Abstract:

AIDS is a pandemic. Over 90% of HIV infections in children less than 15 years are as a result of Mother‐to‐child transmission (MTCT) and more than 90% of MTCT occur in sub-Saharan Africa. Several strategies have been developed to reduce HIV infections in children, with variable successes. We aimed to understand factors influencing the infant HIV positivity at the operational level of the Cameroonian health system.

We carried out a prospective and descriptive study that lasted one year. We followed mother-baby (Zero to 18months) pairs enrolled in PMTCT program in Biyem-Assi and Efoulan district hospitals. We addressed questionnaire and structured interviews to mothers and their caregivers to answer research questions. Data were recorded on excel, and analyzed using SPSS version 23. The Chi square was used to analyze the effect of the level of the education, marital status of the mother on the seropositivity of the exposed child.

We recruited 113 HIV exposed children out of which 111 (98.23%) had early infant diagnosis. 7 over 111 children (6.30%) were tested positive, and most of them had low socio-economic situation. We found an association between the sites of the PCR analysis with the sero-status of the HIV- exposed child.

EID is acceptable in these two health facilities and seropositivity of the child is found mostly among women with low socio-economic status (jobless). Better strategies should increase the family sensitization during perinatal period, to reduce the related cost of EID, and the long waiting time.

Keywords: MTCT, District Hospital, Factors, HIV.

References:

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Abstract:

Background: In Zambia, diarrhea is one of the commonest diseases that affect under five children. It represents 12% of all causes of under-five mortality; and only 60% of children with diarrhea received oral rehydration treatment in 2012.

Objective: To assess if training of community health workers and establishment of women’s support groups will enhance the use of zinc sulphate as adjuvant therapy for childhood diarrheal diseases and decrease child mortality in underserved areas. We therefore conducted a literature review of published clinical trials that were conducted in developing countries.

Search methods: We searched Medline through PubMed database and COCHRANE CRCT database. Our main focus was to identify literatures reporting on the effectiveness of oral zinc in reducing duration and severity of childhood diarrheal episodes; literatures published in developing countries, in English and French languages. We restricted our search to clinical trials. There was no time limit attached to our search.

Main results: After literature screening, 112 articles were excluded for not being clinical trials whilst 24 did not meet the main focus of our study. Only 28 articles were selected. Analysis reported a wide variety of diarrheal-related outcomes depending on number of considerations.

conclusion: Zinc supplementation in children reduces duration and/or severity of diarrheal episodes hence decreases child mortality.

Keywords: “diarrhea”, “child”, “zinc” and “therapeutic use”.

References:

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[2].    Alam DS, Yunus M, El Arifeen S, Chowdury HR, Larson CP, Sack DA, et al. Zinc treatment for 5 or 10 days is equally efficacious in preventing diarrhea in the subsequent 3 months among Bangladeshi children. J Nutr. 2011 Feb;141(2):312-5.

[3].    Bhandari N, Bahl R, Taneja S, Strand T, Molbak K, Ulvik RJ, et al. Substantial reduction in severe diarrheal morbidity by daily zinc supplementation in young north Indian children. Pediatrics. 2002 Jun ;109(6) : e86.

[4].    Bhandari N, Mazumder S, Taneja S, Dube B, Agarwal RC, Mahalanabis D, et al. Effectiveness of zinc supplementation plus oral rehydration salts compared with oral rehydration salts alone as a treatment for acute diarrhea in a primary care setting: a cluster randomized trial Pediatrics. 2008 May;121(5): e1279-85.

[5].    Bhavnagar S, Bahl R, Sharma PK, Kumar GT, Saxena SK, Bhan MK. Zinc with oral rehydration therapy reduces stool output and duration of diarrhea in hospitalized children: a randomized controlled trial. J Pediatr Gastroenterol Nutr. 2004 Jan;38(1):34-40.

[6].    Bhutta ZA, Nizami SQ, Isani Z. Zinc supplementation in malnourished children with persistent diarrhea in Pakistan. Pediatrics. 1999 Apr;103(4): e42.

[7].    Central Statistical Office MoH, Tropical Diseases Research centre, University of Zambia. Zambia Demographic and Health Survey 2007. Lusaka 2013-14. Available from: countryoffice.unfpa.org/Zambia/drive/2007_zdhs_final_report.pdf.

[8].    CDC. Global Diarrhea Burden. Atlanta, USA2013 [15 March 2015]; Available from: www.cdc.gov/healthywater/global/diarrhea-burden.html

[9].    Dalgic N, Sancar M, Bayraktar B, Pullu M, Hasim O. Probiotic, zinc and lactose-free formula in children with rotavirus diarrhea: are they effective? Pediatr Int. 2011 Oct;53(5):677-82.

[10].Fischer Walker, C.L., and R.E. Black: Zinc for the Treatment of Diarrhoea: Effect on diarrhoea morbidity, mortality and incidence of future episodes’, International Journal of Epidemiology, vol. 39, 2010, pp. i63–i69.

[11].Feikin DR, Bigogo G, Audi A, Pals SL, Aol G, Mbakaya C, et al. Village-randomized clinical trial of home distribution of zinc for treatment of childhood diarrhea in rural Western Kenya. PLoS One. 2014;9(5): e94436.

[12].Fischer Walker CL1 BR, Baqui AH. Does age affect the response to zinc therapy for diarrhoea in Bangladeshi infants? J Health Popul Nutr. 2008 Mar;26(1):105-9.

[13].Faruque AS, Mahalanabis D, Haque SS, Fuchs GJ, Habte D. Double-blind, randomized, controlled trial of zinc or vitamin A supplementation in young children with acute diarrhoea. Acta Paediatr. 1999 Feb;88(2):154-60.

[14].Gupta DN, Rajendran K, Mondal SK, Ghosh S, Bhattacharya SK. Operational feasibility of implementing community-based zinc supplementation: impact on childhood diarrheal morbidity. Paediatr Infect Dis J. 2007 Apr;26(4):306-10.

[15].Gupta DN, Mondal SK, Ghosh S, Rajendran K, Sur D, Manna B. Impact of zinc supplementation on diarrhoeal morbidity in rural children of West Bengal, India. Acta Paediatr. 2003 May;92(5):531-6.

[16].Khatun UH MM, Black RE, Sarkar NR, Wahed MA, Fuchs G, Roy SK. A randomized controlled clinical trial of zinc, vitamin A or both in undernourished children with persistent diarrhea in Bangladesh. Acta Paediatr. 2001 Apr;90(4):376-80.

[17].Khan WU, Sellen DW. Zinc supplementation in the management of diarrhoea. Geneva: World Health Organization; 2011 [31 March 2015]; Available from: http://www.who.int/elena/titles/bbc/zinc_diarrhoea/en/.

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Abstract:

Hypertension and overweight/obesity prevalence are associated with high rates of morbidity and mortality which has become a vital public health concern worldwide. Among many studies conducted on hypertension prevalence, there is paucity of data on this subject among workers in the hospital environment. This study thus centered on determining the prevalence of hypertension among non-teaching staff of the College of Medicine, University of Ibadan (CoMUI).

A sum of 315 non-teaching staff of CoMUI on the University College Hospital premises participated in the survey. Blood Pressure (BP) was determined as specified in the ESH/WHO guidelines. BMI was assessed using a known-weight standardized weighing scale and heightometer. Data were analyzed using SPSS. Descriptive statistics, Chi-square and logistic regression were considered.

Hypertension prevalence among respondents was 25.4% (68.8% male; 31.3% female). For the male respondents, the mean SBP was 132.2±19.0mmHg and it was significantly higher than that of the females 124.5±17.8mmHg (t = 3.63, p<0.05). Also, the mean DBP of the male respondents (86.04±11.19) was significantly higher than females (80.95±11.62), t = 3.92, p <0.05. Prevalence of overweight and obesity was 33.1% and 20.3%. Age group of 21-30 years and 31-40years are three times and two times less likely to develop hypertension than those within the age group of 51-60 years (O. R=0.361(3x) and 0.467(2x); 95% CI=0.137-0.951 and 0.219-0.995) see table 6.0.

Prevalence of 25.2% indicated that one quarter of the non-teaching staffs of College of Medicine working within the University College Hospital are hypertensive. This suggests an urgent intervention to avoid resulting complications.

Keywords: Hypertension, Hypertension prevalence, Body Mass Index (BMI), Hospital environment, Obesity, Overweight.

References:

Hypertension and overweight/obesity prevalence are associated with high rates of morbidity and mortality which has become a vital public health concern worldwide. Among many studies conducted on hypertension prevalence, there is paucity of data on this subject among workers in the hospital environment. This study thus centered on determining the prevalence of hypertension among non-teaching staff of the College of Medicine, University of Ibadan (CoMUI).

A sum of 315 non-teaching staff of CoMUI on the University College Hospital premises participated in the survey. Blood Pressure (BP) was determined as specified in the ESH/WHO guidelines. BMI was assessed using a known-weight standardized weighing scale and heightometer. Data were analyzed using SPSS. Descriptive statistics, Chi-square and logistic regression were considered.

Hypertension prevalence among respondents was 25.4% (68.8% male; 31.3% female). For the male respondents, the mean SBP was 132.2±19.0mmHg and it was significantly higher than that of the females 124.5±17.8mmHg (t = 3.63, p<0.05). Also, the mean DBP of the male respondents (86.04±11.19) was significantly higher than females (80.95±11.62), t = 3.92, p <0.05. Prevalence of overweight and obesity was 33.1% and 20.3%. Age group of 21-30 years and 31-40years are three times and two times less likely to develop hypertension than those within the age group of 51-60 years (O. R=0.361(3x) and 0.467(2x); 95% CI=0.137-0.951 and 0.219-0.995) see table 6.0.

Prevalence of 25.2% indicated that one quarter of the non-teaching staffs of College of Medicine working within the University College Hospital are hypertensive. This suggests an urgent intervention to avoid resulting complications.

Keywords: Hypertension, Hypertension prevalence, Body Mass Index (BMI), Hospital environment, Obesity, Overweight.

Abstract:

Background: The proportion of youth involves in cigarette smoking has been escalating in recent years a slight few was known regarding its epidemiology in Rastanura area. The goal of this study was to discover the prevalence of cigarette smoking among adolescents in Rastanura Community, Saudi Arabia.

Method: Primary mode of data collection was used through a well-administered questionnaire to the adolescent both in school and the hospital premises. A school-based cross-sectional workup was conducted during the period of February to October 2018 of which 6 governmental intermediates and high schools’ pupils participated. A total of two hundred and fifty (250) questionnaires was administered. The prevalence of smoking was appraised and statistical analysis was executed including chi-square, frequency, and percentage. The responses from the survey were analyzed using SPSS 20.

Result: The overall feedback rate was 82%,30.2%of the respondent reported having tried smoking 29.9% were male while 4.4% female where 69.8% never smoked. The investigations on the rate of frequency of smoking among adolescents in the study area shown with X2 =317.837, p<0.05.

Conclusion: Findings from our survey show that the level of smoking among male adolescent is higher than their female counterpart. The adolescents in the study area are aware of negative impact of tobacco, but are still addicted to the act despite the knowledge of the danger it portrays. Therefore, parents and guardian should take up the responsibility to reduce their ward’s exposure to tobacco product and excess money that could be used for extravagant spending. Keywords: Adolescent, Feedback, Prevalence, Smoking, Saudi Arabia.

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Abstract:

Objectives: The aim of this study was to investigate and understand the barriers that contribute to successful uptake and implementation of Prevention of Mother to Child Transmission (PMTCT) services for pregnant and breastfeeding mothers at Mulanje Mission Hospital in Malawi.

Methods: A Qualitative study was conducted with data collected through in-depth interviews and focus group discussions. A total of 64 participants were interviewed.

Results: The main barriers to uptake and implementation of PMTCT services were stigma and discrimination against those infected with HIV, traditional and religious beliefs, long waiting time at PMTCT clinic, lack of male involvement, opposition from male partner leading to divorce and gender-based violence and lack of privacy due to non-conducive infrastructure.

Conclusion: In order to promote successful uptake and implementation of PMTCT service, male involvement in reproductive issues has to be enhanced by raising community awareness. In addition, HIV testing and counseling should also be an agenda of community awareness so that women should not wait to be pregnant and then go for testing. Issues of stigma and discrimination should be dealt with during campaign and community meeting with chiefs. Staffing in health facilities should be improved to minimize the waiting time and also improve the quality of care given.

References:

[1].Ahimbisibwe, A., Katirayi, L., Namadingo, H., et al. Acceptability of long-life treatment (Option B+) among HIV positive pregnant and lactating women in selected sites in Malawi. (20^th International AIDS conference Melbourne, Australia, July 2014).

[2].Alemayehu, M., A., Aregay, M., et al (2014). HIV Disclosure to sexual partner and associated factors among women attending ART clinic at Mekelle hospital, Northern Ethiopia. BMC Public Health 14(1):746.

[3].Bwirire, L.D., Fitzgerald, M., Zachariah, R., Chikafa, V., et al. Reasons for loss to follow-up among registered in a prevention –of-mother-to-child transmission program in rural Malawi. Transactions of the Royal Society of Tropical Medicine and Hygiene 2008; 102 (12): 115-120.

[4].Dahlui, M., Azahar, N., Bulgida, A., et al. HIV related Stigma and Discrimination against People Living with HIV/AIDS in Nigerian population 2015. https://doi.org/10.1371/journal.pone.0143749

[5].Malawi Demographic Health Survey 2015-2016 and ICF Macro. Zomba, Malawi and Calverton, Maryland, USA.

[6].Mbokane, A., Ehlers, V., Roos, J. Emotional and disclosure experiences of South African HIV positive women using PMTCT of HIV services. ARC Journal of Public Health and Community Medicine 2016:1 (1):11-17.

[7].Morfaw, F., Mbuagbaw, L., Thaban, L., et al. Male involvement in prevention programs of mother to child transmission of HIV: a systematic review to identify barriers and facilitators 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599633

[8].National AIDS Commission 2014. National HIV Prevention Strategy 2015-2020. Lilongwe, Malawi.

[9].Santos, M.L., Kruger, P., Mellors, S.E., et al. An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa: the people living with HIV stigma index. BMC Public Health 2014; 14(80).

[10]. Speight, C., Phiri, S., Hosseinipour, M., Tweya, H., et al. Implementing Option B+ for prevention of mother to child transmission Bwaila Maternity Unit, Lilongwe: the first 18 months; presented at the 7^th IAS Conference on HIV pathogenesis, Treatment and Prevention Kuala Lumpur, Malaysia 2013.

[11]. Tenthani, L., Haas, A. D., Tweya, H., John, A., et al. Retention in care under universal antiretroviral therapy for HIV infected pregnant and breast-feeding women (Option B+) in Malawi. AIDS 2014; 28 (4): 589-598.

[12]. Tweya, H., Gugsa, S., Hosseinipour, M., Speight, C., et al. Understanding Factors, Outcomes and Reasons for loss to follow up among women in Option B+. PMTCT Programme in Lilongwe. Tropical Med Int Health 2014; 19 (11): 1360-1366.

[13]. UNAIDS (2014). Guidance Note: Reduction of HIV related Stigma and Discrimination. Geneva, Switzerland.

[14]. UNAIDS 2016. HIV Prevention among adolescent girls and young women. Putting HIV Prevention among adolescent girls and young women on the fast track and engaging men and boys. Joint United Nations Programme on HIV/AIDS.

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Abstract:

The achievement of creating a healthy environment and life begins with a conscious effort of an individual and then influencing other members of the family, the society and ultimately, the mind-set of the whole country. Efforts from all these parties can help create a conducive environment, free from diseases and comfortable for everybody to live in (Kasenga, 2016).

There was a transition of Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs) in 2015; this has affected the environment of health plans and strategies. In today's globalized world, rapid urbanization, mechanization of the rural economy, and the activities of trans-national food, drink and tobacco corporations are associated with behavioral changes which include less healthy diet, lower physical activity, tobacco smoking and increased alcohol consumption that increase the risk of chronic non-communicable diseases (NCDs). As a result, population health profiles are rapidly changing. Many in low- and middle-income countries (LMIC) are undergoing rapid changes associated with developing high rates of NCD while concomitantly battling high levels of certain communicable diseases, including HIV, TB and malaria. This has population health, health systems and economic implications for these countries. The rationales of the study are; (a) To highlight the different types of communicable and Non-communicable diseases (b) To highlight different strategic Management of these diseases.

Keywords: Communicable diseases, Non-communicable diseases, MDGs, SDGs, LMIC.

References:

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[2].Basiro, D. 9 2016). Public Health Approaches to Infectious diseases. The Open University. Retrieved from: http://www.open.edu/openlearn/ocw/mod/oucontent/view.php?id=8537&printable=1.

[3].Bela, S. & Mathur, P. (2011). Research Priorities for Prevention and Control of Non-Communicable Diseases in India. Indian Journal of Community Medicine, 36 (Suppl1); s72-s77.

[4].Communicable diseases: preparedness, surveillance and response (n.d) Retrieved from: http://www.who.int/countries/moz/areas/communicable_diseases/en/index2.html.

[5].Kasenga, F. H. (2016). Epidemiology of Communicable and Non-Communicable Diseases_ Attributes of Lifestyle and Nature on Humankind. Intech.

[6].Khasnabis C, Heinicke Motsch K., Achu K. et al. (2010). Community-Based Rehabilitation: CBR Guidelines. Geneva: World Health Organization Prevention. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK310943/

[7].Komen, S. G. (2017). The Best way to improve your chances for Survival. Murray C. (2015). Shifting to Sustainable Development Goals—Implications for Global Health. N Eng J Med. pp.1390–3. doi 10.1056/NEJMp1510082.

[8].Nakatani, H. (2016). Global Strategies for the Prevention and Control of Infectious Diseases and Non-Communicable Diseases. Journal of Epidemiology. Elsevier Publishers; 26(4), pp. 171-178. doi: 10.2188/jea.JE201600100.

[9].Raturi, S. (2017). What are Communicable and Non-Communicable Diseases? Quora. Panjab University, Swami Sarvanand. Retrieved from https://www.quora.com/What-are-communicable-and-non-communicable diseases?

[10]. Rayner, M. (2017). Non-Communicable Diseases Prevention Strategies. University of Oxford.

[11]. Unwin, N. & Oni, T. (2015). Why the Communicable and Non-Communicable Diseases Dichotomy is Problematic for the Public Health Control Strategies in an era of Health Transition. Retrieved from International Health, Oxford Journals; 7(6), pp.390-399. Doi 10.10.93/inthealth/ihv040.

[12]. WHO/ Global Action Plan for the Prevention and Control of Non-communicable diseases from 2013-2020 Retrieved from: http://www.who.int/nmh/publications/ncd-action-plan/en/.

Abstract:

Caesarean section is one of the most common and lifesaving surgeries performed in modern obstetrics. In a developing country like Nepal where health care resources are limited, this rising trend definitely has major implication but it is essential to perform when complications arise during pregnancy and labour without this large number of women and their unborn babies die every year, especially in low-income countries. The World Health Organization suggests 10-15% cesarean section rate and has suggested to be done only when justified by a medical condition². It states that, at a population level, if cesarean section rates higher than 10% does not reduce the maternal and neonatal mortality rates, and it should be performed only when medically justified. Otherwise unnecessary health of mother and babies including social and economic implications would challenge childbearing women, babies, their families and the state. Recently in Nepal there is a sharp rising trend of cesarean section rates from 20 to 81% in different hospitals especially in the private setting indicating over-medicalization of childbirth unnecessarily performing without medically justified. This arise the issue of human rights violence of childbearing women and professional integrity of a practitioner and safety of the clients. The World Health Organization recommended use of the Robson criteria which would be one of the best strategies in reducing the frequency of the procedure that should include avoidance of medically unnecessary primary cesarean section and improving case selection for induction and prelabour cesarean section besides educating childbearing women and their families about the consequences of unnecessary request of the procedure.

Keywords: Cesarean section; Rate; World health organization, Violence.

References:

[1].     Amatya A, Paudel R, Poudyal A, Wagle RR, Singh M, et al. (2013) Examining stratified cesarean section rates using Robson classification system at Tribhuvan University Teaching Hospital. J Nepal Health Res Counc 11(25): 255-258.

[2].     Caesarean sections. Postnote No. 184. London: Parliamentary Office of Science and Technology; 2002. Available from: http://www.parliament.uk /post/pn184.pdf.

[3].     C Black, JA Kaye, H Jick. Betrán AP, Ye J, Moller AB, Zhang J, Gülmezoglu AM, et al. (2016) The increasing trend in cesarean Section Rates: Global, Regional and National Estimates: 1990-2014. PLoS ONE 11(2): e0148343.

[4].     Data and sourcesS1 File. First and latest available CS rate data points per country, the year, total number of data points used for this analysis and sources of the data.

[5].     Lamichhane B, Singh A (2014) Changing trend in instrumental vaginal deliveries at Patan Hospital. Nepal J Obstet Gynaecol 20(2): 22-35.

[6].     Lokugamage AU, Pathberiya SDC (2017) Human rights in childbirth, narratives and restorative justice: a review. Rep Health 14: 17.

[7].     Montagu D, Yamey G, Visconti A, Harding A, Yoong J. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data. PLoS One 2011; 6: e17155.

[8].     Ministry of Health (2017) Nepal demographic and health survey 2016. Ministry of Health, Nepal.

[9].     Ministry of Health (2012) Nepal demographic and health survey 2011. Ministry of Health, Nepal.

[10]. Perez DR (2010) Obstetric violence: a new legal term introduced in Venezuela. Int J Gynecol Obstet 111(3): 201-202.

[11]. Parkhurst JO, Rahman SA. Lifesaving or money wasting? Perceptions of caesarean sections among users of services in rural Bangladesh. Health Policy2007; 80: 392-401.

[12]. Pope TM (2017) Legal Briefing: unwanted cesareans and obstetric violence. J Clin Ethics 28(2): 163-173. 33.

[13]. Robson MS (2001) Can we reduce the cesarean section rate? Best Pract Res ClinObstet Gynecol 15(1): 179-194.

[14]. Schantz C, Sim KL, Petit V, Rany H, Goyet S (2016) Factors associated with cesarean sections in Phnom Penh, Cambodia. Rep Health Matters 24(48): 111-121-44.

[15]. The American College of Obstetrics and Gynecology Committee on Obstetric Practice, The Society for Maternal-Fetal Medicine. (2013) Committee Opinion Number 561: Nonmedically Indicated Early-Term Deliveries. Obstet Gynecol 121: 911-915.

[16]. Vogel JP, Betran AP, Vindevoghel N, Souza JP, Torloni MR, et al. (2015) Use of the Robson classification to assess cesarean section trends in 21 countries: a secondary analysis of two WHO multicountry surveys. The Lancet Global Health 3(5): e260-e270.

[17]. World Health Organization. Appropriate technology for birth. Lancet 1985; 2(8452):436-7.

[18]. WHO World Health Organisation (2015) WHO Statement on cesarean section rates.

Abstract:

Background: Multidrug-resistant tuberculosis (MDR-TB) has become a major public health problem and obstacle to global TB control. MDR-TB is associated with higher case fatality rates, especially among HIV-infected patients, and is much more difficult and costlier to treat than drug susceptible TB. Namibia is the country with the fourth highest TB burden in the world. The incidence rate in 2015 was 651/100 000. Multidrug-resistant tuberculosis (MDR-TB) has become a major public health problem, especially in developing countries, where the MDR-TB burden is the highest. In Namibia, among the regions highly affected by MDR-TB, Ohangwena region is facing many challenges. A recent study has demonstrated that the magnitude of the problem by numbers, about 40 per cent of patients admitted to the Katutura State Hospital’s TB unit and 30 per cent of patients who commenced treatment at the Engela District Hospital in the Ohangwena Region are Angolan nationals.

Objectives: To determine geospatial Multidrug-resistant and extensively drug-resistant Tuberculosis Distribution in Angola and Namibia; To investigate the impact of geospatial distribution on Multidrug-resistant and extensively drug-resistant Tuberculosis. Methods: this is a retrospective cohort study that will be performed on all cases of Multidrug-resistant and extensively drug-resistant Tuberculosis with confirmed laboratory test in Engela District Hospital between January 2013 and December 2017. Geospatial data will be used to illustrate all hypotheses.

Conclusion: this study could be crucial on its genre to establish different gaps between Angolan and Namibian in the management of MDR-TB in Engela district hospital.

References:

[1].     Kolifarhood Goodarz, Khorasani-Zavareh Davoud, Salarilak Shaker, Shoghli Alireza, Khosravi Nasim. Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: An implication of Geographical Information Systems in health policy-making in a developing country. 2015;5(3):221-30.

[2].     Lelamobile. Angolans Treated Free of Charge for TB and HIV. In: https://www.lelamobile.com/content/49464/Angolans-Treated-Free-of-Charge-for-TB-and-HIV/. 2015.

[3].     Liu, Y., Li, X., Wang, W., Li, Z., Hou, M., He, Y., Wu, W., Wang, H., Liang, H. and Guo, X., 2012. Investigation of space-time clusters and geospatial hot spots for the occurrence of tuberculosis in Beijing. The International Journal of Tuberculosis and Lung Disease, 16(4), pp.486-491.

[4].     Mavenyengwa RT, Shaduka E, Maposa I. Evaluation of the Xpert(R) MTB/RIF assay and microscopy for the diagnosis of Mycobacterium tuberculosis in Namibia. Infectious diseases of poverty 2017;6(1):13.

[5].     Migliori Giovanni Battista, Dheda Keertan, Centis Rosella, Mwaba Peter, Bates Matthew, O’Grady Justin, et al. Review of multidrug‐resistant and extensively drug‐resistant TB: global perspectives with a focus on sub‐Saharan Africa. 2010;15(9):1052-66.

[6].     Ministry of Health and Social Services (MOHSS). National Tuberculosis and Leprosy Programme Annual Report: 2015-2016. http://www.mhss.gov.na/files/downloads/ed6_NTLPAnnualReport_20170116_Formatted.pdf 2016.

[7].     Moonan Patrick K, Bayona Manuel, Quitugua Teresa N, Oppong Joseph, Dunbar Denise, Jost Kenneth C, et al. Using GIS technology to identify areas of tuberculosis transmission and incidence. International Journal of Health Geographics 2004;3:23.

[8].     New Era. Angolan TB patients flock to Namibia. In: https://www.newera.com.na/2014/04/07/angolan-tb-patients-flock-namibia/. 2014.

[9].     Patterson Benjamin, Morrow Carl D, Kohls Daniel, Deignan Caroline, Ginsburg Samuel, Wood Robin. Mapping sites of high TB transmission risk: Integrating the shared air and social behaviour of TB cases and adolescents in a South African township. 2017; 583:97-103.

[10]. Ricks Philip M, Mavhunga Farai, Modi Surbhi, Indongo Rosalia, Zezai Abbas, Lambert Lauren A, et al. Characteristics of multidrug-resistant tuberculosis in Namibia. 2012;12(1):385.

[11]. Sagwa EL, Ruswa N, Mavhunga F, Rennie T, Leufkens HG, Mantel-Teeuwisse AK. Comparing amikacin and kanamycin-induced hearing loss in multidrug-resistant tuberculosis treatment under programmatic conditions in a Namibian retrospective cohort. BMC pharmacology &amp; toxicology 2015;16:36.

[12]. Sagwa EL, Ruswa N, Mavhunga F, Rennie T, Leufkens HG, Mantel-Teeuwisse AK. Adverse events and patients' perceived health-related quality of life at the end of multidrug-resistant tuberculosis treatment in Namibia. Patient preference and adherence 2016; 10:2369-77.

[13]. World Health Organization. Multidrug and extensively drug-resistant TB (M/XDR-TB):2010 Global Report on Surveillance and Response. In: http://apps.who.int/iris/handle/10665/44286. 2010.

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[15]. Zignol Matteo, Hosseini Mehran S, Wright Abigail, Weezenbeek Catharina Lambregts–van, Nunn Paul, Watt Catherine J, et al. Global incidence of multidrug-resistant tuberculosis. 2006;194(4):479-85.

[16]. Zvavamwe Simbisayi, Ehlers Valerie J. Implementing a community-based tuberculosis programme in the Omaheke region of Namibia: nurses' perceived challenges. 2008;13(3):54-68.

Abstract:

The study conducted in Sebei sub- region, Eastern Uganda aimed at assessing the risk factors for esophageal cancer among adults aged 40 years and above in Sebei region and to share the findings with the relevant stakeholders for effective management and control strategies. Methodology: The study employed a descriptive, un- matched case control design using quantitative and qualitative approach. 138 respondents were sampled from patients who were both esophageal cancer cases and non- cases (controls). Data was collected using face to face administered pretested questionnaire. Descriptive and inferential (chi- square and logistic linear regression) was applied to analyse the socio- demographic and economic, behavioural, environmental and medical factors of the respondents. Findings: The study found out that only; alcohol consumption (AOR: 9.95 95%, CI: 2.59-36.08), p=0.001, tobacco use (AOR: 15.37 95%, CI: 3.40- 64.00) p=0.00 and H. Pylori infection (AOR: 7.91 95%, CI: 2.02-27.77), p=0.001 were significant risk factors. Other factors in the study were not significant risk factors (p>0.05). Conclusion: The study concluded that behavioural and medical factors were significant risk factors for esophageal cancer and that the lifestyle of adults aged 40 years and above had a significant impact on their esophageal cancer status. Recommendations: Cessation from alcohol consumption and tobacco use coupled with early testing and prompt treatment of H. Pylori infection can help avert the occurrence of esophageal cancer in the region.

Keywords: Risk Factors, Esophageal Cancer, Adults.

References:

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Abstract:

Family planning is referred to as controlling the number of children a couple wishes to have, interval between births by means of artificial contraception or voluntary surgical contraception. It involves the use of contraceptives, other techniques which include sexual health education, prevention, and management of sexually transmitted diseases, pre-conception counselling and infertility management (WHO:2010)

Family planning services are comprehensive and enable an individual to have an informed decision regarding available methods. It considers maternal health as motherhood has risks especially early and late motherhood and has been seen as having benefits for the well- being of women, community and society at large.

Despite the benefits and modern methods that are used women still do not come for family planning services at recommended time. That is, there is still inconsistent use of family planning services by the clientele.

References:

[1].     Borrero s., Dehlendorf C., Rodriquez M.I., Steinauer J. Disparities in Family Planning 2006. Volume 6 Page 212.

[2].     Darroch, J.E. &Frost, J. J. 2008. Factors Associated with Contraceptive Choice and Inconsistent Method Use, United States accessed in June 2008

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Abstract:

Background: World Health Organisation (WHO) has been putting a lot of efforts to end female genital mutilation and together with global efforts that has intensified in recent there is a rising awareness of the numerous complications that go with the process, usually later in the life of the adult female. To examine the effect and impacts on these individuals is vital as prevalence occurs in many countries and the awareness of the health risk has to be ascertain because it is associated with physical, emotional and social health risks which is paramount to the cubing of this practice. This research aims to conduct a review of data so as to address the probability of stopping the act completely in all countries in the world

Methods: A mixed method synthesis was applied comparing the effects and impacts in different countries mostly in the African continent in ten different articles obtained from the Open Access Library Journal database, manually scanning of reference lists and summary feed from international organisations such as WHO, UNICEF and UN. The articles included quantitative and qualitative studies with statistical results and analysis. There were also studies carried out on the environmental issues as related to the act. The articles were in three different languages which included English, French and Spanish.

Results: The study population was made up of victims of the female genital mutilation and health professional who understood the process. The percentage of those who were unaware of the risk was 57.4% and the percentage of those who did not have formal education was 77.6%. There was also a high percentage of prevalence which was represented by 52%.

Conclusion: Female genital mutilation is an act which is supposed to be carried out with much precaution of the socio-cultural beliefs have to be maintained with a possibility of reclassifying the act.

Keywords: Female Genital Mutilation, prevalence, health risk.

References:

[1].     Ali, Abdel Aziem A. (2012). Knowledge and attitudes of female genital mutilation among midwives in Eastern Sudan Reproductive Health 23 Vol 9 Issue 1 ISSN 1742-4755 doi.org/10.1186/1742-4755-9-23

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[3].     Adriana Kaplan-Marcusan, Pere Torán-Monserrat, Juana Moreno-Navarro, Ma Jose Castany Fàbregas, Laura Muñoz-Ortiz (2009). Perception of primary health professionals about Female Genital Mutilation: from healthcare to intercultural competence BMC Health Services Research SP 11, Vol 9 Issue 1 ISSN-1472-6963 https://doi.org/10.1186/1472-6963-9

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[6].     Essa M. Arafa, Amany M. Abdelghany, Nadia M. Madkour, Wael S. Nossair, Ekramy A. Mohamed (2014). Survey Study of Acute and Long-Term Effects of Female Genital Mutilation among Women in Sharkia Governorate Open Journal of Obstetrics and Gynaecology, 4, 874-880 http://dx.doi.org/10.4236/ojog.2014.414123

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Abstract:

Malnutrition is one of the leading causes of morbidity and mortality among children globally has been linked to 60% of the 10.9million deaths annually of children under five. The median stunting prevalence in WHO African region is 31.3%.

Aweil Center of South Sudan has consistently high malnutrition rates despite running nutrition projects with relative stability. Results from nutrition survey in November 2013 indicated a severe acute malnutrition (SAM) prevalence rate of 6.3% (95% CI, 4.5-8.9) and a global acute malnutrition (GAM) rate of 22.4% (95% CI, 17.8-27.7). Both prevalence rates were above the WHO thresholds of 15% and 2% respectively.

A cross-sectional study done with two-stage cluster sampling method showed that generally children 6-59 months in Aweil Center have poor nutritional status with GAM (<-2 z-score and/or edema) of 23.2% (95% CI, 19.0-27.9) and SAM (% < -3SD) of 7% (95% CI, 4.9%-9.9%). However, stunting based on height/length-for-age z-scores was 8.7% (95% CI, 6.5-11.6), which was within the acceptable new WHO’s threshold regarded as low probably due to genetic factors for tallness for Dinka tribe.

The study revealed high burden of infectious diseases at 94.5% with p-value 0.00022 (95%C. I, 0.1667-0.291). Poor feeding and family planning practices; poor access roads to markets contribute to childhood malnutrition.

Multifaceted approach is needed to root out the chronic malnutrition from Aweil center shift from food Aid to support of food production, scale up of primary health care and iCCM interventions and community awareness on feeding practices among others.

Keywords: Prevalence, Associated-factors, Malnutrition, Children 6-59 months, Infectious diseases, Genetics.

References:

[1].     Akombi BJ, Agho KE, Merom D, Renzaho AM, Hall JJ (2017) Child malnutrition in Sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS ONE 12(5): e0177338

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[7].     Pandey L.V, Mahendra D. S, and Jayachandran U 2016. Impact of agricultural interventions on the nutritional status in South Asia: A review. PMC4952527

[8].     Phillip Harvey and Beth Rogers, 2007. Nutrition status and its determinants in Southern Sudan. A2Z_SouthSudan_Doc_MEH_Edits_09.23.08.doc

[9].     Phiri, Thokozani 2014. "Review of Maternal Effects on Early Childhood Stunting." Grand Challenges Canada Economic Returns to Mitigating Early Life Risks Project Working Paper Series, 2014-18. https://repository.upenn.edu/gcc_economic_returns/18

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Abstract:

The study aimed at determining challenges associated with implementation of IRHS in Ndola urban district, Zambia.

Method: A cross section study conducted at Ndola city council over a period of six weeks, all 122 expert service providers were purposively selected, between October and November 2008. Semi-structured questionnaires and checklist used. Data analyzed by content analysis, Univariate and bivariate analysis, SPSS version 11.5. Chi-square determined association of variables; adherence, availability of logistic, acceptability of IRS and the outcome IRS challenges.

Results: Policy challenges: There was compliance n=7 with storage and disposal guidelines, while n=4 did not comply with use and environmental safeguards, as Spray operators spilled DDT on the ground.

Operational challenges: 81.3% of the respondents said experienced no problems while, 71.4% experienced itching, sneezing, and difficulty breathing, p value 0.005. 66% of Spray operators reported fewer problems implementing IRS while, 12% said had poor training and acquired less skill, p value 0.017. 75.2% revealed that Acceptability of IRS was low and 24.7% said IRS was not effective p value 0.036 validated by n=7 program officers. 28.1% reported repainting of walls, 44.7% reported variations in spraying due to late arrival of logistics 68.4%.

Institutional challenges; 43.9% reported inadequate shower and wash bay facilities and affected their operations much n=4. A checklist revealed serious inadequacies evident in poor transport, disposal bay, preparation bay, wash bay, and change rooms.

Conclusion: Poor institutional structure, insufficient logistics greatly impinged on daily operations of IRS and highly contributed to non-adherence to some policy guidelines.

Keywords: Indoor Residual Household spraying.

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Abstract:

Self-medication is the treatment of common health problems with medicines without medical supervision. There is substantive literature on self-medication, however there has been limited focus on undergraduates. Hence, this study aimed to bridge gaps in information on awareness, knowledge and practice of self-medication among respondents. Using cross-sectional study design and stratified random sampling technique, 418 consenting respondents were recruited into this study. Quantitative data was collected using a semi-structured, self-administered questionnaire; analyzed using SPSS version 21 and summarized using proportions and Chi-square tests (p ≤5%). Mean age of respondents was 19.89+2.83 years, 52.4% were males while 47.6% were females. 97.8% had awareness about self-medication, 66.0% had good knowledge on harmful effects of self-medication while 76.8% practiced self-medication. Analgesics was the most common drug used among respondents. Age and sex were statistically significantly associated with respondents’ knowledge on harmful effects of self-medication (p<0.05). Sex was statistically significantly associated with their practice of self-medication (p=0.006). There was a cognitive dissonance between respondents’ knowledge and practice because though results showed that respondents had good knowledge, it did not translate into good practice. The university authorities need to develop intervention strategies to engender behavioral change which can potentially improve their practices towards self-medication.

Keywords: Awareness, Knowledge, Practice, Self-medication, Undergraduates.

References:

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[8].     Musa Y., Awosan K., Ibrahim M., Abdullahi Z., Jafaar M., Peter G., Anthony O., & Isah B. (2016). Knowledge and Practice of Self-Medication among Undergraduate Students of Usman-Danfodio University, Sokoto. Annals of International Medical and Dental Research; 2 (1):83-8.

[9].     Oluwole A., Joseph O., Olujide J., Kabir A., Oladele AA, Paul OA & Olaniyan T., (2016), Self-medication among health workers in a tertiary institution in South-West Nigeria, 24.312.8146.

[10]. Omolase C., Adeleke O., &Afolabi A.O. (2012). Self-Medication amongst General Outpatients in Community Hospital; Annals of Ibadan Postgraduate Medicine, Nigeria 5, 64-67

[11]. Osemene K. & Lamikanra A. (2012). Study of the prevalence of self-medication among university students Southwestern Nigeria.; 11(4):683-689.

[12]. Raj Kumar M & Sujata Sharma, (2016) Knowledge, Attitude and Practice of Self-Medication among Medical Students Chitwan Medical College, Tribhuwan University, Nepal, 4(1), 89-96: 2320-1959.

[13]. Sarahroodi S., Arzi A., Sawalha A.F. & Ashtarinezland A. (2010). Antibiotics Self-medication among Southern Iranian University Students. International Journal of Pharmacology. 6(1), 48-52.

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http://www.wsmi.org/publications.html

Abstract:

The impact of HIV in the world especially in sub-Saharan Africa has led to an extraordinary global effort to ensure adherence to antiretroviral (ARV) therapy to treat the disease in every country where HIV is a threat including Nigeria. However, starting patients on ARVs without ensuring full adherence through an adequate support system is likely to lead to treatment failure and the emergence of drug‐resistant virus which can be transmitted to other. Factors influencing adherence to medication are both patients and service provider related. A descriptive, cross sectional study using a systematic sampling technique to select 473 young women and adolescent living with HIV in North central ART clinics in Nigeria. 77% of respondents have been on ARV regimen in the last 3 years. About 82% had good knowledge of medication adherence while 18% do not understand what adherence to medication means. Most (79%) of HIV patient’s adequate adherence to ART while others (13%) usually had stopped taking their medication when they feel better about their health. The commonest source of information about medication adherence to ARV was through the adherence counselor at during ART clinics (77%). Sixty percent of the respondents agreed that adherence to ARV medication helps in improving standard of living Factors that hindered effective adherence to treatment included poor providers’ attitude (28%) and forgetfulness to take their medication and pill burden (25%). Respondents who did not adhere to treatment were less likely to subsequently adhere to ARV medication (OR= 0.258, 95%CI= 0.1-0.5). Use of treatment supporters was the major determinant of medication adherence (OR = 4.2, 95%CI = 1.4-7.2). Majority of the respondents are knowledgeable about medication adherence.

References:

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Abstract:

Background: In most communities, the first level of healthcare visit is usually the community pharmacies hence, has the chance to detect HIV for the provision of early intervention for HIV services. Consequently, if access to HIV care, treatment and prevention services is enhanced at the level of community pharmacies, the burden of HIV/AIDS in Nigeria will be reduced significantly.

Purpose: The study assessed the knowledge of community pharmacists regarding HIV/AIDS and its management and their level of standard precautions practice.

Methods: Out of 242 community pharmacists in Abuja Municipal Area Council (AMAC), Federal Capital Territory, a total of 155 registered community pharmacists who had valid practicing license were randomly selected. A questionnaire specifically designed for this study was self-administered to these participants. SPSS was used for the analysis, a P-value of less than 0.05 was regarded as significant and Chi-square tests were applied for inferential analysis.

Results: Within the 155 community pharmacists sampled, complete response were obtained from 104 (67%) community pharmacists. The mean age of the participants was 44.3 years (SD ± 2.47). There were 72.1% males. 80.8% of the participants had only Bachelor of Pharmacy degree, 79.8% of participants reported correctly that HIV can be transmitted through with blood and semen and this was significantly associated with level of education (p = 0.002). Most of the participants (92.3%) did not know the HIV transmission rate from mother to child in the deficiency of antiretroviral drugs in developing countries and only 37.8% of community pharmacists keep stock of antiretroviral drugs for post exposure prophylaxis. Many of the participants (83.0%) had good knowledge of the concept of standard precaution and 76.0% knew the conditions of which standard precautions should be practiced. 57.5% of the participants wash their hands with soap and water always after any direct contact with patients, 63.2% recap used needles after giving injections or drawing blood from the patients. Only 26.9% had been vaccinated against Hepatitis B.

Conclusion: The finding of this study revealed that the knowledge and practice of community pharmacists in HIV/AIDS is relatively poor especially mother–to-child transmission. In as much as the knowledge of community pharmacists on standard precaution was good, there were paucities in their practice of standard precaution especially in the area of handling and disposal of used needles, poor availability of HIV post exposure prophylaxis drugs and vaccination against Hepatitis B. Management of HIV/AIDS should be integrated into the curriculum for continuing professional development for pharmacists. The implementation of adherence to the principles of standard precaution through consistent monitoring and supervision is highly recommended.

Keywords: Community pharmacists, knowledge and practices, HIV/AIDS & standard precautions.

References:

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Abstract:

Background: A good referral system serves as a link between the three levels of health care practiced in Nigeria and ensures the continuity of proper health care service delivery. The effectiveness of referral system is an important determinant of the strength of health care service delivery. This study assesses referral system effectiveness among health facilities (primary, secondary and tertiary) in the urban and rural areas using two local government areas in Enugu State. Objective: To assess referral system effectiveness among health facilities in Enugu state Nigeria. Methodology: A cross-sectional epidemiological study of the analytical type was carried out among health workers in the various levels of health facilities within two local governments in the urban and rural areas in Enugu state. Stratified sampling technique was used to select the study participants. A pretested self- administered questionnaire was used to collect data from the respondents and was analysed using SPSS version 23. Results: The mean age of the respondents was 36.26 ± 8.73(SD) years. There was a good overall knowledge and practice of referral given as 392 (95.6%) and 235 (57.3%) respectively. Majority 74(47.3%) of the respondents had a relatively good knowledge of feedback but do not practice the feedback system of referral. Conclusion and Recommendations: The level of awareness of the referral system was impressive. However, the actual referral practice was not very satisfactory due to the lack of proper feedback and poor follow up. Efforts should be made by the agencies involved towards an improvement of the referral system.

References:

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[2].     Agofure O, Absalom B. Knowledge of referral and feedback system among health workers in Billiri local government area of Gombe state Nigeria. European J of Pharm and Med Research 2016: 3(11), 111-115.

[3].     Asuke S, Ibrahim S M, Sabitu K, Asuke A U, Igbaver I I, Joseph S. A comparison of referral among primary health care workers in urban and rural local government in North- West Nigeria. Journal of Medicine in the Tropics (2016) 18:2:93‑97.

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Abstract:

Background: Shortage of obesity awareness campaigns at antenatal clinics; women who were severely obese were 43% less likely to achieve pregnancy than normal-weight women or women who were considered overweight but not obese during the study. The study is among the first to examine the relationship between body weight and infertility in women who ovulate in Harare Zimbabwe. In Harare only five out of twenty-two antenatal clinics had obesity health education talks and measured BMI for ovulating women. In 2018 this prompted an investigation to determine knowledge, attitude and practices of women of child bearing age on obesity and its impact on fertility at Mbuyanehanda Maternity Hospital.

Methods: Analytical cross-sectional study was carried out. Three hundred and eighty-four (384) participants were selected by proportional sampling from Mbuyanehanda antenatal clinic. Questionnaires adapted from the World Health Organization Stepwise approach to Surveillance non-communicable disease instrument and the Health Belief model was used to collect data on knowledge, attitude and risk factors of obesity on fertility in women of childbearing age. BMI measurements were taken. Obesity was defined as BMI above 25.

Results: The proportion of patients who were obese and had their BMI measured was 70%. Only females were enrolled in the study. The statistically significant factors associated with obesity were having heard about the risk obesity (AOR 3.1, 95% C.I 1.7-5.4), knowing that weight check and control was important whilst on childbearing age (AOR 1.8, 95% C.I 1.1-2.9) and health education on dangers of obesity or high BMI (AOR 1.6 95% C.I 1.0-2.7).

Summary: There was a high proportion of elevated BMI amongst patients who were ignorant of the dangers of obesity on fertility. Despite lack of knowledge on BMI monitoring equipment and shortage of staff, majority of patients at Mbuyanehanda maternity hospital of childbearing age were at risk of developing infertility or childbearing complications because of inadequate knowledge on obesity prevention and control. Health promotion and education on dangers of obesity and body weight monitoring and the upgrading of health services factors to improve the monitoring of BMI at maternal health clinics is necessary. Further studies on factors associated with poor control of body weight amongst female patients during child bearing age are needed.

Keywords: Body Mass Index (BMI), fertility, Health Belief Model, Obesity.

References:

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Abstract:

Background: Sexual-Risk behaviours contribute to the leading causes of morbidity, mortality and social problems among youths. Although there are many studies conducted on this subject, the predictors of sexual-risk behaviours among youths have not been well explored. This study was therefore, designed to contribute to existing knowledge and enhance the development of strategies that will positively influence the perception and attitude of youths regarding sexual health risk related matters.

Methods: A descriptive cross-sectional study design using multistage sampling methods was conducted among randomly selected 360 youths (15-24 years) using data collected via pre-tested interviewer administered semi-structured questionnaire, which measured the following variables: socio-demographic characteristics; sexual-risk behavior and predictors of sexual-risk. Data was analyzed using Chi-square test and binary logistics regression at p=0.05. Social learning theory was adopted in the development of the instrument.

Results: Almost half (49.7%) of the respondents reported to have ever had sex, 57.5% and 71.2% of them had sexual intercourse with casual partners and multiple partners respectively, also 68.7% of them did not use condom during their last sexual activity. Age and gender were the most significant predictors of sexual-risk behavior. Youths aged between 15-17 and 18-20 years are about 5.7 and 3.1 times respectively more likely than those older than 21 years to have an early sexual debut (OR = 5.693, CI = 1.205-26.901; 3.067, CI = 1.260-7.465) while male youths were about 2.6 times more likely than females to use condoms (OR = 2.563, CI = 1.171-5.607).

Conclusion: Dearth of information available to youths about sexual health and the dangers associated with risky sexual behaviours can be held responsible for increased levels in participation in sexual-risk behaviours among youths. There is need for concerted effort of all to promote healthy behaviour, via youth-centered programmes and youth targeted behavioural change interventions.

Keywords: Youths, Sexual health, Sexual-risk behaviour, Predictors, Ibadan.

References:

[1].     Adebowale, A., Titiloye, M., Fagbamigbe, A. and Akinyemi, O. 2013. Statistical modelling of social risk factors for Sexually Transmitted Diseases among female youths in Nigeria.

[2].     Ahonsi, B. A. 2013. Targeting Youth for HIV Prevention and Care in Nigeria: What Role for Governments? African Journal of Reproductive Health, 17(4). Nigeria Demographic and Health Survey. 2008.

[3].     Aderibigbe, S. A., and Araoye, M. O., 2008. Effect of health education on sexual behaviour of students of public secondary schools in Ilorin, Nigeria. Eur. J. Sci. Res. 24(1), 33-41.

[4].     Adedapo, A.I., Julie, P. I., and Willy, L. 2014. Factors Contributing to the Risk of HIV Infection in Rural School-Going Adolescents. Int. J. Environ. Res. Public Health. (11): 11805-11821.

[5].    Baba-Djara, M., Brennan, A., Corneliess, C., Agyarko-Poku, T., Akuoko, K., Opoku, K.B., et al., Using what you have to get what you want: vulnerability and prevention needs of female post-secondary students engaged in transactional sex in Kumasi, Ghana. Centre for Global Health and Development Boston University, Boston, Massachusetts, USA and Kwame Nkrumah University of Science and Technology Kumasi Ghana.

[6].     Berry, L. and Hall, K. 2009. HIV & AIDS and STI National Strategic Plan 2007-2011: Multiple sexual partnerships. Cape Town, South Africa: Children’s Institute, University of Cape Town

[7].     Centers for Disease Control and Prevention. 2010. Web-based injury statistics query and reporting system.

[8].     Dessalegn, N. 2006. Gudffecha practice as child problem intervention. Oromo city: The case of Ada’s Libian District.

[9].     Davis-Kean P.E. 2005. The influence of parent education and family income on child achievement: The indirect role of parental expectations and the home environment. Journal of Family Psychology. 2005;19:294-304.

[10]. Dekeke, G.D. and Sandy, P. T. 2014. Factors influencing sexual risk behavior among senior secondary school students (Youths) in Ethopia. International Journal of Scientific and Research Publications.4 (8): 1-32.

[11]. Echendu, D. A, Joseph I.B.A, Nkemakolam O. E, Chima I., Akinsewa A. and Ejike O. 2011. Awareness and use of contraception by women seeking termination of pregnancy in south eastern Nigeria. Asian Pacific Journal of Tropical Disease; 71-75

[12]. Eyitope, O. A. 2014. Sexual Behaviour and Risk Perception for HIV among Youth Attending the National Youth Service Camp, Ede, Osun State, Nigeria. Journal of Health Science. 4(1): 1-6

[13]. Federal Ministry of Health. 2011. Integrated Biological and Behavioral Surveillance Survey (IBBSS), 2010 (Abuja: FMOH).

[14]. Fawole, A. O., Ogunkan, D. V and Adegoke, G. S. 2011. Sexual Behaviour and Perception of Hiv/Aids in Nigerian. University of Ilorin, Nigeria. Global Journal of Human Social Science 11(1); 64-72.

[15]. Imaledo, J. A., Peter-Kio, O. B. and Asuquo, E. O. 2012. Pattern of risky sexual behavior and associated factors among undergraduate students of the University of Port Harcourt, Rivers State, Nigeria. Pan African Medical Journal. 9:97-105.

[16]. Kanku, T. 2010. Attitudes, perceptions and understanding amongst teenagers regarding teenage pregnancy, sexuality and contraception in Taung. SA Fam Pract. 52(6):563-572.

[17]. Nigeria National Youth Policy. 2009. Accessed from http://www.youthpolicy.org/national/Nigeria_2009_National_Youth_Policy.pdf

[18]. World Health Organization. 2008a. Unsafe Abortion: Global Trend and Regional Estimates of the Incidence of Unsafe Abortion and Associated Mortality in 2000. Nigeria Demographic and Health Survey. 20013.

[19]. Onyene, V., Uzoka, N., Ikonta, N. and Bakare, T. V. 2010. “Tertiary Institution learners’ HIV/AIDS sensitisation tool(s) receptivity: Implications for sustainable democracy in Nigeria. Journal of AIDS and HIV Research.2(4):78 – 87.

[20]. Oshi, S.N., Ezugwu, F.O., Oshi, D.C., Dimkpa, U., Korie, F.C. and Okperi, B.O. 2007. Does self-perception of risk of HIV infection make the youth to reduce risky behaviour and seek voluntary counselling and testing services? a case study of Nigerian youth., J. Soc Sci., 14(2), 195-203.

[21]. Romero-Estudillo, E., González-Jiménez, E., Mesa-Franco, M. C. and García-García, I. 2014. Gender-based differences in the high-risk sexual behaviours of young people aged 15-29 in Melilla (Spain): A cross-sectional study. BMC Public Health. 14(745): 1471-2458.

[22]. Terry-McElrath, Y. M., O’Malley, P. M. and Johnston, L. D. (2009). Reasons for drug use among American youth by consumption level, gender, and race/ethnicity: 1976-2005. Journal of Drug Issues. 39:677-714.

Abstract:

Introduction: Lesbians, Gay, Bisexuals and Transgenders (LGBTs) are a key population for HIV risk globally with 17% of male homosexuals having HIV worldwide. Male homosexuals also account for 10% of all new HIV infections in Nigeria. The dearth of information about LGBTs in Nigeria makes it imperative to assess the sexual orientations of university students as well as their knowledge of LGBTs.

Objectives: To determine the sexual orientation of students of University of Ibadan

To determine students’ level of knowledge about LGBTs

Methods: A mixed research method involving quantitative components (self-administered, semi-structured questionnaires) and qualitative components (Focus Group Discussions) was adopted using a multi-stage sampling to select undergraduate and postgraduate students of University of Ibadan.

Results: Students had moderate knowledge about LGBTs. Also, 96% of the respondents were identified as heterosexuals, 0.9% were bisexuals and 2.1% were uncertain about their sexual orientation. There was no statistically significant association between the socio-demographic and academic characteristics of the students and their knowledge about LGBT however there was a statistically significant association between respondent’s knowledge about LGBTs and personally knowing an LGBT person (X²= 16.040; P= <0.001).

References:

[1]. Cochran, S.D; Bandiera, F.C; Mays, V.M. 2013. "Sexual Orientation–Related Differences in Tobacco Use and Secondhand Smoke Exposure Among US Adults Aged 20 to 59 Years: 2003–2010 National Health and Nutrition Examination Surveys". American Journal of Public Health 103 (10): 1837–1844.

[2]. UNAIDS 2014. AIDSinfo Online Database. Accessed from http://www.aidsinfoonline.org/devinfo/libraries/aspx/Home.aspx#&panel1-6 on 12th February, 2016.

[3]. National Agency for the Control of AIDS. Country Progress Report 2014. Accessed from www.unaids.org/sites/default/files/country/documents/NGA_narrative_report_2014.pdf. on 14th August, 2015.

[4]. Jobson GA, Theron LB, Kaggwa JK, Kim HJ. 2012. Transgender in Africa: invisible, inaccessible, or ignored? Sahara J. 2012;9(3):160-3

[5]. Kelley L, Chou CL, Dibble SL, Robertson P.A. 2008. A critical intervention in lesbian, gay, bisexual, and transgender health: knowledge and attitude outcomes among second-year medical students. Teach Learn Med. ;20(3):248-53.

[6]. Saewyc, E. M., Bauer, G.R., Skay, C.L., Bearinger, L.H., Resnick, M.D., Reis, E. and Murphy, E. 2004. Measuring Sexual Orientation in Adolescent Health Surveys: Evaluation of Eight School-based Surveys. Journal of Adolescent Health 2004; 35:345

[7]. Strong, K. L., "Assessing Undergraduate Nursing Students' Knowledge, Attitudes and Cultural Competence in Caring for LGBT Patients" (2013). Honors Projects. Paper 42.

[8]. Alderson, K.G., Orzeck, T.L. and McEwen S.C. 2009. Alberta High School Counselors'          Knowledge of Homosexuality and Their Attitudes Toward Gay Males. Canadian Journal of Education 32, 1 (2009): 87‐117.

[9]. The Williams Institute; 2009. Sexual Minority Assessment Research Team (SMART), Best    Practices for Asking Questions about Sexual Orientation on Surveys.

[10]. Elizabeth Saewyc, Carol Skay, Kimberly Richens, Elizabeth Reis, Colleen Poon, Aileen Murphy. Sexual Orientation, Sexual Abuse, and HIV-Risk Behaviors Among Adolescents in the Pacific Northwest. Am J Public Health. 2006 June; 96(6): 1104–1110.

[11]. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998; 101:895–902.

[12]. Mapayi Boladale, Oginni Olakunle, Aloba Olutayo, and Akinsulore Adesanmi1,2Sexual orientation and quality of life among students of Obafemi Awolowo University (OAU), Nigeria. Afr Health Sci. 2015;15(4):1065-73.

[13]. Cornelius, J, B.; Carrick, J. 2015. A Survey of Nursing Students' Knowledge of and Attitudes toward LGBT Health Care Concerns. Nursing Education Perspectives. Vol. 36, No. 3

[14]. Sanchez, N. F.; Rabatin, J.; Sanchez, J. P.; Hubbard, S.; Kalet, A. 2006. Medical Students’ Ability to Care for Lesbian, Gay, Bisexual, and Transgendered Patients. Fam Med 2006;38(1):21-7

Abstract:

Marijuana use is prevalent among the youth in Ghana today. With reference to Today News (2014), the Narcotic Control Board indicated that out of a total number of 50,000 drug users, 35,000 are youth spanning from junior, secondary and tertiary institutions. This study examines the impact of marijuana use among the youth of Sabon Zongo Community in Ghana and the reasons that influences them to use the drug. These objectives were met by handing out questionnaires to 150 out of which 132 gave their consent and answered them. The study also paid attention to thematic areas that are replete in the existing literature concerning the use of marijuana and its effects on users including the impacts of marijuana use and the reasons given.

Data collected was organized using Excel spreadsheet, Statistical Package for Social Sciences (SPSS) software and analysed with Descriptive Statistics and Pearson’s Chi-Square. Results and discussions from this study revealed that physical impacts and the gateway phenomenon had dependent relationships with marijuana use. As a result, an educational campaign on the negative impacts of marijuana use on physical health and being potentially a gateway to using harder drugs using a multi-sectorial approach is recommended to reduce if not to eliminate the use of marijuana among the youth in Ghana.

Keywords: Marijuana, impact of marijuana use, Gateway phenomenon, marijuana use among the youth of Ghana, physical, psychosocial, economic effects of marijuana use.

References:

[1].Agrawal, A., Neale, M. C., Prescott, C. A., & Kendler, K. S. (2004). A twin study of early cannabis use and subsequent use and abuse/dependence of other illicit drugs. Psychological Medicine, 34(7), 1227–1237.

[2].ARSENEAULT, L., CANNON, M., TON, J. W., & AY, R. M. M. (n.d.). Causal association between cannabis and psychosis: examination of the evidence, 8.

[3].Wayne D. Hall, (2006). Cannabis use and the Mental Health of Young People

[4].Chakravarti, B., Ravi, J., & Ganju, R. K. (2014). Cannabinoids as therapeutic agents in cancer: current status and future implications. Oncotarget, 5(15), 5852–5872.

[5].Drug Policy Alliance. (n.d.). How Marijuana is Consumed. Retrieved June 11, 2018, from http://www.drugpolicy.org/drug-facts/10-facts-about-marijuana/how-marijuana-consumed

[6].    Feeney, K. E., & Kampman, K. M. (2016). Adverse effects of marijuana use. The Linacre Quarterly, 83(2), 174–178. https://doi.org/10.1080/00243639.2016.1175707

[7].    Goode, E. (2012). Drugs in American society (8th ed). New York: McGraw-Hill. Retrieved from https://trove.nla.gov.au/work/6121075

[8].Hall, W. D., & Lynskey, M. (2005). Is cannabis a gateway drug? Testing hypotheses about the relationship between cannabis use and the use of other illicit drugs. Drug and Alcohol Review, 24(1), 39–48.

[9].Heppner, P. P., Kivlighan, D. M., & Wampold, B. E. (2008). Research design in counseling (3rd ed). Belmont, California: Thomson Brooks/Cole. Retrieved from

[10]. Iversen, L. L. (2009). The Science of Marijuana, 2nd edn. British Journal of Clinical Pharmacology, 67(2), 268.

Abstract:

Dementia is a syndrome due to disease of the brain, usually of chronic or a progressive, debilitating disease that often results in weight loss, malnutrition, and dehydration. Most patients with dementia receive care from family members, often untrained for this challenging role. Caregivers may not access publicly available care giving information and caregiver education programs are not widely implemented clinically. Family members often receive inadequate decision-making education. The aim of the study is to assess the effectiveness of IEC Package on level of knowledge regarding management of dementia among the caregiver of elderly in selected urban community, Amethi. The data was collected from 150 experimental and 150 control groups, caregivers of elderly by structured Questionnaire schedule. Stratified Random Sampling technique was used to select the samples.

The findings revealed that the improvement in mean score of overall level of knowledge of caregivers of elderly between pre-test and post-test, experimental was 8.57, paired ‘t’ test experimental was 30.3, which was highly significant at P<0.01 and the improvement in mean score of overall level of knowledge of caregivers of elderly between pre-test and post-test, control group was 1, paired ‘t’ test, control group was 1.97, which was not significant at P<0.01.

This showed that IEC package was effective and hence research hypothesis was accepted. Where as in control group mean score was 1, paired ‘t’ test was, 1.98 which was not significant at P<0.01, hence research hypothesis was rejected and null hypothesis was accepted. The mean difference between experimental group and control group was 7.95, paired ‘t’ test was 17.94, which was highly significant at P<0.01. This showed that IEC package was effective and hence research hypothesis was accepted.

Keywords: IEC Package, Knowledge, Caregiver of Elderly, Management of Dementia.

References:

[1]. Townsend MC. Psychiatric Mental Health Nursing Concepts of Care. Fourth edition. Philadelphia: F.A Davis company / publishers; 2003.

[2].Gupta S P. Statistical methods. New Delhi: Sultan hand and sons’ publishers; 1997.

[3].Dr. Rajesh Konnur. Textbook of Psychiatric Nursing. New Delhi: Jaypee Publishing pvt Ltd; 2015.

[4].Bimla Kapoor. (2012). Textbook of Psychiatric Nursing. New Delhi: Kumar publishing house.

[5].R. Sreevani. (2013). A Guide to Mental Health and Psychiatric Nursing. New Delhi: Jaypee publication.

[6].Cecilia Huang, et.al. (2015). Risk of Developing Dementia: The British Journal of Psychiatry, 207 (1), 46-51.

[7].Gail W. Stuart, Michele T. Laraia. (2005). Principles and Practice of Psychiatric Nursing. Missouri: Mosby publication.

[8].Steve Thompson. (2013). Dementia in the developed world. Retrieved from http:// www.worldhealth.org.

[9].Joosse LL, et al. (2013). Memory loss. 3,107. Retrieved from http:// www. American journal of psychiatric.org.

Abstract:

The study was conducted to investigate the factors that affect management of the referral system at the primary level of health care in Zomba district in Malawi. To accomplish this purpose the study sought to identify the criteria that guided primary health care providers in making referral decisions; assessed the effectiveness of the role of community leaders in the management of referral process at primary care level, and investigated the challenges affecting the implementation of referral system at the primary health care level in Zomba district. The study took a qualitative approach and used face-to-face interviews to collect data from purposively selected nurses, clinicians, health surveillance assistants, ambulance drivers, transport officers, community and health committee leaders from six conveniently sampled primary health facilities. The findings revealed that primary care facilities faced a number of challenges such as lack of referral transport, poor communication, lack of referral guidelines, shortage of skilled personnel, lack of diagnostic equipment and drugs which led to the self-referral and the bypassing of primary care facilities in Zomba district. The study recommended that the government should enhance the availability of needed resources such as skilled personnel, diagnostic equipment, drugs, referral ambulances and communication technology in order to facilitate the referral of patients. The Ministry of Health should provide referral guidelines to all health care providers at all levels as well as consider constructing a district hospital to provide secondary level health care services. The district health office needs to maintain all the ambulances and provide fuel consistently in order to improve the quality of primary health care referral services.

Keywords: Primary health care, referral system, patient outcome, referral process.

References:

[1].Abodurin O.L, Akande T.M., Osagbemi G.K. (2010). Awareness and perception toward referral in health care: a study of adult residents in Ilorin, Nigeria. Annals of African Medicine. 9(3), 176-180. DOI: 10.4103/1596-3519.68359.

[2].Afari H, Hirschhorn LR, Michaelis A, Barker, P., & Sodzi-Tettey, S. (2014). Quality improvement in emergency obstetric referrals: qualitative study of provider perspectives in Assin North district, Ghana. BMJ Open 2014;4: e005052. doi:10.1136/bmjopen-2014-005052.

[3].Afolaranmi, T. O., Hassan, Z. I., Filibus, D. I., Al-MANSUR, U. A., Lagi, L. A., Kumbak, F. D., ...Chirdan, O. O. (2018). Referral system: An assessment of primary health care centres in Plateau state, North Central Nigeria. World journal of research and review (WJRR), 6(1), 82–86. Retrieved from: https://media.neliti.com/media/publications/262704-referral-system-an-assessment-of-primary-936f549f.pdf

[4].Afsar, H.A., & Younus, M. (2004). Patient referral at the grassroots level in Pakistan. Nature and Science, 2(4), 8-27.

[5].Akande, T.M. (2004). Referral system in Nigeria: Study of a tertiary health facility. Annals of African Medicine 3(3), 130-133. Retrieved from:

https://www.researchgate.net/publication/27788897_Referral_System_in_Nigeria_Study_of_a_Tertiary_Health_Facility.

[6].Asuke, S., Ibrahim, M.S., Sabitu, K., Asuke, A.U., Igbaver. I.I., Joseph, S. (2016). A comparison of referrals among primary health-care workers in urban and rural local government areas in North-Western Nigeria. Journal of Medicine in the Tropics, 18 (2) 93 – 97. DOI: 10.4103/2276-7096.192233.

[7].Cervantes, K. Salgado, R., Misun Choi, M., and Henry D. Kalter, H. D. (2003). Rapid Assessment of Referral Care Systems: A Guide for Program Managers. Published by the Basic Support for Institutionalizing Child Survival Project (BASICS II) for the United States Agency for International Development. Arlington, Virginia Retrieved from: https://www.who.int/management/facility/RapidAssessmentofReferralCareSystems.pdf

[8].Chikowe, I., Mwapasa, V., & Kengne, A. P. (2018). Analysis of rural health centers preparedness for the management of diabetic patients in Malawi. BMC Research Notes, 11(267). 1-6. https://doi.org/10.1186/s13104-018-3369-7.

[9].Dunmade, A. D., Afolabi, O. A., & Eletta, A. P. (2010). Challenges of Otolartngologic referral in a Nigerian Tertiary Hospital: An audit. East and Central African Journal of Surgery, 15(1), 87–92.

[10]. Eskandari, M., Abbaszadeh, A., & Borhani, F. (2013). Barriers of referral system to health care provision in rural societies in Iran. Journal of Caring Sciences, 2(3), 229-236 doi:10.5681/jcs.2013.028 http:// journals.tbzmed.ac.ir/ JCS.

[11]. Font F, Quinto L, Masanja H, Nathan R, Ascaso C, Menendez C, et al (2002). Paediatric referrals in rural Tanzania: The Kilombero District study – A case series. BMC International Health and Human Rights, 2(4), 1-6. Retrieved from: https://bmcinthealthhumrights.biomedcentral.com/track/pdf/10.1186/1472-698X-2-4 .

[12]. Government of Malawi (GRM) (2017a). Health Sector Strategic Plan II 2017–2022, Towards universal Health coverage. In: Ministry of Health Malawi Government, editor. 2nd ed. Zomba, Malawi: National Statistics Office (NSO), 2017; Retrieved from: file:///C:/Users/HP/Downloads/HSSP%20II%20Final%20HQ%20complete%20file.pdf%20(2).pdf.

[13]. Government of Malawi (2017b). National Community Health Strategy: 2017–2022 Available from: https://www.healthynewbornnetwork.org/hnn-content/uploads/National_Community_Health_Strategy_2017-2022-FINAL.pdf.

[14]. Hofman, J.J., Dzimadzi, C., Lungu, K., Ratsma, E. Y., & Hussein, J. (2008). Motorcycle ambulancesfor referral of obstetric emergencies in rural Malawi: Do they reduce delay and what do they cost? International Journal of Gynecology & Obstetrics, 102(2), 191–197. https://doi.org/10.1016/j.ijgo.2008.04.001.

[31]. Sanders, D., Kravitz, J., Lewin, S., McKee, M. (1998). Zimbabwe’s hospital Referral System: Does it work. Health Policy and Planning. 13(4), 359 -370. Retrieved from: https://academic.oup.com/heapol/article-abstract/13/4/359/596214.

[32]. Salgado R, Mehari M, Wendo D, Choi M (2002). The status of referral in Eritrea: Analysis of referral pathways in children under five. Arlington, VA: John Snow.

[33]. Siddiqi S, Kielmann A, Khan M., Ali, N., Ghaffar, A., Sheikh, U., & Mumtaz, Z. (2001). The effectiveness of patient referral in Pakistan. Health Policy and Planning 16(2) 193–198. DOI: 10.1093/heapol/16.2.193 · Source: PubMed.

[34]. Simba, D.O., Mbembati, N.A.A., Museru L.M., Lema, L.E.K. (2008). Referral pattern of patients received at the national referral hospital: Challenges in low income countries. East African Journal of Public Health, 5(1), 6–9. Retrieved from: http://www.bioline.org.br/pdf?lp08002.

[35]. Wanjau, K. N., Muiruri, B. W., & Ayodo, E. (2012). Factors affecting provision of service quality in the public health sector: A case of Kenyatta national hospital. International Journal of humanities and social science, 2(3), 114–125. Retrieved from: http://ijhssnet.com/journals/Vol_2_No_13_July_2012/11.pdf .

[36]. World Health Organisation (undated). Referral Systems - A Summary of Key Processes to Guide Health Services Managers. Retrieved from

http://www.who.int/management/facility/referral/en/index.html.