Table of Contents - Issue
Recent articles
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Evaluating the Impact of the 'Zooming-In' Approach on Malaria Prevention and Control in UgandaAuthor: Daudi OchiengDOI: 10.21522/TIJPH.2013.13.04.Art001
Evaluating the Impact of the 'Zooming-In' Approach on Malaria Prevention and Control in Uganda
Abstract:
This study assessed the effectiveness of the Zooming-In strategy, a community-based household intervention designed to strengthen malaria prevention and control in Uganda. The intervention employed structured interpersonal communication and routine follow-up visits to promote improved malaria-related behaviours. A quasi-experimental design was implemented across three regions—Hoima, Masaka, and Rwenzori—using a total sample of 1,200 households (600 intervention; 600 control). Data were obtained through household surveys and secondary analysis of District Health Information System 2 (DHIS2) records. Descriptive statistics, chi-square tests, and interrupted time series (ITS) analysis were applied to determine the intervention’s effects.The Zooming-In strategy was associated with significant improvements in key malaria prevention indicators. Consistent insecticide-treated net (ITN) use was higher in the intervention group compared to the control group (81.8% vs. 76.5%; p = 0.028). Early treatment-seeking behaviour increased markedly among intervention households (81.6% vs. 64.4%; p < 0.001). Test positivity rates declined to 52% in intervention areas compared with 61% in control areas, and malaria prevalence among pregnant women was lower in the intervention group (13% vs. 21%). Overall, the findings demonstrate that the Zooming-In approach enhances household malaria prevention practices and contributes to improved malaria-related outcomes. The strategy shows potential for adaptation and replication in other malaria-endemic settings. Further research is warranted to examine long-term behavioural sustainability and to explore cost-effective avenues for broader implementation.
Evaluating the Impact of the 'Zooming-In' Approach on Malaria Prevention and Control in Uganda
References:
[1]. World Health Organization., 2024, World Malaria Report 2024. Geneva: WHO.
[2]. Batisso, E., et al., 2012, Effects of bed net possession on malaria incidence. Malaria Journal, 11(1):121-126.
[3]. World Health Organization., 2024, Global malaria prevention report. Geneva: WHO.
[4]. Nyarko, P., Cobblah, A., 2014, Socio-cultural determinants of healthcare seeking for malaria. International Journal of Social Science and Public Health, 1(3):118-126.
[5]. Shadish, W. R., Cook, T. D., Campbell, D. T., 2002, Experimental and Quasi-Experimental Designs for Generalized Causal Inference. Houghton Mifflin, Boston.
[6]. Campbell, C., Jovchelovitch, S., 2000, Health, community and development: Towards a social psychology of participation. Journal of Community & Applied Social Psychology, 10(4):255-270.
[7]. Ochieng, D., 2022, Zooming-In Report. USAID Malaria Action Program for Districts, Kampala: Malaria Consortium.
[8]. Ahorlu, C. K., et al., 2020, Effect of community-based interventions on malaria prevention in Kenya. Malaria Journal, 19(1):252-259.
[9]. Koenker, H., et al., 2015, Strategic roles for behavior change in malaria prevention. Malaria Journal, 14(1):1-12.
[10]. Diiro, G. M., et al., 2018, The role of gender dynamics in household health outcomes in Uganda. BMC Public Health, 18:954.
[11]. Fornace, K. M., et al., 2018, Challenges in scaling malaria behavior change interventions in low-resource settings. Tropical Medicine & International Health, 23(2):122-130.
[12]. Lengeler, C., 2004, Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database of Systematic Reviews, 2004(2):CD000363.
[13]. Bhatt, S., et al., 2015, The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature, 526(7572):207-211.
[14]. Snow, R. W., et al., 2017, The prevalence of Plasmodium falciparum in sub-Saharan Africa since 1900. Nature, 550(7677):515-518.
[15]. Tatem, A. J., et al., 2017, The geography of imported malaria to non-endemic countries: a meta-analysis of nationally reported statistics. The Lancet Infectious Diseases, 17(1):98-107.
[16]. WHO Global Malaria Programme., 2021, High burden to high impact: A targeted malaria response. Geneva: WHO.
[17]. Ministry of Health Uganda., 2019, Uganda Malaria Indicator Survey 2018-2019. Kampala: MoH.
[18]. RBM Partnership to End Malaria., 2020, Action and Investment to defeat Malaria 2016–2030. Geneva: RBM.
[19]. Phillips-Howard, P. A., et al., 2003, Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. American Journal of Tropical Medicine and Hygiene, 68(4 Suppl):23-29.
[20]. Chanda, E., et al., 2019, Preventing malaria transmission with insecticide-treated nets and indoor residual spraying in Africa: an integrated approach. Malaria Journal, 18:210.
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Gender Differences in Postnatal Depression in Southwestern Nigeria: A Quantitative AnalysisAuthor: Adeola Oluwatobi AminuDOI: 10.21522/TIJPH.2013.13.04.Art002
Gender Differences in Postnatal Depression in Southwestern Nigeria: A Quantitative Analysis
Abstract:
This study examined gender disparities in postnatal depression (PND) among parents in Southwestern Nigeria, along with the associated sociodemographic factors. A descriptive cross-sectional design was employed alongside stratified random sampling to recruit 200 respondents, comprising 113 mothers and 87 fathers attending postnatal and family planning clinics. The Edinburgh Postnatal Depression Scale (EPDS) was employed to collect data, and SPSS version 25 was used for analysis, encompassing both descriptive and inferential statistical techniques. The overall prevalence of probable postnatal depression (PND) was determined to be 29.6%. Women had significantly elevated mean EPDS scores (M = 1.53, SD = 0.50) in contrast to men (M = 1.16, SD = 0.39; t (198) = –5.33, p < 0.001). A statistically significant connection (p < 0.05) was identified between depressive symptoms and educational level, occupational status, and social support. The findings illuminate the persistence of gender disparities in postnatal emotional health and underscore the necessity of integrating gender-inclusive mental health screenings into postnatal care programs in Nigeria.
Gender Differences in Postnatal Depression in Southwestern Nigeria: A Quantitative Analysis
References:
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[2]. Dadi, A. F., Akalu, T. Y., Baraki, A. G., and Wolde, H. F., 2020, Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS ONE, 15(4), e0231940.
[3]. Paulson, J. F., and Bazemore, S. D., 2020, Paternal depression in the postnatal period and child development. Journal of the American Medical Association (JAMA), 303(19), 1961–1969.
[4]. Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., and Chong, Y. S., 2018, Prevalence and incidence of paternal perinatal depression: A systematic review and meta-analysis. Journal of Affective Disorders, 235, 75–84.
[5]. Wilson, C. A., Bublitz, M., Chandra, P. S., Hanley, S., Honikman, S., et al., 2024, A global perspective: Access to mental health care for perinatal populations. Seminars in Perinatology, 48(6), 151942.
[6]. Khamidullina, Z., Petrova, E., and Davydova, N., 2025, Postpartum depression: Epidemiology, risk factors, and interventions. Journal of Clinical Medicine, 14(7), 2418.
[7]. Hyde, J. S., and Mezulis, A. H., 2020, Gender differences in depression. Current Opinion in Psychology, 32, 17–22.
[8]. Odufuwa, B., Adebayo, A., and Alade, M., 2022, Socio-cultural beliefs and stigma around mental illness in Nigeria. African Journal of Social Sciences,13(2), 45–57.
[9]. Johansson, M., Benderix, Y., and Svensson, I., 2021, Paternal postnatal depression and family functioning. BMC Psychiatry, 21, 467.
[10]. Fallon, V., Grovenor, M., Bennett, K. M., Harrold, J. A., and Silverio, S. A., 2021, Risk factors for paternal postnatal depression: A systematic review and meta-analysis. Journal of Affective Disorders, 293, 66–74.
[11]. Esan, O., Esan, A., Adeoye, A., and Amoo, G., 2022, Perinatal mental-health services in Nigeria: Current status and challenges. Nigerian Journal of Clinical Practice, 25(8), 1025–1032.
[12]. World Health Organization, 2022, Mental Health Gap Action Programme: Maternal and Perinatal Guidelines. Geneva: WHO.
[13]. Cox, J. L., Holden, J. M., and Sagovsky, R., 1987, Detection of postnatal depression: Development of the EPDS. British Journal of Psychiatry, 150, 782–786.
[14]. Oppong, S., 2023, Paternal postpartum depression in Africa. BMC Public Health, 23, 459.
[15]. Connell, R., 2021, Gender. Cambridge: Polity Press.
[16]. Molenaar, N. M., Kamperman, A. M., Boyce, P., Bergink, V., and O’Hara, M. W., 2023, Course and predictors of postnatal depression duration: An individual patient data meta-analysis. Journal of Affective Disorders, 324, 123–130.
[17]. Duko, B., Ayano, G., and Bedaso, A., 2020, Postpartum depression and associated factors among Ethiopian mothers: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20, 290.
[18]. Were, F. N., Bukusi, D., Wambui, E., and Mwangi, P., 2021, Prevalence and correlates of postpartum depression in Kenya: A cross-sectional study. BMC Public Health, 21, 1612.
[19]. Moulds, M. L., Cheung, M. S. P., and Wong, Q. J. J., 2022, Postpartum depression and cognitive bias in mothers and fathers. Clinical Psychological Science, 10(2), 355–369.
[20]. Bedson, J., Jordan, K. P., and Croft, P., 2021, A review of integrated models including behavioral factors. Nature Human Behaviour, 5(7), 834–846.
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Willingness of Parents to Pay for Nitrous Oxide and Oxygen Inhalation Sedation During Dental Treatment for Children in Saudi ArabiaAuthor: Sarah Ali MubarakiDOI: 10.21522/TIJPH.2013.13.04.Art003
Willingness of Parents to Pay for Nitrous Oxide and Oxygen Inhalation Sedation During Dental Treatment for Children in Saudi Arabia
Abstract:
This study aimed to evaluate parental willingness to pay (WTP) for nitrous oxide and oxygen inhalation sedation (NOIS) as a behavior management technique during pediatric dental treatment. A total of 293 parents (aged 20–65 years) having children aged 3–14 years were enrolled in this study. All eligible parents completed an online questionnaire comprising two sections. The first section collected informed consent, demographic data, and previous dental history, while the second section included an educational video on NOIS followed by bidding process questions to elicit WTP. All the collected data on WTP was compared across different groups using Mann-Whitney U and Kruskal-Wallis tests. Nearly, 27.60% of parents were willing to pay the average cost of 600 SAR for NOIS for their children, while the majority, 72.40%, found it to be expensive. Father's education (p = 0.014) and monthly income (p = 0.004) were significantly associated with parents' WTP for NOIS for their children during dental treatment. In contrast, no significant difference in child gender (p = 0.825) or child age (p = 0.064) and mothers' education (p = 0.211) was observed with regard to the WTP. The results showed that most parents found the mean cost for NOIS of 600 SAR for their children during dental treatment to be expensive. Monthly income and the father's education level were the only factors that affected the parents' WTP for NOIS.
Willingness of Parents to Pay for Nitrous Oxide and Oxygen Inhalation Sedation During Dental Treatment for Children in Saudi Arabia
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[14]. McNamee, P., Ternent, L., Gbangou, A., & Newlands, D., 2010, A game of two halves? Incentive incompatibility, starting point bias and the bidding game contingent valuation method. Health economics, 19(1), 75–87. https://doi.org/10.1002/hec.1448.
[15]. Hassan, A. Y. I., Cucculelli, M., & Lamura, G., 2023, Caregivers' willingness to pay for digital support services: Comparative survey. Health policy (Amsterdam, Netherlands), 130, 104751. https://doi.org/10.1016/j.healthpol.2023.104751.
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Stakeholder Perspectives on Maternal Health Service Delivery: Key Performance Indicators and System Challenges in The GambiaAuthor: Joy MichaelDOI: 10.21522/TIJPH.2013.13.04.Art004
Stakeholder Perspectives on Maternal Health Service Delivery: Key Performance Indicators and System Challenges in The Gambia
Abstract:
Maternal health is a major public health concern in The Gambia. The aim of this study was to determine the current status of maternal health services in The Gambia. This study applied well-structured questionnaire to obtain information from 217 participants from seven (7) administrative regions in The Gambia. Descriptive statistics was used to analyze the data. The respondent profile was majorly males, aged 25-34 and highly educated. Findings show that 73.8% reported the presence of community awareness programs, and 83.8% affirmed their personal role in maternal health efforts. Also, the most frequently offered services during community-based maternal health outreach included health education (77.5%), family planning (59.9%), antenatal care (58.2%), and immunization (56.6%). The results also showed that family planning and birth spacing initiatives (65.5%) had the highest implementation rates regarding awareness. Resource and system constraints (55.5%), data availability and quality issues (50.9%), limited technical and human capacity (46.2%), and coordination/communication gaps (32.9%) were frequently reported. Based on the findings of this study, ANC and PNC attendance (67.5%), skilled birth attendance (55.6%), and place of delivery (52.7%) were the most monitored key indicators. The significant representation of nurses/midwives and public health officers is very important, as these professionals are at the forefront of implementing community-based maternal health initiatives. Findings show a strong emphasis on community awareness and engagement in maternal health. Meeting national and international health goals and providing equitable, high-quality maternal health services depend on addressing these issues through focused policy changes and capacity building.
Stakeholder Perspectives on Maternal Health Service Delivery: Key Performance Indicators and System Challenges in The Gambia
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Assessment of the Challenges of Emergency Medical Response in Edo State Health Care DeliveryAuthor: Charles Omheaka OkpereDOI: 10.21522/TIJPH.2013.13.04.Art005
Assessment of the Challenges of Emergency Medical Response in Edo State Health Care Delivery
Abstract:
This article critically evaluates the challenges of Emergency Medical Services/Response within the Edo State healthcare system. The research is premised on the need for an effective Emergency Medical Response call centre and number. Despite the recent launch of an EMR service, public awareness of the existence of a call centre and its number remains unclear, highlighting the need for urgent action. The purpose of this research is to determine the presence of EMS response centres in the study area and also assess public awareness of a designated emergency call number in Edo State. The methodology employed both quantitative and qualitative approaches, using semi-structured questionnaires and in-depth key interviews. Five hundred and twenty-four respondents participated in the research. The study area encompassed the three senatorial districts of Edo State. A multistage sampling technique was applied, and SPSS was ultilized for data analysis. The results and challenges elicited are concerning and entail the following: the absence of an identifiable EMR call centre in the study area, as about four-fifths of the respondents stated they had no knowledge of any EMR team in their locality, and the unawareness of any designated medical emergency phone number; scarce availability of ambulance services and Automated External Defibrillators in the study communities, as over four-fifths of the respondents indicated a non availability of EMR ambulances. Therefore, the Government urgently needs to set up one EMS/ Response centre in every local Government and carry out mass sensitization to encourage use.
Assessment of the Challenges of Emergency Medical Response in Edo State Health Care Delivery
References:
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Adherence to Anti-hypertensive Medication among the Elderly and Associated Factors in Mandeville, JamaicaAuthor: Ainsworth M. ReynoldsDOI: 10.21522/TIJPH.2013.13.04.Art006
Adherence to Anti-hypertensive Medication among the Elderly and Associated Factors in Mandeville, Jamaica
Abstract:
Hypertension remains a leading cause of morbidity and mortality globally, with non-adherence to antihypertensive medication posing a significant barrier to effective control, particularly among older adults. This study assessed adherence levels and associated factors among geriatric hypertensive patients in Mandeville, Jamaica. A mixed-methods design was employed. Quantitatively, a cross-sectional survey of 220 participants aged 65 years and older was conducted using the Morisky Medication Adherence Scale-8 (MMAS-8) and Hill-Bone Compliance Scale. Qualitatively, in-depth interviews were held with 23 patients. Quantitative findings showed that 61% of participants reported moderate adherence and 19% low adherence on the MMAS-8. At the same time, the Hill-Bone scale produced an average adherence score of 55.3 (SD = 30.1). Significant reasons for non-adherence included lack of funds (55%), forgetfulness (19.5%), and limited time for refills (23.2%). Significant associations were observed between adherence and health education (χ² = 20.40, p = 0.008), possession of a National Health Fund card (p = 0.004), physician-patient relationship (p = 0.005), and polypharmacy (χ² = 6.689, p = 0.035). Qualitative insights underscored challenges with medication management, coping strategies, and knowledge gaps regarding hypertension. These findings highlight the urgent need for multifaceted interventions addressing financial, educational, and relational factors to improve adherence and hypertension control in the elderly.
Adherence to Anti-hypertensive Medication among the Elderly and Associated Factors in Mandeville, Jamaica
References:
[1]. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., Wright, J. T., 2018, 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Journal of the American College of Cardiology, 71(19):e127-e248.
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[6]. Burnier, M., Egan, B. M., 2019, Adherence in hypertension: a review of prevalence, risk factors, impact, and management. Circulation Research, 124(7):1124-1140.
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[8]. Chowdhury, R., Khan, H., Heydon, E., Shroufi, A., Fahimi, S., Moore, C., Franco, O. H., 2018, Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. European Heart Journal, 39(33):2946-2955.
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[15]. Morisky, D. E., Ang, A., Krousel-Wood, M., Ward, H. J., 2008, Predictive validity of a medication adherence measure in an outpatient setting. The Journal of Clinical Hypertension, 10(5):348-354.
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Assessment of Self-Medication among Healthcare Professionals in Walvis Bay, NamibiaAuthor: Jean-Paul Mukeba TshitendeDOI: 10.21522/TIJPH.2013.13.04.Art007
Assessment of Self-Medication among Healthcare Professionals in Walvis Bay, Namibia
Abstract:
Healthcare workers are more likely to self-medicate due to their extensive knowledge and experience with different medical problems and medications. This study aimed to ascertain the prevalence of self-medication and its associated characteristics among healthcare practitioners. One hundred eighty-nine healthcare personnel were selected for this cross-sectional study via random sampling at two hospitals in Walvis Bay, Namibia. Data collection used a researcher-designed questionnaire on self-medication. The gathered data were analyzed using descriptive and inferential statistics in SPSS 25 software, namely the Chi-square test and Fisher’s exact test. The prevalence of self-medication among healthcare professionals was 89.98%. Out of the 189 participants, 73.01% were female. Most of them were at least 26 years old (68.3%), unmarried (75.13%), held a bachelor’s degree (93.65%) primarily in nursing (49.74%), resided at a considerable distance from a health institution (71.96%), possessed medical insurance (87.3%), and had a monthly income over NAD 20,000 (95.1%). The most prevalent conditions leading to self-medication were the common cold (86.4%), headache (84.7%), and gastrointestinal problems (39.7%). There was no significant difference in self-medication rates across gender, marital status, age, educational level, health insurance, or proximity to a health facility. However, there was a significant difference in self-medication rates between participants earning more than NAD 20000 monthly (95.1%) and those earning less than NAD 20000 monthly (83.7%). Self-medication is common among healthcare professionals in Walvis Bay. It is imperative to actively address the adverse consequences of this practice with them through education, awareness campaigns, and policy changes.
Assessment of Self-Medication among Healthcare Professionals in Walvis Bay, Namibia
References:
[1]. Hughes, C. M., McElnay, J. C., and Fleming, G. F., 2001, Benefits and risks of self-medication. Drug Safety, 24, 1027–1037.
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[8]. Ali, A. N., Kai, J. T. K., Keat, C. C. and Dhanaraj, S. A., 2012, Self-medication practices among health care professionals in a Private University, Malaysia. International Current Pharmaceutical Journal, 1(10), 302-310.
[9]. Alshakka, M., Al-Abd, N. and Alkubati, S. S., 2019, Knowledge, Attitude and Practice of Self Medication: A Cross-sectional Study among Yemeni Health Profession Students. Journal of Drug Delivery and Therapeutics, 9(3),130-137.
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[23]. Tobin, E. A., Erhazele, J., Okonofua, M., Nnadi, C., and Nmema, E. E., 2020, Self-medication among health care workers in a tertiary hospital in Southern Nigeria: Knowledge, attitude and practices. Medical Journal of Indonesia, 29(4), 403–409, https://doi.org/10.13181/mji.oa.204223
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[25]. Obodo, P. M., Peter, O. A., Ayinla, S. I., Ugochukwu, O. D., Henry‑Prince, O., and Aghogho, T. O., 2025, Prevalence and pattern of self-medication among healthcare professionals in a tertiary hospital in South-South Nigeria. Online Journal of Otolaryngology & Rhinology, 7(3), https://doi.org/10.33552/OJOR.2025.07.000665
[26]. Kumar, N., Kanchan, T., Unnikrishnan, B., Rekha, T., Mithra, P., Kulkarni, V., and Papanna, M. K., 2013, Perceptions and practices of self-medication among medical students in coastal South India. PLoS ONE, 8(8), e72247, https://doi.org/10.1371/journal.pone.0072247
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Impact of Conflict on Under-Five Children's Health and Nutrition in Gogrial West, South SudanAuthor: Odette Kum ChouDOI: 10.21522/TIJPH.2013.13.04.Art008
Impact of Conflict on Under-Five Children's Health and Nutrition in Gogrial West, South Sudan
Abstract:
This study explores the consequences of conflict on the health and nutrition of children under five years in Gogrial West County, Warrap State, South Sudan. Conflict has disrupted essential health services, food security, and community livelihoods, placing young children at heightened risk of malnutrition and disease. Using a mixed-methods approach, the research combines findings from a 2021 SMART Survey and a 2024–2025 household-based survey (Gogrial Child Health and Nutrition Conflict Assessment) to analyze how conflict correlates with displacement, poor Infant and Young Child Feeding (IYCF) practices, healthcare access, and acute malnutrition. Quantitative data from 603 children were analyzed alongside qualitative caregiver interviews to understand community coping strategies and urgent needs. Results show that 66.87% of families were displaced, 86.75% experienced food shortages, and 80% of caregivers reported stress-related disruptions in feeding practices. The study concludes with recommendations for integrated interventions combining emergency nutrition and healthcare with long-term peacebuilding and development efforts.
Impact of Conflict on Under-Five Children's Health and Nutrition in Gogrial West, South Sudan
References:
[1]. Action Against Hunger, 2021, South Sudan SMART survey report: Gogrial West County. Action Against Hunger. p. 24
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Early Postoperative Complications of Open-Heart SurgeryAuthor: Tameem ThamirDOI: 10.21522/TIJPH.2013.13.04.Art009
Early Postoperative Complications of Open-Heart Surgery
Abstract:
Cardiovascular illnesses continue to be the primary cause of worldwide death. Heart transplantation is regarded as the only treatment intervention recognized as the gold standard for managing end-stage heart failure. Nonetheless, the persistent postoperative problems adversely affect both the survival rate and quality of life in heart transplant patients. This study aimed to detect the earliest complications after open-heart surgery at the Mosul center, using a prospective cohort design during the period from 1st May to 1st June 2025. The study includes 47 patients who had undergone CABG and valve replacement for the first time in intensive care units and wards, in Mosul Open Heart Center. Descriptive statistics were used to summarize baseline characteristics and complication rates. Comparative analyses: Chi-square tests for categorical variables and t-tests for continuous variables will be used to assess differences in complications across demographic factors, comorbidities, and surgical variables. The study shows that approximately 59.5% of the patients are experiencing moderate pain. Low urine output occurred in (40%) according to gender. Acute renal dysfunctions occurred in (27.6%), gastrointestinal dysfunctions occurred in (57.4%), according to age. Respiratory dysfunctions, acute renal dysfunctions, and low urine output had a significant relationship in the patients according to the chronic diseases. The study concluded that several complications occurred in open-heart surgery patients at the Mosul Surgery Center, including pain, respiratory distress, renal, and gastrointestinal problems. The results indicated that there is a statistically significant relationship between patients' age and kidney dysfunction and lack of gastrointestinal function, as well as a relationship between chronic diseases, kidney dysfunction, and gastrointestinal dysfunction. It also showed a relationship between most of the variables and the occurrence of complications in terms of the type of operation (CABG).
Early Postoperative Complications of Open-Heart Surgery
References:
[1]. Negargar, S., Sadeghi, S., 2023, Early Postoperative Cardiac Complications Following Heart Transplantation:-. Galen Medical Journal, 12, e2701, Doi:10.31661/gmj.v12i.2701.
[2]. Amini, M., Zayeri, F., Salehi, M., 2021, Trend analysis of cardiovascular disease mortality, incidence, and mortality-to-incidence ratio: results from the Global Burden of Disease Study 2017. BMC public health, 21(1), 401, Doi:10.1186/s12889-021-10429-0.
[3]. Yurievich, A. A., Sergeevich, G. A. R., Ivanovich, K. D., Vladimirovich, R. O., Viktorovna, S. O., Ivanovna, G. L., Vladimirovna, F. R., 2021, Clinical management of cardiovascular care on the basis of big Data: Electronic medical records. Journal of Medicinal and Chemical Sciences, 4(4), 395-403, Doi:10.26655/JMCHEMSCI.2021.4.11.
[4]. Shi, H., Ren, C., Mahmod, S. R. B., 2025, Monitoring Molecular Biological Changes During Neurological and Musculoskeletal Rehabilitation after Stroke using a Telemedicine Platform: An Optimization Strategy for Personalized Rehabilitation Treatment. Journal of Natural Science, Biology and Medicine, 16:108-118, Doi:10.4103/jnsbm.JNSBM_16_1_12.
[5]. Khalil Arjmandi, R., Asharein, M. R., 2021, Case study of femoral and radial angiography in cardiovascular patients. Chemical Methodologies, 5(1), 1-10, doi:10.22034/chemm.2021.118221.
[6]. Şahin, B., İlgün, G., 2022, Risk factors of deaths related to cardiovascular diseases in World Health Organization (WHO) member countries. Health & Social Care in the Community, 30(1), 73-80, Doi:10.1111/hsc.13156.
[7]. Hudiyawati, D., Ainunnisa, K., Riskamala, G., 2021, Self-care and its related factors among patients with congestive heart failure in Surakarta, Indonesia. Journal of Medicinal and Chemical Sciences, 4(4), 364-373, Doi:10.26655/JMCHEMSCI.2021.4.7.
[8]. Timmis, A., Vardas, P., Townsend, N., Torbica, A., Katus, H., De Smedt, D., Achenbach, S., 2022, European Society of Cardiology: cardiovascular disease statistics 2021. European heart journal, 43(8), 716-799, Doi:10.1093/eurheartj/ehab892.
[9]. Zaveri, F., Naser, S., 2025, The Role of SGLT2 Inhibitors in Cardiovascular Outcomes for Heart Failure Patients with Reduced Ejection Fraction. Texila International Journal of Public Health,13(1):438-441, Doi: 10.21522/TIJPH.2013.13.01.Art042.
[10]. Zaveri, F., Naser, S., 2025, Efficacy and Safety of Finerenone in Patients with Heart Failure, Chronic Kidney Disease, and Type 2 Diabetes: A Comprehensive Review of the FINE-HEART Pooled Analysis. Texila International Journal of Public Health, 13(1):526-529, Doi:10.21522/TIJPH.2013.13.01.Art051.
[11]. Shaburishvili, G., Shaburishvili, N., Zeikidze, S., 2025, Proportion of heart failure patients receiving guideline recommended doses of beta blockers in georgia: a study on titration and tolerability. Georgian medical news, (358), 70-77.
[12]. Tariq, M., Natheer, M., Allo, R. R., 2023, Effect of Nursing Care Regarding Postoperative Complications among Diabetic Patients after Hip Replacement Surgery. Medical Journal of Babylon, 20(2), 412-416, Doi:10.4103/MJBL.MJBL_101_23.
[13]. Suganya, M., Vijayalakshmi, R., Parimala, L., 2025, Association of Cardiometabolic Diseases in Adolescents with Level of Obesity and Lifestyle Pattern at Metropolitan City; Findings from Southern India. Texila International Journal of Public Health. 13(1):706-712, Doi:10.21522/TIJPH.2013.13.01.Art066.
[14]. Gospodinov, D., Pishev, S., Parashkevova, B., Gerasimov, N., Petrova, G., 2025, Pilot study on the cardiovascular morbidity in older people in the region of burgas in bulgaria. Georgian medical news, (361), 142-147.
[15]. Izmaylov, N., Abduragimov, A., Platonova, E., Evchenko, D., Bogatyrev, G., Isakova, M., Yakhyaeva, N., 2025, Comprehensive assessment of vegetative and nociceptive status in patients with cardiac arrhythmias. Georgian medical news, (360), 177-179.
[16]. Sridani, N. W., Sabir, M., Devi, R., Arifuddin, A., Rahman, A., Nur, A. F., 2025, Innovative Approach: Exploring the Efficacy of Red Ginger Infusion Therapy in Hypertension Management. Public Health of Indonesia, 11(1), 1-9, Doi:10.36685/phi.v11i1.824.
[17]. Jayadipraja, E. A., Natsir, M., Supodo, T., Sukma, K. A., 2025, Risk Factors for Type 2 Diabetes Mellitus in Women of Childbearing Age at Unaaha Public Health Center, Konawe Regency. Public Health of Indonesia, 11(S1), 1-8, Doi:10.36685/phi.v11iS1.846.
[18]. Peretto, G., Durante, A., Limite, L. R., Cianflone, D., 2014, Postoperative arrhythmias after cardiac surgery: incidence, risk factors, and therapeutic management. Cardiology research and practice, 2014(1), 615987, Doi: 10.1155/2014/615987.
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Cost Analysis of Conventional Antimicrobial Resistance Diagnostics in Zambia: Evidence for Sustainable Laboratory Investment in Resource-Limited SettingsAuthor: Lutinala Nachilembo NalombaDOI: 10.21522/TIJPH.2013.13.04.Art010
Cost Analysis of Conventional Antimicrobial Resistance Diagnostics in Zambia: Evidence for Sustainable Laboratory Investment in Resource-Limited Settings
Abstract:
Antimicrobial resistance (AMR) is a growing global health threat, particularly in low- and middle-income countries (LMICs) like Zambia, where diagnostic capacity is limited, and funding constraints hinder effective response. This study aimed to assess the per-test cost of conventional AMR diagnostic methods, Gram stain, culture, and antimicrobial susceptibility testing (AST), to support sustainable investments and policy decisions. Between December 2024 and March 2025, data were collected from 13 laboratories across nine provinces in Zambia using structured questionnaires. Inputs related to labour, reagents, and equipment were analysed using the WHO Laboratory Testing Costing Tool (LTCT) and Julius AI. Pricing adhered to Zambia’s Public Procurement Act, and ethical approvals were obtained from UNZABREC and NHRA. Results showed that test costs varied widely by input type. Gram stains were the least expensive at $3.15 per test, while enriched media like Blood/Chocolate agar reached $4.92 due to high labour and reagent requirements. Biochemical test costs ranged from $4.25 to $7.99, with Coagulase being the most expensive due to reagent costs. Testing for WHO-priority pathogens, such as E. coli and K. pneumoniae, costs approximately $37–38 per test, while testing for Neisseria gonorrhoeae costs $42. Sensitivity analysis identified reagents as the primary cost driver across all test types. Batch testing was cost-effective only for tests with high fixed costs, such as Blood Culture. This study underscores the importance of standardized costing, context-specific planning, and bulk procurement in sustaining affordable diagnostics in resource-limited settings. Future research should incorporate indirect costs to provide a comprehensive understanding of laboratory financial needs.
Cost Analysis of Conventional Antimicrobial Resistance Diagnostics in Zambia: Evidence for Sustainable Laboratory Investment in Resource-Limited Settings
References:
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[10]. Shempela, D. M., Mudenda, S., Kasanga, M., Daka, V., Kangongwe, M. H., Kamayani, M., et al., 2024, A situation analysis of the capacity of laboratories in faith-based hospitals in Zambia to conduct surveillance of antimicrobial resistance: opportunities to improve diagnostic stewardship, Microorganisms, 12(8), 1697.
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Regression Analysis of Determinants of Breast Self-Examination and Practices Among Midwifery Students in a Teaching Hospital, NigeriaAuthor: Umar N. JibrilDOI: 10.21522/TIJPH.2013.13.04.Art011
Regression Analysis of Determinants of Breast Self-Examination and Practices Among Midwifery Students in a Teaching Hospital, Nigeria
Abstract:
Globally, women are exposed to various forms of breast diseases, of which breast cancer poses a serious, devastating state of ill health. Efforts to control breast cancer focus on early detection through periodic breast examination for early diagnosis. This study assessed the Regression analysis of determinants of Breast Self-Examination and practices among 209 midwifery students at Tafawa Balewa University Teaching Hospital, Bauchi. A descriptive cross-sectional survey design was adopted using mixed methods for data collection. The data collected was analysed using descriptive statistics, chi-square, logistic regression and thematic analysis. Findings revealed that 61.0% students practiced BSE, and 66.0% of them opined that BSE enables the detection of breast abnormalities such as discharges and lumps. While students’ barriers to consistent BSE were: poor knowledge about BSE (48.0%), lack of time (60.0%), and privacy (48.0%) in practicing BSE. Furthermore, exercise (OR = 1.844, p < 0.05) and family history of cancer (OR = 1.572, p < 0.05) significantly decreases the odd to practice BSE among students. This study concluded that students expressed reduction in breast cancer anxiety with mean = 2.51, std = 0.705, which explained a better understanding of BSE (mean = 2.61; std dev. = 0.623), while some perceived BSE as an effective means of early detection of breast cancers. We recommended that BSE practices should be given a high priority by students’ midwives, as they are major health educators to females and women in the communities.
Regression Analysis of Determinants of Breast Self-Examination and Practices Among Midwifery Students in a Teaching Hospital, Nigeria
References:
[1]. Mulugeta, T. W., Rosemary, O., Micheal, H., Mekitiew, A. B., 2023, The practice of breast self-examination and associated factors among female healthcare professionals. medRxiv, 04.10.23288382; doi; https://doi.org/10.1101/2023.04.10.2328
[2]. World Health Organization., 2024, Breast-cancer analysis; https://www.who.int/news-room/fact-sheets/detail/
[3]. Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., Jemal, A., 2018, Global cancer statistics. GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.
[4]. Asmare, K., Yeneabat, B., Zerko, W., 2022, Knowledge, attitude, practice towards breast self-examination and associated factors among women in Gondar town, Northwest Ethiopia, : a community-based study. 10.1186/s12905-022-01764-4
[5]. Rejoice, O. U., Chime, H. O., Esegbue, P., Agofure, O., 2024, Effect of educational intervention on the knowledge, attitude and practice of breast self-examination among female students at a private university in Southern Nigeriaz/articles/10. 1186/s12885-024-12116-w
[6]. Salman albeshan, Naseer Shubayr, Yazeed Alashban, 2023, Assessment of Knowledge and Awareness About Breast Self-Examination Among University Female Students in Saudi Arabia. Breast Cancer (Dove Med Press). 1;15:91–99. doi: 10.2147/BCTT.S396903. PMCID: PMC9900142 PMID: 36755689.https://www.dovepress.com/assessment-of-knowledge-and-awareness-about-breast-self-examination-am-peer-reviewed-fulltext-article-BCTT. retrieved on 11th Nov. 2024.
[7]. Rakhshani, T., Maryam, D., Seyyed, M. K., Amirhossein, K., Ali, K. J., 2022, The Effect of Educational Intervention on Knowledge, Attitude, and Practice of Women towards Breast Cancer Screening. 10.1155/2022/5697739
[8]. Johnson, R. H., Chien, F. L., & Bleyer, A., 2013, Incidence of breast cancer with distant involvement among women in the United States, 1976 to 2009. JAMA, 309(8), 800–805. https://doi.org/10.1001/jama.2013.776
[9]. Nirmala, M., Padmavathi, R., Chitra., 2024, Eeffectiveness of planned teaching program on Knowledge. of breast self-examination among students. https://www.researchgate.net/publication/381598943
[10]. Ran Kang, S., Hyewon, S., Jungmin, L., Shin-Jeon, K., 2020, Knowledge and practice Breast self-examination. https://doi.org/10.111/jjns.12318
[11]. Al-Naggar, R. A., Al-Naggar, D. H., Bobryshev, Y. V., Chen, R., & Assabri, A., 2011, Practice and barriers toward breast self-examination among young Malaysian women. Asian Pacific Journal Cancer Prev, 12(5), 1173-8.
[12]. Abubakar Tafawa Balewa, 2024, University Teaching Hospital, Bauchi. School registry; LinkedIn. https://ng.linkedin.com/company/atbuth
[13]. Smith, J., 2020, Increasing breast health awareness through community education programs. Health Promotion International. 34(5), 987–995. https://doi.org/10.1093/heapro/daz023
[14]. Yakubu, M. A., Gadanya, M. A., Sheshe, A. A., 2014, Knowledge, attitude and. practice of breast self-examination among female nurses in Aminu Kano Teaching hospital Kano Nigeria. https://www.researchgate.net/links /58ee7465a6fdcc61cc125f19/
[15]. Rosemary, A. A., Joyce Komesuor., Hubert Amu, Elvis Enowbeyang, T., 2023, Factors Influencing the Practice of Breast Self-Examination among Female Tertiary Students in Ho, Ghana. Available published by Advance in public Health at https://doi.org/10.1155/2022/7724050
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[17]. Harris, L. N., Isakoff, S. J., Davey, A., Dominici, L., Javid, S. H., Come, S. E., Burstein, H. J., et al., 2021, Breast cancer in very young women. Journal of the National Comprehensive Cancer Network. 19(10), 1222-1234. https://doi.org/10.6004/jnccn.2021.7104
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Systemic Biochemical Disruptions from Chronic Generator Exhaust Exposure: Oxidative, Hematologic, and Heavy Metal Biomarkers in Urban Nineveh, IraqAuthor: Liqaa Saeed AlkhalidyDOI: 10.21522/TIJPH.2013.13.04.Art012
Systemic Biochemical Disruptions from Chronic Generator Exhaust Exposure: Oxidative, Hematologic, and Heavy Metal Biomarkers in Urban Nineveh, Iraq
Abstract:
In urban regions with chronic power instability—such as Mosul, Iraq—diesel generators are essential yet environmentally hazardous. Prolonged exposure to generator exhaust introduces a spectrum of toxicants, including carbon monoxide, nitrogen oxides, and heavy metals, raising significant concerns for long-term systemic health effects. This research aimed to explore changes in body systems and blood composition resulting from long-term exposure to diesel generator fumes among community members. The study used a cross-sectional comparative design with 260 participants, divided into exposed (150) and control (110). The analysis included blood gases; oxidative stress indicators like MDA and GSH; inflammatory markers such as CRP and CA; hematological parameters like HgB, and PCVs; and serum levels of trace metals including Zink, Zn, Cadmium, Nickel. The significance is at p≤0.05. Exposed Individuals showed decreases in oxygen (lower Pa02 and Sa02, and higher COHa levels), an increase in red blood cell production and hemoglobin, and a significant increase in MDA and a decrease in GSH. Also, C protein (CRP) levels increased significantly at p < 0·001). Trace metal analysis following exposure showed a buildup of lead (Pb) alongside cadmium (Cd), Copper (Cu), and Nickel (Ni), with a simultaneous decrease in zinc content, further weakening the body's antioxidant defenses. The results show that long-term exposure to generator fumes leads to health issues, including breathing problems, imbalances in the body's oxidation processes, and the accumulation of harmful metals in the system.
Systemic Biochemical Disruptions from Chronic Generator Exhaust Exposure: Oxidative, Hematologic, and Heavy Metal Biomarkers in Urban Nineveh, Iraq
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The Prevalence and Pattern of Adverse Drug Reaction in HIV/AIDS Patients on Antiretroviral Therapy in Kaduna State, Nigeria: Case Review StudyAuthor: Abubakar SuleimanDOI: 10.21522/TIJPH.2013.13.04.Art013
The Prevalence and Pattern of Adverse Drug Reaction in HIV/AIDS Patients on Antiretroviral Therapy in Kaduna State, Nigeria: Case Review Study
Abstract:
In Nigeria, Human immunodeficiency virus (HIV) infected patients on highly active antiretroviral therapy (HAART) are at higher risk of developing adverse drug reactions (ADRs). Objective: To assess the prevalence and pattern of ADR in HIV/AIDS patients on antiretroviral therapy. A Case review of 170 patients initiated on ARVs between July 2010 and July 2014 was carried out in eight health facilities in Kaduna state, Nigeria. Regimens prescribed include zidovudine /lamivudine, tenofovir/lamivudine, abacavir/lamivudine in combination with either nevirapine, efavirenz or lopinavir/ritonavir. Patient adverse drug reactions and offending drugs were noted and categorized using descriptive statistics. The prevalence of adverse drug reactions is 0.9%. Out of 170 documented cases of reported adverse drug reactions, 11.8% were male and 88.2% were female. The most reported ADR is anaemia (37.2%) associated with zidovudine (42.9%). ADR is most prevalent between the ages of 30 – 39, with reported cases of (46.4%). 91.8% of all patients with reported ADR recovered fully, 1.2% recovered with disability, 3.5% experienced life-threatening conditions, and 3.5% died. 22.4% of the patients are admitted. Adverse drug reaction occurred most (61.4%) among patients weighing between 41 and 61 kg. The 0.9% prevalence of adverse drug reactions among the study population is markedly lower than what has been reported in the USA, India, South Africa, Ethiopia, and Cameroon, but higher than the expected national target of 100/100000 (0.01 prevalence).
The Prevalence and Pattern of Adverse Drug Reaction in HIV/AIDS Patients on Antiretroviral Therapy in Kaduna State, Nigeria: Case Review Study
References:
[1]. UNAIDS, 2012, Access to antiretroviral therapy in Africa. Status report on progress towards the 2015 targets, https://www.unaids.org/sites/default/files/media_asset/20131219_AccessARTAfricaStatusReportProgresstowards2015Targets_en_0.pdf
[2]. Rockville, M. D., 2011, Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents, http://www.aidsinfo.nih.gov/ContentFiles/AdultandAdolescentGL.pdf.
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[5]. González, M. G., Yańez, C. G., Gonzâlez, C. L., 1999, Adverse drug reactions (ADRs) in patients with HIV infection. A prospective study Int J Clin Pharmacol Ther, 37, 34-40, https://pubmed.ncbi.nlm.nih.gov/10027481/
[6]. Manzardo, C., Zaccarelli, M., Agûero, F., 2007, Optimal timing and best antiretroviral regimen in treatment-naive HIV-infected individuals with advanced disease. J Acquir Immune Defic Syndr, 46 (Suppl1),9-18, https://journals.lww.com/jaids/fulltext/2007/09011/optimal_timing_and_best_antiretroviral_regimen_in.3.aspx
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[10]. Ogwuche, L. O., Ojeh, V. B., London, I. A., et al., 2014, Adverse Drug Reaction Reports in an Antiretroviral Treatment Centre in Jos, North Central Nigeria. British Journal of Pharmaceutical Research 4(6), 714-721, https://journaljpri.com/index.php/JPRI/article/view/823/1651
[11]. Ammassari, A., Murri, R., Pezzotti, P., Trotta, M. P., Ravasio, L., De Longis P., et al., 2001, Self-reported symptoms and medication side effects influence adherence to highly active antiretroviral therapy in persons with HIV infection. J Acquir Immune Defic Syndr, 28, 445–9, https://journals.lww.com/jaids/abstract/2001/12150/self_reported_symptoms_and_medication_side_effects.6.aspx
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A Comparative Analysis of the Academic Performance of Nursing Students in Three Selected Nursing Institutions in Sierra LeoneAuthor: Christiana Baindu MassallyDOI: 10.21522/TIJPH.2013.13.04.Art014
A Comparative Analysis of the Academic Performance of Nursing Students in Three Selected Nursing Institutions in Sierra Leone
Abstract:
As the number of trained and qualified nurses continues to increase in clinical settings, concerns about nursing students’ academic performance, which translates into their output in patient care, emerge. Sierra Leone has seen high failure rates among nursing students in state council examinations. This study compares nursing students' academic performance across public, faith-based, and private institutions in Sierra Leone. A descriptive cross-sectional research design using mixed methods was used to evaluate and compare the academic performance of nursing students at the selected nursing institutions in the council exams conducted for first-timers in November 2022. Thematic analysis was also used to explore factors associated with students' performance. In total, 235 candidates were presented to the State Board Examination in November 2022 by the Institutions under review. 125 students from the Faculty of Nursing-(COMAHS),61 from Tonkolili District College of Health Sciences (TDCHS), and 49 from St John of God - University of Makeni (UNIMAK). From the findings, UNIMAK had a 100% pass rate; COMAHS had a 69.6% pass rate and a 30.4% failure rate; Tonkolili District College Health Sciences (TDCHS) had an 88.5% pass rate and 11.5% failure rate. Factors influencing the Academic Performance of students were large class size, unharmonized Curricula, inappropriate teaching methods, and poor preparation for state council exams. The study concludes that exceptional performance is associated with nursing institutions with smaller class sizes. Factors that affected the students' academic performance were teacher-student and institutional influences.
A Comparative Analysis of the Academic Performance of Nursing Students in Three Selected Nursing Institutions in Sierra Leone
References:
[1]. Dube, M. B., & Mlotshwa, P. R., 2018, Factors influencing enrolled nursing students’ academic performance at a selected private nursing education institution in KwaZulu-Natal. Curationis, 41(1), a1850–a1857.
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Implementation of Food Service Management Standards at Orphanages A and B in Palangka Raya, IndonesiaAuthor: Dhini AndenDOI: 10.21522/TIJPH.2013.13.04.Art015
Implementation of Food Service Management Standards at Orphanages A and B in Palangka Raya, Indonesia
Abstract:
Orphanages are social institutions that play a crucial role in providing protection, care, and education to children who have lost their parents or families. According to the Indonesian government, the number of abandoned children in Indonesia has reached 67,368, although only a portion of them receive care in orphanages. Currently, there are approximately 12,000 orphanages in Indonesia. One of the critical services provided in orphanages is food service management, which aims to meet children's nutritional needs. This study aims to evaluate the implementation of food service management standards at orphanages in Palangka Raya City and to intervene in the food service process to align it with applicable standards. This research used a quasi-experimental method with a non-equivalent control group design in a two-group pre-test-post-test design. The study sample comprised the entire populations of Orphanage A and Orphanage B, selected using purposive sampling. The respondents in Orphanage A were predominantly male (82%) with an average age of 18 years, while in Orphanage B, the majority were also male (63%) with an average age of 13 years. The score for the implementation of management standards increased from 55 to 77 in Orphanage A and from 58 to 85 in Orphanage B after the intervention. There was a significant improvement in the implementation of food-service management standards across both orphanages. These results indicate that proper implementation of standards can enhance the quality of food services, which ultimately fulfill the nutritional needs of orphans.
Implementation of Food Service Management Standards at Orphanages A and B in Palangka Raya, Indonesia
References:
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Macrolide Resistance Among Group B Streptococcus Isolated from Clinical Samples In and Around KanchipuramAuthor: Evangeline Pretty GnanamaniDOI: 10.21522/TIJPH.2013.13.04.Art016
Macrolide Resistance Among Group B Streptococcus Isolated from Clinical Samples In and Around Kanchipuram
Abstract:
Streptococcus agalactiae (Group B Streptococcus, GBS) remains a significant cause of invasive infections, particularly in pregnant women, neonates, and immunocompromised individuals. Rising resistance to macrolides and lincosamides, especially among penicillin-allergic patients, is a growing concern. This study aimed to determine the prevalence and patterns of macrolide resistance in clinical GBS isolates, evaluate inducible clindamycin resistance, and assess associated demographic and clinical variables in a tertiary care setting in South India. A cross-sectional study was conducted at Meenakshi Medical College Hospital and Research Institute, Kanchipuram, from January 2023 to June 2024. A total of 600 clinical samples—including high vaginal swabs, urine, pus, blood, and cerebrospinal fluid—were processed. GBS isolates were identified using standard microbiological and automated methods. Antimicrobial susceptibility testing was performed according to CLSI 2023 guidelines, and inducible clindamycin resistance was detected using the D-zone test. GBS was isolated from 130 samples (21.7%), predominantly from females (78.5%) and high vaginal swabs (32.4%). All isolates were susceptible to penicillin, vancomycin, and linezolid. Resistance to erythromycin and clindamycin was observed in 43.1% and 37.7% of isolates, respectively. Among erythromycin-resistant strains, the M phenotype was most prevalent (39.3%), followed by inducible MLSB (32.1%) and constitutive MLSB (25.0%). No significant associations were found with age, sex, or specimen type. These findings underscore the need for routine susceptibility testing and support penicillin as the first-line therapy.
Macrolide Resistance Among Group B Streptococcus Isolated from Clinical Samples In and Around Kanchipuram
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Evaluation The Correlation between Bmal1 and Clock Genes Expression with miRNA In kids With Bipolar DisorderAuthor: Owayes M. HamedDOI: 10.21522/TIJPH.2013.13.04.Art017
Evaluation The Correlation between Bmal1 and Clock Genes Expression with miRNA In kids With Bipolar Disorder
Abstract:
The study aimed to explore the influence of methylation levels of two clock genes, Bmal1 and Clock, and the association between gene expression and miRNA molecules (miRNA155 and miRNA211) in bipolar disorder. The study sample contains 40 kids whose ages ranged from 2 to 12 years with bipolar disorders, and 20 healthy kids as a control group. The study axes were divided into three parts. The first part involved determining the levels of gene expression for the Bmal1 and Clock genes using qRT-PCR. The second part is the determination of the levels of miRNA and snoRNA molecules that regulate Bmal1 and Clock genes using qRT-PCR. Third part: measuring methylation levels in the promoters of Bmal1 and clock genes using PCR. The results showed a significant decrease in the Bmal1 gene expression; it was the value of folding expression Bmal1 gene = 0.73, and a significant increase in the Clock gene; it was the value of folding expression Clock gene = 1.23. and the results showed a significant increase in miRNA gene expression; the value of folding expression for miRNA155/Bmal1 = 1.76, and a significant decrease in miRNA gene expression; the value of folding expression for miRNA211/Clock = 0.26. while the gene expression level for snoRNA molecule = 1.76 compared with control = 1. Conclusion: The results of this study demonstrate increases in the gene expression folding of the Clock gene and a significant decrease in miRNA211 gene expression which regulates the Clock gene.
Evaluation The Correlation between Bmal1 and Clock Genes Expression with miRNA In kids With Bipolar Disorder
References:
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The Role of Stigma in HIV Prevention: A Focused Analysis of PrEP Hesitancy in GuyanaAuthor: Samuel Anthony PellewDOI: 10.21522/TIJPH.2013.13.04.Art018
The Role of Stigma in HIV Prevention: A Focused Analysis of PrEP Hesitancy in Guyana
Abstract:
Human immunodeficiency virus (HIV) remains a major global health challenge, responsible for more than 42.3 million deaths as of July 2024. Despite the proven efficacy of pre-exposure prophylaxis (PrEP), uptake in Guyana remains limited, particularly among high-risk populations. This mixed-methods study investigated barriers to PrEP uptake in Guyana, focusing on stigma. A total of 280 participants completed structured questionnaires and 10 took part in in-depth interviews. Quantitative data were analyzed descriptively to determine prevalence of awareness and barriers, while thematic analysis using NVivo was employed for qualitative data. Findings revealed that 60% of participants had considered PrEP; however, stigma (50%), lack of awareness (36%), affordability (32%), side-effect concerns (29%), and confidentiality fears (21%) emerged as key barriers. Stigma was consistently described in interviews as fear of being labeled promiscuous or HIV-positive, leading to reluctance to seek PrEP services. Younger participants and LGBTQ+ individuals reported higher stigma experiences. Integration of both strands demonstrated how stigma interacts with structural issues such as cost and clinic availability, creating cumulative deterrents. Recommendations include provider training, culturally sensitive anti-stigma campaigns, community outreach, and decentralized service delivery. These findings underscore the urgent need for Guyana to address stigma as part of national HIV prevention strategies and to achieve UNAIDS 95-95-95 targets. Limitations include reliance on convenience sampling and descriptive statistics, which may restrict representativeness and generalizability.
The Role of Stigma in HIV Prevention: A Focused Analysis of PrEP Hesitancy in Guyana
References:
[1]. World Health Organization, HIV – Global. Available at: https://www.who.int (Accessed: 2024).
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Factors Influencing Health and Environmental Conditions in Hwiida, A Community Near Landfill Site in Gomoa West, Central Region, GhanaAuthor: Anita AsanteDOI: 10.21522/TIJPH.2013.13.04.Art019
Factors Influencing Health and Environmental Conditions in Hwiida, A Community Near Landfill Site in Gomoa West, Central Region, Ghana
Abstract:
Municipal solid waste management remains a significant challenge in low- and middle-income countries (LMICs), particularly in rapidly urbanizing areas like Ghana’s Central Region. This study examines the health and environmental impacts of the Hwiida Landfill Site on nearby communities in Gomoa West District. Using a cross-sectional correlational design, data were collected from 100 systematically selected residents within a 1-kilometre radius of the landfill via a structured questionnaire. Descriptive and binary logistic regression analyses were conducted. Results show that 81% of respondents reported health problems potentially linked to landfill exposure, including respiratory issues, skin conditions, and diarrhoea, and 73% indicated that at least one household member was affected in the past year. Environmental concerns were widespread: 72% cited air pollution (notably odour) and 48% reported pest and rodent infestations. Most participants (92%) lived within 300 metres of the site and lacked access to improved sanitation or formal waste collection. Inadequate landfill management especially the absence of leachate containment and minimal waste segregation was identified as a key contributor to pollution. These findings highlight the urgent need for engineered landfill upgrades, community health education, and targeted policy interventions. Context-specific evidence such as this can inform sustainable waste management strategies and reduce the health burden on vulnerable populations near landfills.
Factors Influencing Health and Environmental Conditions in Hwiida, A Community Near Landfill Site in Gomoa West, Central Region, Ghana
References:
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[16]. Parikh, P., Bisaga, I., Loggia, C., Georgiadou, M., & Ojo-Aromokudu, J., 2020, Barriers and opportunities for participatory environmental upgrading: Case study of Havelock informal settlement, Durban, City and Environment Interactions, https://doi.org/10.1016/j.cacint.2020.100041
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[20]. Nyame, F., Tigme, J., Kutu, J., & Armah, T., 2012, Environmental Implications of the Discharge of Municipal Landfill Leachate into the Densu River and Surrounding Ramsar Wetland in the Accra Metropolis, Ghana, Journal of Water Resource and Protection, 04, 622-633, https://doi.org/10.4236/JWARP.2012.48072
[21]. Fagariba, C., & Song, S., 2016, Assessment of Impediments and Factors Affecting Waste Management: A Case of Accra Metropolis, https://doi.org/10.20944/PREPRINTS201609.0012.V2
[22]. Sackey, L., Kočí, V., & Gestel, C., 2020, Ecotoxicological effects on Lemna minor and Daphnia magna of leachates from differently aged landfills of Ghana, The Science of the total environment, 698 (13) 42-95, https://doi.org/10.1016/j.scitotenv.2019.134295
[23]. Oduro-Appiah, K., Scheinberg, A., Afful, A., & Vries, N., 2020, The contribution of participatory engagement strategies to reliable data gathering and inclusive policies in developing countries: Municipal solid waste management data in the Greater Accra Metropolitan Area of Ghana, African Journal of Science, Technology, Innovation and Development, 13, 735 – 746, https://doi.org/10.1080/20421338.2020.1797267
[24]. Asibey, M., King, R., Lykke, A., & Inkoom, D., 2021, Urban planning trends on e-waste management in Ghanaian cities. Cities, 108 (10), 29-43, https://doi.org/10.1016/j.cities.2020.102943
[25]. Ofori-Boateng, C., Lee, K., & Mensah, M., 2013, The prospects of electricity generation from municipal solid waste (MSW) in Ghana: A better waste management option, Fuel Processing Technology, 110, 94-102, https://doi.org/10.1016/J.FUPROC.2012.11.008
[26]. Owusu-Sekyere, E., 2020, Altered urban landscape: Shedding light on conflicts in a landfill community in Ghana. African Journal of Science, Technology, Innovation and Development, 14, 76-85, https://doi.org/10.1080/20421338.2020.1811928
[27]. Roy, S., Bose, A., Basak, D., & Chowdhury, I., 2022, Open landfill site and threat to the proximity resident’s: Addressing perceived consequences of unscientific solid waste dumping using GIS techniques, https://doi.org/10.21203/rs.3.rs-1231009/v1
[28]. Owusu, G., Nketiah-Amponsah, E., Codjoe, S. N. A., & Afutu-Kotey, R. L., 2014, How do Ghanas landfills affect residential property values? A case study of two sites in Accra, Urban Geography, 35(8), 1140–1155, https://doi.org/10.1080/02723638.2014.945261
[29]. Maalouf, A., Cook, E., Velis, C. A., Mavropoulos, A., Godfrey, L., & Kamariotakis, H., 2020, From dumpsites to engineered landfills: A systematic review of risks to occupational and public health, Urban Geography, 35(8), 1157–1168, https://doi.org/10.1080/02723638.2014.945261
[30]. Shaddick, G., Ranzi, A., Thomas, M., Aguirre-Perez, R., Bekker-Nielsen, M., Parmagnani, F., & Martuzzi, M., 2018, Towards an assessment of the health impact of industrially contaminated sites: waste landfills in Europe, Epidemiologia e prevenzione, 42 (6), 69-75, https://doi.org/10.19191/EP18.5-6.S1.P069.089
[31]. Elliott, P., Briggs, D., Morris, S., Hoogh, C., Hurt, C., Jensen, T., Maitland, I., Richardson, S., Wakefield, J., & Jarup, L., 2001, Risk of adverse birth outcomes in populations living near landfill sites, BMJ: British Medical Journal, 323, 363 – 368, https://doi.org/10.1136/bmj.323.7309.363
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Cost-Effectiveness Analysis of the Piloting of Malaria Rapid Diagnostic Test kits within Region 8, GuyanaAuthor: Tatkan G.DOI: 10.21522/TIJPH.2013.13.04.Art020
Cost-Effectiveness Analysis of the Piloting of Malaria Rapid Diagnostic Test kits within Region 8, Guyana
Abstract:
The objective of this study was to conduct a Cost-Effectiveness Analysis (CEA) of piloting Rapid Diagnostic Test (RDT) kits in Region 8 of Guyana. The primary aim was to assess whether the introduction of RDTs provided good value for money and whether it could be considered a cost-effective intervention for malaria diagnosis in remote, high-burden areas. A quantitative analysis approach was employed, utilizing secondary data collected from multiple authorized sources, including government agencies such as the Ministry of Health. The data included expenditure records, payment vouchers, project reports, and receipts, providing critical financial information to estimate costs associated with the RDT pilot and microscopy testing. The results revealed that the total cost of implementing the RDT pilot project was USD 67,161, with the majority of expenditures allocated towards human resources. The estimated cost for administering a single RDT was USD 13.23. The findings demonstrated that the community-based approach was more cost-effective because it avoided additional expenses related to the construction and operation of new health facilities and hiring of personnel. By comparison, the cost of microscopy testing was estimated at USD 31.44 per patient, with the principal cost drivers identified as human resource salaries and facility operational expenses. Based on the Incremental Cost-Effectiveness Ratio (ICER) analysis, the intervention was deemed highly cost-effective. When compared to Guyana’s GDP per capita, which was USD 3,883 in 2017 according to the Guyana Bureau of Statistics, the piloting of RDTs was shown to be a financially sustainable and impactful approach to strengthening malaria diagnosis in underserved regions.
Cost-Effectiveness Analysis of the Piloting of Malaria Rapid Diagnostic Test kits within Region 8, Guyana
References:
[1]. WHO, 2017, World Malaria Report. Geneva: WHO.
[2]. White, M. T., Conteh, L., Cibulskis, R., Ghani, A. C., 2011, Costs and cost-effectiveness of malaria control interventions—a systematic review. Malaria Journal, 10(1):337.
[3]. WHO, 2010, World Malaria Report. Geneva: WHO.
[4]. United Nations, 2015, Transforming our World: The 2030 Agenda for Sustainable Development.
[5]. Guyana Ministry of Health, 2016, Guyana National Malaria Strategic Plan [2016 to 2021].
[6]. Fonseca, A. G., Carvalho, S., Dias, S., Baptista, J. L., Torgal, J., 2016, Understanding the occupational traveller profile towards malaria prevention enables directed health promotion and preventive practices. International Journal of Tropical Medicine and Public Health, 6. 10.5455/211930/ijtmph.
[7]. Ruktanonchai, N. W., DeLeenheer, P., Tatem, A. J., Alegana, V. A., Caughlin, T. T., zu Erbach-Schoenberg, E., Lourenço, C., Ruktanonchai, C. W., Smith, D. L., 2016, Identifying malaria transmission foci for elimination using human mobility data. PLoS Computational Biology, 12(4):e1004846.
[8]. Global Fund, 2016, Standard Concept Note; Investing for impact against HIV, tuberculosis or Malaria, 2016 to 2019.
[9]. Snow, R. W., Amratia, P., Kabaria, C. W., Noor, A. M., Marsh, K., 2012, The changing limits and incidence of Malaria in Africa: 1939–2009. In Advances in Parasitology, 78:169–262. Academic Press.
[10]. Shafiee, S., Topal, E., 2010, An overview of global gold market and gold price forecasting. Resources Policy, 35(3):178–189.
[11]. Broom, M., Rychtář, J., Spears-Gill, T., 2016, The Game-Theoretical Model of Using Insecticide-Treated Bed-Nets to Fight Malaria. Applied Mathematics, 7(9):852–860.
[12]. Katureebe, A., Zinszer, K., Arinaitwe, E., Rek, J., Kakande, E., Charland, K., et al., 2016, Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study. PLOS ONE. [cited 2018 Dec 4]. Available from: http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002167.
[13]. Yukich, J. O., Zerom, M., Ghebremeskel, T., Tediosi, F., Lengeler, C., 2009, Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets. Malaria Journal, 8(1):51.
[14]. Yukich, J. O., Zerom, M., Ghebremeskel, T., Tediosi, F., Lengeler, C., 2009, Costs and cost-effectiveness of vector control in Eritrea using insecticide-treated bed nets. Malaria Journal, 8(1):51.
[15]. Uzochukwu, B. S., Obikeze, E. N., Onwujekwe, O. E., Onoka, C. A., Griffiths, U. K., 2009, Cost-effectiveness analysis of rapid diagnostic test, microscopy and syndromic approach in the diagnosis of Malaria in Nigeria: implications for scaling-up deployment of ACT. Malaria Journal, 8(1):265.
[16]. Ansah, E. K., Epokor, M., Whitty, C., Yeung, S., Hansen, K. S., 2013, Cost-effectiveness analysis of introducing RDTs for malaria diagnosis as compared to microscopy and presumptive diagnosis in central and peripheral public health facilities in Ghana. The American Journal of Tropical Medicine and Hygiene, 89(4):724–736. https://doi.org/10.4269/ajtmh.13-0033.
[17]. Hansen, K. S., Ndyomugyenyi, R., Magnussen, P., Lal, S., Clarke, S. E., 2017, Cost-effectiveness analysis of Malaria rapid diagnostic tests for appropriate treatment of Malaria at the community level in Uganda. Health Policy and Planning, 32(5):676–689. https://doi.org/10.1093/heapol/czw171.
[18]. Batwala, V., Magnussen, P., Hansen, K. S., et al., 2011, Cost-effectiveness of malaria microscopy and rapid diagnostic tests versus presumptive diagnosis: implications for malaria control in Uganda. Malaria Journal, 10:372. https://doi.org/10.1186/1475-2875-10-372.
[19]. Guyana Ministry of Health, Coordination with stakeholders in the Malaria affected regions. Pilot project: Operationalization of the malaria strategy in Region 8 – Potaro-Siparuni, Guyana.
[20]. Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., et al., 2013, Consolidated Health Economic Evaluation Reporting Standards [CHEERS]—Explanation and Elaboration: A Report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value in Health, 16(2):231–250.
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Exploring Community Knowledge and Awareness of Emergency Medical Services in the Kweneng West Subdistrict, BotswanaAuthor: Kolobetso MalatsiDOI: 10.21522/TIJPH.2013.13.04.Art021
Exploring Community Knowledge and Awareness of Emergency Medical Services in the Kweneng West Subdistrict, Botswana
Abstract:
In rural Botswana, accessing to Emergency Medical Services (EMS) remains challenging due to logistical, infrastructural, and awareness-related barriers. This study aimed to explore community knowledge and identify specific needs regarding Emergency Medical Services (EMS) in the Kweneng West Subdistrict utilizing a qualitative descriptive approach. This study was conducted at Letlhakeng village. In-depth interviews and focus group interviews were conducted and triangulated data from 34 community stakeholders, including healthcare providers, Village Development Committee (VDC) members, police officers, and community workers. Purpose sampling was used to select the participants for this study. The findings revealed significant gaps in awareness and understanding. A substantial proportion of the participants were unaware of the emergency contact numbers for EMS and often relied on informal communication channels. Additionally, most participants reported receiving information through health talks at the clinic, police stations and Kgotla gatherings. The lack of formal EMS education contributed to misconceptions about EMS services. These findings underscore the need for targeted interventions to enhance community knowledge and awareness of EMS.
Exploring Community Knowledge and Awareness of Emergency Medical Services in the Kweneng West Subdistrict, Botswana
References:
[1]. Dalinjong, P. A., Wang, A. Y., & Dong, Y., 2018, The influence of service quality on healthcare utilization among rural residents in Africa. Journal of Health, Population and Nutrition, 37(1), 8.
[2]. Sibanda, M. C., 2017, Work conditions and experiences of emergency medical services personnel in the department of Health in two Provinces. Mahikeng: North-West University.
[3]. Mould-Millman, N. K., Naidoo, R., De Vries, S., & Stein, C., 2015, Cross-sectional study of barriers to accessing emergency medical services in rural Africa: A South African perspective. African Journal of Emergency Medicine, 5(1), 30-35.
[4]. Schultz, R., Abbott, T., Yamaguchi, J., & Cairney, S., 2018, Indigenous land management as primary health care: qualitative analysis from the Interplay research project in remote Australia. BMC Health Services Research, 18, 1-10. https://doi.org/10.1186/s12913-018-3764-8
[5]. Oppong, E., Hinson, R. E., Adeola, O., Muritala, O., & Kosiba, J. P., 2021, The effect of mobile health service quality on user satisfaction and continual usage, Total Quality Management & Business Excellence, Doi: 10.1080/14783363.2018.1541734
[6]. Wills, J., 2022, Foundations for Health Promotion-E-Book: Foundations for Health Promotion-E-Book. Elsevier health Sciences, 19 - 340.
[7]. Kobusingye, O. C., Hyder, A. A., Bishai, D., Hicks, E. R., Mock, C., & Joshipura, M., 2005, Emergency medical systems in low- and middle-income countries: recommendations for action. Bulletin of the World Health Organization, 83(8)626–631.
[8]. Saunders, B., Sim, J., Kingstone, T., Baker, S., Waterfield, J., Bartlam, B., & Jinks, C., 2018, Saturation in qualitative research: exploring its conceptualization and operationalization. Quality & Quantity, 52, 1893–1907. https://doi.org/10.1007/s11135-017-0574-8
[9]. Aljabri, D., & Albinali, H., 2022, Public awareness and use of 997 emergencies medical service phone number during the COVID-19 pandemic. Frontiers in Public Health, 10,937202
[10]. Hamam, A. F., Bagis, M. H., AlJohani, K., & Tashkandi, A. H., 2015, Public awareness of the EMS system in Western Saudi Arabia: Identifying the weakest link. International Journal of Emergency Medicine, 8, 1-7.
[11]. von dem Knesebeck, O., Koens, S., Schäfer, I., Strauß, A., Klein, J., 2022, Public knowledge about emergency care-results of a population survey from Germany. Frontiers in Public Health, 9,787921. Doi: 10.3389/fpubh.2021.787921. PMID: 35071168; PMCID: PMC8777036.
[12]. Balakrishnan, M. P., Herndon, J. B., Zhang, J., Payton, T., Shuster, J., & Carden, D. L., 2017, The association of health literacy with preventable emergency department visits: a cross-sectional study. Academic Emergency Medicine, 24(9) 1042-1050.
[13]. Schaeffer, D., Gille, S., Hurrelmann, K., 2020, Implementation of the National Action Plan Health Literacy in Germany—Lessons Learned. International Journal of Environmental Research and Public Health, 17 (12):4403. https://doi.org/10.3390/ijerph17124403
[14]. Anderson, P. D., Suter, R. E., Mulligan, T., Bodiwala, G., Razzak, J. A., Mock, C., & International Federation for Emergency Medicine., 2012, World Health Assembly Resolution 60.22 and its importance as a healthcare policy tool for improving emergency care access and availability globally. Annals of Emergency Medicine, 60(1): 35-44. Doi: 10.1016/j.annemergmed.2011.10.018.
[15]. Carr, B. G., Bowman, A. J., Wolff, C. S., Mullen, M. T., Holena, D. N., Branas, C. C., Wiebe, D. J., 2017, Disparities in Access to Trauma Care in the United States: A Population-Based Analysis. Injury, 48:332–338. Doi: 10.1016/j.injury.2017.01.008.
[16]. King, R., Oprescu, F., Lord, B., & Flanagan, B., 2021, Patient experience of non-conveyance following emergency ambulance service response: a scoping review of the literature. Australasian emergency care, 24(3):210-223. https://doi.org/10.1016/j.auec.2020.08.006
[17]. Sultan, M., Abebe, Y., Tsadik, A. W., Jennings, C. A., & Mould-Millman, N. K., 2018, “Epidemiology of ambulance utilized patients in Addis Ababa, Ethiopia.” BMC Health Services Research, 18,1-7 https://doi.org/10.1186/s12913-018-3820-4
[18]. Patel, A. B., Waters, N. M., Blanchard, I. E., Doig, C. J., & Ghali, W. A., 2012, Validation of ground ambulance pre-hospital times modeled using geographic information systems. International journal of health geographics, 11, 1-10. https://doi.org/10.1186/1476-072X-11-42.
[19]. Wesson, H. K., Stevens, K. A., Bachani, A. M., Mogere, S., Akungah, D., Nyamari, J., & Hyder, A. A., 2015, Trauma systems in Kenya: a qualitative analysis at the district level. Qualitative health research, 25(5)589-599.
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Factors Associated with Non-Adherence to Medication Among Geriatric Diabetic Patients in Mandeville, JamaicaAuthor: Ainsworth M. ReynoldsDOI: 10.21522/TIJPH.2013.13.04.Art022
Factors Associated with Non-Adherence to Medication Among Geriatric Diabetic Patients in Mandeville, Jamaica
Abstract:
Diabetes mellitus is a common health problem in Jamaica, causing a massive burden for individuals, families, communities, and the health sector. Diabetes leads to chronic physical and socioeconomic challenges. Adherence to diabetes therapy is crucial for preventing complications and alleviating the socioeconomic burden on the healthcare system. This study aimed to determine the factors contributing to non-adherence to diabetic therapy among geriatric patients with diabetes in Mandeville, Jamaica. Using a convenient sampling method, a quantitative cross-sectional design was conducted across five health centers in Mandeville, Jamaica. A sample size of 150 participants was surveyed using a semi-structured, self-administered questionnaire. Using a convenient sampling method, a quantitative cross-sectional design was conducted across five health centers in Mandeville, Jamaica. A semi-structured, self-administered questionnaire was used to survey 150 participants. The prevalence of diabetes among geriatric diabetic patients was 62.5% for Type 2 diabetes and 37.5% for Type 1 Diabetes. The sample size used indicates an overall prevalence of 100. The study concluded that medication adherence was low and significantly associated with poor compliance. However, future management interventions for diabetic geriatrics should focus on improving medication adherence.
Factors Associated with Non-Adherence to Medication Among Geriatric Diabetic Patients in Mandeville, Jamaica
References:
[1]. Conget, I., 2017, Medication adherence among ambulatory patients with type 2 diabetes: in a tertiary healthcare setting in southwestern Nigeria. Pharmacy Practice, PubMed.
[2]. World Health Organization, 2016, Factors contributing to non-compliance among diabetics attending primary health centers in the Al Hasa district of Saudi Arabia. Journal of Family Community Medicine.
[3]. Lee, R., 2010, A competing risks prescription refill model of compliance and persistence. Value Health.
[4]. Cramer, J., 2004, Patient-reported perceptions of side effects of antihyperglycemic medication and adherence to medication regimens in persons with diabetes mellitus. Clinical Journal.
[5]. Pallock, R. J., 2011, Full coverage for preventive medications after myocardial infarction. English Journal of Medicine.
[6]. Barron, T. I., Bennett, K., Feely, J., 2010, A competing risks prescription refill model of compliance and persistence. 13(6),796–804.
[7]. Chao, J., Nau, D. P., and Aikens, J. E., 2007, Patient-reported perceptions of side effects of antihyperglycemic medication and adherence to medication regimens in persons with diabetes mellitus. Clinical Journal, 29(1),177–80.
[8]. Choudhry, N. K., Avorn, J., Glynn, R. J., 2011, Full coverage for preventive medications after myocardial infarction. English Journal of Medicine, 365(22),2088–2097.
[9]. Ferguson, T., Tulloch-Reid, M., and Wilks, R., 2010, The epidemiology of diabetes mellitus in Jamaica: a Caribbean: a historical review. West Indian Medical Journal, (59),259- 64.
[10]. Haynes, R. B., Ackloo, E., Sahota, N., McDonald, H. P., and Yao, X., 2008, Interventions for enhancing medication adherence. Cochrane Database Systematic Review. [PubMed].
[11]. Hughes, C. M., 2004, Medication non-adherence in the elderly: how big is the problem? Drugs Aging, (21),793–811.
[12]. Hutchins, V., Zhang, B., Flourence, R. L., Krishnarajah, G., and Graham, J., 2011, A systematic review of adherence, treatment satisfaction, and costs, in fixed-dose combination regimens in type 2 diabetes,27(6),1157–68.
[13]. Jin. J., Sklar, G. E., MinSen, O. V., Chuen Li., 2008, Factors affecting therapeutic compliance: A review from the patient’s perspective.4(1), 269–86.
[14]. Wild, S., Roglic, G., Green, A., Sicree, R., & King, H., 2004, Global Prevalence of Diabetes: Estimates for the year 2000 and projections for 2030. Diabetes care, 27(5), 1047-1053.
[15]. Wilks, R., Younger, N., Tulloch-Reid, M., McFarlane, S., Francis, D., 2008, Jamaica Health and Lifestyle Survey II.
[16]. Wong, M. C., Kong, A. P., So, W. Y., Jiang, J. Y., Chan, J. C., & Griffiths, S. M., 2011, Adherence to oral hypoglycemic agents in 26 782 Chinese patients: a cohort study. The Journal of Clinical Pharmacology, 51(10), 1474-1482.
[17]. Wong, E. S., Piette, J. D, Liu, C., 2012, Measures of adherence to oral hypoglycemic agents at the primary care clinic level. Med Care,50(7),591–598.
[18]. World Health Organization, 2003, Adherence to Long-Term Therapies: Evidence for Action Geneva. Available from, http://whqlibdoc.who.int/publications/2003/9241545992. Accessed January 29, 2013.
[19]. Bailer-Goering, M, M., Roy, k., Howards, D. H., 2019, Relationship between adherence to Antidiabetic medication Regimen: and out-of-pocket cost among people aged 35-64. with employer-sponsored health insurance, 16,180-381.
[20]. Barnett, K., Mercer, S., & Norbury, M., 2012, Epidemiology of Multi Morbidity and Implications for health care research: and medical education, 9836, 37-43.
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Knowledge of Male Caregivers on Childhood Routine Immunization and Zero Dose Children in Borno StateAuthor: Bashir Adebayo ElegbedeDOI: 10.21522/TIJPH.2013.13.04.Art023
Knowledge of Male Caregivers on Childhood Routine Immunization and Zero Dose Children in Borno State
Abstract:
Immunization remains a mainstay in safeguarding children's health worldwide, but achieving universal vaccination coverage has been a significant global challenge. Nigeria faces a particularly alarming situation among these countries, with over 2.2 million estimated zero-dose children in 2021. This study determined male caregivers' knowledge of childhood RI and zero-dose children in Borno. It is a settlement-based descriptive cross-sectional study, and a multi-stage sampling technique was employed to recruit 1,318 respondents. Data collection involved a structured questionnaire and data analysis was completed using IBM SPSS version 25 and STATA SE Version 17. The level of significance was set at 5%. Overall, 56% of respondents demonstrated poor knowledge of childhood RI and ZD, whereas 44% showed good knowledge. Using the Chi-Square Test, there was a statistically significant association between socio-demographic factors (educational status, occupation, and income) and poor understanding of childhood RI and zero-dose vaccination. Also, the multivariate logistics regression analysis results further buttress the outcome of the Chi Square tests; analysis showed that participants who attained secondary education (AOR=0.45, 95% CI=0.26-0.79) and those with tertiary education (AOR=0.46, 95% CI=0.24-0.88) had statistically significantly lower odds for poor knowledge compared to their counterparts with none, Qur’anic or primary education. Despite some positives regarding increased awareness of childhood RI, the understanding of male caregivers about childhood RI and zero-dose vaccination remains poor. Initiatives such as health education and community engagement targeting men should be incorporated into immunization activities.
Knowledge of Male Caregivers on Childhood Routine Immunization and Zero Dose Children in Borno State
References:
[1]. Bulut, A., Immunization and Vaccines, 2023, Experimental and Applied Medical Science, 4(1), 502-7.
[2]. Lakshmanan, M. T., Karunakaran, U., 2020, Polio vaccination coverage among children aged 12-23 months in a health block in North Kerala. International Journal of Community Medicine and Public Health, May 27, 7(6), 2291–7.
[3]. Carter, A., Msemburi, W., Sim, S. Y., Gaythorpe, K. A. M., Lambach, P., and Lindstrand, A., 2024, Modeling the impact of vaccination for the immunization Agenda 2030, Deaths averted due to vaccination against 14 pathogens in 194 countries from 2021 to 2030. Vaccine. 42, S28–37.
[4]. Wonodi, C., Farrenkopf, B. A., 2023, Defining the Zero Dose Child, A Comparative Analysis of Two Approaches and Their Impact on Assessing the Zero Dose Burden and Vulnerability Profiles across 82 Low-and Middle-Income Countries. Vaccines. 11(10):1543.
[5]. Bergen, N., Cata-Preta, B. O., Schlotheuber, A., Santos, T. M., Danovaro-Holliday, M. C., Mengistu, T., 2022, Economic-Related Inequalities in Zero-Dose Children - A Study of Non-Receipt of Diphtheria-Tetanus-Pertussis Immunization Using Household Health Survey Data from 89 Low- and Middle-Income Countries. Vaccines. 10(4), 633.
[6]. Santos, T. M., Cata-Preta, B. O., Wendt, A., Arroyave, L., Blumenberg, C., Mengistu, T., 2024, Exploring the Urban Advantage in Access to Immunization Services - A Comparison of Zero-Dose Prevalence Between Rural, and Poor and Non-poor Urban Households Across 97 Low- and Middle-Income Countries. Journal of urban health, Bulletin of the New York Academy of Medicine. 101(3):638–47.
[7]. Jean-Baptiste, A. E., Wagai, J., Hahné, S., Adeniran, A., Koko, R. I., Vos, S. D., 2024, High-Resolution Geospatial Mapping of Zero-Dose and Under-immunized Children Following Nigeria’s 2021 Multiple Indicator Cluster Survey/National Immunization Coverage Survey. The Journal of Infectious Diseases. 230(1), e131–8.
[8]. Abdullahi, S., 2018. Factors affecting completion of childhood immunization in Northwest Nigeria. Walden University.
[9]. Ingle, E. A., Shrestha, P., Seth, A., Lalika, M. S., Azie, J. I., Patel, R. C., 2023, Interventions to Vaccinate Zero-Dose Children, A Narrative Review and Synthesis. Viruses. 15(10).
[10]. Khan, S., Gupta, G. K., Agrawal, D., Zaidi, S. H. N., Batra, J., Syed, S., Sharma, L., et al., 2024, The Big Catch-up: Addressing Zero-Dose Children as a Surrogate of Vaccination Disruptions During Public Health Emergencies. European Scientific Journal, ESJ, 33, pp.286-286.
[11]. Parsekar, S. S., Vadrevu, L., Jain, M., Menon, S., Taneja, G., 2024, Interventions addressing routine childhood immunization and its behavioural and social drivers. Frontiers in Public Health.
[12]. Oyo-Ita, A., Oduwole, O., Arikpo, D., Effa, E. E., Esu, E. B., and Balakrishna, Y., 2023, Interventions for improving coverage of childhood immunisation in low- and middle-income countries. The Cochrane database of systematic reviews. 12(12), CD008145.
[13]. Shah, M. P., Morgan, C. J., Beeson, J. G., Peach, E., Davis, J., McPake, B., 2024, Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries, Systematic Review Update 2011–2020. Vaccines. 12(12):1313.
[14]. Kalkowska, D. A., Duintjer, Tebbens, R. J., & Thompson, K. M., 2014. Modelling strategies to increase population immunity and prevent poliovirus transmission in the high-risk area of northwest. Journal of Infectious Diseases. 210(Suppl 1), 412–23.
[15]. Kalkowska, D. A., Franka, R., Higgins, J., Kovacs, S. D., Forbi, J. C., Wassilak, S. G., 2021, Modeling Poliovirus Transmission in Borno and Yobe, Northeast Nigeria. Risk Analysis, 41(2), pp.289-302.
[16]. Ameen, H. A., Musa, S., Ibraheem, R. M., Oladiji, F., Musa, O. I., Salaudeen, A. G., 2023. Routine immunization uptake and knowledge of caregivers in selected rural communities in Northwestern Nigeria. Nigerian Journal of Basic and Clinical Sciences. 20(2), 135–41.
[17]. Aliyu, I., Mohammed, A., Ibrahim, H. U., Ghidazuka, Y. B., 2019, Acceptance of immunization by caregivers of children attending a tertiary health facility in Northwestern Nigeria. Acta Medica International. 6(1), 17–21.
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[24]. Papagiannis, D., Tiganis, N., Kotsiou, O. S., Lampropoulos, I. C., Fradelos, E. C., Malli, F., 2024, Assessment of Knowledge, Attitudes, and Vaccination Practices Regarding the New RSV Vaccine among Health Professionals in Greece. Healthcare. 12(15), 1536.
[25]. Raji, M. O., Sani, A. A., Ibrahim, L. S., Muhammad, H., Oladigbolu, R. A., Kaoje, A. U., 2019, Assessment of the knowledge of fathers, uptake of routine immunization, and its associated factors in a rural community of North West Nigeria, Annals of African medicine. 18(2), 97–102.
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[27]. Idowu, A. E., Yusuf, O. B., Oladele, D. A., 2024, Socio-demographic determinants of immunization uptake in Nigeria, Insights from the 2021 Nigeria Demographic and Health Survey. BMC Public Health. 24(1), 1510.
[28]. Ameen, H. A., Musa, S., Ibraheem, R. M., Oladiji, F., Musa, O. I., Salaudeen, A. G., 2023, Routine immunization uptake and knowledge of caregivers in selected rural communities in Northwestern Nigeria. Nigerian Journal of Basic and Clinical Sciences. 20(2), 135–41.
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[30]. Ishaku, S. M., Ibrahim, S., Ahmed, A., 2021, Awareness and knowledge of immunization schedules among caregivers in Kaduna State, Nigeria. African Journal of Reproductive Health. 25(4):112–21.
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[33]. Olaniyan, A., Isiguzo, C., Agbomeji, S., Akinlade-Omeni, O., Ifie, B., Hawk, M., 2022, Barriers, facilitators, and recommendations for childhood immunisation in Nigeria: perspectives from caregivers, community leaders, and healthcare workers. The Pan African Medical Journal. 43:97.
[34]. Adeyanju, G. C., Sprengholz, P., Betsch, C., Essoh, T. A., 2019, Caregivers’ views on childhood immunization and the sources of information in Northern Nigeria. Vaccine. 37(45), 6724–31.
[35]. Sobieh, A. E., Kamara, M. K., Johnson, F. T., 2020, Education and immunization uptake, Evidence from West African caregivers. Pan African Medical Journal. 36, 210.
[36]. Sobieh, A. E., Adamu, Y., Conteh, A., 2020, Traditional beliefs and immunization uptake in West Africa, A systematic review, West African Journal of Medicine. 37(6), 601–9.
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Effect of Covid-19 Pandemic on Maternal Health Indicators in NigeriaAuthor: Oyaole Daniel RasheedDOI: 10.21522/TIJPH.2013.13.04.Art024
Effect of Covid-19 Pandemic on Maternal Health Indicators in Nigeria
Abstract:
This study examines the impact of the COVID-19 pandemic on maternal healthcare indicators in Nigeria between 2018 and 2024. Before the pandemic, Nigeria’s health system faced significant challenges, reflected in persistently high maternal mortality rates. COVID-19 exacerbated these issues, disrupting services and testing the healthcare system's resilience. Using a retrospective, cross-sectional comparative design, this research analyzed nationally representative secondary data from the Demographic and Health Survey (DHS) before and during the pandemic. Descriptive statistics, Chi-square tests, logistic regression, and multivariate analysis of variance (MANOVA) were employed to assess temporal and regional shifts in maternal health indicators. Nationally, declines were observed in skilled birth attendance (67% to 63%) and antenatal care participation (57% to 52%), although these changes were not statistically significant (p > 0.05). Regional analyses revealed substantial declines in skilled birth attendance in the North-East and North-West regions (p < 0.001) and a substantial improvement in antenatal care attendance in the South-West (p = 0.032). Modest improvements were also noted nationally, with institutional deliveries increasing from 39% to 43%, and modest gains in postnatal care utilization. These findings underscore the fragility of maternal healthcare services during global health crises and highlight urgent need to strengthen health system resilience at regional levels. Key recommendations include improving healthcare access in underserved areas, enhancing the healthcare workforce, expanding digital health initiatives, and promoting community-based maternal health education. This study provides critical insights into the pandemic’s impact on maternal health outcomes and emphasizes the importance of equity-focused public health strategies for future emergencies.
Effect of Covid-19 Pandemic on Maternal Health Indicators in Nigeria
References:
[1]. Oleribe, O. O., Nwanyanwu, O., Shen, E. Y. L., & Taylor-Robinson, S. D., 2019, Revisiting public health programming in Nigeria: challenges and solutions, International Journal of General Medicine, 12, 161, https://doi.org/10.2147/IJGM.S203172
[2]. Hogan, D. R., Stevens, G. A., Hosseinpoor, A. R., & Boerma, T., 2018, Monitoring universal health coverage within the Sustainable Development Goals, Lancet Global Health, 6(2), e152–e168, https://doi.org/10.1016/S2214-109X(17)30472-2
[3]. Ihekweazu, C., 2022, Lessons from Nigeria’s Adaptation of Global Health Initiatives during the COVID-19 Pandemic, Emerging Infectious Diseases, 28(Suppl 1), S299, https://doi.org/10.3201/EID2813.221175
[4]. Anikwe, C. C., et al., 2023, Patterns and causes of hospital maternal mortality in a tertiary center in Nigeria, International Journal of Medical and Health Development, 28(3), 202–210, https://doi.org/10.4103/IJMH.IJMH_30_22
[5]. Oyedepo, E. O., 2023, Trends and patterns of maternal mortality in Nigeria: Any link with economic growth?, Journal of Social Development in Africa, 38(2), 64–93.
[6]. Oladipo, I. A., & Akinwaare, M. O., 2023, Trends and patterns of maternal deaths from 2015 to 2019 in rural Lagos, Nigeria, Pan African Medical Journal, 44, 185, https://doi.org/10.11604/PAMJ.2023.44.185.37567
[7]. Nasir, N., Aderoba, A. K., & Ariana, P., 2022, Scoping review of maternal and newborn health interventions and programmes in Nigeria, BMJ Open, 12(2), e054784, https://doi.org/10.1136/BMJOPEN-2021-054784
[8]. Okereke, E., et al., 2019, Reducing maternal and newborn mortality in Nigeria: A qualitative study, Human Resources for Health, 17(1), 1–9, https://doi.org/10.1186/S12960-019-0430-0
[9]. Zhang, X., Anser, M. K., Ahuru, R. R., Zhang, Z., Peng, M. Y. P., Osabohien, R., & Mirza, M., 2022, Do predictors of health facility delivery among reproductive-age women differ by health insurance enrollment? A multi-level analysis of Nigeria's data, Frontiers in Public Health, 10, 797272, https://doi.org/10.3389/fpubh.2022.797272
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[11]. Roberton, T., et al., 2020, Early estimates of the indirect effects of the COVID-19 pandemic on maternal and child mortality, Lancet Global Health, 8(7), e901–e908, https://doi.org/10.1016/S2214-109X(20)30229-1
[12]. Takemoto, M. L. S., et al., 2020, The tragedy of COVID-19 in Brazil: 124 maternal deaths and counting, International Journal of Gynecology and Obstetrics, 151(1), 154–156, https://doi.org/10.1002/ijgo.13300
[13]. Chmielewska, B., et al., 2021, Effects of the COVID-19 pandemic on maternal and perinatal outcomes, Lancet Global Health, 9(6), e759–e772, https://doi.org/10.1016/S2214-109X(21)00079-6
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[17]. Sarker, A. R., et al., 2020, Prevalence and determinants of health facility delivery in Bangladesh, PLoS One, 15(10), e0241436, https://doi.org/10.1371/journal.pone.0241436
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Impact of Cervical Cancer Screening Education on Knowledge, Attitude, and Willingness to Uptake HPV Self-Sampling in Delta StateAuthor: Priscilla Uruemuesiri EBUNUDOI: 10.21522/TIJPH.2013.13.04.Art025
Impact of Cervical Cancer Screening Education on Knowledge, Attitude, and Willingness to Uptake HPV Self-Sampling in Delta State
Abstract:
Cervical cancer remains a significant public health challenge in Nigeria, particularly among women of childbearing age. Despite available screening methods, the uptake of Human Papillomavirus Self-Sampling (HPVSS) remains low due to limited awareness and knowledge. This study evaluated the outcomes of a cervical cancer screening educational intervention on knowledge, attitude, and willingness to uptake HPVSS among childbearing women in Delta State, Nigeria. A quasi-experimental study was conducted using pre- and post-intervention assessments. A total of 196 questionnaires (98 each at pre- and post-intervention) were analyzed using SPSS version 25.0. The intervention involved structured educational sessions on cervical cancer screening and HPVSS. Descriptive statistics and paired-sample t-tests were used for data analysis. Post-intervention, awareness of HPVSS increased from 35.7% to 66.3%. The proportion of women with adequate knowledge improved from 6.1% to 45.9%. Positive attitude towards HPVSS risen from 99% to 100%, while willingness to uptake HPVSS improved from 93.9% to 99%. Significant differences were observed between pre- and post-intervention scores across all measured parameters (p < 0.000). The educational intervention significantly improved knowledge, attitude, and willingness to uptake HPVSS among childbearing women. These findings suggest that structured educational programs can enhance cervical cancer screening awareness and acceptance of HPVSS, potentially increasing screening uptake and reducing cervical cancer burden in Nigeria.
Impact of Cervical Cancer Screening Education on Knowledge, Attitude, and Willingness to Uptake HPV Self-Sampling in Delta State
References:
[1]. Cao, W., Qin, K., Li, F., & Chen, W., 2024, Comparative study of cancer profiles between 2020 and 2022 using global cancer statistics (GLOBOCAN). Journal of the National Cancer Center, 4(2), 128-134.
[2]. Singh, D., Vignat, J., Lorenzoni, V., Eslahi, M., Ginsburg, O., Lauby-Secretan, B., ... & Vaccarella, S., 2023, Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative. The lancet global health, 11(2), e197-e206.
[3]. World Health Organization, 2020, Global strategy to accelerate the elimination of cervical cancer as a public health problem. World Health Organization.
[4]. Lin, K., Hong, Q., Fu, Y., Tu, H., Lin, H., Huang, J., ... & Chen, M., 2024. Cervical HPV infection and related diseases among 149,559 women in Fujian: an epidemiological study from 2018 to 2023. Frontiers in Microbiology, 15, 1418218.
[5]. Arbyn, M., Costa, S., Latsuzbaia, A., Kellen, E., Girogi Rossi, P., Cocuzza, C. E., ... & Castle, P. E., 2023, HPV-based cervical cancer screening on self-samples in the Netherlands: challenges to reach women and test performance questions. Cancer Epidemiology, Biomarkers & Prevention, 32(2), 159-163.
[6]. Talabi, O., Gilbert, H., Fawzi, M. C. S., Anorlu, R., & Randall, T., 2023, Examining barriers and facilitators of HPV vaccination in Nigeria, in the context of an innovative delivery model: a mixed-methods study. BMJ Public Health, 1(1).
[7]. Amponsah-Dacosta, E., Kagina, B. M., & Olivier, J., 2020, Health systems constraints and facilitators of human papillomavirus immunization programmes in sub-Saharan Africa: a systematic review. Health policy and planning, 35(6), 701-717.
[8]. Oghenevwarhe, O. B., Soter, A., Adekunbiola, B., & Omosivie, M., Feasibility and Acceptability of Self-sampling for Human Papillomavirus DNA Testing Among Asymptomatic Women in Rural Delta State, Nigeria.
[9]. Dzobo, M., Dzinamarira, T., Maluleke, K., Jaya, Z. N., Kgarosi, K., & Mashamba-Thompson, T. P., 2023, Mapping evidence on the acceptability of human papillomavirus self-sampling for cervical cancer screening among women in sub-Saharan Africa: a scoping review. BMJ open, 13(4), e062090.
[10]. Maver, P. J., & Poljak, M., 2020, Primary HPV-based cervical cancer screening in Europe: implementation status, challenges, and future plans. Clinical microbiology and infection, 26(5), 579-583.
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Seasonality of COVID-19 Transmission in Tropical Countries: The Case of the Health Districts of Kati and Commune VI of Bamako in MaliAuthor: Moulaye BabyDOI: 10.21522/TIJPH.2013.13.04.Art026
Seasonality of COVID-19 Transmission in Tropical Countries: The Case of the Health Districts of Kati and Commune VI of Bamako in Mali
Abstract:
The existence of seasonality in COVID-19 transmission remains a major concern in the management of COVID-19 outbreaks. To answer this question, we conducted a retrospective cohort study using epidemiological surveillance data from the health districts of Kati and Commune VI of Bamako. The data was collected between January 1, 2021 and December 31, 2021. Two semi-structured questionnaires included 114 cases of COVID-19, including 43 symptomatic and 71 asymptomatic, for whom 1227 contacts were identified and followed daily for 14 days. Our results showed that 112 of the contacts followed developed the disease, i.e. an incidence rate of 9.1%. The sex ratio was 1.5 in favour of the female sex. The incidence rate was higher in the dry season with 13.2% 95% CI [10.3 - 16.7] compared to 6.7% 95% CI [4.6 - 9.4] in the cool season and 5.8% 95% CI [3.4 - 9.2] in the winter period. Also, the risk of contracting COVID-19 for exposed contacts was 2.25 times higher in the dry season compared to other seasons (RR=2.25 95% CI [1.55 - 3.28]). Incidence rates were higher for average temperatures between 28 and 34 degrees Celsius, the same is true for humidity between 19 and 37%. The dry season has been identified as favorable for the transmission of COVID-19 in our study area. As a result, response measures must be stepped up before and during the dry season.
Seasonality of COVID-19 Transmission in Tropical Countries: The Case of the Health Districts of Kati and Commune VI of Bamako in Mali
References:
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[2]. Okada, P., Buathong, R., Phuygun, P., 2020, Early transmission patterns of coronavirus disease 2019 (COVID-19) in travellers from Wuhan to Thailand. Euro Surveill, 25(2), 201-297.
[3]. Li, Q., Guan, X., 2020, Early transmission dynamic in Wuhan, China, of novel coronavirus infected pneumonia. N Engl J Med, 1-1207.
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[14]. De Lusignan, S., Dorward, J., Correa, A., 2020, Risk factors for SARS-CoV-2 among patients in the Oxford Royal College of General Practitioners Research and Surveillance Centre primary care network: a cross- sectional study, Lancet Infect Dis, 20(9), 1034-1042.
[15]. Lagacé-Wiens, P., Bullard, J., Cole, R., 2021, The seasonality of the coronavirus and other viruses in Canada: The consequences of COVID-19. Canada Communicable Disease, 47(3), 101-151, https://doi.org/10.14745/ccdr.v47i03a02f
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[17]. Peter, J., Martina, R., Pavlos, B., 2020, Effects of climate and public health interventions on the COVID-19 pandemic, CMAJ, 192(11), 1301-13778, https://doi: 10.1503/cmaj.200920-e
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Trends and Predictors of Pre-Eclampsia between 1990 and 2020 in Ghana: A Systematic ReviewAuthor: Priscilla N. A. Odei-QuansahDOI: 10.21522/TIJPH.2013.13.04.Art027
Trends and Predictors of Pre-Eclampsia between 1990 and 2020 in Ghana: A Systematic Review
Abstract:
Pre-eclampsia is a specific form of hypertension in pregnancy that raises significant public health concerns globally. Mothers may sometimes appear healthy, yet later develop pre-eclampsia, leading to adverse consequences, including death. This situation has underscored the necessity for ongoing research to improve maternal birth outcomes and prevent disabilities and fatalities. This systematic review assessed trends and predictors of pre-eclampsia in Ghana over the last three decades. This review covered publications from January 1990 to December 2020, using three bibliographic databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to screen and select the papers included in the review. The tool for Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to enhance the quality of the evaluated papers. The majority (13 out of 21) of studies on the prevalence and predictors of pre-eclampsia were conducted between 2011 and 2020. The review found an average incidence rate of 9.1% for pre-eclampsia and identified approximately twenty-six predictors among pregnant women. These predictors included demographic and maternal factors, dietary and environmental influences, as well as maternal and perinatal care services. There is an increasing trend of pre-eclampsia among women in Ghana. Although the predictors of pre-eclampsia are relatively similar to those in other parts of the world, healthcare providers should ensure timely screening, treatment, and management to reduce adverse outcomes, including maternal mortality during pregnancy.
Trends and Predictors of Pre-Eclampsia between 1990 and 2020 in Ghana: A Systematic Review
References:
[1]. Walle, T. A., & Azagew, A. W., 2019, Hypertensive disorder of pregnancy prevalence and associated factors among pregnant women attending ante natal care at Gondar town health Institutions, North West Ethiopia 2017. J Pregnancy hypertension, 16, 79-84. https://www.sciencedirect.com/science/article/pii/S2210778918306871.
[2]. Grum, T., Seifu, A., Abay, M., Angesom, T., & Tsegay, L., 2017, Determinants of pre-eclampsia/Eclampsia among women attending delivery Services in Selected Public Hospitals of Addis Ababa, Ethiopia: a case control study. BMC pregnancy childbirth, 17(1), 1-7.
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[14]. Lee, Q. Y., Odoi, A. T., Opare‐Addo, H., & Dassah, E. T., 2012, Maternal mortality in Ghana: a hospital‐based review. J Acta obstetricia et gynecologica Scandinavica, 91(1), 87-92.
[15]. Asundep, N. N., Jolly, P. E., Carson, A., Turpin, C. A., Zhang, K., & Tameru, B., 2014, Antenatal care attendance, a surrogate for pregnancy outcome? The case of Kumasi, Ghana. Maternal child health journal, 18(5), 1085-1094.
[16]. Apanga, P. A., & Awoonor-Williams, J. K., 2018, Maternal death in rural Ghana: a case study in the upper East Region of Ghana. J Frontiers in public health, 6, 101.
[17]. Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., & Brennan, S. E., 2021, The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj, 372.
[18]. Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, S., 2014, The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International journal of surgery, 12(12), 1495-1499.
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[20]. Adu-Bonsaffoh, K., Ntumy, M. Y., Obed, S. A., & Seffah, J. D., 2017, Prevalence of hypertensive disorders in pregnancy at Korle-Bu Teaching Hospital in Ghana. J Gynecol Neonatal Biol, 3(1), 8-13.
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[22]. Beyuo, T. K., Lawrence, E. R., Kobernik, E. K., & Oppong, S. A., 2022, Clinical presentation and predictors of eclampsia among women with hypertensive disorders of pregnancy in Ghana. Pregnancy Hypertension, 30, 171-176.
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Barriers to Optimal Index Testing for Improved HIV Positivity Yield in Lusaka Urban District of ZambiaAuthor: Cibangu KatambaDOI: 10.21522/TIJPH.2013.13.04.Art028
Barriers to Optimal Index Testing for Improved HIV Positivity Yield in Lusaka Urban District of Zambia
Abstract:
As the proportions of people living with HIV who do not know their HIV infection status decrease, reaching the first 90 will require effective and efficient HIV testing approaches. This project used an explanatory sequential mixed-methods study design to: 1) to understand the perceived facilitators and barriers to HIV partner testing from the perspective of the health-care provider; and 2) to propose interventions necessary for improved HIV case finding. At baseline, 452 index contacts (53.5%) tested HIV negative, 113 index contacts (13.4%) tested HIV positive. Following the intervention, 384 index clients were enrolled in the study. Total number of 668 contacts: 333 males and 335 females. The mean age of contacts was 34.5, ranging from 18 to 68 (SD = 8.638). HIV status: 320 tested positive, 240 tested negative, 29 not tested, 79 known positive. Positivity yield = 57% (320/560). Provider and client related challenges were addressed with the following key interventions: implemented were: Peer pairing approach using experienced counselors and hand holding mentorship; Training facility based volunteers and healthcare workers in Index Testing; Setting up network of counselors to reach contacts not in the same catchment as the index clients; Improving appointment system: After hours, week-ends and men’s clinics; Ensuring correct, complete and consistent documentation in all registers. As in several other literatures, our study findings show that following appropriate interventions addressing barriers to index testing, the testing positivity rate improved from 20% to 57%.
Barriers to Optimal Index Testing for Improved HIV Positivity Yield in Lusaka Urban District of Zambia
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Evaluation of the Preparedness and Responses for Medical Emergencies in Edo StateAuthor: Charles Omheaka OkpereDOI: 10.21522/TIJPH.2013.13.04.Art029
Evaluation of the Preparedness and Responses for Medical Emergencies in Edo State
Abstract:
This article helps evaluate the preparedness and response to medical emergencies within the Edo State healthcare system. Having a functional emergency medical response could reduce deaths in low and middle-income countries by about 25%. This entails efficient pre-hospital care, functional ambulance services, a prompt and designated emergency call centre and number, trained first responders, efficient transportation to a ready healthcare facility, and more. This study was conducted in the three senatorial regions of Edo State. The study design was cross-sectional, with data collected via a semi-structured questionnaire. Five hundred and twenty-four people were sampled in the research, and the analysis was conducted using SPSS software. The research revealed that three-quarters of the participants have no available call centre and/or call number in their location. More than four-fifths of the respondents reported having no ambulance services and no available Automated External Defibrillators (AEDs) in their localities. Two-thirds of the participants are unable to carry out CPR, and only about one–fourth had training in CPR in the last two years. To have an effective preparedness and prompt response to medical emergencies, the following are recommended: 1. The government needs to set up a functional emergency response centre in every Local Government Area. 2. The government should provide functional ambulance vehicles and position them in strategic locations across the state. 3. The training of the first responders should be prioritized to shorten response time.
Evaluation of the Preparedness and Responses for Medical Emergencies in Edo State
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Decade of Progress: Trends in Key Maternal Health Performance Indicators in The GambiaAuthor: Joy MichaelDOI: 10.21522/TIJPH.2013.13.04.Art030
Decade of Progress: Trends in Key Maternal Health Performance Indicators in The Gambia
Abstract:
Maternal health remains a pressing public health challenge in The Gambia, where maternal mortality rates have historically exceeded 300 deaths per 100,000 live births. Despite national efforts and global partnerships aligned with Sustainable Development Goal (SDG) 3.1, which aims to reduce maternal mortality to below 70 per 100,000 live births by 2030, significant disparities persist. This study, Decade of Progress: Trends in Key Maternal Health Performance Indicators in The Gambia, evaluates the effectiveness of community-based maternal health interventions implemented between 2010 and 2020. Employing a retrospective quasi-experimental design and secondary data analysis, the study focuses on eight key regions—Banjul, Kanifing, Brikama, Mansakonko, Kerewan, Kuntaur, Janjanbureh, and Basse—selected for their diverse socioeconomic profiles and disparities in healthcare access. Quantitative data were supplemented with qualitative insights from structured questionnaires and hospital interviews. Findings reveal substantial improvements in maternal health indicators. Health facility births increased across all ethnic groups. Skilled birth attendance rose from 57% to 84%, traditional birth attendant involvement declined sharply from 26.96% to 6.73%, reflecting a shift toward professionalized care but postnatal care coverage improved. These trends suggest that the deployment of community health workers and traditional birth attendant training, have contributed to improved maternal health outcomes, although disparities still persist. This study provides actionable insights for policymakers, healthcare providers, and researchers, emphasizing the need for inclusive strategies and data-driven planning to reduce maternal mortality further and enhance maternal care in The Gambia.
Decade of Progress: Trends in Key Maternal Health Performance Indicators in The Gambia
References:
[1]. Elemuwa, C., Nwosu, I., & Gimba, J., 2024, Community dialogue and maternal health outcomes in Nigeria. Community Dialogue Review, 7(3), 41–58.
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[3]. Okeke, C., Ezenwaka, U., Ekenna, A., Onyedinma, C., & Onwujekwe, O., 2023, Analysing the progress in service delivery towards achieving universal health coverage in Nigeria: A scoping review. BMC Health Services Research, 23(1), 1094.
[4]. Mordecai, O., 2023, A Ten-Year Retrospective Study Evaluating the Effectiveness of the Maternal New-born and Child Health Weeks Intervention among Pregnant Women in Nigeria, 3(1), 17–30. https://www.researchgate.net/publication/373949175
[5]. Mordecai, O., & Jeremiah, G. O., 2023, The Impact of Poverty on Under 5 Children in Rural Communities of the West African Region Alliance for Sustainable Development, 12, 645. https://www.researchgate.net/publication/374255751
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[9]. Idoko, P., Anyanwu, M. O., & Bass, S. A., 2017, A retrospective analysis of trends in maternal mortality in a Gambian tertiary health centre. BMC Research Notes, 10(1), 493. https://doi.org/10.1186/s13104-017-2817-0
[10]. Camara., B., Oluwalana, C., Miyahara., R., Lush, A., Kampmann, B., Manneh., K., Okomo, U., D'Alessandro, U., & Roca, A., 2021, Stillbirths, neonatal morbidity, and mortality in health-facility deliveries in urban Gambia. Frontiers in Pediatrics, 9, 579922. https://doi.org/10.3389/fped.2021.579922
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[14]. The Gambia Bureau of Statistics (GBOS) and ICF International, 2014, The Gambia Demographic and Health Survey 2013. Banjul, The Gambia, and Rockville, Maryland, USA: GBOS and ICF International. Available at: http://dhsprogram.com/pubs/pdf/FR289/FR289.pdf
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[16]. Ferguson., L., Hasan, R., Boudreaux, C., Thomas, H., Jallow, M., Fink, G., & Project Implementation Committee (PIC), 2020, Results-based financing to increase uptake of skilled delivery services in The Gambia: using the 'three delays' model to interpret midline evaluation findings. BMC Pregnancy and Childbirth, 20(1), 712. https://doi.org/10.1186/s12884-020-03387-9
[17]. Amouzou., A., Leslie, H. H., & Ram, M., 2019, Advances in the measurement of coverage for RMNCH and nutrition: From contact to effective coverage. BMJ Global Health, 4, i114–i124. doi:10.1136/bmjgh-2018-001297
[18]. Sayinzoga., F., Bijlmakers, L., van Dillen, J., Mivumbi, V., Ngabo, F., & van der Velden, K., 2016, Maternal death audit in Rwanda 2009–2013: A nationwide facility-based retrospective cohort study. BMJ Open, 6, e009734. 10.1136/bmjopen-2015-009734
[19]. Blencowe, H., Cousens, S., Jassir, F. B., Say, L., Chou, D., Mathers, C., Hogan, D., Shiekh, S., Qureshi, Z. U., You, D., & Lawn, J. E., 2016, Stillbirth Epidemiology Investigator Group. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: A systematic analysis. Lancet Global Health, 4(2), e98-e108. doi: 10.1016/S2214-109X(15)00275-2.
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[21]. Mehari, M. A., Maeruf, H., Robles, C. C., Woldemariam, S., Adhena, T., Mulugeta, M., Haftu, A., Hagose, H., & Kumsa, H., 2020, Advanced maternal age pregnancy and its adverse obstetrical and perinatal outcomes in Ayder comprehensive specialized hospital, Northern Ethiopia, 2017: A comparative cross-sectional study. BMC Pregnancy Childbirth, 20(1), 60. doi: 10.1186/s12884-020-2740-6.
[22]. Andersen, R., & Newman, J. F., 2005, Societal and Individual Determinants of Medical Care Utilization in the United States. Milbank Q., 83(4), 10.1111/j.1468-0009.2005.00428.x.
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Exploring Sociocultural and Familial Dimensions of Postnatal Depression in Southwestern Nigeria: A Mixed-Methods PerspectiveAuthor: Adeola Oluwatobi AminuDOI: 10.21522/TIJPH.2013.13.04.Art031
Exploring Sociocultural and Familial Dimensions of Postnatal Depression in Southwestern Nigeria: A Mixed-Methods Perspective
Abstract:
Postnatal depression (PND) has emerged as a significant public health issue, affecting individual health, family cohesion, and child development. This study investigated the societal and familial dimensions of postpartum depression among parents in Southwestern Nigeria through a mixed-methods approach. Quantitative data were collected from 200 respondents (113 women and 87 men) using stratified random sampling, while qualitative insights were derived from 8 focus group discussions, 4 for men and 4 for women. The Edinburgh Postnatal Depression Scale (EPDS) was utilised for screening, and thematic analysis guided the qualitative interpretation. Quantitative findings revealed that 29.6% of participants met the criteria for probable depression with a higher frequency in females (34.5%) than in males (24.1%). The qualitative findings revealed four primary themes: cultural stigma and emotional silence, maternal guilt and unrealistic expectations, family-role conflict, and inadequate social support. The integration of data indicated that patriarchal norms, gendered expectations, and insufficient mental health literacy intensify vulnerability to depression. The study shows that gender-sensitivity and family-centred interventions are essential for the prompt recognition and treatment of postpartum depression within Nigeria's postnatal care system.
Exploring Sociocultural and Familial Dimensions of Postnatal Depression in Southwestern Nigeria: A Mixed-Methods Perspective
References:
[1]. Fisher, J., Cabral de Mello, M., Patel, V., Rahman, A., Tran, T., Holton, S., and Holmes, W., 2012, The global prevalence of perinatal depression: A systematic review. Bulletin of the World Health Organization, 90(2), 139–149.
[2]. Dadi, A. F., Akalu, T. Y., Baraki, A. G., and Wolde, H. F., 2020, Epidemiology of postnatal depression and its associated factors in Africa: A systematic review and meta-analysis. PLoS ONE, 15(4), e0231940.
[3]. World Health Organization, 2022, Mental Health Gap Action Programme: Maternal and Perinatal Guidelines. Geneva: WHO.
[4]. Shorey, S., Chee, C. Y. I., Ng, E. D., Chan, Y. H., Tam, W. W. S., and Chong, Y. S., 2018, Prevalence and incidence of paternal perinatal depression: A systematic review and meta-analysis. Journal of Affective Disorders, 235, 75–84.
[5]. Gelaye, B., Rondon, M. B., Araya, R., and Williams, M. A., 2016, Epidemiology of maternal depression, risk factors, and child outcomes in low-income and middle-income countries. Current Opinion in Psychiatry, 29(5), 372–379.
[6]. Hyde, J. S., and Mezulis, A. H., 2020, Gender differences in depression: Biological, cognitive, and sociocultural factors. Current Opinion in Psychology, 32, 17–22.
[7]. Odufuwa, B., Adebayo, A., and Alade, M., 2022, Socio-cultural beliefs and stigma surrounding mental illness in Nigeria. African Journal of Social Sciences, 13(2), 45–57.
[8]. Esan, O., Esan, A., Adeoye, A., and Amoo, G., 2022, Perinatal mental-health services in Nigeria: Current status and challenges. Nigerian Journal of Clinical Practice, 25(8), 1025–1032.
[9]. Paulson, J. F., and Bazemore, S. D., 2010, Prenatal and postpartum depression in fathers and its association with maternal depression: A meta-analysis. Journal of the American Medical Association (JAMA), 303(19), 1961–1969.
[10]. Oppong, S., 2023, Paternal postpartum depression in Africa: A systematic review. BMC Public Health, 23, 459.
[11]. Connell, R., 2021, Gender. Cambridge: Polity Press.
[12]. Cox, J. L., Holden, J. M., and Sagovsky, R., 1987, Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782–786.
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[14]. Duko, B., Ayano, G., and Bedaso, A., 2020, Postpartum depression among Ethiopian mothers: A systematic review and meta-analysis. BMC Pregnancy and Childbirth, 20, 290.
[15]. Were, F. N., Bukusi, D., Wambui, E., and Mwangi, P., 2021, Prevalence and correlates of postpartum depression in Kenya: A cross-sectional study. BMC Public Health, 21, 1612.
[16]. Moulds, M. L., Cheung, M. S. P., and Wong, Q. J. J., 2022, Postpartum depression and cognitive bias in parents: A meta-analytic review. Clinical Psychological Science, 10(2), 355–369.
[17]. Adewuyi, E. O., Akinloye, O. A., Musa, T. H., 2023, Sociodemographic and health predictors of postpartum depression among Nigerian women: A cross-sectional analysis. Int J Ment Health Syst, 17:65.
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Applying the Health Belief Model to COVID-19 Vaccine Hesitancy Among Health Care Workers in Nigeria: A Comparative StudyAuthor: Sotimehin OladipoDOI: 10.21522/TIJPH.2013.13.04.Art032
Applying the Health Belief Model to COVID-19 Vaccine Hesitancy Among Health Care Workers in Nigeria: A Comparative Study
Abstract:
Though health care workers (HCW) are central to the COVID-19 pandemic response, they face a higher risk of infection in the course of their duties, and vaccine hesitancy exists among them. This study aimed to compare the barriers and drivers of hesitancy among medical doctors with other HCWs to COVID-19 vaccination in two health facilities in Abuja, Nigeria (April-May 2022), with a view to designing interventions to mitigate the problem. A cross-sectional study was undertaken using a self-administered questionnaire for data collection. 316 HCPs completed the questionnaire, comprising 49.7% doctors and 50.3% other HCWs. Descriptive and inferential statistics were applied in the analysis. Among the hesitant HCWs, more doctors were unwilling to receive the COVID-19 vaccine though the finding was not statistically significant nor was the proportion of the two groups who received COVID-19 vaccination. However, other HCWs (22%) believed that their chances of serious complications and hospitalization if they contracted COVID-19 were higher than those of doctors (8.3%), and the difference was statistically significant (χ2=11.609, p=0.003). Some of the perceived barriers in both groups included uncertainty of the safety and efficacy of the vaccines, perceived absence of scientific assurances, religious belief and lack of trust in the government. HCWs’ confidence plays a critical role in patient vaccination behaviour. Therefore, it is highly recommended to implement effective awareness campaigns, educational initiatives, and continuous medical training for healthcare workers, supported by strong leadership endorsement. Additionally, policymakers should avoid adopting a one-size-fits-all communication approach to better address the specific needs and barriers among frontline providers.
Applying the Health Belief Model to COVID-19 Vaccine Hesitancy Among Health Care Workers in Nigeria: A Comparative Study
References:
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[3]. Eze, U. A., Ndoh, K. I., Ibisola, B. A., Onwuliri, C. D., Osiyemi, A., Ude, N. Abdullahi, A., 2021, November 22. Determinants for Acceptance of COVID-19 Vaccine in Nigeria. Cureus 13(11): e19801. DOI 10.7759/cureus.19801
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[6]. Yurttas, B., Poyraz, B. C., Sut, N., Ozdede, A., Oztas, M., Uğurlu, S., Tabak, F., Hamuryudan, V., & Seyahi, E., 2021. Willingness to get the COVID-19 vaccine among patients with rheumatic diseases, healthcare workers and general population in Turkey: a web-based survey. Rheumatology International, 41(6), 1105–1114. https://doi.org/10.1007/s00296-021-04841- 3
[7]. Dror, A. A., Eisenbach, N., Taiber, S., Morozov, N. G., Mizrachi, M., Zigron, A., Srouji, S., & Sela, E., 2020. Vaccine hesitancy: the next challenge in the fight against COVID-19. European Journal of Epidemiology, 35(8), 775–779. https://doi.org/10.1007/s10654-020-00671-y
[8]. Troiano, G., & Nardi, A., 2021, Vaccine hesitancy in the era of COVID-19. Public health, 194, 245-251.
[9]. Marzo, R. R., Chen, H. W. J., Abid, K., Chauhan, S., Kaggwa, M. M., Essar, M. Y., Jayaram, J., Changmai, M. C., Wahab, M. K. b. A., Arin, IAB, Alwi, MNBM, Head, MG and Lin, Y., 2022, Adapted digital health literacy and health information seeking behavior among lower income groups in Malaysia during the COVID-19 pandemic. Front. Public Health 10:998272. doi: 10.3389/fpubh.2022.998272
[10]. Marzo, R. R., Ahmad, A., Abid, K., Khatiwada, A. P., Ahmed, A., Kyaw, T. M., & Shrestha, S., 2022, Factors influencing the acceptability of COVID-19 vaccination: a cross-sectional study from Malaysia. Vacunas (English Edition), 23, S33-S40.
[11]. Brackstone, K., Marzo, R. R., Bahari, R., Head, M. G., Patalinghug, M. E., & Su, T. T., 2022, COVID-19 vaccine hesitancy and confidence in the Philippines and Malaysia: a cross-sectional study of sociodemographic factors and digital health literacy. PLOS global public health, 2(10), e0000742
[12]. Alsubaie, S. S., Gosadi, I. M., Alsaadi, B. M., Albacker, N. B., Bawazir, M. A., Bin-Daud, N., & Alzamil, F. A., 2019, Vaccine hesitancy among Saudi parents and its determinants: Result from the WHO SAGE working group on vaccine hesitancy survey tool. Saudi medical journal, 40(12), 1242.
[13]. Crawshaw, A. F., Deal, A., Rustage, K., Forster, A. S., Campos-Matos, I., Vandrevala, T., Hargreaves, S., 2021, What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination among migrants? Journal of Travel Medicine, 28(4). doi: 10.1093/jtm/taab048
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[16]. Youssef, D., Abou-Abbas, L., Berry, A., Youssef, J., & Hassan, H., 2022, Determinants of acceptance of Coronavirus disease-2019 (COVID-19) vaccine among Lebanese health care workers using health belief model. PLOS ONE, 17(2), e0264128. Retrieved from https://doi.org/10.1371/journal.pone.0264128
[17]. Mahmud, I., Kabir, R., Rahman, M. A., Alradie-Mohamed, A., Vinnakota, D., & Al-Mohaimeed, A., 2021, The health belief model predicts intention to receive the covid-19 vaccine in saudi arabia: Results from a cross-sectional survey. Vaccines, 9(8), 864.
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[35]. Adedeji-Adenola, H., Olugbake, O. A., & Adeosun, S. A., 2022, Factors influencing COVID-19 vaccine uptake among adults in Nigeria. PLOS ONE, 17(2), e0264371. https://doi.org/10.1371/journal.pone.0264371
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Predictors of Hesitancy in Childhood Vaccination Uptake Post-Covid-19 in Bayelsa State, NigeriaAuthor: Adelekun, Omobolanle EstherDOI: 10.21522/TIJPH.2013.13.04.Art033
Predictors of Hesitancy in Childhood Vaccination Uptake Post-Covid-19 in Bayelsa State, Nigeria
Abstract:
The COVID-19 pandemic disrupted routine immunization services worldwide, including in Bayelsa State, Nigeria. This study aims to identify the predictors of childhood vaccination uptake post-COVID-19 and understand the factors associated with vaccine hesitancy in this region. A cross-sectional study was conducted involving 810 parents and caregivers of children eligible for vaccination in Bayelsa State. Data on demographic characteristics, attitudes towards vaccination, and vaccination uptake were collected using structured questionnaires. Logistic regression analysis was performed to identify significant predictors of vaccine hesitancy. The study found that female participation in child healthcare was significantly higher (78%), with most participants being married (60.2%) and having secondary education (55.1%). Positive attitudes towards childhood immunization were associated with higher vaccination uptake (88.9%). Significant predictors of vaccine hesitancy included self-employment (aOR 1.3), rural residence (aOR 1.8), not believing in mandatory immunization (aOR 5.1), not advising other parents to immunize (aOR 4.1), never taking children for scheduled immunizations (aOR 8.4), and not participating in community programs (aOR 3.1). The study highlights the importance of parental education, occupation, area of residence, and attitudes towards immunization in determining childhood vaccination uptake. Targeted interventions addressing these factors, promoting positive attitudes, and enhancing community engagement are essential to improve vaccination rates and reduce vaccine hesitancy in Bayelsa State.
Predictors of Hesitancy in Childhood Vaccination Uptake Post-Covid-19 in Bayelsa State, Nigeria
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Reagent Costs as Primary Drivers of Biochemical and AST Expenses: Challenging Assumptions of Time-Based Laboratory Efficiency: An Example from ZambiaAuthor: Lutinala Nachilembo NalombaDOI: 10.21522/TIJPH.2013.13.04.Art034
Reagent Costs as Primary Drivers of Biochemical and AST Expenses: Challenging Assumptions of Time-Based Laboratory Efficiency: An Example from Zambia
Abstract:
Microbiological testing underpins effective antimicrobial resistance (AMR) surveillance; however, its financial implications remain poorly characterized in resource-limited settings. This study evaluated the time, labor, and cost components of biochemical and antimicrobial susceptibility testing (AST) in Zambia. Between December 2024 and March 2025, data were collected from 13 laboratories across nine provinces using structured questionnaires. Inputs related to labor and time, reagents, and equipment were analysed using the WHO Laboratory Testing Costing Tool (LTCT) and Julius AI, with pricing guided by the Zambia Public Procurement Act. Ethical approval was obtained from the University of Zambia Biomedical Research Ethics Committee (UNZABREC) and the National Health Research Authority (NHRA). A mixed-methods approach was employed to complement quantitative costing with contextual insights. Biochemical tests clustered into two categories based on time requirements: high-intensity tests averaging 78 minutes and rapid tests averaging 13 minutes. Despite this variation, costs ranged from USD 4.25 to 7.99 per test, with rapid tests such as Coagulase being the most expensive due to specialized reagent needs. AST using Mueller Hinton media averaged USD 11.86 per test, with reagents accounting for over 88% of total expenditure. Across all test types, reagent costs dominated, while labor and equipment contributed minimally. Findings reveal a disconnect between test duration and cost, underscoring that efficiency gains are limited primarily by reagent pricing rather than workflow optimization. Strategic procurement, local reagent production, and targeted cost-control measures are essential to sustain affordable microbiological diagnostics in Zambia and similar low-resource settings.
Reagent Costs as Primary Drivers of Biochemical and AST Expenses: Challenging Assumptions of Time-Based Laboratory Efficiency: An Example from Zambia
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Adherence to Anti-hypertensive Medication among Geriatric Hypertensive Patients in Mandeville, JamaicaAuthor: Ainsworth M. ReynoldsDOI: 10.21522/TIJPH.2013.13.04.Art035
Adherence to Anti-hypertensive Medication among Geriatric Hypertensive Patients in Mandeville, Jamaica
Abstract:
This study assesses adherence to hypertensive therapy among geriatric hypertensive patients in Mandeville, Jamaica, in two different clinical settings. A clinic-based cross-sectional survey will be conducted in five comparable Level 5 health centers and at the Mandeville Regional Hospital in Jamaica among geriatric patients aged 65 years and older. Individuals will be selected purposively for both study sites. A Quantitative sample size of 220 participants will be surveyed using a semi-structured self-administered questionnaire. The Hill-Bone Compliance Scale and the Morisky Medication Adherence 8-item Self-Report Scale will be incorporated into the data collection instrument. The Qualitative part of the study will involve 23 participants and employ an interpretivist approach, using in-depth interviews. An interview guide will be used to collect data from participants diagnosed with hypertension for at least five years at the time of the interview and who attend the hypertension clinic at Mandeville Regional Hospital, Jamaica. Data collected from the quantitative analysis will be coded and entered into Microsoft Excel and the Statistical Package for the Social Sciences (SPSS) software, version 21. Thematic analysis, employing an inductive approach, will be applied to the qualitative data analysis. Before the study is conducted, ethical approval will be sought from the Southern Regional Health Authority and the Ministry of Health Ethics Committee for both study sites. The data are expected to reveal the level of adherence to hypertensive therapy among geriatric patients in Mandeville, Jamaica. Based on the findings, recommendations will be made.
Adherence to Anti-hypertensive Medication among Geriatric Hypertensive Patients in Mandeville, Jamaica
References:
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Community-Led Initiatives in Building Resilience to Flooding and Resulting Waterborne Diseases in Africa: A Scoping ReviewAuthor: NKERIFAC Christine AkasingDOI: 10.21522/TIJPH.2013.13.04.Art036
Community-Led Initiatives in Building Resilience to Flooding and Resulting Waterborne Diseases in Africa: A Scoping Review
Abstract:
Flooding ranks among the most frequent natural disasters in Africa often leading to outbreaks of waterborne diseases. This places considerable strain on already vulnerable communities. While top-down disaster management approaches are crucial, African communities have developed innovative strategies to enhance resilience to flooding and its related consequences. This scoping review explores the nature, scope, and effectiveness of community-led initiatives addressing flood resilience and associated waterborne diseases across African settings. Articles, reports, and case studies published between 2010 and 2025 that provided empirical evidence on community-based interventions targeting flooding and waterborne diseases across Africa were reviewed. Findings revealed a wide range of community-led strategies across Africa aimed at building resilience to flooding and mitigating waterborne diseases. Key interventions included community-based early warning systems, flood-resistant infrastructure, participatory water and sanitation management, hygiene education, and localized disease prevention efforts. Communities also leveraged social networks, indigenous knowledge, and decentralized resource management to strengthen preparedness and recovery. These approaches were linked to reduced disease incidence, such as cholera and dysentery, and improved infrastructure resilience. However, implementation was often hindered by limited financial and technical resources, poor coordination with government structures, rapid urban growth, and the escalating impacts of climate change. Community-led initiatives are vital in enhancing resilience to flooding and mitigating the impacts of flooding and waterborne diseases in Africa. Future efforts should focus on scaling and integration of broader resilience strategies for sustainable impact.
Community-Led Initiatives in Building Resilience to Flooding and Resulting Waterborne Diseases in Africa: A Scoping Review
References:
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Quality at the Core: Strengthening Healthcare Delivery in Sub-Saharan Africa through Laboratory Quality Management SystemsAuthor: Adebola AdekoyaDOI: 10.21522/TIJPH.2013.13.04.Art037
Quality at the Core: Strengthening Healthcare Delivery in Sub-Saharan Africa through Laboratory Quality Management Systems
Abstract:
Laboratory Quality Management Systems (LQMS) are pivotal in ensuring accurate, reliable, and timely diagnostic services, which are foundational to effective healthcare delivery. In Sub-Saharan Africa, the role of LQMS has become increasingly critical due to the region's diverse healthcare challenges and resource constraints. This review systematically examines the multifaceted impact of LQMS on healthcare systems within the region, drawing from a broad spectrum of scholarly literature and case studies. Key areas explored include enhancing diagnostic accuracy, improving operational efficiency, and facilitating timely clinical interventions. The review further investigates how LQMS fosters compliance with international quality standards such as ISO 15189 and ISO/IEC 17025, supports laboratory accreditation, and promotes trust among healthcare providers and patients. Additionally, the paper assesses the impact of LQMS on public health outcomes by examining its role in disease surveillance, outbreak response, and health system resilience. Challenges related to LQMS implementation, including infrastructural limitations, workforce capacity, and regulatory inconsistencies, are critically assessed. Moreover, the benefits and limitations of standardization in laboratory practices under LQMS frameworks are discussed, highlighting the importance of metrological traceability and global coordination. Through a structured thematic analysis, this review highlights the importance of strategic investment in quality management infrastructure, stakeholder training, and policy development to fully realize the potential of LQMS in enhancing healthcare delivery across Sub-Saharan Africa.
Quality at the Core: Strengthening Healthcare Delivery in Sub-Saharan Africa through Laboratory Quality Management Systems
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A Roadway to a Mixed Fungal Infection- A Rare Case SeriesAuthor: M. PreethiDOI: 10.21522/TIJPH.2013.13.04.Art038
A Roadway to a Mixed Fungal Infection- A Rare Case Series
Abstract:
Fungal infections of the nose and paranasal sinuses can be categorized into invasive and non-invasive forms. The clinical presentation and course of the disease is primarily determined by the immune status of the host and can range from harmless or subtle presentations to life threatening complications. Immunocompromised patients with poorly controlled diabetes mellitus, HIV and patients receiving chemotherapy or chronic oral corticosteroids are mostly affected In our first case A 54 years male came with complaint of nasal blockage for 3 months , UTI , headache and heaviness of head for 4 months. microscopically necrotic tissue with fungal colonies along with mixed inflammatory cell composed of neutrophilis and lymphocytes seen and silver stain both mucormycosis and aspergillosis fungal organism. A 58 years female came with complaint of nasal pain for 3 months, nasal block , headache, sneezing and heaviness of head for 4 months,right ear pain for 10years associated with tinnitus. microscopically section shows necrotic tissue with fungal colonies along with mixed inflammatory cell infiltrate composed of eosinophilis and lymphocytes and silver stain conforms the presence of both mucormycosis and aspergillosis fungal organism. Case 3 A 48 years male came with complaint of nasal blockage for 3 months. history of upper respiratory tract infection, headache and heaviness of head for 2 months. microscopically section shows necrotic tissue with fungal colonies along with mixed inflammatory cell infiltrate composed of eosinophilis and lymphocytes and silver stain conforms the presence of both mucormycosis and aspergillosis fungal organism in the slide.
A Roadway to a Mixed Fungal Infection- A Rare Case Series
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Angiolymphoid Hyperplasia with Eosinophilia in a Male Patient: A Case ReportAuthor: Duvvuru Pooja ReddyDOI: 10.21522/TIJPH.2013.13.04.Art039
Angiolymphoid Hyperplasia with Eosinophilia in a Male Patient: A Case Report
Abstract:
Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, vascular tumor that often creates diagnostic challenges because of its multiple possible presentations. This case report details a 34-year-old male who has had multiple itchy nodular lesions on his chin for three years while also dealing with diabetes. Histopathological analysis showed ALHE, with vascular proliferation and eosinophilic and lymphocytic infiltration. A surgical procedure was successful when followed by split-skin grafting. Diagnosis accuracy and surgical treatment effectiveness for ALHE become vital for Asian male patients because of their higher risk of developing this condition. Additional research is needed to create optimal treatment approaches.
Angiolymphoid Hyperplasia with Eosinophilia in a Male Patient: A Case Report
References:
[1]. Brahs, A., Sledge, B., Mullen, H., Newman, A., Mengesha, Y., & Estrada, S., 2021. Angiolymphoid Hyperplasia with Eosinophilia: Many Syllables, Many Unanswered Questions. The Journal of clinical and aesthetic dermatology, 14(6), 49–54.
[2]. Adler, B. L., Krausz, A. E., Minuti, A., Silverberg, J. I., & Lev-Tov, H., 2016. Epidemiology and treatment of angiolymphoid hyperplasia with eosinophilia (ALHE): A systematic review. Journal of the American Academy of Dermatology, 74(3), 506–12.e11. https://doi.org/10.1016/j.jaad.2015.10.011
[3]. Taylor, S. K., Meyerle, J. H., Glusac, E. J., 2008, Angiolymphoid Hyperplasia with Eosinophilia (eMedicine Website). December 11, 2008. http://emedicine.medscape.com/article/1082603-overview
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[6]. Al-Muharraqi, M. A., Faqi, M. K., Uddin, F., Ladak, K., & Darwish, A., 2011. Angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma) of the face: An unusual presentation. International journal of surgery case reports, 2(8), 258–260. https://doi.org/10.1016/j.ijscr.2011.03.007
[7]. Li, E., Sinard, J., Distefano, A., & Sohrab, M. 2020. Angiolymphoid Hyperplasia with Eosinophilia with Clinical Presentation Concerning for Juvenile Temporal Arteritis. Ocular oncology and pathology, 6(1), 25–30. https://doi.org/10.1159/000500361
[8]. Zarrin-Khameh, N., Spoden, J. E., & Tran, R. M., 2005. Angiolymphoid hyperplasia with eosinophilia associated with pregnancy: a case report and review of the literature. Archives of pathology & laboratory medicine, 129(9), 1168–1171. https://doi.org/10.5858/2005-129-1168-AHWEAW
[9]. Zaraa, I., Mlika, M., Chouk, S., Chelly, I., Mokni, M., Zitouna, M., & Osman, A. B., 2011. Angiolymphoid hyperplasia with eosinophilia: a study of 7 cases. Dermatology online journal, 17(2), 1.
[10]. Atiq, A., Raza, M., Ud Din, N., 2025, Angiolymphoid hyperplasia with eosinophilia. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodesangiolymphoidhyperplasiawitheosinophili.html. Accessed April 1st, 2025.
[11]. Hasan, U., Ahmed, N., Malik, T., et al., June 05, 2023, A Rare Case of Angiolymphoid Hyperplasia with Eosinophilia with a New Effective Treatment. Cureus 15(6): e39966. Doi:10.7759/cureus . 39966.
[12]. Youssef, A., Hasan, A. R., Youssef, Y., Al-Soufi, L., Elshimali, Y., & Alshehabi, Z., 2018, Angiolymphoid hyperplasia with eosinophilia: a case report. Journal of medical case reports, 12(1), 89. https://doi.org/10.1186/s13256-018-1599-x
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Roadway to A Rare Hemolytic Anemia - A Case Series of Cooley’s AnemiaAuthor: M. PreethiDOI: 10.21522/TIJPH.2013.13.04.Art040
Roadway to A Rare Hemolytic Anemia - A Case Series of Cooley’s Anemia
Abstract:
Thalassemia is a hemolytic anemia resulting from an inherited autosomal recessive genetic disorder. It is characterized by reduced hemoglobin synthesis due to defective production of either the alpha or beta globin chains. In our case report, we have discussed 3 case reports with exact similarity. All 3 cases were 5-year-old sex presented to the outpatient pediatric department at Sree Balaji Medical College and Hospital with complaints of cough, cold, dyspnea, irritability, and fatigue. On examination, the patient exhibited scleral pallor and a whitish tinge over the fingernails and extremities. There was evidence of a decayed upper tooth, though it was not associated with pain or swelling. Head and neck examination revealed maxillary prominence, a retracted upper lip, and a saddle nose, collectively giving the classical appearance of "chipmunk facies." The patient’s hemoglobin level was critically low at 3.5 g/dL. Hematological investigations showed microcytic hypochromic anemia with anisopoikilocytosis and nucleated red blood cells (RBCs). Peripheral smear findings were consistent with hemolytic anemia, strongly suggesting thalassemia with concurrent hemolytic crisis.
Roadway to A Rare Hemolytic Anemia - A Case Series of Cooley’s Anemia
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