batenanya, M., Nyagura, T., Ncube, G., Merrigan, M., Chabikuli,O., Mpofu, M. 2019, Sustained high HIV case-finding through Index testing and partner notification services: experiences from three provinces in Zimbabwe. Journal of the International AIDS Society, 22 doi.10.1002/jia2.25321.

[3].   Nigerian AIDS Indicator Impact Survey 2018. www.naiis.ng .Accessed on 5^th October 2019.

[4].   UNAIDS. 90-90-90: an ambitious treatment target to help end the AIDS epidemic. 2014.

[5].   UNAIDS: Global HIV & AIDS statistics- 2019 fact sheet. Available from

https://www.avert.org/professionals/hiv-around-world/global-response/funding accessed on 14th October 2019.

[6].  www.citypopulation.de/php/nigeria-admin.php?adm1id=NGA004 accessed on 13^th October 2019.

Abstract:

Background. The emergence of MDR TB poses a great treat to global health. Progress in response to the global MDR/RR-TB crisis is dismal. There is need to intensify efforts.

Methods We mapped the gene experts in Kano state. We reviewed the MDR-TB patients line list using the National tuberculosis and leprosy control program (TBLCP) line listing template. The data was analyzed using Epi Info version 3.5.4 and Microsoft Excel 2007.

Results The number of Cepheid gene Xpert machines increased from 1 in 2013 to 18 in 15 (34.1%) of the 44 LGAs in 2018. A total of 288 MDR TB cases were managed in 2017 and 2018 in Kano state, of which 262 (90.1%) were cases identified within the 2 years, 26 (9.0%) were referred in from other states. Of the 288 cases managed, 225 (78.1%,) were enrolled, 6 (2.1%), died, 8 (2.7%) refused enrollment and 18 (6.3%) loss to follow up. Of the 68151 reported and tested cases, 60479 (88.7%) were MTB negative, 7672 (11.3%) were MTB positive. Of the 7672 MTB positive cases, 7313 (95.3%) were drug sensitive (DS MTB), 280 (3.7%) were MDR TB and 79 (1.0%) were indeterminate.

Conclusions We conclude that there is progress in the MDR TB control program of Kano state with number of gene Xpert machines increased over time. We found improvement in MDR TB enrollment rate by 24.4% from 2017 to 2018. However, there is need to intensify tracking of MDR TB cases for enrollment.

Keywords: Multidrug-resistant tuberculosis (MDR-TB), control, progress, Kano state, north west Nigeria.

References:

[1].   WHO Global TB report. 2016. [cited 2018 January 22]. Available from:

http://www.who.int/tb/publications/global_report/gtbr2016.

[2].   WHO WHO END TB strategy? 2015. [cited 2018 January 22]. Available from:

http://www.who.int/tb/End_TB_brochure.pdf?ua=1.

[3].   World Health Organization: WHO report 2011. Global Tuberculosis Control: Surveillance, planning, Financing. WHO/HTM/TB/2010. Geneva, Switzerland: WHO; 2010.

[4]. Report A. International Union Against Tuberculosis and Lung Disease. Tuberculosis. 2006;(December).

[5]. Toungoussova O, Zellweger J, Spanevello A, Cirillo D, Lange C, Migliori GB. Epidemiology and clinical management of XDR-TB: a systematic review by TBNET. 2009;33(4):871–81.

[6]. National Tuberculosis and Leprocy Control Programme (NTBLCP); Federal Ministry of Health. Accessed from URL; http://ntblcp.org.ng/ on 15/10/19.

[7]. Fawcett IW, Watkins BJ nitial resistance of Mycobacterium tuberculosis in Northern Nigeria. Tubercle 1976; 57:71-3.

[8].   Osman E, Daniel O, Ogiri S, Awe A, Obasanya O, Adebiyi E, et al. Resistance of Mycobacterium tuberculosis to first- and second-line anti-tuberculosis drugs in South West, Nigeria. J Pulmon Resp Med 2012. doi: 10.4172/2161-105X.S6-001.

[9].   Mariandyshev A, Eliseev P. Drug-resistant tuberculosis threatens WHO’s End-TB strategy. Lancet Infect Dis. 17(7):674–675. https://doi.org/10.1016/S1473-3099(17)30246-3 [PubMed] [Google Scholar].

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[11].  Weyer K, Falzon D, Jaramillo E, Zignol M, Fuad M, Raviglione M. (2017). Drug-Resistant Tuberculosis: What Is the Situation, What Are the Needs to Roll It Back? AMR control. Jul 26, 2017. Accessed on 14/10/13 from URL; http://resistancecontrol.info/2017/drug-resistant-tuberculosis-what-is-the-situation-what-are-the-needs-to-roll-it-back/.

[12].  The World Gazetteer. Profile of Kano, the capital city of State. Archived from the original on 9 February2013. Retrieved 2007-03-27. Accessed on 07/10/2019 from URL:http://www.http/kano/profile.

[13].  Cuevas LE, Vassin MA, Al-Sonboli, Lawson N, BAhader J (2011) A multi-country non-inferioriy cluster randomize trial of front–loaded smear microscopy for the diagnosis of pulmonary tuberculosis. PLOS Med 8: l000403.

[14].  Hooja S, Pal N, Malhotra B, Goyal S, Kumar V (2011) Comparison of Ziehl- Neelsen and Auramine staining methods on direct and concentrated.

[15].  Carlton AA (2011) Gene Xpert: Agame changer for tuberculosis control? PLOS Medicine.

[16].  World Health Organisation (2012) WHO Nigeria supports introduction of Xpert MTB/RIF technology for diagnosis of MDRTB in Nigeria.

[17].  Papaventsis D, Ioannidis P, Evangelos V (2014) Tuberculosis diagnosis update: the new gene Xpert MTB /RIF assay. Hellenic centre for Disease Control and prevention. E-bulletin.

[18].  World Health Organisation (2010) WHO endorses new rapid tuberculosis test.

[19].  Gandhi NR, Moll A, Sturm AW, Pawinski R, Govender T, Lalloo U, et al. Extensively drug-resistant tuberculosis as a cause of death in patients co-infected with tuberculosis and HIV in a rural area of South Africa. Lancet. 2006 Nov 4;368(9547):1575–80.

[20].  Lawson L, Yassin MA, Abdurrahman ST, Parry CM, Dacombe R, Sogaolu OM, et al. Resistance to first-line tuberculosis drugs in three cities of Nigeria. Trop Med Int Health. 2011; 16:974–80. [PubMed] [Google Scholar].

Abstract:

Background. The role of health cost in vaccination programmes cannot be overemphasized: it has contributed significantly to creating and sustaining demand for vaccination services and improving vaccination coverage. In Centre for Disease Control and Prevention (CDC), numerous cost approaches have been deployed but these interventions are not without challenges. We therefore aimed to compare the CDC cost of vaccine according to brand name and find out which manufacturer produces the most expensive and the cheapest vaccine.

Methods. We used a quantitative approach and conducted a comparative study using the 5 manufacturers published on CDC website: Sanofi Pasteur, GlaxoSmithKline, Merck, Pfizer, Grifols and their vaccine brand names respectively. We identified cost of each vaccine for children program for September 2019 form CDC website. We also reviewed relevant documents. Secondary Data generated were analyzed manually because the data was small.

Results. The CDC cost for all the vaccine for children program are cheaper than the private sector cost. The cheapest vaccine is Hiberix manufactured by GlaxoSmithKline for both CDC and private sector cost ($9.46 and $ 10.85). The most expensive vaccine is Gardasil manufactured by Merck for both CDC and private cost ($178.14 and $217.11).

Conclusions. It is important to realize that health is wealth and a healthy nation is a wealthy nation! For every $1 spent on childhood vaccinations, United State of America saves $10.90. And CDC estimates that for the vaccination of children born between 1994 and 2018 has saved the U.S. nearly $406 billion in direct medical costs and $1.88 trillion in total society costs.

Keywords: VACCINE, COST, CDC, Sanofi Pasteur, GlaxoSmithKline, Merck, Pfizer, Grifols.

References:

[1].   Pastor-Satorras R, Castellano C, Mieghem PV, Vespignani A. Epidemic processes in complex networks. Rev Mod Phys 2015; 87:92.

[2].   Bonanni P. Demographic impact of vaccination: a review. Vaccine 1999; 17: S120–5.

[3].   Funk S, Salathé M, Jansen VA. Modelling the influence of human behavior on the spread of infectious diseases: a review. J R Soc Interface 2010; 7:20100142.

[4].   Manfredi P, D’Onofrio A. Modeling the interplay between human behavior and the spread of infectious diseases. New York: Springer; 2013.

[5].   Wang Z, Andrews MA, Wu Z-X, Wang L, Bauch CT. Coupled disease–behavior dynamics on complex networks: A review. Phys Life Rev 2015c; 15:1–29.

[6].   J.B.L. Gargasson, F.K. Nyonator, M. Adibo, B.D. Gessner, A. Colombini Costs of routine immunization and the introduction of new and underutilized vaccines in Ghana Vaccine, 33S (2015), pp. A40-A46.

[7].   C.B. Janusz, C.C. Orjuela, I.B.M. Aguilera, et al.Examining the cost of delivering routine immunization in Honduras Vaccine, 33S (2015), pp. A53-A59.

[8].   K. Goguadze, I. Chikovani, C. Gaberi, et al. Costs of routine immunization services in Moldova: Findings of a facility-based costing study Vaccine, 33S (2015), pp. A60-A65.

[9].   C. Schutte, C. Chansa, E. Marinda, et al. Cost analysis of routine immunisation in Zambia.

[10].  Vaccine, 33S (2015), pp. A47-A52.

[11].  WHO, UNICEF, World Bank? State of the world’s vaccines and immunization. Geneva: World Health Organization; 2009.

[12].  Hinman A. Eradication of vaccine-preventable diseases. Annu Rev Public Health. 1999; 20:211–29.

[13].  Goldstein S, MacDonald NE, Guirguis S, SAGE Working Group. Health communication and vaccine hesitancy. Vaccine. 2015;33(2015):4212–4.

[14].  Streefland P. Public doubts about vaccination safety and resistance against vaccination. Health Policy. 2001; 55:159–72.

[15].  Uddin M, Larson C, Oliveras E, Khan A, Quaiyum M, Chandra Saha N. Child immunization coverage in rural hard-to-reach Haor areas of Bangladesh: possible alternative strategies. Asia Pac J Public Health. 2009; 21:8–18.

[16].  Bondy J, Thind A, Koval J, Speechley K. Identifying the determinants of childhood immunization in the Philippines. Vaccine. 2009; 27:169–75.

[17].  Cheng P-J, Huang S-Y, Shaw S-W, Kao C-C, Chueh H-Y, Chang S-D, Hsu T-Y, Kung F-T, Hsieh T-T. Factors influencing women’s decisions regarding pertussis vaccine: A decision-making study in the Postpartum PertussisImmunization Program of a teaching hospital in Taiwan. Vaccine. 2010; 28:5641–7.

[18].  Odusanya OO, Alufohai EF, Meurice FP, Ahonkhai VI. Determinants of vaccination coverage in rural Nigeria. BMC Public Health. 2008;8(1):1–8.

[19].  Muñoz DC, Llamas LM, Bosch-Capblanch X. Exposing concerns about vaccination in low-and middle-income countries: a systematic review. Int J Public Health. 2015;60(7):767–80.

[20].  The Price of Prevention: Vaccine Costs Are Soaring By Elisabeth Rosenthal July 2, 2014 https://www.nytimes.com/2014/07/03/health/Vaccine-Costs-Soaring-Paying-Till-It-Hurts.html.

[21].  Estimating the costs of achieving the WHO–UNICEF Global Immunization Vision and Strategy, 2006–2015 Lara J Wolfson, a François Gasse, b Shook-Pui Lee-Martin, c Patrick Lydon, d Ahmed Magan, b Abdelmajid Tibouti, bBenjamin Johns, e Raymond Hutubessy, a Peter Salamab & Jean-Marie Okwo-Beled https://www.academia.edu/3168704/Estimating_the_costs_of_achieving_the_WHO-UNICEF_Global_Immunization_Vision_and_Strategy_2006-2015.

[22].  Bilous J, Eggers R, Gasse F, Jarrett S, Lydon P, Magan A, et al. A new global 1. immunization vision and strategy. Lancet 2006; 367:1464-6. PMID:16679143 doi:10.1016/S0140-6736(06)68625-XGIVS.

[23].  global immunization vision and strategy 2006–2015. Geneva; UNICEF/WHO: October 2005. Available at: http://www.who.int/vaccinesdocuments/DocsPDF05/GIVS_Final_EN.pdfUNICEF.

[24].  A world fit for children: Millennium Development Goals. Special session on children documents: the convention on the rights of the child. July, 2002. Available at: http://www.unicef.org/publications/index 4445.htmlGodal T. Viewpoint: immunization against povert

[25].  Trop Med Int Health2000; 5:160-6. PMID:10747277 doi:10.1046/j.1365 3156.2000. 00534.xMuraskin W. The Global Alliance for Vaccines and Immunization: is it a new model for effective public-private cooperation in international public health? Am J Public Health 2004; 94:1922-5. PMID:15514228Wittet S. Introducing GAVI and the Global Fund for children’s vaccines.

[26].  Vaccine 2000; 19:385-6. PMID:11027798 doi:10.1016/S0264-410X (00)00196-1Lu C, Michaud CM, Gakidou E, Khan K, Murray CJ. Effect of the Global.

[27].  Alliance for Vaccines and Immunization on diphtheria, tetanus, and pertussis vaccine coverage: an independent assessment. Lancet 2006; 368:1088-95. PMID:16997663 doi:10.1016/S0140-6736(06)69337-9International Financial Facility for Immunization (IFFIm) program overview.

[28].  Global Alliance for Vaccines and Immunization: 2006. Available at:

http://www.gavialliance.org/resources/FS_IFFIm_en.pd.

[29].  Advance market commitments for Vaccines, Global Alliance for Vaccines and Immunization: 2007. Available at: http://www.vaccineamc.org/about/index.html Saving 10 million more lives through immunization; the price tag.

[30].  Shortfall. WHO/IVB: (2006). Available at:

http://www.who.int/immunization/givs/GAVI_Imm_Forum_piece.pdfWorld Development Indicators 2004, https://www.cdc.gov/vaccines/programs/vfc/awardees/vaccine-management/price-list/index.html.

[31].  Centers for Disease Control and Prevention Salary Statistics". federalpay.org. Retrieved July 4, 2019. The Centers for Disease Control and Prevention had 10,899 employees in 2015 with an average pay (base salary + bonus) of $103,285.75.

[32].  City of Atlanta's expansion to Emory and CDC approved". www.ajc.com. Retrieved December 5, 2017. Mission, Role and Pledge". Centers for Disease Control and Prevention.

[33].  Economics of Health Care Financing: The Visible Hand By Cam Donaldson, Karen Gerard, Stephen Jan, Craig Mitton, Virginia Wiseman https://www.vaccinateyourfamily.org/why-vaccinate/vaccine-benefits/costs-of-disease-outbreaks/.

Abstract:

The Boma Health Teams training report was part of my capstone project. South Sudan like other developing countries has critical skilled human resources for health (HRH) challenges that have dramatically impeded timely delivery of basic health care services. The country is characterized by sparse population settlements, semi mobile communities, few qualified health workers and poor health seeking behavior among some communities and social groups which has hampered effective delivery of health services to all citizens. Only 44% of the population has access to health care services as a result the maternal, new-born and child health indicators are amongst the worst in the world. The training of Boma Health Teams (BHTs) was conducted to address the skilled health personnel gaps by having community owned resource person to deliver health services within reach to increase access and create demand for health care service utilization. The participants were identified and selected within the community by the community. The training was designed and offered through 30% of the time for modified lectures, 20% of the time on skills demonstration and return demonstration using models and Mankins in the training hall and 50% of the time for supervised skills practice at a health facility and community settings. Learning was assessed through written and practical pre-and post-tests.

Keywords: Boma health team, community health system strengthening, human resource for health.

References:

[1].   Human Resources for Health Strategic Plan., 2017-20121. Strengthening Leadership and Management of Health Systems. Juba, South Sudan.

[2].   National Health Policy., 2016-2026. A Community Anchored Health System for Sustainable Health Sector Development. Juba, South Sudan.

[3].   South Sudan Health Sector Development Plan,.2016-2021. One maternal death is one too many. Juba, South Sudan.

[4].   The Boma Health Initiative Strategy., 2016. The Community Health System in South Sudan. Juba, South Sudan.

[5].   United Nations Population Fund., 2018. South Sudan key reproductive health indicators. Working paper, Juba -South Sudan.

Abstract:

Sickle cell disease is the general name for a group of disorders that affect haemoglobin, the red pigment in red blood cells that delivers oxygen to cells throughout the body. Fortunately, Vitamin C has been found to be very vital in improving and sustaining health. This study sought to determine the effect of vitamin C supplementation on the blood pressure and blood count in sickle cell patients. The study was a randomized double blind, placebo –controlled study. The treatment group received 300mg of vitamin C per day for 3 months. The data of 60 subjects were analysed. Vitamin C supplementation increased the mean haemoglobin concentration and haematocrit of the subjects with SC genotype by 2.4% and 2.5% respectively compared to baseline (even though not statistically significant). There was a statistically significant increase in the Mean Copuscular Haemoglobin Concentration of the subjects with SC genotype on vitamin C (from 29.61 to 31.32 g/dl) compared to those on placebo (from 30.44 to 28.5 g/dl) (P = 0.01). Vitamin C supplementation therefore has some beneficial effects on some full blood count parameters of sickle cell patients with SC genotype.

Keywords: Sickle Cell Disease; Vitamin C.

References:

[1].   Adiiboka, F. (2012). Effects of Vitamin C supplementation on Sickle Cell disease. Thesis submitted to the university of Ghana, Legon, in partial fulfilment of the requirements for the award of Mphil. Nutrition degree.

[2].   Cox, M. (2009). Interpreting Blood Tests and Investigations. RCN Conference (January). USA.

[3].   Harris, Y.R. and Graham, J.A (2007). The African Child: development. Springer Publishing Company. USA.

[4].   Higdon, J. and Drake, V. (2011). An Evidence-Based Approach to Vitamins and Minerals: Health Benefits and Intake Recommendations. Thieme Publishers. Pg. 39.

[5].   Jaja, S.I., Ikotun, A.R., Gbenebitse, S. and Temiye, E.O. (2002). Blood pressure, hematologic and erythrocyte fragility changes in children suffering from sickle cell anemia following ascorbic acid supplementation. Journal of Tropical Pediatrics, 48(6), 366-70.

[6].   Jekel, J.F., Katz, D.L., Elmore, J.G. (2007). Epidemiology, biostatistics and preventive medicine. Saunders Elsevier, Philadelphia. Pp. 198-200.

[7].   World Health Organisation (WHO) (2006). Sickle cell anaemia. Report by the Secretariat. 59th World Health Assembly.11.4.

Abstract:

Background: LLIN is one of the proven interventions adopted by the national malaria program to reduce malaria burden in Nigeria. Despite the marginal high ownership of LLIN across the geo-political zones of Nigeria, utilization among the under-five children is low. The study aimed to identify determinants of household use of long-lasting insecticidal net among under-five children in Nigeria.

Methods: A review of 2015 Malaria Indicator Survey was done. Independent variables include household’s and women socio-demographic and economic characteristics. Outcome variables of interest was LLIN use by persons in household. Univariate, bivariate and multivariate analysis done to identify predictors of HH LLIN use in under-five children. Level of significance was set at <0.05.

Results: Twenty-five thousand six hundred and thirty-nine (66.7%) of under-five children slept under LLIN the night before the conduct of the survey. There was statistically significant association (p<0.05) between age, type of residence, wealth index, fever in the last two weeks before the conduct of the survey, number of mosquito bed nets and number of sleeping rooms.

Conclusion : LLIN ownership among household members most especially the under-five children were still not optimal bearing in mind the need for universal coverage of LLIN. Predictors of LLIN use among under-five children include age, type of residence, wealth index, fever in the last two weeks before the conduct of the survey, number of mosquito bed nets and number of sleeping rooms.

Keywords: LLIN ownership, LLIN utilization, Under-five children, Malaria, Household, Nigeria.

References:

[1].   Adeneye, A. et al. (2014) ‘Perception and affordability of long-lasting insecticide-treated nets among pregnant women and mothers of children under five years in Ogun State, Nigeria.’, J Infect Public Health, 7(6), pp. 522–33.

[2].   Aderibigbe, S. et al. (2014) ‘Ownership and utilization of long-lasting insecticide treated nets following free distribution campaign in South West Nigeria.’, Pan African Medical Journal, 17(8), p. 263.

[3].   Baume, C. and Marin, M. (2008) ‘Gains in awareness, ownership and use of insecticide-treated nets in Nigeria, Senegal, Uganda and Zambia.’, Malaria Journal, 7(2), p. 153.

[4].   Bejon, P. et al. (2009) ‘Interactions between age and ITN use determine the risk of febrile malaria in children.’, Plos One, 4(12), p. e8321. doi: 10.1371/journal.pone.0008321.

[5].   CDC (2014) Insecticide-Treated Bed Nets. Malaria. Available at:

http://www.cdc.gov/malaria/malaria_worldwide/reduction/itn.html .

[6].   Diabaté, S. et al. (2014) ‘Insecticide-treated nets ownership and utilization among under-five children following the 2010 mass distribution in Burkina Faso.’, Malaria Journal, 13, p. 353.

[7].   Eisele, T. et al. (2006) ‘Interpreting household survey data intended to measure insecticide-treated bednet coverage: results from two surveys in Eritrea.’, Malar J., 5(5), p. 36.

[8].   Graves, P. et al. (2011) ‘Factors associated with mosquito net use by individuals in households owning nets in Ethiopia.’, Malaria Journal, 10, p. 354.

[9].   Lengeler, C. (2004) ‘Insecticide-treated bed nets and curtains for preventing malaria.’, Cochrane Database Syst Rev., 2(10), p. 1002.

[10].  Malusha, J. et al. (2009) ‘Use of insecticide treated nets among caregivers of children under five years in Makueni District, Kenya.’, East African Medical Journal, 86(7), pp. 308–13.

[11].  National Malaria Elimination Programme (NMEP), National Population Commission (NPopC), National Bureau of Statistics (NBS), and ICF International. 2016. Nigeria Malaria Indicator Survey 2015. Abuja, Nigeria, and Rockville, Maryland, USA: NMEP, NPopC, (no date).

[12].  National Population Commission (NPC) [Nigeria] and ICF International. 2014. Nigeria Demographic and Health Survey 2013. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International. (no date).

[13].  Nwaorgu, O. C. (2011) ‘Prevalence of Malaria among Children 1 – 10 Years Old in Communities in Awka North Local Government Area, Anambra State South East Nigeria’, International Multidisciplinary Journal, Ethiopia, 5(5), pp. 264–281.

[14].  Obembe, A., Anyaele, O. and Oduola, A. (2014) ‘Lessons from the implementation of LLIN distribution campaign in Ilorin Kwara State, Nigeria.’, BMC Public Health, 14, p. 514.

[15].  Otsemobor, O. et al. (2013) ‘Determinants of long-lasting insecticidal nets distribution, ownership and use in the Federal Capital Territory, Nigeria – implications for malaria programmes.’, Journal of Public Health and Epidemiology, 5(11), pp. 445–458.

[16].  Ouattara, A. et al. (2011) ‘Malaria knowledge and long-lasting insecticidal net use in rural communities of central Côte d’Ivoire.’, Malaria Journal, 10, p. 288.

[17].  Ozims, S. and Eberendu, I. (2014) ‘Awareness, ownership and utilization of Long-Lasting Insecticide-treated Net (LLIN) among pregnant women attending antenatal clinic in Imo State university teaching hospital, Orlu, Imo State’, International Journal of Research in Medical and Health Sciences, 4(8), pp. 2307–2083.

[18].  Pulford, J. et al. (2011) ‘Reported reasons for not using mosquito net when one is available: a review of the published literature.’, Malaria Journal, 10, p. 83.

[19].  Thwing, J. et al. (2008) ‘Insecticide-treated net ownership and usage in Niger after a nationwide integrated campaign.’, Trop Med Int Health, 13(6), pp. 827–34.

[20].  Toé, L. et al. (2009) ‘Decreased motivation in the use of insecticide-treated nets in a malaria endemic area in Burkina Faso.’, Malaria Journal, 8, p. 175.

[21].  Tokponnon, F. T. et al. (2014) ‘Assessment of long-lasting insecticidal net coverage, use and physical integrity one year after universal distribution campaign in Plateau department in South-East Benin’, Journal of Public Health and Epidemiology, 6(2), pp. 76–84.

[22].  WHO World malaria report 2016. World Health Organization (2017).

[23].  World Health Organization. (2018). World malaria report 2018. World Health Organization. (no date). Available at: https://apps.who.int/iris/handle/10665/275867.

[24].  World Health Organization (2013). Available at: www.who.int.

[25].  Zuradam, S. F. (2012) Factors associated with use and non-use of mosquito nets for children less than 5 years of age in the Mfantseman municipality, Ghana.

Abstract:

Elderly in India, older ones (above 80yrs) are growing at a fast pace and these very elderly people are usually weaker, insecure, dependent and suffer more often from age-related diseases ^[4]. A Cross sectional study was done using a Questionnaire along with Geriatric Depression Scale (GDS) to evaluate both physical and mental health of 410 participants above 60yrs of age using a Multi Stage Cluster Sampling technique with 137 samples each from 3 regions of Urban Chennai. Physically elderly complained with Joint pain, Leg pain, Loss of power or sensation, followed by Back pain, Constipation, Chest pain and Neck pain for the past two months. And mentally they complained about Loss of memory, appetite and Sleep. Amongst 233 males &177 females, physically 38.2 % &30.5% and 15.0% &27.7% were evaluated to be with Stage 1 &Stage 2 Hypertension. Amongst males and female, 1.3% and 6.8% were found to be with Severe Depression similarly, 3.9% and 14.1% were Moderately Depressed and 13.7% and 32.8% had Mild Depression while others were normal. Analysis of Chi-square Test for depression with other factors were sleeplessness, being widowed, monthly Income of less than Rs. 5000, Feeling Neglected, Living in Old Age Home and in Joint Family revealed a significant association (p < 0.05) with SPSS11.0. There is a strong association of depression amongst elderly were with External and Family influence which could make way for more studies related to development of Psycho physiological and Psycho social impacts on Geriatric health.

Keywords: Elderly, Geriatric, Depression, GDS, Chennai.

References:

[1].   Keller I, M. A. K. T. K. A., 2002. Global Survey on Geriatrics in the Medical Curriculum, Geneva, [Online] Available at: http://www.who.int/ageing/projects/en/alc_global_survey_tegeme.pdf [Accessed 2 Feb 2013].

[2].   Judith Banister, D. E. B. L. R., 2010. Population Aging and Economic Growth in China. Program on the Global Demography of Aging (PGDA), March, pp. Paper No. 53.

[3]. Apoorva Jadhav, K. S. S. K. K. J., 2011. Living Arrangements of the Elderly in India: Who lives alone and what are the patterns of familial support? Living Arrangements of the Elderly in India International Union for the Scientific Study of Population.

[4]. Gopal K Ingle, A. N., 2008 October. Geriatric Health in India: Concerns and Solutions. Indian Journal of Community Medicine, pp. 33(4): 214-218.

[5]. Salagre, S. B., 2013. Health Issues in Geriatrics. In: Medicine Update 3/chap177.pdf. Mumbai: Association of Physicians of India, pp. 767-770.

[6].   B, S., 1999. Report of the workshop on research and health care priorities in geriatric medicine and ageing, New Delhi: Indian Council of Medical Research.

[7].   World health organization, 2004. The global burden of disease. [Online] Available at: http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf [Accessed 2 Feb 2013].

[8].   P.A. Saunders, J. M. C. B. H., 1993. The Prevalence of Dementia, Depression and Neurosis in Later Life: The Liverpool MRC-ALPHA Study. International Journal of Epidemiology, pp. 22 (5): 838-847.

[9].   E. Breeze, 2005. Area deprivation, social class, and quality of life among people aged 75 years. International Journal of Epidemiology, pp. 34 (2): 276-283.

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Abstract:

Department of Health (DOH) the regulator of Abu Dhabi region in UAE launched Baby Friendly Hospital Initiative (BFHI) on March 21, 2016. Despite this drive for last 3 years, there has been no noticeable changes or initiatives in private health sector. There are different factors that affect the breastfeeding behaviors that may result in sluggish response from private healthcare sector. The purpose of this article is to develop a comprehensive conceptual model that can guide researches investigating the factors affecting breastfeeding behavior. This study will analyze different theories related to breastfeeding to identify common theoretical constructs that constitutes the breastfeeding behavior. Prominent constructs identified will be used to develop a conceptual framework. A methodical survey of existing literatures is reviewed to delineate the factors affecting breastfeeding. The factors are then categorized using the concept of bioecological systems theory to formulate the conceptual model. The conceptual model assumes the breastfeeding behavior as the resultant of interaction between the person, behavior and environment. Breastfeeding is the end behavior, while personal factors is a combination of maternal and infant synergies. Environmental factors are categorized as micro and marco-environmental factors based on their level of influences.

Keywords: breastfeeding, breastfeeding factors, breastfeeding practice, breastfeeding theories.

References:

[1]. Ahmed, O., and Salih, A, 2019, Determinants of the early initiation of breastfeeding in the kingdom of Saudi Arabia. International breastfeeding journal, 14(13). doi.org/10.1186/s13006-019-0207-z.

[2].   Ajzen, I., & Fishbein, M., 1980, Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.

[3].   Ajzen, I., 2012, The theory of planned behavior. Handbook of theories of social psychology. 438-455)10.4135/9781446249215.n22.

[4].   Ajzen, I.,1991, The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2). p.179-211. /doi.org/10.1016/0749-5978(91)90020-T.

[5].   Al Tajir, G.K., Sulieman, H., Badrinath, P., 2006, Intragroup differences in risk factors for breastfeeding outcomes in a multicultural community. J Hum Lactation; 22:39-47.

[6].   Al-Mutairi, N. F., Al-Omran, Y. A., and Parameaswari, P. J., 2017, Breastfeeding practice and knowledge among women attending primary health-care enters in Riyadh. Journal of family medicine and primary care. April to June; 6(920), 392-398, doi: 10.4103/jfmpc_243_17.

[7].   Bandura, A., 2012, Social cognitive theory. In P. A. M. Van Lange, A. W. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology (pp. 349-373). Thousand Oaks, CA, Sage Publications Ltd. http://dx.doi.org/10.4135/9781446249215.n18.

[8].   Bronfenbrenner, Urie, and Pamela A. Morris, 2006, “The bioecological model of human development.” Handbook of Child Psychology.

[9].   Eidelman, A.I., Schanler, R.J., Johnston, M., Landers, S., Noble, L., Szucs, K., Viehmann, L., 2012, Breastfeeding and the use of human milk. Pediatrics, 129, doi:10.1542/peds.2011-3552.

[10].  Ettekal, Andrea & Mahoney, Joseph. 2017, Ecological Systems Theory. 10.4135/9781483385198.n94.

[11].  Hector, King, and Webb, 2005, Factors affecting breastfeeding practices. Applying a conceptual framework. New South Wales public health bulletin. 16. 52-5. 10.1071/NB05013.

[12].  McLennan, J. D., 2001, Early termination of breast-feeding in periurban Santo Domingo, Dominican Republic: mothers’community perceptions and personal practices. Rev Panam Salud Publica 2001; 9(6): 362–367.

[13].  Radwan, H., 2013, Patterns and determinants of breastfeeding and complementary feeding practices of Emirati mother in the United Arab Emirates. BMC Public Health, 13: 171. http://www.biomedcentral.com/1471-2458/13/171.

[14].  Taha, Z., 2017, Trends of Breastfeeding in the United Arab Emirates (UAE). Knowledge E. doi: 10.18502/ajne. v2i3.1356.

[15].  Taha, Z., Garemo, M., & Nanda, J., 2018, Patterns of breastfeeding practices among infants and young children in Abu Dhabi, United Arab Emirates. International breastfeeding journal, 13, 48. doi:10.1186/s13006-018-0192-7.

Abstract:

Objective: To critically review the preventive strategies of Hepatitis C and its prevalence in Pakistan; and to find out any existing gap in health care delivery, so as to minimize the burden of this major health problem.

Research Design and Methods: This study follows systemic review method and includes randomized control trial studies which focus on preventive strategies of Hepatitis C. Strict inclusion and exclusion criteria for study selection were made and followed. Data’s were properly extracted and analyzed to minimize bias. Different data base was used including Google Chrome, Google, Pub Med, Cochrane Review using key words as Hepatitis C prevalence and prevention in Pakistan.

Results: The results from Randomized control trials studies will compare the benefits in control and cases using risk reduction strategy, drug intervention and are expected to show huge benefits in cases group.

Conclusion: Health education, access to ARVs at government Hospital, stop reusing of syringes, ANC visit for pregnant women, good governance decreases prevalence of hepatitis C.

References:

[1].   Ferri, Clodoveo (2015). "HCV syndrome: A constellation of organ- and non-organ specific autoimmune disorders, B-cell non-Hodgkin's lymphoma, and cancer" World Journal of Hepatology. 7 (3): 327–43. doi:10.4254/wjh. v7.i3.327.

[2].   Shepard, CW; Finelli, L; Alter, MJ (Sep 2005 "Global epidemiology of hepatitis C virus infection". Lancet Infect Dis. 5 (9): 558–67. doi:10.1016/S1473-3099(05)70216-4.

[3].   Prevalence of hepatitis B and C viral infections in Pakistan: findings of a national survey appealing for effective prevention and control measures. Available at https://www.ncbi.nlm.nih.gov/pubmed/21495584/ Accessed at 2/11/2019.

[4].   Federal Ministry of Health Hygiene and Environmental Health Department. Health care waste management national guidelines. Addis Ababa: Federal Ministry of Health Hygiene and Environmental Health Department; 2008.

[5].   Almuneef, M, Memish, ZA. "Effective medical waste management: it can be done". Am J Infect Control. vol. 31. 2003. pp. 188-92.

[6].   Hossain MS, Santhanam A, Nik Norulaini NA, Omar AK. Clinical solid waste management practices and its impact on human health and environment-A review. Waste Manag 2011; 31:754–6.

[7].   Ministry of Environment. Hospital Waste Management Issues and Steps Taken by the Government of Pakistan. 2006 [20 Sep 2011]; Available from: http://www.env.go.jp/recycle/3r/en/asia/ 02 03-2/04.pdf

[8].   Ayoub HH, Abu-Raddad LJ. Impact of treatment on hepatitis C virus transmission and incidence in Egypt: A case for treatment as prevention. J Viral Hepat 2016; 24:486–95. [PubMed].

[9].   Breban R, Arafa N, Leroy S. et al. Effect of preventive and curative interventions on hepatitis C virus transmission in Egypt (ANRS 1211): a modelling study. Lancet Global Health 2014;2: e541–49.

[10].  Westbrook RH, Dusheiko G. Natural history of hepatitis C. J Hepatol 2014;61(Suppl 1): S58–68.

[11].  Morgan RL, Baack B, Smith BD, Yartel A, Pitasi M, Falck-Ytter Y. Eradication of hepatitis C virus infection and the development of hepatocellular carcinoma: a meta-analysis of observational studies. Ann Intern Med 2013;158(Pt 1):329–37.

[12].  Nishtar S. Health Indicators of Pakistan. Gateway Paper II. Islamabad: Federal Bureau of Statistics and Ministry of Health, 2007.

[13].  Pakistan Medical Research Council. National Health Survey of Pakistan: Health Profile of the People of Pakistan, 1990-94. Islamabad: Pakistan Medical Research Council, 1998.

[14].  Pakistan Medical Research Council, Directorate of Malaria Control, Save The Children. Malaria Indicator Survey in 38 High Risk Districts of Pakistan 2013-2014. Islamabad: PMRC, 2015.

[15].  Guerra J, Garenne M, Mohamed M, Fontanet A. 2012. HCV burden of infection in Egypt: results from a nationwide survey. J. Viral Hepat. 19, 560–567. (doi:10.1111/j.1365-2893.2011.01576.x) [PubMed].

[16].  Health Mo, Population/Egypt, El-Zanaty, Associates/Egypt, ICF International. 2015. Egypt health issues survey 2015. Cairo, Egypt: Ministry of Health and Population/Egypt and ICF International.

[17].  NHANES. National Health and Nutrition Examination Survey 1999–2016. See http://www.cdc.gov/nchs/nhanes/nhanes_questionnaires.htm.

[18].  Benova L, Awad SF, Abu-Raddad LJ. 2017. Estimate of vertical transmission of hepatitis C virus in Pakistan in 2007 and 2012 birth cohorts. J. Viral Hepat. 24, 1177–1183. (doi:10.1111/jvh.12748).

[19].  Zaheer HA, Waheed U. 2014. Blood safety system reforms in Pakistan. Blood Transfus. 12, 452.

Abstract:

The present literature review aims to examine a range of reciprocal effects between alcohol abuse and family relations: as individuals and as a system. The study targets the mutual relationship between alcohol abuse and the family. Alcohol abuse is being examined to affect the personalities of family members and the functioning and interactions of the family as a system. The family in turn is examined in terms of contributing to the onset, alleviation or persistence of alcohol abuse. Accordingly, recovery from alcohol abuse would necessitate the involvement of family members besides the main subject of abuse. An ethnographic study would be used to examine the direct and indirect mutual effect families and alcohol abuse have on one another.

Keywords: Alcohol, abuse, family, systems, recovery, abstinence.

References:

[1].   Alcoholism and Family (2018). Marital Problems. American Addiction Centers. Retrieved from: https://americanaddictioncenters.org/alcoholism-treatment/family-marital-problems/.

[2].   Bradshaw, S. D. et al (2016). Family Functioning and Readiness in Family Recovery from Addiction. Article. Research Gate. Retrieved from:

https://www.researchgate.net/publication/298422755_Family_Functioning_and_Readiness_in_Family_Recovery_From_Addiction.

[3].   Cochran, L. A. (2014). Children of Alcoholics: How Patterns and Perceptions of the Past Affect the Future. Thesis. Portland State University. Retrieved from:

https://pdxscholar.library.pdx.edu/cgi/viewcontent.cgi?referer=https://www.google.com.eg/&httpsredir=1&article=1047&context=honorstheses.

[4].   Global status report on alcohol and health (2018). World Health Organization. Retrieved from: http://apps.who.int/iris/bitstream/handle/10665/274603/9789241565639-eng.pdf?ua=1.

[5].   Jackson, J. K. (1958), Alcoholism and the Family by JOAN K. JACKSON, The Annals of the American Academy, Volume: 315 issue: 1. Retrieved from:

http://journals.sagepub.com/doi/abs/10.1177/000271625831500112.

[6].   Jacob, J and Johnson, S. (1997). Parenting Influences on the Development of Alcohol Abuse and Dependence. Alcohol Health & Research World Vol. 21. Retrieved from:

https://pdfs.semanticscholar.org/39ff/4f4814347193495367e8650b50afef573da3.pdf.

[7].   Kaufman, E. (2004). Substance Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series, No. 39. Center for Substance Abuse Treatment. Substance Abuse and Mental Health Services Administration (US). Rockville (MD). Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK64269/.

[8].   Laslett, A.M. et al (2015). The Hidden Harm: Alcohols Impact on Children and Families. Foundation for Alcohol Research And Education Ltd. Retrieved from: https://www.fasdhub.org.au/research-and-publications/publications/2015/alcohols-impact-on-children-and-families/.

[9].   Saatcioglu. O. et al (2006). Role of family in alcohol and substance abuse. Psychiatry and Clinical Neurosciences. Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1440-1819.2006.01476.x.

[10].  Saatcioglu. O. et al (2006). Role of family in alcohol and substance abuse. Psychiatry and Clinical Neurosciences. Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1440-1819.2006.01476.x.

[11].  Wallis, D. J. (2013). Adolescent Substance Abuse Treatment: Does Family Systems Therapy Improve Family Functioning and Decrease Drug Use? Dissertation. University of Denver. Retrieved from:Https://Digitalcommons.Du.Edu/Cgi/Viewcontent.Cgi?Article=1682&Context=Etd.

[12].  Younkin, F. L. L. (2013). Differentiation and Relationship Satisfaction: Mediating Effects of Alcohol Use. Dissertation, The Ohio State University. Retrieved from:

https://etd.ohiolink.edu/rws_etd/document/get/osu1384942239/inline.

Abstract:

Out of every 10 women, 9 of them receive skilled ante-natal care but only 4 receive skilled birth attendance. The objective was to assess the knowledge and perception of birth Preparedness and complication readiness (BP/CR) among mothers attending antenatal clinics (ANC) in medina health center. The specific objectives were to assess the knowledge of antenatal mothers concerning BP/CR, the attitude and perception of antenatal mothers about BP/CR, determine the proportion of pregnant women who have BP/CR plan in Galbet ward. The study population was women at 36 weeks attending ANC. A descriptive study was carried out. Data collection was done using questionnaires and interviews. Every client who attended ANC and consented was included in the study. The sample size was 339 mothers. SPSS 18.0 was used for analysis. The study found out that the BP/CR is low at 18%. The most planned for aspect was the care taker (51%) followed by birth companion (49%) and the least was arrangement of a blood donor (22%). Illiteracy affected levels of preparedness in the area. The research recommends to ministry of health to sensitize women of reproductive age on BP/CR. BP should be improved through quality ANC. The government should encourage education of the girl child.

References:

[1].   JHPIEGO (2004). Monitoring birth preparedness and complication readiness. USA: Baltimore.

[2].   JHPIEGO (2004). Monitoring birth preparedness and complication readiness. USA: Baltimore.

[3].   Thaddeus S and Maine D. (1994). Too far to walk: maternal mortality in context. Social Science and Medicine, 1994, 38:1091–1110. UNICEF (2004). Surviving childbirth and pregnancy in south East Asia. South East Asia: UNICEF.

[4].   WWW.knbs (2010). or.ke/download/economic-survey-2010.

[5].   Ouma P. O., (2010). Ante-natal and delivery care in rural western Kenya: The effect of training health care workers to provide "focused ante-natal care in Biocentral journal.

[6].   WHO ANC model (2016) www.mcsprogram.org/.../ANC-OverviewBriefer-A4-1.pdf.

[7].   Siddaharth A., Vani S., Karishma S., Prubhat K. J. and Abdullah H. B., (2010). Birth preparedness and complication readiness among slum women in Indore city, India in health population nutrition journal; 28(4): 383-391.

[8].   Barbara, K. and G omez, P (2004). Basic maternal and newborn care: A guide for skilled providers. JPIEGO.

[9].   S.M. Mutiso, Z. Qureshi and J. Kinuthia, (2008) Birth preparedness among antenatal clients East African Medical Journal Vol. 85 No. 6.

Abstract:

Introduction: Malaria is a major cause of fever and a leading public health problem in Uganda, causing significant morbidity, mortality and negative socio-economic impact. However, malaria is not the only cause of fever; there are other none malaria causes of fever that must be ruled out before treatment with expensive Artemisinin-based Combination Therapy (ACTs). In 2010 and 2011 World Health Organisation (WHO) and Ministry of Health (MOH) Uganda respectively recommended that all fever cases be subjected to malaria test, provided an appropriate treatment according to test results and tracked. This study assessed the compliancy of health workers in public and private health facilities in four Northern districts of Uganda i.e. Apac, Dokolo, Gulu and Nwoya in implementation of Test, Treat and Track (T3) strategy for malaria.

Methods and materials: Across sectional descriptive study design was adopted. Both quantitative and qualitative data collection approaches were applied to ascertain the extent health workers in the targeted districts adhere to the T3 policy. The study was conducted in 115 public, 22 PNFP and 20 private health facilities. In total 489 health workers, 63 community health workers (CHWs) and seven district officials participated in the study as respondents. Quantitative data were entered and cleaned in EpiData 3.1 and analysed using Stata 12.0. Qualitative data were audio-recorded, transcribed and entered into Nvivo 10 for analysis and coded based on both pre-determined themes as well as those that emerged from the data.

Results: The study showed that adherence to testing was excellent in public (97.1%) as compared to 70.3% in the PFP (P < 0.001). Averagely, 95% of positive cases across the four districts were treated with recommended antimalarial medicines (ACTs). The study found that senior health workers had poorer adherence to T3 compared to their junior counterparts. For instance, on average 64% of malaria negative confirmed patients seen by medical officers received antimalarial medicines compared to 23% and 5% that were seen by nurses and Community Health Workers (CHWs) respectively. We also found that adherence to T3 reduces as you ascend from low level to high level facilities. As such adherence to testing all suspected cases of malaria was highest (100%) at CHWs and lowest (70.1%) at hospital level

Conclusion: Adherence to T3 strategy was found to be dependent to the Health facility level, ownership and level of education and seniority of health workers.

Keywords and abbreviations: Adherence, Community health Workers (CHW), Private for Profit (PFP), Private Not for Profit (PNFP), Ministry of Uganda (MOH), World Health Organisation (WHO).

References:

[1].   WHO. World Malaria Report 2018 [Internet]. World Malaria Report. 2018. Available from: http://www.who.int/malaria/world_malaria_report_2010/en/index.html.

[2].   World Health Organization. Global Malaria Programme. World malaria report. 2017.

[3].   Abeku TA, Helinski MEH, Kirby MJ, Kefyalew T, Awano T, Batisso E, et al. Monitoring changes in malaria epidemiology and effectiveness of interventions in Ethiopia and Uganda: Beyond Garki Project baseline survey. Malar J. 2015;14(1).

[4].   Malaria Consortium. mRDT Private Sector Market Landscape for Uganda. 2016;(April).

[5].   World Health Organization. Guidelines for the Treatment of Malaria, Second Edition. Geneva, World Health Organization. Geneva World Heal Organ. 2010.

[6].   World Health Organization. Scaling up diagnostic testing, treatment and surveillance for malaria. Who. 2012;1–12.

[7].   Uganda Ministry of Health. Uganda National Malaria Control Policy. 2011;(June).

[8].   World Health Organization. World Malaria Report 2014. Lille Med. 2014;22(4 Sup.1):269–71.

[9].   Altaras R, Nuwa A, Agaba B, Streat E, Tibenderana JK, Strachan CE. Why do health workers give anti-malarials to patients with negative rapid test results? A qualitative study at rural health facilities in western Uganda. Malar J. 2016;15(1):1–14.

[10].  WHO. World Malaria Report 2013. Nat News. 2013;13536.

[11].  Kankpetinge C, Kweku M, Baiden F, Agboli E, Akapoeh D, Takramah W, et al. Clinicians’ Adherence to Implementation of Test, Treat and Track Strategy for Malaria Control among Children Under-five Years in Ho Municipality, Volta Region, Ghana. Int J Trop Dis Heal [Internet]. 2016;20(1):1–11. Available from: http://www.sciencedomain.org/abstract/16722.

[12].  Nyandigisi A, Memusi D, Mbithi A, Ang’wa N, Shieshia M, Muturi A, et al. Malaria Case-Management following change of policy to universal parasitological diagnosis and targeted Artemisinin-Based combination therapy in Kenya. PLoS One. 2011;6(9).

[13].  Manyando C, Njunju EM, Chileshe J, Siziya S, Shiff C. Rapid diagnostic tests for malaria and health workers’ adherence to test results at health facilities in Zambia. Malar J. 2014;1–8.

[14].  Uganda Ministry of Health. The Uganda Malaria Reduction Strategic Plan 2014-2020. 2014;(May):1–83.

[15].  Uganda Bureau of Statistics (UBOS) and ICF. The National Population and Housing Census 2014 – Main Report, Kampala, Uganda. 2016.

Abstract:

The objective of the study was to assess the effectiveness of the Electronic Health Records system (EHR) and the level of adoption by health facility personnel.

This study was conducted between January and June, 2019 at Kalewa Urban Health Center in Ndola, Zambia. This was a pilot secondary case study before EHRs could be rolled out to other facilities. Fifty-six (n=56) representing 94.9% of facility staff.

06 (10.7%) had previously been using EHRs in HIV Clinic before the training under review. 44 (78.6%) of respondents preferred e-first based practice while 12 (21.4%) preferred e-last based practice. 51 (91%) respondents argued that it was not possible to do away with paper-based practice. 38 (67.9%) respondents agreed that members of the community appreciated EHRs use.

The advantages associated with use of EHRs were appreciated by every health worker. Each service point had personnel trained with emphasis to the role each department plays at the facility. The study produced positive results and recommendations would be used to ensure that use of EHRs produced the desired results. The experiences of Kalewa Urban Health Center would be useful as the program is extended to other Defence Force facilities.

Keywords: Electronic Health Records, Defence Force, Logistics Management Information System, Health Management Information Systems, SmartCare.

References:

[1].   Ramesh Krishnamurthy and Dr. David Novillo-Ortiz, (2017). World Health Organization (WHO) and Pan American Health Organization (PAHO/WHO). Handbook for Electronic Health Records Implementation.

[2].   Farzaneh Aminpour et al, (2014 Jan). Utilization of open source electronic health record around the world: A systematic review. Retrieved 4:32, June 17, 2019 from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3963324/.

[3].   Florence Femi Odekunle, Raphael Oluseun Odekunle and Srinivasan Shankar, (2017 Sep-Oct). Why sub-Saharan Africa lags in electronic health record adoption and possible strategies to increase its adoption in this region. Retrieved 15:11, June 17, 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654179/.

[4].   Keith Mweebo, (2014). Security of electronic health records in a resource limited setting: The case of smart-care electronic health record in Zambia. Retrieved 15:41, June 17, 2019 from https://pdfs.semanticscholar.org/3e3f/b3d870bc24f5f7b0daa03b16886024c03242.pdf.

Abstract:

Vaccines hesitancy is an established phenomenon that contributes significant health challenges with resultant high morbidities and mortalities. This study examined the impact of health education in resolving vaccines hesitancy and non-adherence to routine immunization schedule among intervention group in comparison to the non-intervention group in Taraba State. Interventions to resolve vaccines-hesitancy and non-adherence to childhood routine immunization schedule in Nigeria is highly needed but inadequate.

Quasi-experimental design used; newborn infant’s mothers accessing immunization in two health facilities PHCC Kona (the intervention group) and PHC Mayo Gwai (the control group) constitute target population explored in this study. Sample size of 20 newborn infant mothers each from the two health facilities, intervention and non-intervention.

The mean age for both intervention and control group are 27.20+ 2.93, and 27.51+ 2.95 respectively. Participants were female, 60% have non-education, 25% have primary education, 15% have secondary education, participants with none and tertiary education 0%. Married [78%] Single [18%]; Divorced [4%]; Widow [0%]; Separated [0%]. The results of appointment-keeping measured at 9thmonth follow-up on a 9-point scale reported for control (𝑋=4.77, SE=0.13 or 64.1%) and for intervention one (𝑋=7.50, SE=0.06 or 94.3%) showed a large effect size (ES) of 2.31(95%CI: 2.74 to 3.88) that was significant at p<0.001.

At the end of the study fully vaccinated were 20 (100%), partial and not vaccinated 0% each. For the control group, fully vaccinated were 5(25%) partially vaccinated 13 (65%) not vaccinated 0 (0%).

Keywords: Vaccines hesitancy, vaccination, routine immunization schedule adherence, vaccines preventable diseases, mothers, and family support health education.

References:

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Abstract:

Water in Zambia, is not equally provided to everyone. For example, out of the population of about 13 million in Zambia, about 5 million do not have access to clean water. This also applies to sanitation in Zambia; about 7 million of Zambians do not have access to sanitation facilities.

In Zambia, water pollution has been seriously affecting the life of humans, plants as well as animals. The eco-system of rivers, streams and lakes is also getting deteriorated due to the contamination of water, through various sources. This condition also leads to the outbreak of numerous diseases, majority of them being lethal and contagious. Although certain natural processes may cause some of the water pollution, however, human activity is the largest cause of our streams, rivers and lakes getting polluted. We get this water from groundwater sources, rivers, and lakes, and after using it, and often contaminating it, most of this water gets back into the rivers, lakes, and streams. The used water from agricultural and industrial practices as well as household use creates wastewater, also referred to as sewage.

References:

[1].   Puja Mondel; Water Pollution: Effects and Health Hazards of Water Pollution;

https://www.alliedacademies.org.

[2].   1st Edition Yongxin Xu, Brent Ush; Groundwater pollution in Africa; CRC Press Published October 5, 2006.

[3].   Impact of Wastewater on Surface Water Quality in Developing Countries: A Case Study of South Africa By Joshua N. Edokpayi, John O. Odiyo and Olatunde S. Durowoju Published: January 18th 20.

[4].   https://www.who.int › resourcesquality › watpolcontrol by R Helmer – published Dec 15, 1994, water pollution control-WHO.

[5].   Water pollution, Zambian villagers sue mining giant Vedanta ,https://www.lifegate.com/lifestyle/Zambia-pollution-case-Vedanta Jan 10, 2017.

Abstract:

Road safety has become a global issue of concern and concrete effort needs to be espoused at the ground level to dwindle the thousands of lives being lost in road traffic accidents around the world. The present study was conducted to dissect factors contributing to impair driving in Ghana; a case study of the Ashanti region of Ghana and scan the association between impaired driving and road traffic accidents. Cross-sectional study design was used. Questionnaire, alcohol breathalyzer test and focus group discussions were used to collect data. Simple random and convenient sampling methods were used to select participants, who were made up of motor vehicle users, Driver Vehicle and Licensing Authority, Motor Traffic and Transport Department and Ghana Private Road Transport Union. The study participants were 216. 96% of the study participants were males. The average age of the respondents was 45.5. Distracted driving, drugs driving, drunk driving, emotions and fatigue driving were the major causes of impaired driving. 74% of the subjects practice drunk driving. The study found that, drunk driving, fatigue and distracted driving were the major causes of road crashes. Drunk driving causes almost 40% of road traffic accidents and it is related to over speeding. Driving while using a cell phone is the major cause of distracted driving. Most of the motor vehicle users continuously drive more than 8 hours. Loss of lives and property damages are expected to continue if suitable corrective measures are not put in place to peter out the problem.

Keywords: impaired driving, road crashes, safety measures, enforcement.

References:

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[2].   Baker et al, (1992), and Voas et al, (1998). Use of alcohol has been associated with one third to one half of all fatal crashes in the USA.

[3].   Carnegie Mellon, (June 2010) http://www.distraction.gov/content/get-the-facts/facts-and statistics.html

[4].   Ghana Statistical Service. (2010) Census.

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[9].   Kircher and Anderson (2012) Investigated Truck Drivers Opinion on Road Safety in Tanzania.

[10].  Kopits E, Cropper M. (2003), fatalities and economic growth. Washington, DC, World Bank, (Policy Research Working Paper No. 3035).

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[13].  Motor Traffic and Transport Department (2018), the Ghana Police Service report.

[14].  Mohan D: (2002), safety and health in Indian cities. Journal of Transport and Infrastructure.

[15].  NHTSA, (1996), Drowsy driving and automobile crashes.

[16].  Open Journal of Preventive Medicine, (2014) Vol.04 No.11, Article ID: 51371,6 pages.

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Abstract:

Road safety has become a global issue of concern and concrete effort needs to be adopted at the ground level to abate the thousands of lives being lost in road traffic accidents around the world. One of the important and cogent measures for subsidising road crashes fatalities is continuously improving and maintaining good shapes and conditions of our roads. The design of roads plays paramount role in terms of road safety.

This study provides strategies and measures that are concrete to tail off the problem through multifaceted methods which involve effective road engineering solutions at the design stage.

The purpose of the study was to assess road infrastructure situation in Ghana and provide effective measures to recede the problem.

The study seeks to measure how roads are maintained with frequent relaying of road surfaces and markings of road safety signs and also to assess the condition of pedestrian’s footpaths and pedestrians crossing at intersection and measure availability of road signs and signals, pavement, and road lanes.

Cross sectional study design was used to collect data. Ashanti region of Ghana was used as a case study. Open and close ended questions and also focus group discussions were used to collect data from the respondents. The study participants were made up of road users (motor vehicle users and pedestrians), and stakeholders within road infrastructure management. The study participants were 217. The study found that, road infrastructure in the region is strongly associated with road traffic accidents in the region.

References:

[1].   Aeron-Thomas A S and Hess S (2005). Red light cameras for the prevention of road traffic crashes. Cochrane Database of Systematic Reviews 2005, Issue 2.

[2].   Allen D, Bygrave S and Harper H (2005). Behaviour at cycle advanced stoplines. TRL PPR 240. Crowthorne: Transport Research Laboratory (TRL).

[3].   Allsbrook L E (1999). Pedestrian signal countdown device. Presented at Enhancing Transportation Safety in the 21st Century ITE International Conference, Kissimmee, Florida, March 1999.

[4].   Andrew H W (1991). Factors influencing pedestrians’ cautiousness in crossing streets. Journal of Social Psychology, 131, p367-372.

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[10].  Baguley C J and Ray S D (1989). Behavioural assessment of speed discrimination at traffic signals. TRRL Report RR117. Crowthorne: Transport Research Laboratory (TRL).

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Abstract:

Background: Immunization is considered as one of the key interventions for protection of children against life threatening conditions that are preventable. In India, nearly 8.9 million are missed for full immunization every year. The study was conducted to assess the reasons for partial immunization of below two years children in Raipur district of Chhattisgarh.

Methodology: Out of all villages and urban wards, randomly one urban and one rural area were selected. A community based cross-sectional study was done with 300 children aged below two years. Simple random sampling (using revolving pen) was used to select the first household for the survey. The immunization status of the child was assessed by vaccination card and by mother's recall where vaccination card was not available.

Results: Chhattisgarh has increased its full immunization coverage from 58% in 2002-04 to 76.4%. overall 67% (135/203) children were fully immunized. In urban areas, 74% (74/100) children were fully immunized whereas in rural areas 59% (61/103) children were fully immunized. Dropout rate for BCG to measles rubella vaccine in urban areas was 5%, while, it was 7% in rural areas. Two most common reasons came out to be unaware of missed dose (38%) and fear of adverse event following immunization (28%).

Conclusion: Immunization program has not only failed in achieving its target but is lagging far behind the desired coverage goal. More awareness should be generated among the people immunize their children.

Keywords: Below two years children, immunization, reasons for partial immunization, drop out, full immunization.

References:

[1].   Universal Immunization Program, Comprehensive Multiyear Plan, 2018-23.

https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/cMYP_2018-22_final_pdf.

[2].   Intensified Mission Indradhanush, Operational guidelines.

https://mohfw.gov.in/sites/default/files/Mission%20Indradhanush%20Guidelines.pdf.

[3].World Health Organization https://www.who.int/news-room/fact-sheets/detail/immunization-coverage.

[4]. Unicef http://unicef.in/whatwedo/3/immunization.

[5].  Government of India, Roadmap for achieving 90% full immunization coverage.

https://nhm.gov.in/New_Updates_2018/NHM_Components/Immunization/Guildelines_for_immunization/Roadmap_document_for_90%25_FIC.pdf.

[6].  Annual Health Survey 12-13.

http://www.censusindia.gov.in/vital_statistics/AHSBulletins/AHS_Factsheets_2012-13/FACTSHEET-Chhattisgarh.pdf.

[7]. study of knowledge, attitude and practices on immunization of children in urban slums of bijapur city, karnataka, India. https://www.ncbi.nlm.nih.gov/pubmed/24551642.

[8].   Reasons for failure of immunization: A cross-sectional study among 12-23-month-old children of Lucknow, India, Rajaat Vohra, Anusha Vohra, Pankaj Bhardwaj, Jyoti Prakash Srivastava, and Pratibha Gupta https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3814854/.

Abstract:

The purpose of the study was to analyze the underlying factors affecting effective solid waste management in the Ghana using the Tamale metropolis as a case. Solid waste management has become a major development challenge in Tamale Metropolitan Assembly (TAMA) in recent times. This deserves not only the attention of the Metropolitan Assembly and the waste management institutions but also concerns of corporate organizations and individuals to find a lasting solution to the problem. Therefore, with the aid of concurrent mixed method design, three main techniques employed in gathering the primary data were: preliminary field investigation, questionnaire survey and face-to-face interview. Findings of the study established that factors affecting effective solid waste management in the Metropolis included inadequate skip supply for storing waste, lack of routine collection of waste and poor methods of waste management. The study also concluded that there were inadequate resources for waste management institutions to effectively collect the waste generated. In the light of these problems enumerated above, the research recommended the adequate supply of skips, regular collection of waste, use of Integrated Solid Waste Management Model (ISWM), proper management of the landfill and adequate resourcing of the waste management institutions.

Keywords: Ghana, Environment, Waste management, Solid waste.

References:

[1].   Anomanyo, D.E (2004). Integration of Municipal Solid Waste Management in Accra, Ghana: Biofactor treatment technology as an integral part of the management process. Presented to Lund University, Sweden.

[2].   Babbie, E. R., & Benaquisto, L. (2009). Fundamentals of social research. Cengage Learning.

[3].   Boadi K.O and Kuitunen, M. (2004). Municipal Solid Waste Management in the Accra Metropolitan Area in the Environmentalist Journal. Volume 23, No.3.

[4].   Creswell, J. W. (2014). A concise introduction to mixed methods research. Sage Publications.

[5].   Kumah, A.M. (2007). The Situation of Solid Waste in Ghana. Accra, Ghana.

[6].   Momoh, J.J. and Oladebeye, D.H. (2010). Assessment of Awareness of Attitude and Willingness of People to Participate in Household Solid Waste Recycling Programme in Ado-Eketi, Nigeria, in the Journal of Applied Sciences in Environmental Sanitation. Jakarta, Indonesia.

[7].   Ogawa, H. (2005). Sustainable Solid Waste Management in Developing Countries. (www.gdrc.org.). Accessed on 30th January, 2010.

[8].   Shafiul, A.A. and Mansoor, A. (2003). Partnerships for solid waste management in developing countries: Linking theories to realities in the Institute of Development Engineering, Water and Development Centre (WEDC). Loughborough University, U.K.

[9].   Tsiboe, I.A. and Marbell, E. (2004). A Look at Urban Waste Disposal Problems in Accra. Roskilde University, Denmark.

[10].  Zerbock, O. (2003). Urban Solid Waste Management: Waste Reduction in Developing Nations. (www.cee.mtu.edu). Accessed on 18th July, 2009.

Abstract:

Introduction: Assessing patients’ perceptions on the quality of health services they receive is an integral part of health service quality management strategies and an important vehicle for improving health services. Zimbabwe has limited data on patients’ perceptions of the quality of maternal and child health services.

Methodology: An analytic cross-sectional study was conducted to determine perceptions of pregnant women attending antenatal care (ANC) on the quality of maternal and child health services at 21 health facilities in 2 out of the 10 provinces. Exit interviews with 190 pregnant women were conducted using a semi-structured questionnaire. Data were analysed using Epi Info, generating measures of central tendency, proportions, bivariate and multivariate analysis.

Results: A majority (84.8%) of participants were satisfied with maternal and child health services. Participants who reported having been given a pleasant welcome [COR=3.37 (1.92 – 5.90)], given clear instructions on how to take medication [COR=2.11 (1.03 – 3.91)], and treated with respect [COR=4.14 (2.37 – 7.33)] were more likely to be satisfied with health services. Patients who visited several departments to get health services were less likely to be satisfied [COR=0.38 (0.19 - 0.67)]. Independent determinants of satisfaction / dissatisfaction include being given a pleasant and warm welcome (AOR=1.38, p=0.01), being treated with respect (AOR=2.14, p=0.03) and visiting several departments to get health services (AOR=0.47, p=0.04).

Discussion: Although a majority of participants reported satisfaction with quality of maternal and child health services, there is room for improvement especially patients’ clinical consultation process and integration of health services.

Keywords: Satisfaction, maternal, child, health services, Zimbabwe.

References:

[1].   Zimbabwe National Health Strategy, 2016-2020.

[2].   Zimbabwe Demographic and Health Survey, 2015.

[3].   Multiple Indicators Cluster Survey, 2014.

[4].   Zimbabwe Population Based HIV Impact Assessment, 2015-2016.

[5].   Zimbabwe Ministry of Health and Child Care 2015 HIV Estimates.

[6].   National Strategic Plan for Elimination of new HIV infections in Children and keeping mothers and families alive, Zimbabwe Ministry of Health and Child Care: 2011 - 2015.

[7].   Epstein A. Sounding board: the outcomes movement, will it get us where we want to go? New England Journal of Medicine, 1990, 323 (4): 266–269.

[8].   Blumenfeld SN. Quality assurance in transition. Papua New Guinea Medical Journal, 1993, 36 (2): 8 Fisher AW. Patient’s evaluation of outpatient medical care. Journal of Medical Education, 1971, 46 (3): 238–244.

[9].   Smith WA. Consumer demand and satisfaction. The hidden key to successful privatization. Washington, DC, Academy for Educational Development, Health Com, Communication for Child Survival, 1989.

[10].  De Geydnt W. Managing the quality of health care in developing countries. Washington, DC, The World Bank, 1995.

[11].  Fitzpatrick R, Hopkins A. Problems in the conceptual framework of patient satisfaction research: an empirical exploration. Social Health Illness 1983: 5 297-311.

[12].  Jenkinson C, Coulter A, Bruster S. The Picker Experience Questionnaire: development and validation using data from inpatient surveys in five countries. International Journal for Quality in Health Care 2002 14 (5) 353-358.

[13].  Carr-Hill R. A. The measurement of Patient Satisfaction. Journal of Public Health Medicine 1992, 14 (3) 236-249.

[14].  The Picker Institute 2004 The Picker Surveys – our method for understanding the patient experience: http://www.pickerinstitute.org/about.htm.

[15].  Commission for Health Improvement; NHS UK Patient Experience. Dimensions, Definitions and Clinical Governance Review Codes http://www.chi.nhs.uk/patients/methods_app1.pdf viewed 19th December 2004.

[16].  Howard, John A. and J.N. Sheth. The theory of buyer behaviour. New York: John Wiley and Sons,P,145 1969.

[17].  Gerteis M, Edgman-Levitan S, Daley J, Delbanco T: Through the Patient's Eyes: Understanding and Promoting Patient-Centered Care. San Francisco: Jossey.

[18].  Birna A. The quality of hospital services in eastern Ethiopia: Patient's perspective. Ethiop J Health Dev. 2006;20.199–200.

[19].  Opare Bernard Kofi. 1996. “The effect of user fees on the quality of rural health services. (A case study from Tororo, Uganda).” University of Heidelberg. Institute of Tropical Hygiene and Public Health.

[20].  Camphel C, Scott K, Madanhire C, Nyamukapa C, Gregson C. A “good hospital”: Nurse and patient perception on good clinical care for HIV positive people on Antiretroviral therapy in rural Zimbabwe – A mixed-methods qualitative study. Int J. Nur Stu. Feb 2011; 48(2-3): 175-183.

[21].  Davies AR, Ware JE. Involving consumers in quality of care. Health Aff. 1988;33– 48. http://dx.doi.org/10.1377/hlthaff .7.1.33, PMid:3360392.

[22].  Dish Project in Four Selected Districts, Uganda. 1999. “Quality of Reproductive Healthcare Study.” Delivery of Improved Services for Health.

Abstract:

Background: Lassa fever is a viral haemorrhagic disease caused by an RNA virus of the family Arenaviridae. The seroprevalence in Nigeria is about 21%. Since 1969, several outbreaks reported in various states in Nigeria. The objective of this study was to investigate and control the Lassa fever outbreak in Ebonyi State, Nigeria.

Methodology: A cross-sectional study was done with laboratory confirmation. Sociodemographic data were collected and recorded on a line list and used for descriptive epidemiology. Blood samples were collected for confirmation by reverse transcriptase-polymerase chain reaction.

Findings: From January 22nd to March 1st, 2019 a total of 92 suspected cases were identified; with most being between 15-44 years, (59.1%), female (62.5%) and from Abakaliki LGA (47.6%). There were 30 laboratory-confirmed cases and 12 deaths with a case fatality rate (CFR) of 40%. Following confirmation, the incidence was highest in those aged 15-44 years (66.7%), and the CFR was highest in the same age group (58.3%). Disaggregated CFR showed a CFR of 25% in males and 50% in females. The Number of days from onset of symptoms to the presentation at the health facility was statistically significant with an odds ratio of 1.3 (1.009-1.700). (P-value < 0.05).

Conclusion: Poor health-seeking behaviour increases the chance of death from Lassa fever infection. It is essential to continue to institute preventive measure like health promotion. it will increase awareness on signs and symptoms as well as service availability of health for Lassa fever management.

Keywords: Lassa fever, Arenaviridae, Incidence, Disease Outbreak.

References:

[1].   Shaffer JG, Grant DS, Schieffelin JS, Boisen ML, Goba A, Hartnett JN, et al. Lassa Fever in Post-Conflict Sierra Leone. PLoS Negl Trop Dis. 2014;8(3).

[2].   Faso B, Leone S, Diseases ZI. Lassa Fever. 2011.

[3].   Richmond JK, Baglole DJ. Clinical review social consequences. 2002;1271–5.

[4].   Shehu NY, Gomerep SS, Isa SE, Iraoyah KO, Mafuka J, Bitrus N, et al. Lassa Fever 2016 Outbreak in Plateau State, Nigeria—The Changing Epidemiology and Clinical Presentation. Front Public Heal. 2018;6(August):1–5.

[5].   Iroezindu MO, Unigwe US, Okwara CC, Ozoh GA, Ndu AC, Ohanu ME, et al. Lessons learnt from the management of a case of Lassa fever and follow-up of nosocomial primary contacts in Nigeria during Ebola virus disease outbreak in West Africa. Trop Med Int Heal. 2015;20(11):1424–30.

[6].   Du Toit A. Lassa fever outbreak in Nigeria. Nat Rev Microbiol. 2018;16(5):260.

[7].   Stephen Ilesanmi O, Omotoso B, Osaretin Alele F, Adewuyi P. Awareness of Lassa Fever in a Rural Community in South West Nigeria. J Community Heal Res. 2015;4(1):1–10.

[8].   Adebayo D, Amaechi Nwobi E. Response Preparedness to Viral Hemorrhagic Fever in Nigeria: Risk Perception, Attitude towards Lassa Fever. Epidemiol Open Access. 2015;05(03).

[9].   Richmond JK, Baglole DJ. Lassa fever: epidemiology, clinical features, and social consequences. BMJ Br Med J. 2003;327(7426):1271–5.

[10].  Ajayi NA, Nwigwe CG, Azuogu BN, Onyire BN, Nwonwu EU, Ogbonnaya LU, et al. Containing a Lassa fever epidemic in a resource-limited setting: outbreak description and lessons learned from Abakaliki , Nigeria. Int J Infect Dis. 2013;17: e1011–e1016.

[11].  NCDC. 2019 Lassa Fever Outbreak Situation Report. 2019.

Abstract:

Background: The National Tuberculosis Program plan to eliminate Tuberculosis (TB) as a public health problem in Nigeria by 2050 and WHO 90-90-90 target of ending TB may be difficult to achieve without an efficient and effective sample referral system.

Aims: The aim of this study is to critically evaluate the outsourcing of sputum transportation logistics in TB diagnosis, prevention, and control in Nigeria.

Materials and Method: Information was obtained from all the TB testing laboratories in all the 36 states and the Federal Capital Territory in Nigeria. Data were extracted from the excel database used for tracking specimen transportation logistics, cleaned and analyzed using IBM-SPSS version 25.0.

Result: This study revealed a steady increase in the number of samples transported from collection centers to testing laboratories from 393 in March 2018 to 5211 in March 2019. Samples transported by 3PLs increased by 508.7% at month 7 (midway) and increased by 1,326% at month 13. Similarly, the number of results transported from testing laboratories back to collection centers increased by 1,121% and 3,166% respectively. Akwa Ibom state recorded the highest number of sample movements; (13.6%), followed by Benue (11.7%) and Lagos state (11.5%). Percentage of sputum results pick-up were above 50% and 69% overall. Sample rejection was low, at 0.25%, indicating effectiveness and efficiency in the system.

Conclusion and Recommendation: The study reported very good performance of 3PL services. However, the low sample transportation in some states requires further investigation and attention.

Keywords: Tuberculosis, Sputum, Sample Referral, Logistics, 3PL, Outsourcing.

References:

[1].   Adebambo, S. O., Omolola, O. M., & Victor, D. A. (2016). Analysis of Outsourcing Logistics Service and Customer Satisfaction in Manufacturing Companies in South Western Nigeria. European Journal of Logistics, Purchasing, and Supply Chain Management, 4(1), 1–10.

[2].   Adegboyega O, Eyitayo A, Emmanuel L. (2017). Tuberculosis and the determinants of treatment outcome in Zaria, North Western Nigeria – A nine-year (2007–2015) epidemiological review. Journal of Medicine in the Tropics, 31(4), 116–122. https://doi.org/10.4103/jomt.jomt.

[3].   Alemnji, G., Nkengasong, J. N., & Parekh, B. S. (2011). HIV testing in developing countries: What is required? Indian Journal of Medical Research, 134(12), 779–786.

[4].   Aliyu, G., Ezati, N., Iwakun, M., Peters, S., & Abimiku, A. (2017). Diagnostic system strengthening for drug-resistant tuberculosis in Nigeria: impact and challenges. African Journal of Laboratory Medicine, 6(2), 1–6. https://doi.org/10.4102/ajlm.v6i2.502.

[5].   Aruna, O., Nsofor, I., & Kola Oyediran. (2018). Tuberculosis in Nigeria Rapid Assessment of Infectious Disease Surveillance and Reporting. Retrieved from www.measureevaluation.org.

[6].   Desmon, S. (2018). Taking a Deep Dive into Why Nigeria’s TB Rates are So High. Johns Hopkins Center for Communication Programs. Retrieved from https://ccp.jhu.edu/2018/10/22/nigeria-tb-rates-high-tuberculosis/

[7].   Dr.Abhineet Mehrotra, D. A. M. (2013). An Evaluation of Laboratory Specimen Rejection Rate in a North Indian Setting-A Cross-Sectional Study. IOSR Journal of Dental and Medical Sciences, 7(2), 35–39. https://doi.org/10.9790/0853-0723539.

[8].   Faruna, T., Akintunde, E., & Odelola, B. (2019). Leveraging private sector transportation/logistics services to improve the National Integrated Specimen Referral Network in Nigeria © Society for Business and Management Dynamics © Society for Business and Management Dynamics. 8(7), 8–20.

[9].   Gebreegziabher, S. B., Yimer, S. A., & Bjune, G. A. (2016). Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives. Tuberculosis Research and Treatment, 2016, 1–8

https://doi.org/10.1155/2016/2036234.

[10].  Global Health Education. (2018). TB in Nigeria - Funding, children, diagnosing TB, HIV/TB. Global Health Education. Retrieved from https://www.tbfacts.org/tb-nigeria/.

[11].  GOV.UK. (2018). Tuberculosis testing in Nigeria. Retrieved from

https://www.gov.uk/government/publications/tuberculosis-test-for-a-uk-visa-clinics-in-malaysia/tuberculosis-testing-in-malaysia.

[12].  Joloba, M., Mwangi, C., Alexander, H., Nadunga, D., Bwanga, F., Modi, N., … Nkengasong, J. N. (2016). Strengthening the Tuberculosis Specimen Referral Network in Uganda: The Role of Public-Private Partnerships. Journal of Infectious Diseases, 213(Suppl 2), S41–S46. https://doi.org/10.1093/infdis/jiw035.

[13].  Ju, Y., Wang, Y., Cheng, Y., & Jia, J. (2019). Investigating the impact factors of the logistics service supply chain for sustainable performance: Focused on integrators. Sustainability (Switzerland), 11(2).

https://doi.org/10.3390/su11020538.

[14].  Kalinzi, C. (2017). Outsourcing (Logistics) Services and Supply Chain Efficiency – A Critical Review of Outsourcing Function in Mukwano Group of Companies. Journal of Outsourcing and Organizational Information Management, (July), 1–22. https://doi.org/10.5171/2016.937323.

[15].  Kebede, Y., Fonjungo, P. N., Tibesso, G., Shrivastava, R., Nkengasong, J. N., Kenyon, T., … Ayana, G. (2016). Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership. Journal of Infectious Diseases, 213(CDC), S59–S64. https://doi.org/10.1093/infdis/jiv576.

[16].  Kooffreh, M., Offor, J., Ekerette, E., & Udom, U. (2016). Prevalence of tuberculosis in Calabar, Nigeria: A case study of patients attending the outpatients Department of Dr. Lawrence Henshaw Memorial Hospital, Calabar. Saudi Journal for Health Sciences, 5(3), 130. https://doi.org/10.4103/2278-0521.195817.

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[19].  Muthoni, D. K. (2016). Effect of Supply Chain Processes Outsourcing on the Performance of Manufacturing Firms in Kenya.

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[22].  Parsons, L. M., Somoskövi, Á., Gutierrez, C., Lee, E., Paramasivan, C. N., Abimiku, A, Nkengasong, J. (2011). Laboratory diagnosis of tuberculosis in resource-poor Countries: Challenges and opportunities. Clinical Microbiology Reviews, 24(2), 314–350. https://doi.org/10.1128/CMR.00059-10.

[23].  PEPFAR. (2015). Remarks on “Creating an AIDS-Free Generation. Retrieved from

http://wwwstategov/%0Asecretary/20092013clinton/rm/2011/11/176810htm.

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[25].  Shiferaw, M. B., Yismaw, G., & Getachew, H. (2018). Specimen rejections among referred specimens through referral network to the Amhara Public Health Institute for laboratory testing, Bahir Dar, Ethiopia. BMC Research Notes, 11(1), 4–9. https://doi.org/10.1186/s13104-018-3891-7.

[26].  USAID. (2018). SPECIMEN TRANSPORTATION A HOW-TO GUIDE.

[27].  World Health Organisation. Vanuatu: Estimates of TB and MDR-TB burden. , (2018).

[28].  Adebambo, S. O., Omolola, O. M., & Victor, D. A. (2016). Analysis of Outsourcing Logistics Service and Customer Satisfaction in Manufacturing Companies in South Western Nigeria. European Journal of Logistics, Purchasing, and Supply Chain Management, 4(1), 1–10.

[29].  ADEGBOYEGA OYEFABI, EYITAYO ADETIBA, EMMANUEL LEESHAK, O. A. (2017). Tuberculosis and the determinants of treatment outcome in Zaria, North Western Nigeria – A nine-year (2007–2015) epidemiological review. Journal of Medicine in the Tropics, 31(4), 116–122.

https://doi.org/10.4103/jomt.jomt.

[30].  Alemnji, G., Nkengasong, J. N., & Parekh, B. S. (2011). HIV testing in developing countries: What is required? Indian Journal of Medical Research, 134(12), 779–786.

[31].  Aliyu, G., Ezati, N., Iwakun, M., Peters, S., & Abimiku, A. (2017). Diagnostic system strengthening for drug-resistant tuberculosis in Nigeria: impact and challenges. African Journal of Laboratory Medicine, 6(2), 1–6. https://doi.org/10.4102/ajlm.v6i2.502.

[32].  Aruna, O., Nsofor, I., & Kola Oyediran. (2018). Tuberculosis in Nigeria Rapid Assessment of Infectious Disease Surveillance and Reporting. Retrieved from www.measureevaluation.org.

[33].  Desmon, S. (2018). Taking a Deep Dive into Why Nigeria’s TB Rates are So High. Johns Hopkins Center for Communication Programs. Retrieved from https://ccp.jhu.edu/2018/10/22/nigeria-tb-rates-high-tuberculosis/.

[34].  Dr.Abhineet Mehrotra, D. A. M. (2013). An Evaluation of Laboratory Specimen Rejection Rate in a North Indian Setting-A Cross-Sectional Study. IOSR Journal of Dental and Medical Sciences, 7(2), 35–39. https://doi.org/10.9790/0853-0723539.

[35].  Faruna, T., Akintunde, E., & Odelola, B. (2019). Leveraging private sector transportation/logistics services to improve the National Integrated Specimen Referral Network in Nigeria © Society for Business and Management Dynamics © Society for Business and Management Dynamics. 8(7), 8–20.

[36].  Gebreegziabher, S. B., Yimer, S. A., & Bjune, G. A. (2016). Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives. Tuberculosis Research and Treatment, 2016, 1–8

https://doi.org/10.1155/2016/2036234.

[37].  Global Health Education. (2018). TB in Nigeria - Funding, children, diagnosing TB, HIV/TB. Global Health Education. Retrieved from https://www.tbfacts.org/tb-nigeria/.

[38].  GOV.UK. (2018). Tuberculosis testing in Nigeria. Retrieved from

https://www.gov.uk/government/publications/tuberculosis-test-for-a-uk-visa-clinics-in-malaysia/tuberculosis-testing-in-malaysia.

[39].  Joloba, M., Mwangi, C., Alexander, H., Nadunga, D., Bwanga, F., Modi, N., … Nkengasong, J. N. (2016). Strengthening the Tuberculosis Specimen Referral Network in Uganda: The Role of Public-Private Partnerships. Journal of Infectious Diseases, 213(Suppl 2), S41–S46. https://doi.org/10.1093/infdis/jiw035.

[40].  Ju, Y., Wang, Y., Cheng, Y., & Jia, J. (2019). Investigating the impact factors of the logistics service supply chain for sustainable performance: Focused on integrators. Sustainability (Switzerland), 11(2). https://doi.org/10.3390/su11020538.

[41].  Kalinzi, C. (2017). Outsourcing (Logistics) Services and Supply Chain Efficiency – A Critical Review of Outsourcing Function in Mukwano Group of Companies. Journal of Outsourcing and Organizational Information Management, (July), 1–22. https://doi.org/10.5171/2016.937323.

[42].  Kebede, Y., Fonjungo, P. N., Tibesso, G., Shrivastava, R., Nkengasong, J. N., Kenyon, T., … Ayana, G. (2016). Improved Specimen-Referral System and Increased Access to Quality Laboratory Services in Ethiopia: The Role of the Public-Private Partnership. Journal of Infectious Diseases, 213(CDC), S59–S64. https://doi.org/10.1093/infdis/jiv576.

[43].  Kooffreh, M., Offor, J., Ekerette, E., & Udom, U. (2016). Prevalence of tuberculosis in Calabar, Nigeria: A case study of patients attending the outpatients Department of Dr. Lawrence Henshaw Memorial Hospital, Calabar. Saudi Journal for Health Sciences, 5(3), 130. https://doi.org/10.4103/2278-0521.195817.

[44].  MOH. (2013). Nigeria Federal Ministry of Health. National Tuberculosis Prevalence Survey 2012. Federal Ministry of Health, 15–98. Retrieved from http://www.who.int/tb/publications/NigeriaReport.

[45].  MOH. (2014). Federal Ministry of Health: National Tuberculosis and Leprosy Control (NTBLC). In O. Nwobi, B., Kabir, M., Obasanya & O. Ogbeiwi (Eds.), Worker’s Manual (5th ed.). Federal Ministry of Health.

[46].  Muthoni, D. K. (2016). Effect of Supply Chain Processes Outsourcing on the Performance of Manufacturing Firms in Kenya.

[47].  Ogbo, F. A., Ogeleka, P., Okoro, A., Olusanya, B. O., Olusanya, J., Ifegwu, I. K., … Page, A. (2018). Tuberculosis disease burden Nigeria. 1–11.

[48].  Oguntade, G. (2018). World Tuberculosis Day 2018, on the search for TB Leaders in Nigeria | ARFH Nigeria. Arfh. Retrieved from https://arfh-ng.org/world-tuberculosis-day-2018-on-the-search-for-tb-leaders-in-nigeria/.

[49].  Parsons, L. M., Somoskövi, Á., Gutierrez, C., Lee, E., Paramasivan, C. N., Abimiku, A., … Nkengasong, J. (2011). Laboratory diagnosis of tuberculosis in resource-poor Countries: Challenges and opportunities. Clinical Microbiology Reviews, 24(2), 314–350. https://doi.org/10.1128/CMR.00059-10.

[50].  PEPFAR. (2015). Remarks on “Creating an AIDS-Free Generation. Retrieved from http://wwwstategov/%0Asecretary/20092013clinton/rm/2011/11/176810htm.

[51].  Plebani, M. (2015). Diagnostic Errors and Laboratory Medicine - Causes and Strategies. Ejifcc, 26(1), 7–14. Retrieved from

https://www.ncbi.nlm.nih.gov/pubmed/27683477%0Ahttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4975219/pdf/ejifcc-26-007.pdf.

[52].  Shiferaw, M. B., Yismaw, G., & Getachew, H. (2018). Specimen rejections among referred specimens through referral network to the Amhara Public Health Institute for laboratory testing, Bahir Dar, Ethiopia. BMC Research Notes, 11(1), 4–9. https://doi.org/10.1186/s13104-018-3891-7.

[53].  USAID. (2018). SPECIMEN TRANSPORTATION A HOW-TO GUIDE.

[54].  World Health Organisation. Vanuatu: Estimates of TB and MDR-TB burden., (2018).

Abstract:

The subject of poliomyelitis cuts across several courses undertaken as part of the requirements for the PhD in Public Health program. It involves issues of public health, use of data in its implementation and monitoring, including education of communities and the population at large on the dangers of the disease and prevention.

In 1988, the Forty-first World Health Assembly adopted a resolution for the worldwide eradication of polio. This resolution marked the launch of the Global Polio Eradication Initiative (GPEI), a public-private partnership led by national governments with five partners – spearheaded by national governments, WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), UNICEF, and later joined by additional key partners including the Bill & Melinda Gates Foundation and Gavi, the Vaccine Alliance. This followed the certification of the eradication of smallpox in 1980, progress during the 1980s towards elimination of the poliovirus in the Americas, and Rotary International’s commitment to raise funds to protect all children from the disease.

The main goal of the GPEI is to eradicate polio worldwide using four strategies, namely: strong routine immunization coverage, conduct supplemental immunization activities (SIAs), conduct Acute Flaccid Paralysis (AFP) surveillance and conduct mop up immunization campaigns wherever and whenever the cases are detected. Since the resolution to eradicate polio was adopted in 1988, the number of wild poliovirus cases have decreased by over 99%,

There are 3 strains of wild poliovirus (type 1, type 2, and type 3). Wild poliovirus type 2 was eradicated in 1999 while wild poliovirus type 3 was declared eradicated in October 2019 during the celebration of the world polio day. This paper has been prepared to enhance the reader’s understanding of the disease of poliomyelitis. The paper will present an overview of poliomyelitis in relation to the following

1.  Background to GPEI

2.  Definition of Poliomyelitis,

3.  Transmission and symptoms

4.  Types of Polio

5.  Prevention,

6.  Complications

7.  Challenges to polio eradication

8.  Possibility of eradicating polio?

9.  Progress made toward polio eradication

10. Measures to keep the world free of polio after certification of eradication,

11. Benefits of polio eradication

12. GPEI Monitoring Boards

13. Conclusion

This paper is aimed at creating awareness of the disease to the larger community so as to promote understanding of the importance of eradicating it just as smallpox was eradicated several years ago.

Keywords: Poliomyelitis

References:

[1].  Alexander, J.P. et al (2017) Poliomyelitis. Centers for Disease Control & Prevention. Chapter 3.

[2].  NC Grassly, C Fraser, J Wenger, JM Deshpande, RW Sutter, DL Heymann, et al. New strategies for elimination of polio from India. Science 2006; 314: 1150-3. (In Lahariya. 2017).

[3].   GPEI. Independent Monitoring Board of the Global Polio Eradication Initiative (Sixteenth Report: October 2018)https://reliefweb.int/report/nigeria/independent-monitoring-board-global-polio-eradication-initiative-sixteenth-report.

[4].  Lahariya c. (2007) Global Eradication of polio: the case for “finishing the job”.

[5].   Paul D. Rutter, Liam J. Donaldson. Oversight Role of the Independent Monitoring Board of the Global Polio Eradication Initiative. The Journal of Infectious Diseases, Volume 210, Issue suppl_1, November 2014, Pages S16–S22, https://doi.org/10.1093/infdis/jiu181.

[6].Tarek Tawfik Amin (2014) Types of epidemics and epidemic investigations. https://www.slideshare.net/Tawfikzahran/types-of-epidemics-and-epidemic-investigations.

[7].   http://polioeradication.org/who-we-are/governance-and-structure/independent-monitoring-board/.

[8].   The End of The Beginning. http://polioeradication.org/wp-content/uploads/2017/07/TIMB_Report-no1_Jul2017_EN.pdf. Poliomyelitis. www.polioeradication.org.

[9].   https://www.who.int/news-room/fact-sheets/detail/poliomyelitis.

[10].   https://www.ncbi.nlm.nih.gov/pubmed/31120868.

[11].  Wassilak, G.F et al (2017) Using Acute Flaccid Paralysis Surveillance as a platform for Vaccine-Preventable Disease Surveillance. The Journal of Infectious Diseases. Oxford University Press.

[12].  .    MedicineNet.com: Medical Definition of Poliomyelitis.

[13].  www.Healthline.com.

[14].   www.polioeradication.org.

[15].weekly-GPEI-polio-analyses-wpv20191115:http://polioeradication.org/wp-content/uploads/2016/08/Weekly-GPEI-Polio-Analyses-WPV-20191115.pdf.

Abstract:

The study identified the causes and effects of teenage pregnancy in kalingalinga compound of Lusaka province. Teenage pregnancy is a case of which the under aged girl usually within the ages of thirteen to nineteen years gets pregnant, it is both a social and economic problem of each and every country that has not been solved. Therefore, the study examined the general causes and effects, and measures and strategies that can be used to prevent teenage pregnancy. Its focus was on women and teenage girls only. And the targeted population was 50 respondents (interviewees) of which 35 were women and 15 where teenage girls.

A non-probability technique which is the purposive (judgemental) sampling method was used when interviewing people. The study, therefore, used a descriptive method to identify the basic causes and effects of teenage pregnancy as they affect our communities. And the main causes are; peer pressure, environmental influence, lack of financial support, lack of sex education, early marriage and media influence. And the main effects are; economic hardship, school dropout, early marriage and pregnancy complications during birth.

It was recommended that the government should come up with sensitization programs in order to notify teenagers about the effects that may arise if they engage themselves in sexual activities. And also, that the government should start to reach out to orphans and vulnerable in every part of a country.

References:

[1].   Getachew Mullu Kassa, A. O. Arowojolu, A. A. Odukogbe and Alemayehu Worku Yalew(2018). Prevalence and determinants of adolescent pregnancy in Africa: a systematic review and Meta-analysis.

[2].   Reproductive Health201815:195.

[3].   https://doi.org/10.1186/s12978-018-0640-2.

[4].   Ibrahim Yakubu and Waliu Jawula Salisu, (2018). Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review Reproductive Health. 2018; 15: 15.

[5].   Yohannes Ayanaw Habitu, Anteneh Yalew and Telake Azale Bisetegn (2018). Prevalence and Factors Associated with Teenage Pregnancy, Northeast Ethiopia, 2017: A Cross-Sectional Study Journal of Pregnancy Volume 2018, Article ID 1714527, 7 pages https://doi.org/10.1155/2018/1714527.

[6].   Demetrius Madrigal and Bryan McClain (2012). Strengths and weaknesses of quantitative and qualitatative research. https://www.uxmatters.com.

[7].   Interview schedule: definition, types, templates and tips (2016). https://www.cleverism.com.

[8].   https://writing.colostate.edu  advantages of open-ended questions

[9].   Dejonckheere M. and Vaughn (2018). Semistructured interviewing in primary care research: a balance of relationship and rigour. Family Medicine and Community Health Vol 7, issue 2.

[10].  https://www.odi.org/publications/5695-research-tools-focus-group-discussion.

[11].  Burrows, D., & Kendall, S. (1997). Focus groups: What are they and how can they be used in nursing and health care research? Social Sciences in Health, 3, 244– 253. Google Scholar.

[12].  Kitzinger, J. (1995). Introducing focus groups. British Medical Journal, 311, 299– 302. Google Scholar

[13].  Krueger, R. A. (1994). Focus groups: A practical guide for applied research. Thousand Oaks, CA: Sage Publications Inc. Google Scholar.

[14].  Tobias O.Nyumba, Kerrie Wilson, Christina J. Derrick and Nibedita Mukherjee (2018). The use of focus group discussion methodology: Insights from two decades of application in conservation https://doi.org/10.1111/2041-210X.12860.

[15].  https://en.m.wikipedia.org/wiki/Thematic_analysis.

Abstract:

Background: Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels, either due to insufficient endogenous insulin production by the pancreatic beta cells, known as Type1 Diabetes Mellitus (T1DM) or due to impaired insulin secretion and/or action, known as Type2 Diabetes Mellitus (T2DM). It is a growing public health problem that poses major socio-economic challenges.

Local context: For a long time, there has been marginalization and neglect of our African traditional foods in favor of western diets and lifestyle. This has culminated in an increased prevalence of Diabetes Mellitus among Cameroonians in general and North West populations in particular. As at now no scientific research has been carried out to seek solutions to this imminent Non-communicable Disease epidemic.

Objective: The general objective of this study was to evaluate the nutritional status, and dietary management of elderly diabetic patients attending the diabetic clinic in the Bamenda Regional Hospital (BRH).

Purpose: The purpose was to provide crucial baseline information that could be used in the planning and implementation of the prevention, control and treatment strategies for T2DM in the Bamenda health district Mezam Division.

Methodology: The study design was a cross sectional explorative and analytic design and the sample size consisted of all one hundred and forty (140) elderly diabetic patients receiving treatment at Bamenda Regional Hospital (BRH).

Results: The results showed that 71% of the participants had no family history of diabetes. Meanwhile anthropometric assessment showed that there was no significant difference (P<0.05) in the mean weight of the patients, even though 86% of the females were obese compared to their male counterparts (14%). The Fasting Blood Sugar (FBS) for all the participants was above the normal range of 126mg/dl.

Keywords: Diabetes, Nutrition, Food, Blood Glucose, and Anthropometry.

References:

[1].   Abioye-Kuteyi EA, Ojofeitimi EO, Ijadunola KT, FasanuAO 2008.Assessment of dietary knowledge, practices and control in type 2 diabetes in a Nigerian teaching hospital.

[2].   2.Adebayo FO. 2010. Dietary habits and prevalence of obesity among type 2 Diabetes patients seen at Scott Hospital, Morija, Lesotho.

[3].   Ashwell M, Gunn P & Gibson S. 2012. Obesity Comorbidity Diagnostic. Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: Systematic review and meta-analysis.

[4].   Badreldin A. Mohamed, Ali M. Almajwal, Abdalla A. Saeedand Ibrahim A. Bani, 2013. Dietary practices among patients with type 2 diabetes in Riyadh, Saudi Arabia.

[5].   Blanck, H.M., Gillespie, C., Kimmons, J.E., Seymour, J.D. and Serdula, M.K. 2008 Trends in fruit and vegetable consumption among US men and women.

[6].   Bloom DE, Boersch-Supan A, McGee P, Seike A, 2011. Population Aging: Facts, Challenges, and Responses.

[7].   Centers for Disease Control and Prevention (CDC). 2011. National diabetes fact sheet: nationalestimates and general information on diabetes and prediabetes in the United States.

[8].   Danaei G, Finucane MM, Lu Y, et al.,2011. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 27 million participants.

[9].   Evert AB, Boucher JL, Cypress M, Dunbar SA, Franz MJ, Mayer-Davis EJ, Neumiller JJ, Nwankwo R, Verdi CL, Urbanski P &Yancy WS. 2013. Nutrition Therapy Recommendations for the Management of Adults with Diabetes.

[10].  International Diabetes Federation. 2011. IDF Diabetes Atlas, 5^thedition.

[11].  International Diabetes Federation. 2013b. IDF Diabetes Atlas, 6^thEdition.

[12].  International Diabetes Federation (African Region). 2006. Dietary management of type 2 diabetes mellitus.

[13].  International Diabetes Federation 2015.IDF Diabetes Atlas, 7th ed. Brussels, Belgium.

[14].  International Diabetes Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia. 2010. Report of a WHO/IDF Consultation.

Abstract:

Background and objective: More than half of the global cancer burden of breast cancer is found in low- and middle-income countries. The magnitude of cancer mortality will be directly related to the presentation and effectiveness of efforts to treat cancer. This study aims to determine the presentation, management and outcome of breast cancer in an African setting.

Methodology: Retrospective study of all consecutive histologically confirmed cases of breast cancer in women was extracted from patient’s clinical case notes and histopathology reports. Data was analyzed using SPSS software version 25.

Results & discussions: A total of 107 patients were seen in a period of 5 years with a breast cancer prevalence of 6.6 per 100,000. The mean age of presentation is 44.5 years. 90% presented with Invasive ductal carcinoma and 71% presented with TNM stages 3. 77% had modified radical mastectomy and 42% had chemotherapy. No patient had radiotherapy within the setting.

After six months the overall mortality was 10.3%. Only 8.4% patients were seen in the first follow up while 30% were loss to follow up.

Conclusion: The breast cancer is still a major public health concern in low- and middle-income countries. Late presentation and absence of modern management techniques contributes to the high mortality associated with the disease in this region.

Keywords: Breast Cancer, Presentation, Management, Outcome, Kebbi, Nigeria.

References:

[1].   Ferlay J, S.I., Ervik M, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, and B. Forman D, F (2013), GLOBOCAN 2012 v1.0, in Cancer Incidence and Mortality Worldwide: 2013, International Agency for Research on Cancer.: Lyon, France.

[2].   Ferlay, J., et al., Global burden of breast cancer, in Breast Cancer Epidemiology. 2010, Springer. p. 1-19.

[3].   Bray, F., P. McCarron, and D.M. Parkin, The changing global patterns of female breast cancer incidence and mortality. childhood, 2004. 4(5).

[4].   Benjamin O. Anderson, Breast Cancer Epidemiology and Breast Physiology, in Ghana Breast Cancer Specialty Training Course, T.B.H.G. Initiative, Editor. 2010, The Breast Health Global Initiative: Ghana.

[5].   W.H.O, Global status report on noncommunicable diseases 2010, in WHO Library Cataloguing-in-Publication Data, D.A. Alwan, Editor. 2012: Geneve, Switzerland.

[6].   Harford, J.B., Breast-cancer early detection in low-income and middle-income countries: do what you can versus one size fits all. The lancet oncology, 2011. 12(3): p. 306-312.

[7].   Abdulrahman, G.O. and G.A. Rahman, Epidemiology of breast cancer in Europe and Africa. Journal of cancer epidemiology, 2012. 2012.

[8].   Paper, A.C.P., Access to Cancer Treatment in Low- and Middle-Income Countries. 2010, International Union Against Cancer (UICC): USA.

[9].   Nations, U., Millennium Development Goal and Beyond 2015, in Report of the UN Secretary-General. 2013.

[10].  Porter, P., “Westernizing” women's risks? Breast cancer in lower-income countries. New England Journal of Medicine, 2008. 358(3): p. 213-216.

[11].  Organization, W.H., World health day 2012. 2012.

[12].  Babatunji, O., Awareness, Attitude and Practice of Rural Women regarding Breast Cancer in Northeast Nigeria. Journal of Community Medicine & Health Education, 2012.

[13].  Odigie, V., et al., Psychosocial effects of mastectomy on married African women in Northwestern Nigeria. Psycho‐Oncology, 2010. 19(8): p. 893-897.

[14].  Ibrahim, N. and M. Oludara, Socio-demographic factors and reasons associated with delay in breast cancer presentation: a study in Nigerian women. The Breast, 2012. 21(3): p. 416-418.

[15].  Jedy-Agba, E., et al., Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer Epidemiol, 2012. 36(5): p. e271-8.

[16].  Sharma, K., et al., A systematic review of barriers to breast cancer care in developing countries resulting in delayed patient presentation. Journal of oncology, 2012. 2012.

[17].  Kantelhardt, E., et al., Breast cancer survival in Ethiopia: A cohort study of 1,070 women. International Journal of Cancer, 2014.

[18].  Paper, A.C.P., Access to Cancer Treatment in Low and Middle-Income Countries, in CanTreat International, Axios, V. Sowedi Muyingo, Editor. 2010, International Union Against Cancer (UICC) Conference: USA.

[19].  Anyanwu SN (2000) Breast cancer in eastern Nigeria: a ten-year review. West Afr J Med 19: 120-125

[20].  Ihekwaba FN (1992) Breast cancer in Nigerian women. Br J Surg 79: 771-775.

[21].  Althuis MD, Dozier JM, Anderson WF, Devesa SS, Brinton LA (2005) Global trends in breast cancer incidence and mortality 1973-1997. Int J Epidemiol 34: 405-412.

[22].  Adebamowo CA, Adekunle OO (1999) Case-controlled study of the epidemiological risk factors for breast cancer in Nigeria. Br J Surg 86: 665-668.

[23].  Joslyn SA, West MM (2000) Racial differences in breast carcinoma survival. Cancer 88: 114-123.

[24].  Elmore JG,Moceri VM, Carter D, Larson EB (1998) Breast carcinoma tumour characteristics in black and white women. Cancer 83: 2509-2515.

[25].  Gao Q, Neuhausen S, Cummings S, Luce M, Olopade OI (1997) Recurrent germ-line BRCA1 mutations in extended African American families with early onset breast cancer. Am J Hum Genet 60: 1233-1236.

[26].  Ntekim, A., F.T. Nufu, and O.B. Campbell, Breast cancer in young women in Ibadan, Nigeria. Afr Health Sci, 2009. 9(4): p. 242-6.

[27].  Mbuka-Ongona D, Tumbo J M (2013) Knowledge about breast cancer and reasons for late presentation by cancer patients seen at Princess Marina Hospital, Gaborone, Botswana. Afr J Health Care Fam Med 5: 1-7.

[28].  Otieno ES, Micheni JN, Kimende SK, Mutai KK (2010) Delayed presentation of breast cancer patients. East Afr Med J 87: 147-150.

[29].  Kakarala M, Rozek L, Cote M, Liyanage S, Brenner DE (2010) Breast cancer histology and receptor status characterization in Asian Indian and Pakistani women in the U.S.—a SEER analysis. BMC Cancer 10: 191.

[30].  Dodwell, D., et al., Radiotherapy following breast-conserving surgery for screen-detected ductal carcinoma in situ: indications and utilisation in the UK. Interim findings from the Sloane Project. British journal of cancer, 2007. 97(6): p. 725-729.

[31].  Cutuli, B., et al., Breast-conserving surgery with or without radiotherapy vs mastectomy for ductal carcinoma in situ: French Survey experience. British journal of cancer, 2009. 100(7): p. 1048-1054.

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Abstract:

Study aimed at establishing efficacy of Indoor Residual Household Spraying (IRHS) program in controlling malaria among children under-five in Ndola, Zambia.

Methods: A comparative study conducted at Nkwazi (intervention) and Masala (non- intervention) compound, over a period of six months from October 2017 to April 2018. Sample size; 410 caretakers and 6 key informants. Sampling: Cluster, systematic and purposive, from, 6^th to 30^th April 2018 and 28^th May to 26^th August 2019 respectively. Interview guide, Semi-structured questionnaire and checklist used. Content analysis, univariate and bivariate, SPSS version 20 Chi-square determined association of variables: Demographic, morbidity, knowledge, acceptability, compliance, and outcome efficacy of IRHS.

Results: Malaria incidence was 25.4% among children under five at IRHS intervention area after six months and non-intervention areas accounted 2.1%. 83.3% had positive results and most affected aged 0-1year 46.1%, and 74 were positive, P >0.225. 96.1% and 74.1% of caretakers in Nkwazi and Masala were knowledgeable about malaria, while 43.4% in Nkwazi lacked knowledge on danger signs. IRHS coverage was average n=4. 83.8% of the caretakers said IRHS was useful P< 0.000. 70% had homes sprayed P<0.000. 68.2% in Nkwazi slept in sprayed houses P<0.000. Acceptability of IRHS was average 56% p<0.000. Community sensitization influences sleeping under mosquito net p<0.000. Program officers n=5 reported spraying done at the same time yearly. Refusals accounted 90.2% and 66.3% in Nkwazi and Masala P<0.000.

Conclusion: Malaria morbidity among children under-five continued to increase in the intervention area despite IRHS.

Keywords: Indoor Residual Household Spraying Malaria Comparative.

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Abstract:

Cholera remains the major public health problem in the world. DRC is frequently affected by cholera introduction of 7^th pandemic in the country in 1974. The 2018 cholera outbreak affected Kasai Oriental Province more than 14 years after the previous one despite constant poverty and lack of potable water. Our main objective was to describe this epidemic focusing on Mbuji-Mayi vs. rural area. We conducted a descriptive study using the line listing data. The case definition used was that of the ministry of public health. Analyses were performed using Microsoft Excel 2010. Out of 5,869 suspected cholera cases including 277 deaths (CFR: 4.7%), 3,228 including 144 deaths (CFR: 4.5%) were from Mbuji-Mayi and 2,626 cases including 133 deaths (CFR: 5.1%) from rural area. Mbuji-Mayi with an Attack Rate of 144 cases per 100,000 inhabitants, were less affected than rural area of the Province (AR: 137 cases per 100,000 inhabitants). Vibrio cholera group 01 was incriminated. This outbreak started after 15 years without cholera in city of Mbuji-Mayi but later, also affected rural area. AR and CFR were higher in rural area.

Keywords: Outbreak, cholera, epidemiology, Mbuji-Mayi.

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