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The Effect of Male Partner Involvement in ANC and IPTP-SP Uptake in Urban and Rural Areas of Benue State, NigeriaAuthor: Justice AdajiDOI: 10.21522/TIJAR.2014.13.02.Art001
The Effect of Male Partner Involvement in ANC and IPTP-SP Uptake in Urban and Rural Areas of Benue State, Nigeria
Abstract:
Globally, malaria infection is a serious communicable infectious disease that is a threat to the lives of half of world population. In regions where malaria is widespread, the World Health Organization (WHO) advises that every pregnant woman should receive a minimum of three doses of intermittent preventive treatment with Sulfadoxine-pyrimethamine (IPTp-SP) to reduce the risk of malaria during pregnancy. This study examined how male partner involvement like accompaniment to ANC, IPTp-SP awareness, and encouragement/reminders affects optimal IPTp-SP uptake among pregnant women in urban and rural of Benue State, Nigeria, comparing settings to inform targeted interventions. A community-based comparative cross-sectional study was conducted among women of reproductive age (15–49 years) in selected urban and rural communities in Benue State using a multistage sampling technique. Data analysis involved chi-square tests, logistic regression, and Spearman's correlation (p ≤ 0.05 significance). Male involvement was higher in urban areas (65.2% partner accompaniment to ANC) than rural (49.4%). Urban women whose partners accompanied them to ANC (OR = 3.882, 95% CI: 2.561–5.885), were aware of IPTp-SP (OR = 3.600, 95% CI: 2.374–5.458), or encouraged/reminded them (OR = 4.778, 95% CI: 1.718–13.298) had significantly higher odds of optimal uptake. In rural areas, male partner awareness of IPTp-SP was significantly associated with optimal uptake (OR = 1.534, 95% CI: 1.074–2.193). Targeted strategies in rural communities, including community education, male partner engagement, and improved access to antenatal care services, are essential to reduce disparities and enhance maternal and neonatal health outcomes.
The Effect of Male Partner Involvement in ANC and IPTP-SP Uptake in Urban and Rural Areas of Benue State, Nigeria
References:
[1]. Fana, S. A., Bunza, M. D. A., Anka, S. A., Imam, A. U., Nataala, S. U., 2015, Prevalence and risk factors associated with malaria infection among pregnant women in a semi-urban community of north-western Nigeria. Infectious Diseases of Poverty, 4(1), 1–17, https://doi.org/10.1186/s40249-015-0054-0
[2]. Desai, M., Hill, J., Fernandes, S., Walker, P., Pell, C., Gutman, J., et al., 2018, Prevention of malaria in pregnancy. The Lancet Infectious Diseases, 18(4), 119–132, http://dx.doi.org/10.1016/S1473-3099(18)30064-1
[3]. Poespoprodjo, J. R., Douglas, N. M., Ansong, D., Kho, S., Anstey, N. M., 2023, Malaria. The Lancet, 402(10419), 2328–2345, https://doi.org/10.1016/S0140-6736(23)01249-7
[4]. Mangusho, C., Mwebesa, E., Izudi, J., Aleni, M., Dricile, R., Ayiasi, R. M., et al., 2023, High prevalence of malaria in pregnancy among women attending antenatal care at a large referral hospital in northwestern Uganda: A cross-sectional study. PLoS One, 18, 1–16, http://dx.doi.org/10.1371/journal.pone.0283755
[5]. Ogba, P., Baumann, A., Chidwick, H., Banfield, L., DiLiberto, D. D., 2022, Barriers and facilitators to access and uptake of intermittent preventive treatment with sulfadoxine-pyrimethamine among pregnant women in Nigeria: A scoping review. Malaria World Journal, 13(4), 1–18, https://pmc.ncbi.nlm.nih.gov/articles/PMC9242533/
[6]. Anto, F., Agongo, I. H., Asoala, V., Awini, E., Oduro, A. R., 2019, Intermittent preventive treatment of malaria in pregnancy: Assessment of the sulfadoxine-pyrimethamine three-dose policy on birth outcomes in rural northern Ghana. Journal of Tropical Medicine, 2019(6712685), 1–10, https://doi.org/10.1155/2019/6712685
[7]. Obi, S. N., Emmanuel, M., Roseline, C., Mbbs, U., 2012, The impact of intermittent preventive treatment with sulfadoxine-pyrimethamine on the prevalence of malaria parasitaemia in pregnancy. Tropical Doctor, 42, 133–135, https://doi.org/10.1258/td.2011.110402
[8]. Muhammad, F. M., Nedjat, S., Sajadi, H. S., Parsaeian, M., Assan, A., Majdzadeh, R., 2021, Malaria intermittent preventive treatment in Nigeria: A qualitative study to explore barriers. BMC Infectious Diseases, 21(438), 2–7, https://doi.org/10.1186/s12879-021-06135-2
[9]. Mutanyi, J. A., Onguru, D. O., Ogolla, S. O., Adipo, L. B., 2021, Determinants of the uptake of intermittent preventive treatment of malaria in pregnancy with sulphadoxine pyrimethamine in Sabatia Sub County, Western Kenya. Infectious Diseases of Poverty, 10(1), 1–13, https://doi.org/10.1186/s40249-021-00887-4
[10]. Roman, E., Andrejko, K., Wolf, K., Henry, M., Youll, S., Florey, L., 2019, Determinants of uptake of intermittent preventive treatment during pregnancy: A review. Malaria Journal, 18(1), 1–9, https://doi.org/10.1186/s12936-019-3004-7
[11]. Diala, C. C., Pennas, T., Marin, C., Belay, K. A., 2013, Perceptions of intermittent preventive treatment of malaria in pregnancy (IPTp) and barriers to adherence in Nasarawa and Cross River States in Nigeria. Malaria Journal, 12(342), 1–16, https://doi.org/10.1186/1475-2875-12-342
[12]. Hill, J., Hoyt, J., van Eijk, A. M., D’Mello-Guyett, L., ter Kuile, F. O., Steketee, R., 2013, Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: A systematic review and meta-analysis. PLoS Medicine, 10(7), 1–23, https://doi.org/10.1371/journal.pmed.1001488
[13]. Ameh, S., Owoaje, E., Oyo-Ita, A., Kabiru, C. W., Akpet, O. E. O., Etokidem, A., et al., 2016, Barriers to and determinants of the use of intermittent preventive treatment of malaria in pregnancy in Cross River State, Nigeria: A cross-sectional study. BMC Pregnancy and Childbirth, 16(1), 1–9, http://dx.doi.org/10.1186/s12884-016-0883-2
[14]. Azizi, S. C., Chongwe, G., Chipukuma, H., Jacobs, C., Zgambo, J., Michelo, C., 2018, Uptake of intermittent preventive treatment for malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) among postpartum women in Zomba District, Malawi: A cross-sectional study. BMC Pregnancy and Childbirth, 18(1), 1–13, https://doi.org/10.1186/s12884-018-1744-y
[15]. Annoon, Y., Hormenu, T., Ahinkorah, B. O., Seidu, A. A., Ameyaw, E. K., Sambah, F., 2020, Perception of pregnant women on barriers to male involvement in antenatal care in Sekondi, Ghana. Heliyon, 6(7), 1–9, https://doi.org/10.1016/j.heliyon.2020.e04434
[16]. Onoka, C. A., Onwujekwe, O. E., Hanson, K., Uzochukwu, B. S., 2012, Sub-optimal delivery of intermittent preventive treatment for malaria in pregnancy in Nigeria: Influence of provider factors. Malaria Journal, 11(317), 1–8, https://doi.org/10.1186/1475-2875-11-317
[17]. Exavery, A., Mbaruku, G., Mbuyita, S., Makemba, A., Kinyonge, I. P., Kweka, H., 2014, Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania. Malaria Journal, 13(1), 1–9, https://doi.org/10.1186/1475-2875-13-22
[18]. Boateng, E. Y., Anyormi, G. E., Otoo, J., Abaye, D. A., 2018, Drivers of intermittent preventive treatment of malaria during pregnancy in Ghana: A generalized linear model with negative binomial approach. Applied Informatics, 5(10), 1–12, https://doi.org/10.1186/s40535-018-0057-6
[19]. Ansong, D., Otoo, D. M., Mensah, V., 2025, Knowledge, uptake and therapeutic effectiveness of sulfadoxine-pyrimethamine (IPTp-SP) among pregnant women attending the antenatal clinic at Ayeduase Health Centre in Oforikrom Municipality in the Ashanti Region, Ghana. BMC Pregnancy and Childbirth, 25(265), 1–13, https://doi.org/10.1186/s12884-024-07089-4
[20]. Kretchy, I. A., Atobrah, D., Adumbire, D. A., Ankamah, S., Adanu, T., Badasu, D. M., 2025, Enhancing the uptake of intermittent preventive treatment for malaria in pregnancy: A scoping review of interventions and gender-informed approaches. Malaria Journal, 24(49), 1–17, https://doi.org/10.1186/s12936-025-05275-z
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Data-Linked Community-Health Facility Strategy to Identify and Reach Zero-Dose Children in Urban Informal Settlements: An Implementation Study in Wakiso District, UgandaAuthor: Dominic Savio KakeetoDOI: 10.21522/TIJAR.2014.13.02.Art002
Data-Linked Community-Health Facility Strategy to Identify and Reach Zero-Dose Children in Urban Informal Settlements: An Implementation Study in Wakiso District, Uganda
Abstract:
Despite substantial global progress in routine childhood immunisation, inequities persist, particularly among children living in urban informal settlements. Globally, an estimated 13 million children remain zero-dose each year—defined as children who have not received the first dose of a diphtheria–tetanus–pertussis (DTP)-containing vaccine. These children represent the most systematically excluded populations within immunisation systems and face the highest risk of vaccine-preventable diseases. In Uganda, rapid urbanisation has contributed to the concentration of zero-dose children in peri-urban districts such as Wakiso, where informal settlements are characterised by high population mobility, weak community–health facility linkages, and fragmented immunisation data systems. This study evaluates the effectiveness and implementation performance of a data-linked community–health facility strategy to improve identification, referral completion, and vaccination uptake among zero-dose and under-immunised children aged 0–23 months in urban informal settlements of Wakiso District, Uganda. A mixed-methods implementation research design will be used. Quantitative data will be obtained from routine immunisation records, household verification surveys, and integrated community registers, while qualitative data will be collected through focus group discussions and key informant interviews with caregivers, Village Health Teams, and health workers. Primary outcomes include changes in the identification and vaccination initiation of zero-dose children, measured through DTP1 uptake. Secondary outcomes include the acceptability, feasibility, and scalability of the intervention using the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) framework. By strengthening integration between community-generated data and health facility immunisation records, the study aims to generate practical implementation evidence for improving immunisation equity in urban informal settlements. Findings will inform district immunisation microplanning and outreach strategies. The study will also generate implementation-relevant evidence to support national immunisation policy and scalable approaches for identifying and reaching zero-dose children in rapidly urbanising settings.
Data-Linked Community-Health Facility Strategy to Identify and Reach Zero-Dose Children in Urban Informal Settlements: An Implementation Study in Wakiso District, Uganda
References:
[1]. World Health Organization, 2023, Immunization coverage. World Health Organization, Geneva. Available at: https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
[2]. Gavi, the Vaccine Alliance, 2021, The Zero-Dose Strategy 2021–2025: Reaching children who have never been vaccinated. Gavi Secretariat, Geneva. Available at: https://www.gavi.org
[3]. UNICEF, 2023, The State of the World’s Children 2023: For every child, vaccination. United Nations Children’s Fund, New York. Available at: https://www.unicef.org/reports/state-of-worlds-children-2023
[4]. United Nations Human Settlements Programme (UN-Habitat), 2022, World Cities Report 2022: Envisaging the Future of Cities. UN-Habitat, Nairobi. Available at: https://unhabitat.org
[5]. Antai, D., & Awofeso, N., 2014, The urban paradox in child health: Trends and determinants of vaccination coverage in urban settings. BMC Public Health, 14, 349. https://doi.org/10.1186/1471-2458-14-349
[6]. Fotso, J. C., Ezeh, A. C., Madise, N. J., & Ciera, J., 2007, Progress towards the child mortality millennium development goal in urban sub-Saharan Africa: The dynamics of population growth, immunization, and health service utilization. Health & Place, 13(1), 205–215. https://doi.org/10.1016/j.healthplace.2005.11.001
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[8]. Uganda Ministry of Health, 2023, Uganda National Immunization Strategy 2024–2028. Ministry of Health, Kampala. Available at: https://health.go.ug
[9]. UNICEF & World Health Organization, 2022, Reaching Zero-Dose Children: A global immunization strategy to improve equity in immunization. WHO and UNICEF, Geneva. Available at: https://www.who.int
[10]. Sambayuka, A., Mshana, C., & Mboya, D., 2023, Rapid urban immunization intervention to identify and vaccinate zero-dose children in Dar es Salaam, Tanzania. Vaccine, 41(12), 2015–2022. https://doi.org/10.1016/j.vaccine.2023.01.067
[11]. Jammeh, A., Sowe, A., & Camara, A., 2023, Barriers to childhood vaccination in urban informal settlements: A systematic review. BMC Health Services Research, 23, 1043. https://doi.org/10.1186/s12913-023-09961-3
[12]. McLennan, S., Wicker, S., & Bettenworth, D., 2022, Vaccine hesitancy and public trust in vaccination programs in low- and middle-income countries. Vaccine, 40(10), 1452–1458. https://doi.org/10.1016/j.vaccine.2021.12.019
[13]. Amouzou, A., Maiga, A., & Yoder, P., 2023, Social determinants of vaccination uptake in sub-Saharan Africa: A multi-country analysis. The Lancet Global Health, 11(4), e543–e552. https://doi.org/10.1016/S2214-109X(23)00034-4
[14]. Santos, T., Wallace, A., & Goodson, J., 2024, Structural barriers to immunization in urban informal settlements: Implications for equitable vaccination coverage. Vaccine, 42(5), 742–749. https://doi.org/10.1016/j.vaccine.2023.12.011
[15]. Zimba, R., Kulkarni, S., & Kawooya, M., 2024, Understanding the urban immunization paradox in sub-Saharan Africa. Global Health Research and Policy, 9(1), 21. https://doi.org/10.1186/s41256-024-00319-7
[16]. Bedford, H., Attwell, K., & Danchin, M., 2018, Vaccine hesitancy, refusal and access barriers: The need for clarity in terminology. Vaccine, 36(44), 6556–6558. https://doi.org/10.1016/j.vaccine.2017.08.004
[17]. Andersen, R. M., 1995, Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior, 36(1), 1–10. https://doi.org/10.2307/2137284
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Intergenerational Transmission of Menstrual Shame: A Qualitative Investigation of Parental Influence on Adolescent Menstrual Health Attitudes in Urban GhanaAuthor: Aba Appiah-Mensah AmpemDOI: 10.21522/TIJAR.2014.13.02.Art003
Intergenerational Transmission of Menstrual Shame: A Qualitative Investigation of Parental Influence on Adolescent Menstrual Health Attitudes in Urban Ghana
Abstract:
This qualitative study examined how parents transmit menstrual health attitudes and knowledge to their adolescent daughters in urban Ghana through focus group discussions with 15 parents representing diverse socio-economic backgrounds and educational levels. Thematic analysis revealed four major themes: intergenerational transmission of menstrual shame despite improved hygiene practices, persistent influence of cultural and religious beliefs on menstrual attitudes, notable generational shifts in comfort levels with menstrual discussions, and evolving perspectives on male involvement in menstrual health education. Parents acknowledged transmitting the same shame and discomfort they experienced in their own adolescence, despite possessing better factual knowledge than previous generations. Cultural restrictions preventing menstruating girls from cooking, touching food, or participating in ceremonies remained firmly embedded across socio-economic levels, while religious beliefs imposed additional constraints on worship and spiritual activities. Parents expressed internal conflicts between maintaining traditional practices and adapting to modern health perspectives, using ancestral teachings to legitimize restrictive attitudes. However, parents also recognized that their daughters' generation demonstrates greater openness and comfort with menstrual topics compared to their own upbringing, though many admitted their personal discomfort continues despite intellectual acceptance of menstruation as normal. Educated urban parents increasingly supported teaching boys about menstruation to create supportive environments, while traditional attitudes maintaining menstruation as exclusively female knowledge persisted particularly in less educated populations. These findings illuminate the complex mechanisms through which cultural beliefs persist across generations even as health knowledge improves, highlighting the critical need for family-centered interventions addressing both parents' and daughters' attitudes simultaneously rather than focusing on adolescent education alone.
Intergenerational Transmission of Menstrual Shame: A Qualitative Investigation of Parental Influence on Adolescent Menstrual Health Attitudes in Urban Ghana
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[3]. Mohammed, S., and Larsen-Reindorf, R. E., 2020, Menstrual knowledge, sociocultural restrictions, and barriers to menstrual hygiene management in Ghana: Evidence from a multi-method survey among adolescent schoolgirls and schoolboys. PLoS ONE, 15(10), e0241106.
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[18]. Dwumfour-Asare, B., Agbemafle, I., Nyarko, K. B., et al., 2024, Menstrual hygiene management among adolescent girls in low- and middle-income countries: A scoping review. International Journal of Environmental Research and Public Health, 21(3), 345-362.
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87-98.[26]. Agyei-Sarpong, N., Mensah-Bonsu, A., and Adu-Gyamfi, R., 2025, School environment and menstrual hygiene management: Evidence from Greater Accra Region, Ghana. Journal of School Health, 95(1), 12-24.
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Navigating Institutional Gaps: Lived Experiences of Family Caregivers Managing Chronic Psychosis in ZambiaAuthor: Virginia SimasikuDOI: 10.21522/TIJAR.2014.13.02.Art004
Navigating Institutional Gaps: Lived Experiences of Family Caregivers Managing Chronic Psychosis in Zambia
Abstract:
Family caregivers bear the burdens of managing chronic psychosis as critical yet unrecognised partners in clinical decision making particularly in low resource settings where institutional support is inadequate. Their support exceeds beyond relational responsibility to include clinical decision making, medication management and crisis management. The objective of the study was to explore the experiences of caregivers on the roles, challenges and interactions with the formal mental health services. The study recruited 30 participants through purposive sampling and collected data using in-depth interviews. Data were analysed using the interpretive phenomenological design by Smith et.al (2009) criteria to identify superordinate and subordinate themes. Three overarching themes were identified: 1) primary managers of treatment decisions, 2) integrating biomedical and spiritual decision making, and 3) bearing clinical responsibility without adequate support. The experiences highlight the central role of caregivers in the management of psychosis within the limited mental health services. In conclusion, caregivers should be recognised as core stakeholders in clinical decision making rather than health seekers, as failure to integrate them may endanger their wellbeing. This risk of mismanagement could result from emotionally based decisions due to poor education on the illness. There is need to continuously engage caregivers in care planning, knowledge on adverse effects, provision of coping strategies and management of psychosis. These findings provide a basis for mental health policy to structure caregivers’ frameworks that include mandatory crisis guidance and to nursing practice by incorporating routine assessments of caregiver wellbeing and support as standard psychiatric care.
Navigating Institutional Gaps: Lived Experiences of Family Caregivers Managing Chronic Psychosis in Zambia
References:
[1]. Hardy, A., Keen, N., van den Berg, D., Varese, F., Longden, E., Ward, T., & Brand, R. M., 2023, Trauma therapies for psychosis: A state-of-the-art review. Psychology and Psychotherapy: Theory, Research and Practice, 96(4), 1234–1256, https://doi.org/10.1111/papt.12499
[2]. Solmi, M., Seitidis, G., Mavridis, D., Correll, C. U., Dragioti, E., Guimond, S., Tuominen, L., Dargél, A., et al., 2023, Incidence, prevalence, and global burden of schizophrenia—data, with critical appraisal, from the Global Burden of Disease (GBD) 2019. Molecular Psychiatry, 28, 5319–5327, https://doi.org/10.1038/s41380-023-02138-4
[3]. Deng, S., Wang, Y., Peng, M., Zhang, T., Li, M., Luo, W., & Ran, M., 2023, Quality of life among family caregivers of people with schizophrenia in rural China. Quality of Life Research, 32(6), 1759-1769. https://doi.org/10.1007/s11136-023-03349-6
[4]. Yoo, A., Kim, M., Ross, M. M., Vaughn-Lee, A., Butler, B., & dosReis, S., 2018, Engaging Caregivers in the Treatment of Youth with Complex Developmental and Mental Health Needs. The Journal of Behavioral Health Services & Research, 45(3), 440-453. https://doi.org/10.1007/s11414-018-9604-0
[5]. Isaacs, A. N., Lawn, S., Lambert, C., and Dyer, A., 2025, A qualitative study of the responsibilities and unmet needs of carers of persons with severe mental health challenges. Journal of Mental Health, 1–11. https://doi.org/10.1080/09638237.2025.2558501
[6]. Alasmee, N., 2020, Primary caregivers experience of anti-psychotic medication: A qualitative study. Archives of Psychiatric Nursing, 34(6), 520-528. https://doi.org/10.1016/j.apnu.2020.09.002
[7]. Stomski, N. J., & Morrison, P., 2018, Carers' involvement in decision making about antipsychotic medication: A qualitative study. Health Expectations: An International Journal of Public Participation in Health Care and Health Policy, 21(1), 308–31. https://doi.org/10.1111/hex.12616
[8]. Lewins, A., Morant, N., Akther-Robertson, J., Crellin, N. E., Stansfeld, J. L., Smith, R., and Moncrieff, J., 2024, A qualitative exploration of family members’ perspectives on reducing and discontinuing antipsychotic medication. Journal of Mental Health, 33(3), 333–340. https://doi.org/10.1080/09638237.2022.2069710
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Assessment of Knowledge, Attitude and Practice of Food Safety and Hygiene Procedure among Rural and Urban Food Vendors in Oyo State, NigeriaAuthor: Olatunde Ademoye FalusiDOI: 10.21522/TIJAR.2014.13.02.Art005
Assessment of Knowledge, Attitude and Practice of Food Safety and Hygiene Procedure among Rural and Urban Food Vendors in Oyo State, Nigeria
Abstract:
Foodborne diseases are a major global health problem that kills millions of people each year, especially in low- and middle-income countries. In Nigeria, food contamination due to improper handling and poor hygiene by street vendors is a major cause of diseases such as diarrhea and cholera. The objective of this study was to assess the knowledge, attitudes and practices (KAP) of food vendors in rural and urban areas of Oyo State, Nigeria, on food safety and hygiene practices. A cross-sectional descriptive study was conducted among 350 food vendors in Oyo State, selected using multistage sampling techniques. Data were collected using a pre-tested self-administered questionnaire designed based on objectives and analysed using an IBM SPSS version 25.0. Findings were presented using charts and tables and the level of significance was at p<0.05. The study results showed that 96.6% of urban vendors had good knowledge of food safety, while 70.3% of rural vendors had knowledge of food safety. However, urban vendors had a higher negative attitude toward food safety (57.7%) compare to rural vendors. In terms of practice, 86.9% of urban vendors adhered to good hygiene practices, while rural vendors had a higher compliance rate (95.4%). Factors such as education level and marital status were significantly associated with food safety knowledge and practices. Despite high levels of knowledge, urban vendors showed low attitudes and hygiene practices, indicating a gap between knowledge and implementation. Targeted interventions aimed at changing behaviour and improving hygiene practices are recommended to improve food safety, especially in urban area.
Assessment of Knowledge, Attitude and Practice of Food Safety and Hygiene Procedure among Rural and Urban Food Vendors in Oyo State, Nigeria
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Trends in Cardiovascular Risk Factors and Mortality among Adults with Diabetes in Sub-Saharan Africa (2000-2025): A Secondary Data AnalysisAuthor: Jean-Paul Mukeba TshitendeDOI: 10.21522/TIJAR.2014.13.02.Art006
Trends in Cardiovascular Risk Factors and Mortality among Adults with Diabetes in Sub-Saharan Africa (2000-2025): A Secondary Data Analysis
Abstract:
Cardiovascular disease remains the leading cause of morbidity and mortality among people with type 2 diabetes mellitus. In sub-Saharan Africa, the burden of diabetes and its cardiovascular complications have increased substantially over the past two decades, yet long-term regional trend analyses remain limited. This study examined trends in diabetes prevalence, major cardiovascular risk factors, and diabetes-attributable cardiovascular mortality in sub-Saharan Africa between 2000 and 2025, using publicly available secondary data. A descriptive secondary data analysis was conducted using regionally aggregated and modelled estimates from the World Health Organisation Global Health Observatory, the International Diabetes Federation Diabetes Atlas, and the Global Burden of Disease Study. Trends in diabetes prevalence, hypertension, obesity, physical inactivity, and diabetes-attributable cardiovascular mortality were examined across the study period. Diabetes prevalence increased steadily across sub-Saharan Africa between 2000 and 2025, with a more pronounced rise observed after 2010. Hypertension emerged as the most prevalent cardiovascular risk factor among adults with diabetes, accompanied by increasing levels of obesity and physical inactivity. Cardiovascular mortality attributable to diabetes also increased consistently over the study period, with stroke and hypertensive heart disease accounting for a substantial proportion of deaths. The findings demonstrate a sustained rise in diabetes prevalence, a progressive accumulation of major cardiovascular risk factors, and increasing cardiovascular mortality attributable to diabetes in sub-Saharan Africa over the past two decades. These trends highlight the urgent need for integrated non-communicable disease prevention strategies and strengthened primary healthcare systems to reduce the growing cardiovascular burden among people with diabetes.
Trends in Cardiovascular Risk Factors and Mortality among Adults with Diabetes in Sub-Saharan Africa (2000-2025): A Secondary Data Analysis
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[30]. Sobngwi, E., Mbanya, J. C. N., Unwin, N. C., Aspray, T. J., Alberti, K. G. M. M., and Collins, R., 2012, Diabetes mellitus and its complications in sub-Saharan Africa: A systematic review. The Lancet, 378(9786), 2254–2264. https://doi.org/10.1016/S0140-6736(11)60550-8
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Attitude as a Complete Mediator: Unraveling the Knowledge-Practice Paradox in Adolescent Menstrual Hygiene Management in Urban GhanaAuthor: Aba Appiah-Mensah AmpemDOI: 10.21522/TIJAR.2014.13.02.Art007
Attitude as a Complete Mediator: Unraveling the Knowledge-Practice Paradox in Adolescent Menstrual Hygiene Management in Urban Ghana
Abstract:
This study investigated the knowledge-attitude-practice relationships in menstrual hygiene management among 386 adolescent girls aged 10-19 years in the Greater Accra Region of Ghana, employing structural equation modeling to test mediating and moderating mechanisms. Results revealed substantial knowledge deficits with only 47.2 percent demonstrating good knowledge (mean score 10.8/20, 54.0 percent), while 56.7 percent exhibited good practices (mean 15.9/20, 79.5 percent) and 52.3 percent held positive attitudes (mean 3.97/5, 79.5 percent). Structural equation modeling demonstrated that knowledge did not directly predict practices (β equals 0.091, p equals 0.573) but influenced them indirectly through attitudes as a complete mediator (β equals 0.316, p less than 0.001), challenging traditional knowledge-deficit models. Parental guidance significantly moderated the knowledge-practice relationship (β equals 0.693, p equals 0.001), while age and education showed no moderation effects. These findings validate Social Cognitive Theory reciprocal determinism and Theory of Planned Behaviour attitude-behaviour pathways, supporting family-centered interventions that address attitude formation and environmental support systems rather than isolated knowledge transfer for improving adolescent menstrual health management in urban Ghana.
Attitude as a Complete Mediator: Unraveling the Knowledge-Practice Paradox in Adolescent Menstrual Hygiene Management in Urban Ghana
References:
[1]. Dwumfour-Asare, B., Agbemafle, I., Nyarko, K. B., et al., 2024, Menstrual hygiene management among adolescent girls in low- and middle-income countries: A scoping review. International Journal of Environmental Research and Public Health, 21(3), 345-362.
[2]. Mohammed, S., and Larsen-Reindorf, R. E., 2020, Menstrual knowledge, sociocultural restrictions, and barriers to menstrual hygiene management in Ghana: Evidence from a multi-method survey among adolescent schoolgirls and schoolboys. PLoS ONE, 15(10), e0241106.
[3]. UNICEF and WHO, 2022, Progress on Household Drinking Water, Sanitation and Hygiene 2000-2020: Five Years into the SDGs. Geneva: United Nations Children's Fund and World Health Organization.
[4]. World Bank, 2025, Menstrual Health and Hygiene. Washington, DC: The World Bank Group.
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[7]. Anbesu, E. W., and Asgedom, Z. A., 2023, Menstrual hygiene practice and its associated factors among adolescent girls in sub-Saharan Africa: A systematic review and meta-analysis. BMC Public Health, 23(1), 892.
[8]. Belayneh, Z., and Mekuriaw, B., 2019, Knowledge and menstrual hygiene practice among adolescent school girls in southern Ethiopia: A cross-sectional study. BMC Public Health, 19(1), 1595.
[9]. Bulto, G. A., 2021, Knowledge towards menstruation and practice of menstrual hygiene management among adolescent girls in central Ethiopia: A cross-sectional study. Risk Management and Healthcare Policy, 14, 911-921.
[10]. Daniel, M., Araya, T., Mekonnen, Z., et al., 2023, Menstrual hygiene practice and associated factors among high school girls in Ethiopia: A systematic review and meta-analysis. Journal of Water, Sanitation and Hygiene for Development, 13(3), 145-159.
[11]. Hussein, M. H., Wijnhoven, A. M., van den Broek, I., et al., 2022, Knowledge, practices, and challenges regarding menstrual hygiene management amongst adolescent girls in Eritrea: A cross-sectional study. BMC Women's Health, 22(1), 456.
[12]. Stoilova, Y., Borowski, A., and Baumgartner, J. N., 2022, Menstrual health literacy among adolescent girls: A systematic review. Reproductive Health, 19(1), 78.
[13]. Gyasi-Gyamerah, A., Asante, K. P., Owusu-Agyei, S., et al., 2022, Menstrual hygiene management among adolescent girls in Ghana: Evidence from rural and peri-urban areas. International Journal of Women's Health, 14, 1345-1358.
[14]. Kpodo, F. M., Baku, E. A., Kumi-Kyereme, A., et al., 2022, Socio-cultural factors influencing menstrual hygiene management among adolescent girls in Ghana. Journal of Health, Population and Nutrition, 41(1), 23.
[15]. Asumah, M. N., Opoku-Agyemang, C., Adokiya, M. N., et al., 2022, School preparedness and menstrual hygiene management among adolescent girls in northern Ghana. BMC Women's Health, 22(1), 178.
[16]. Baku, E. A., Agbemafle, I., Kotoh, A. M., et al., 2020, Menstrual hygiene management and school absenteeism among adolescent girls in Ghana. International Journal of Adolescent Medicine and Health, 32(4), 189-197.
[17]. Adane, B. B., Kaso, M., Lenjebo, T. L., et al., 2024, Poor menstrual hygiene management and associated factors among school adolescent girls in northeast Ethiopia: A cross-sectional study. Reproductive Health, 21(1), 45.
[18]. Quayson, E., Opoku-Agyeman, K., and Amoah, S. T., 2024, Awareness versus practice: Examining menstrual hygiene management among urban adolescent girls in Ghana. Health Education Research, 39(2), 156-171.
[19]. Bandura, A., 1986, Social Foundations of Thought and Action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.
[20]. Ajzen, I., 1991, The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179-211.
[21]. Hair, J. F., Black, W. C., Babin, B. J., et al., 2019, Multivariate Data Analysis (8th ed.). Andover: Cengage Learning.
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[27]. Sarpong, K. A., and Amoako, E., 2024, Male involvement in menstrual health discussions: Perspectives from Ghanaian adolescents. Gender and Development, 32(3), 245-261.
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[29]. Sahiledengle, B., Mwanri, L., Petrucka, P., et al., 2022, Determinants of menstrual hygiene management practices among adolescent girls in low and middle-income countries: A systematic review. International Journal of Environmental Research and Public Health, 19(21), 14122.
[30]. Umami, F., Hasanah, O., and Devy, S. R., 2022, Factors associated with menstrual hygiene management among adolescent girls: A systematic review. International Journal of Women's Health, 14, 1567-1582.
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A Desk Review of Standard Operating Procedures of Ethics Committees in the Philippines on the Review of Clinical Trial Protocol DeviationsAuthor: Edwin C. Ruamero, Jr.DOI: 10.21522/TIJAR.2014.13.02.Art008
A Desk Review of Standard Operating Procedures of Ethics Committees in the Philippines on the Review of Clinical Trial Protocol Deviations
Abstract:
The review of post-approval submissions such as clinical trial protocol deviations (PDs) is a key function of Ethics Committees (ECs) to ensure data integrity and participant safety. However, the quality of PD management by ECs depends on the SOPs that are anchored in national and international guidelines. This desk review aimed to analyze the SOPs of Level III-accredited ECs in the Philippines in terms of protocol deviation management. From July to September 2025, SOPs of ECs were obtained from institutional websites and through web searches. The SOPs were then compared with recommendations by the Philippine Health Research Board SOP workbook for the presence or absence of the following: (a) policy statement; (b) objectives; (c) scope; and (d) work flow; (e) definition of protocol deviation (PD) or protocol violation (PV); and determine the (f) required timeline for submission to EC; (g) EC processing time; and (h) type of review for the noncompliance. A total of 28 SOPs were reviewed. The results revealed that while most institutional SOPs follow PHREB recommendations, ECs operationalize PD review differently. Key SOP provisions, such as the definition of PD/PV, timelines for reporting, processing time, and the type of review, can affect the quality of EC review and resolution of clinical trial noncompliance. Future research should extend beyond document analysis to investigate the practical implementation of SOP provisions regarding protocol deviation management.
A Desk Review of Standard Operating Procedures of Ethics Committees in the Philippines on the Review of Clinical Trial Protocol Deviations
References:
[1]. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, 2025, Good Clinical Practice (ICH E6(R3)). Available from: https://database.ich.org/sites/default/files/ICH_E6%28R3%29_Step4_FinalGuideline_2025_0106.pdf
[2]. U.S. Department of Health, Human Services Food and Drug Administration Center for Drug Evaluation, Research (CDER) Center for Biologics Evaluation and Research (CBER) Guidance for Industry. E3 Structure and Content of Clinical Study Reports, 2013. Available from: https://www.fda.gov/media/84857/download
[3]. Council for International Organizations of Medical Sciences, 2016, International Ethical Guidelines for Health-related Research Involving Humans. Available from: https://cioms.ch/wp-content/uploads/2017/01/WEB-CIOMS-EthicalGuidelines.pdf
[4]. Ghooi, R. B., Bhosale, N., Wadhwani, R., Divate, P., & Divate, U., 2016, Assessment and classification of protocol deviations. Perspectives in clinical research, 7(3), 132–136. https://doi.org/10.4103/2229-3485.184817
[5]. Zemsi, A., Nekame, L. J. G., Mohammed, N., et al., 2024, Practical Guidelines for Standardised Resolution of Important Protocol Deviations in Clinical Trials Conducted in Sub-Saharan Africa. Ther Innov Regul Sci, 58, 395–403. https://doi.org/10.1007/s43441-023-00604-3
[6]. U.S. Department of Health and Human Services, Food and Drug Administration Center for Drug Evaluation and Research (CDER), Center for Biologics Evaluation and Research (CBER), Center for Devices and Radiological Health (CDRH), and Oncology Center of Excellence (OCE), 2024, Protocol Deviations for Clinical Investigations of Drugs, Biological Products, and Devices Guidance for Industry. Available from: https://www.fda.gov/media/184745/download
[7]. European Medicines Agency, 2023, Guideline for the notification of serious breaches of Regulation (EU) No 536/2014 or the clinical trial protocol. Available from: https://www.ema.europa.eu/en/documents/scientific-guideline/guideline-notification-serious-breaches-regulation-eu-no-5362014-or-clinical-trial-protocol_en.pdf#page=8.08
[8]. World Health Organization, 2005, Handbook for good clinical research practice (GCP): guidance for implementation. Available from: https://iris.who.int/handle/10665/43392
[9]. Philippine Council for Health Research and Development (PCHRD), 2020, About PCHRD. Available from: https://www.pchrd.dost.gov.ph/about-pchrd/#
[10]. Philippine National Health Research System, 2006, National Ethical Guidelines for Health Research. Available from: https://ethics.healthresearch.ph/index.php/phoca-downloads/category/4-neg?download=33:neghr-2006
[11]. Philippine Council for Health Research and Development (PCHRD), 2015, PHREB Level 3 Accredited RECs. Available from: https://ethics.healthresearch.ph/index.php/level-3-accredited-recs
[12]. Philippine Health Research Ethics Board, 2020, PHREB Standard Operating Procedures. Available from: https://ethics.healthresearch.ph/index.php/phoca-downloads/category/19-2020-phreb-sop-workbook
[13]. Philippine Health Research Ethics Board, n.d., Ethics in Research - Capacity Building for RECs in Davao Region. Available at: https://ethics.healthresearch.ph/index.php/2018-08-28-03-27-16/remb-region-xi/369-ethics-in-research-capacity-building-for-recs-in-davao-region#:~:text=The%20training%20consists%20of%20lectures,Josephine%20Lumitao%20of%20PHREB
[14]. University of the Philippines Open University, 2021, Standard Operating Procedure (SOP) Workshop. Available at: https://www.upou.edu.ph/news/phreb-and-pchrd-conduct-standard-operating-procedure-workshop-for-up-open-university-institutional-research-ethics-committee-upou-irec/
[15]. Region 1 Health Research and Development Consortium, 2019, SOP Workshop Conducted for Quality Assurance. Available at: https://region1.healthresearch.ph/index.php/17-news/latest-news/177-sop-workshop-conducted-for-quality-assurance#:~:text=In%20order%20to%20help%20the,and%20simplify%20their%20unclear/vagueprocesses.
[16]. Philippine Health Research Ethics Board, 2022, National Ethical Guidelines for Research Involving Human Participants. Available at: https://www.pchrd.dost.gov.ph/wp-content/uploads/2023/05/2022-NEGRIHP_Official-Gazatte_Ver-5-1.pdf
[17]. Republic of the Philippines, Department of Health, 2020, Administrative Order 2020-0010- Regulations on the Conduct of Clinical Trials for Investigational Products. Available at: https://www.fda.gov.ph/wp-content/uploads/2020/05/Administrative-Order-2020-0010.pdf
[18]. Halwai, A., & Vaswani, V., 2023, Post-approval process: A challenge for ethics committees. Perspectives in Clinical Research, 14(3), 139-145. DOI: 10.4103/picr.picr_214_22.
[19]. Shetty, Y. C., & Seetharaman, R., 2023, Strengthening postapproval oversight in research ethics committees: Challenges and solutions. Perspectives in Clinical Research, 14(3), 105-107. Doi: 10.4103/picr.picr_151_23
[20]. Betchel, J., et al., 2020, Improving the quality conduct and efficiency of clinical trials with training: Recommendations for preparedness and qualification of investigators and delegates. Contemporary Clinical Trials, 89:105918. https://doi.org/10.1016/j.cct.2019.105918
[21]. Jalgaonkar, S. V., Bhide, S. S., Tripathi, R. K., Shetty, Y. C., Marathe, P. A., Katkar, J., & Thatte, U. M., 2016, An Audit of Protocol Deviations Submitted to an Institutional Ethics Committee of a Tertiary Care Hospital. PloS one, 11(1), e0146334. https://doi.org/10.1371/journal.pone.0146334
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Chemical Addiction in Intimate Relationships: The Neurobiology of Trauma Bonding and Emotional DependencyAuthor: Tolulope Oko-IgaireDOI: 10.21522/TIJAR.2014.13.02.Art009
Chemical Addiction in Intimate Relationships: The Neurobiology of Trauma Bonding and Emotional Dependency
Abstract:
The neurobiological reinforcement of trauma bonding and emotional dependency in intimate relationships is increasingly being understood as a process, as opposed to a purely psychological pattern. This review integrates evidence on fifteen peer-reviewed articles to investigate the interaction between dopaminergic reward systems, oxytocin-mediated bonding systems, cortisol-induced stress responses, and reinforcement-learning processes to maintain maladaptive attachment despite the occurrence of relational inconsistency, conflict cycles, or intermittent affection. The key goal was to combine the results of addiction neuroscience, attachment theory, and trauma psychology to have a single explanation of the continuity of the emotionally dysregulated relational bonds. Five major databases were searched in a structured literature search, and 612 records were located; 15 records were included in the study that was analyzed using thematic synthesis based on reward processing, attachment neuropeptides, HPA-axis regulation and cognitive-emotional conditioning. Findings indicate that trauma bonding is the result of a vicious cycle of increased dopamine-based reward sensitivity, oxytocin-based trust and emotional proximity, cortisol-related hyperarousal, and attachment-based cognitive distortions. These interdependent systems produce the addiction-like patterns of stress, relief and reconnection that strengthen emotional dependence in spite of misery. The review finds that trauma bonding is a neurobiological phenomenon that is multisystemic and needs to be addressed with trauma-informed and neurobiologically oriented therapy in order to be effectively treated. More studies are required to develop specific clinical resources and models that would help to overcome these complicated relational dynamics.
Chemical Addiction in Intimate Relationships: The Neurobiology of Trauma Bonding and Emotional Dependency
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[5]. Arias-Carrión, O., Pöppel, E., 2007, Dopamine, learning, and reward-seeking behavior. Acta Neurobiologiae Experimentalis, 67, 481–488.
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1048–1054.[8]. Schneiderman, I., Zagoory-Sharon, O., Leckman, J. F., Feldman, R., 2012, Oxytocin during the initial stages of romantic attachment. Psychoneuroendocrinology, 37(8), 1277–1285.
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Knowledge and Attitude of Dental Clinicians and Dental Technologists on Removable Complete Denture Fabrication Procedures in Uganda: A Qualitative StudyAuthor: David NonoDOI: 10.21522/TIJAR.2014.13.02.Art010
Knowledge and Attitude of Dental Clinicians and Dental Technologists on Removable Complete Denture Fabrication Procedures in Uganda: A Qualitative Study
Abstract:
Removable Complete Dentures (RCDs) are crucial for restoring function and aesthetics in edentulous patients. The prevalence of edentulism rises with age, affecting 2.3% of the world's population. This study explored the knowledge and attitudes of dental clinicians and technologists regarding Removable Complete Denture (RCD) fabrication procedures at Makerere University Dental Hospital, Uganda. This qualitative study employed a phenomenological approach and 25 respondents were purposively selected to elicit data on a range of patient-specific considerations and needs during the Removable Complete Dentures fabrication process. Semi-structured interviews were conducted, and data were analyzed thematically. Respondents identified the critical steps in RCD fabrication, including examination and diagnosis, impression taking, determination of Occlusal Rim Block (ORB) height, proper jaw relation recording, and meticulous fabrication techniques during RCD fabrication, continuous professional development and patients’ education, and went further to explain how these processes align with international guidelines. While dental clinicians and technologists generally adhered to international guidelines, our findings highlighted the need for updated and context-specific guidelines tailored to the Ugandan setting, as well as the importance of effective communication and synchronization among dental practitioners for successful RCD fabrication. The study highlighted dental clinicians' and technologists' knowledge of critical steps in removable complete denture (RCD) fabrication emphasized the need for updated, context-specific guidelines, particularly in impression taking, occlusal rim block height, removable complete denture fabrication steps, examination and diagnosis and patient education, to ensure accurate measurements and improved patient outcomes.
Knowledge and Attitude of Dental Clinicians and Dental Technologists on Removable Complete Denture Fabrication Procedures in Uganda: A Qualitative Study
References:
[1]. Awawdeh, M., Alotaibi, M. B., Alharbi, A. H., Alnafisah, S. A., Alasiri, T. S., Alrashidi, N. I., and Alnafisah, S. A., 2024, A systematic review of patient satisfaction with removable partial dentures (RPDs). Cureus, 16(1).
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[3]. Nono, D., Bagenda, G., Okullo, I., and Rwenyonyi, C. M., 2024, Exploring lived experiences on the usage of removable complete dentures among edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda. BMC Oral Health, 24(1), p.709.
[4]. Felton, D., Cooper, L., Duqum, I., Minsley, G., Guckes, A., Haug, S., Meredith, P., Solie, C., Avery, D., and Deal Chandler, N., 2011. Evidence‐based guidelines for the care and maintenance of complete dentures: A publication of the American College of Prosthodontists. Journal of Prosthodontics: Implant, Esthetic and Reconstructive Dentistry, 20, pp. S1-S12.
[5]. Kausher, H., Suganna, M., Ali, A. B. M. R., Ahmed, S. T., Punj, A., and Gomawi, A. A., 2023, Dental Technicians’ Perception of the Quality of Dentists’ Communication on the Fabrication of Removable Partial Dentures: A Cross-Sectional Study in Saudi Arabia. Cureus, 15(11).
[6]. Prakash, P., Singh, K., Bahri, R., and Bhandari, S. K., 2020, Utility versus futility of facebow in the fabrication of complete dentures: A systematic review. The Journal of Indian Prosthodontic Society, 20(3), pp.237-243.
[7]. Farias Neto, A., Mestriner Junior, W., and Carreiro, A. D. F. P., 2010, Masticatory afficiency in denture wearers with bilateral balanced occlusion and canine guidance. Brazilian Dental Journal, 21, pp.165-169.
[8]. Al-Quran, F. A., Al-Ghalayini, R. F. and Al-Zu'bi, B. N., 2011. Single-tooth replacement: factors affecting different prosthetic treatment modalities. BMC Oral Health, 11(1), p.34.
[9]. Albeshti, R., Khmaj, M., Khmaj, A., Albaden, A., and Almagtof, H., 2024, A Questionnaire-based Study on Impression Materials and Techniques for Complete Denture Construction among Dentists Practicing in Central/Western Regions of Libya. Libyan Journal of Dentistry, 8(1), pp. 33-41.
[10]. Deshmukh, M., Rajaraman, V., Duraisamy, R., and Maiti, S., 2022, Knowledge, awareness, and attitude of dentists toward use of denture adhesives in Tamil Nadu: A questionnaire survey. Journal of Advanced Pharmaceutical Technology & Research, 13(Suppl 1), pp. S243-S248.
[11]. Guest, G., Namey, E., and Chen, M., 2020, A simple method to assess and report thematic saturation in qualitative research. PloS One, 15(5), p.e0232076.
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[14]. Nono, D., Bagenda, G., Okullo, I., and Rwenyonyi, C. M., 2024, Exploring lived experiences with tooth loss among fully edentulous patients attending Makerere University Dental Hospital, Kampala, Uganda. BMC Oral Health, 24(1), p.1355.
[15]. World Medical Association, 2013, Declaration of Helsinki: Ethical principles for medical research involving human subjects. Journal of the American Medical Association, 310 (20):2191–4.
[16]. Saidin, W., Kassim, N., Yusof, Y., and Ahmad Rajion, Z., 2012, Manufacturing of removable complete dentures using vacuum casting technique. Applied Mechanics and Materials, 120, pp. 32-35.
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Pathways to Food Security: The Influence of Livelihood Assets and Shocks among Farming HouseholdsAuthor: Blessing Ukamaka UgwunneDOI: 10.21522/TIJAR.2014.13.02.Art011
Pathways to Food Security: The Influence of Livelihood Assets and Shocks among Farming Households
Abstract:
Food security remains a major challenge for farming households in low- and middle-income countries, where agricultural livelihoods are highly affected by economic, climatic, and social shocks. This study examines how livelihood assets, income-generating activities, exposure to shocks, and access to safety nets were associated with household food security among farming households in North Central Nigeria, a primary food production zone. Mixed-methods were used. Quantitative data were obtained from 615 farming, North Central households in the Nigeria General Household Survey Panel (2023/2024). Food security was measured using Food Insecurity Experience Scale (FIES). Logistic regressions were used to assess factors associated with food security. Qualitative data were collected through interviews and focus group discussions with farmers, community members, and local officials, focusing on perceptions of food access, livelihood strategies, and shock. Quantitative results showed that 56% of households were food secure. Higher levels of physical and financial capital were associated with higher odds of food security. Exposure to economic and consumption-related shocks was strongly associated with lower odds of food security. Female-headed households and larger households were less likely to be food secure. Qualitative findings highlighted that food security was affected by seasonal variations in agricultural production, and financial capacity. Participants reported that market price fluctuations and climatic events disrupted food access. Farming households in North Central Nigeria experience substantial food insecurity, associated with exposure to shocks and limited livelihood assets. Strengthening productive and financial assets and reducing vulnerability to shocks are critical for improving food security. These findings provide evidence to inform policies and interventions aimed at building resilience among farming households in rural agricultural communities.
Pathways to Food Security: The Influence of Livelihood Assets and Shocks among Farming Households
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Evaluating the Impact of Common Technical Document Adoption on Medicines Regulatory Performance in Nigeria: An Interrupted Time-Series AnalysisAuthor: Ake, Paul AyodeleDOI: 10.21522/TIJAR.2014.13.02.Art012
Evaluating the Impact of Common Technical Document Adoption on Medicines Regulatory Performance in Nigeria: An Interrupted Time-Series Analysis
Abstract:
The Common Technical Document (CTD) has been widely adopted to harmonise medicines regulatory submissions and strengthen regulatory systems, yet empirical evidence on its performance impact in low- and middle-income countries remains limited. This study evaluated the effect of CTD adoption on medicines regulatory performance in Nigeria using a quasi-experimental interrupted time-series design. Monthly regulatory data from January 2018 to December 2024 were analysed, with June 2020 marking the introduction of mandatory CTD submissions. Outcomes examined included medicines approval volumes, regulatory safety signals (alerts and recalls per 100 approvals), and post-market quality outcomes measured through risk-based post-market surveillance (RB-PMS) failure rates. Segmented regression analysis showed no statistically significant pre-intervention trend in approvals (p = 0.788), no immediate level change following CTD adoption (p = 0.658), and no significant post-intervention trend change (p = 0.723). Similarly, no significant changes were observed in regulatory safety signal rates at the point of CTD implementation (p = 0.971) or in post-intervention trends (p = 0.894). In contrast, RB-PMS outcomes showed a statistically significant immediate reduction in failure rates following CTD adoption (p < 0.001), followed by a significant positive post-intervention trend (p < 0.001), indicating that initial quality gains were not sustained over time. Overall, the findings suggest that CTD adoption functions as a foundational harmonisation reform but does not independently produce sustained improvements in regulatory throughput or safety outcomes without complementary institutional and operational strengthening.
Evaluating the Impact of Common Technical Document Adoption on Medicines Regulatory Performance in Nigeria: An Interrupted Time-Series Analysis
References:
[1]. International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use, n.d., The common technical document (CTD). ICH, https://www.ich.org/page/ctd.
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[3]. Ndomondo-Sigonda, M., Miot, J., Naidoo, S., Ambali, A., & Dodoo, A., 2017, Medicines regulation in Africa: Current state and opportunities. Pharmaceutical Medicine, 31(6), 383–397, https://doi.org/10.1007/s40290-017-0210-x.
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Assessment of Medication Errors and Prevention Strategies in Selected Hospitals in Kwara State, NigeriaAuthor: Idowu Makinde OlapemiDOI: 10.21522/TIJAR.2014.13.02.Art013
Assessment of Medication Errors and Prevention Strategies in Selected Hospitals in Kwara State, Nigeria
Abstract:
Medication errors pose a significant challenge to patient safety worldwide, with Africa bearing the highest burden of preventable medication-related harm; however, limited data exist for Kwara State, Nigeria. This study assessed the knowledge, awareness, prevalence, causes, and prevention strategies of medication errors among 450 healthcare workers in selected hospitals across the three senatorial zones of Kwara State, using a sequential explanatory mixed-method design that included key informant interviews with five professionals. Findings showed that 91.8% of participants were aware of medication errors, but only 60.2% demonstrated good knowledge, which was significantly associated with age, tribe, religion, and professional role. The prevalence of self-reported medication errors was 73.6%, with poor handwriting (62.9%) and lack of communication among healthcare providers (54.9%) identified as the main causes; the most common self-reported error was failure to consider patient allergies (48.9%). Although 73.8% of facilities had training programs and 67.3% had medication error reporting systems, key informants highlighted staff shortages and work overload as primary contributing factors. Participants recommended more frequent training (74.9%), improved interprofessional communication (70%), and increased resource allocation (97.3%) to reduce errors. The study concludes that despite high awareness, knowledge gaps remain, and the high prevalence of medication errors calls for urgent implementation of comprehensive prevention strategies, including regular training, adequate staffing, standardized reporting systems, and enhanced communication among healthcare professionals. Future studies should attempt to assess the drivers of the major causes of medication errors reported in the present study as well as identify the medication error rates in under-studied populations.
Assessment of Medication Errors and Prevention Strategies in Selected Hospitals in Kwara State, Nigeria
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[17]. Abdullahi, A. K., Fatima, I., Abdurrahaman, U., et al., 2023, Assessment of legibility of handwritten prescriptions and adherence to WHO prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria. Innovations in Pharmacy, 14(1), 51–64.
[18]. Afework, A., Tamene, A., Tesfaye, A., Tafa, A., & Gemede, S., 2023, Status and factors affecting patient safety culture at Dilla University Teaching Hospital: A mixed-method cross-sectional study. Risk Management and Healthcare Policy, 16, 1157–1169.
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[21]. Ayorinde, M. O., & Alabi, P. I., 2019, Perception and contributing factors to medication administration errors among nurses in Nigeria. International Journal of Africa Nursing Sciences, 11, 100153.
[22]. Sufiyan, M. A. B., Abdulkareem, S. B., Joshua, I. A., et al., 2023, Knowledge and perception of medication errors among healthcare workers in Ahmadu Bello University Teaching Hospital Zaria, Kaduna State, Nigeria. Nigerian Postgraduate Medical Journal, 30(2), 150–155.
[23]. Hariyati, R. T. S., Mediawati, A. S., & Eryando, T., 2021, Workload as the most important influencing factor of medication errors by nurses. Open Nursing Journal, 15(1), 204–210.
[24]. Alotaibi, J. S., 2024, Causes of medication administration errors and barriers to reporting as perceived by nurses in Saudi Arabia: A qualitative study. Belitung Nursing Journal, 10(2), 215–221.
[25]. Iloh, G. U. P., Chuku, A., & Amadi, A. N., 2017, Medical errors in Nigeria: A cross-sectional study of medical practitioners in Abia State. Archives of Medicine and Health Sciences, 5(1), 44–49.
[26]. Ikonne, P. I., & Nwozichi, C. U., 2024, Factors associated with medication error underreporting among healthcare professionals in Nigerian Air Force Hospital, Ikeja, Lagos, Nigeria. International Journal of Public Health Pharmacy and Pharmacology, 9(2), 37–55.
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[28]. Awoyale, O. D., Dairo, M. D., Fagbamigbe, A. F., et al., 2025, Yellow fever in plain sight: assessing disease surveillance officers' knowledge and self-efficacy in identification and reporting in Kwara State, Nigeria. BMC Public Health, 25(1), 2127.
[29]. Nwasor, E. O., Sule, S. T., & Mshelia, D. B., 2014, Audit of medication errors by anesthetists in North Western Nigeria. Nigerian Journal of Clinical Practice, 17(2), 226–231.
[30]. Nkurunziza, A., Chironda, G., & Mukeshimana, M., 2018, Perceived contributory factors to medication administration errors and barriers to self-reporting among nurses working in paediatric units of selected referral hospitals in Rwanda. International Journal of Research in Medical Sciences, 6(2), 401–407.
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Prevalence of Depression and Anxiety Among Nigerian Adolescents and the Impact of School-Based Cognitive Behavioural Therapy: A Randomized Controlled TrialAuthor: Freedom NwokediDOI: 10.21522/TIJAR.2014.13.02.Art014
Prevalence of Depression and Anxiety Among Nigerian Adolescents and the Impact of School-Based Cognitive Behavioural Therapy: A Randomized Controlled Trial
Abstract:
Mental health disorders, including depression and anxiety, pose a significant challenge among adolescents in low- and middle-income countries [LMICs] like Nigeria, where access to mental health care is limited. This study evaluated the prevalence of these conditions and the efficacy of school-based Cognitive Behavioural Therapy [CBT] among Nigerian adolescents through a randomized controlled trial [RCT]. 239 adolescents between the ages of 12 and 18 from secondary schools in Abeokuta, Ogun State, were randomly divided into two groups: 120 students participated in a CBT intervention group, while the remaining 119 formed a control group. The CBT programme, delivered by trained school counsellors over three weeks [three 45-minute sessions per week], focused on cognitive restructuring and coping strategies. Pre- and post-intervention assessments used the Patient Health Questionnaire-9 [PHQ-9] and Generalised Anxiety Disorder-7 [GAD-7] scales. Statistical analysis employed repeated measures ANOVA with significance set at p < 0.05. Baseline prevalence indicated 46.3% mild and 26.0% moderate depression, and 38.0% mild and 42.4% moderate anxiety. Post-intervention, the CBT group showed a significant reduction in anxiety [p = 0.001, Cohen’s d = 3.586] and a borderline significant reduction in depression [p = 0.059, Cohen’s d = 3.856] compared to the control group. Additional benefits included improved emotional regulation [p = 0.02, Cohen’s d = 0.61] and coping strategies [p = 0.01, Cohen’s d = 0.69], with no significant changes in the control group. In conclusion, School-based CBT is an effective and feasible intervention for reducing anxiety and depression among Nigerian adolescents, with potential for scalability in similar settings. Future studies should explore extended interventions and longitudinal outcomes to optimise impact.
Prevalence of Depression and Anxiety Among Nigerian Adolescents and the Impact of School-Based Cognitive Behavioural Therapy: A Randomized Controlled Trial
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Effectiveness of a Theory-Based Health Education on Knowledge of Long-Acting Reversible Contraceptives (LARC) among Women Attending Antenatal Clinics in Katsina State, NigeriaAuthor: Shaima’u KABIR AbbaDOI: 10.21522/TIJAR.2014.13.02.Art015
Effectiveness of a Theory-Based Health Education on Knowledge of Long-Acting Reversible Contraceptives (LARC) among Women Attending Antenatal Clinics in Katsina State, Nigeria
Abstract:
This study assessed how a theory-based health education intervention affected pregnant women in Katsina State, Nigeria, in terms of their increased awareness of and intention to use long-acting reversible contraceptives (LARC). 796 women were first enrolled and randomized into intervention and control groups using a randomized controlled trial methodology. There were 685 responders in the final analysis. Data was gathered at baseline, three months, and six months after the intervention, and an organized educational module based on the Health Belief Model (HBM) was given. The effectiveness of theory-driven education in promoting reproductive health was confirmed by the intervention's notable improvements in LARC knowledge, health beliefs, and intention to use LARC.
Effectiveness of a Theory-Based Health Education on Knowledge of Long-Acting Reversible Contraceptives (LARC) among Women Attending Antenatal Clinics in Katsina State, Nigeria
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Cardiovascular Disease Burden and Associated Risk Factors among Adults with Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Narrative ReviewAuthor: Jean-Paul Mukeba TshitendeDOI: 10.21522/TIJAR.2014.13.02.Art016
Cardiovascular Disease Burden and Associated Risk Factors among Adults with Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Narrative Review
Abstract:
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality among individuals with type 2 diabetes mellitus (T2DM) globally, and its burden is increasing rapidly in sub-Saharan Africa due to rising diabetes prevalence, population ageing, urbanization, and constrained health systems. This narrative review synthesizes evidence on the prevalence of CVD and associated risk factors among adults with T2DM in sub-Saharan Africa. A structured literature search was conducted across PubMed/MEDLINE, Scopus, Google Scholar, and African Journals Online, covering English-language publications from January 2000 to December 2025. Following screening and eligibility assessment, 42 studies were included and synthesized descriptively. The reviewed literature indicates that CVD is a common complication among adults with T2DM in sub-Saharan Africa, with reported prevalence ranging from approximately 20% to over 50%, depending on study setting and methodology. Hypertension-related CVD was the most frequently reported manifestation, followed by stroke, heart failure, and coronary artery disease. Increasing age, longer duration of diabetes, hypertension, poor glycemic control, dyslipidaemia, obesity, and adverse lifestyle behaviors emerged consistently as major cardiovascular risk factors. In addition, health system weaknesses—such as limited access to care, inadequate screening and diagnostic capacity, medication stock-outs, and fragmented chronic disease services—together with socioeconomic disadvantage, were recurrently associated with poor cardiovascular outcomes. Overall, the evidence highlights a substantial and growing cardiovascular burden among patients with T2DM in sub-Saharan Africa, driven by a convergence of modifiable clinical risk factors and structural health system and socioeconomic challenges. Strengthening integrated diabetes and cardiovascular care, improving access to essential services, and addressing underlying social determinants of health are critical priorities for reducing cardiovascular morbidity and mortality in this population.
Cardiovascular Disease Burden and Associated Risk Factors among Adults with Type 2 Diabetes Mellitus in Sub-Saharan Africa: A Narrative Review
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[30]. Kibirige, D., Lumu, W., Jones, A. G., Smeeth, L., Hattersley, A. T., and Nyirenda, M. J., 2019, Understanding the manifestations of diabetes in sub-Saharan Africa to inform therapeutic approaches and preventive strategies: A narrative review. Clinical Diabetes and Endocrinology, 5(2), 1–13. https://doi.org/10.1186/s40842-019-0078-9
[31]. Ekoru, K., Doumatey, A., Bentley, A. R., Chen, G., Zhou, J., Shriner, D., Fasanmade, O., Johnson, T., Oli, J., Okafor, G., Amoah, A., Acheampong, J., Agyenim-Boateng, K., Adeyemo, A., and Rotimi, C., 2020, Type 2 diabetes complications and comorbidities in sub-Saharan Africa: A multi-country study. The Lancet Diabetes & Endocrinology, 8(7), 548–558. https://doi.org/10.1016/S2213-8587(20)30113-4
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Institutional Shocks Transmission and Impact on Entrepreneurship Development in Developing EconomiesAuthor: Ayorinde A EzekielDOI: 10.21522/TIJAR.2014.13.02.Art017
Institutional Shocks Transmission and Impact on Entrepreneurship Development in Developing Economies
Abstract:
Entrepreneurship constitutes a major pathway through which developing economies pursue economic expansion and social transformation. This study investigates how institutional disturbances are transmitted across economies and how such disturbances influence self-employment and entrepreneurship development. Panel data drawn from twenty developing countries covering the period 1996–2022 are analysed using a Panel Vector Autoregression (PVAR) framework. The Generalized Forecast Error Variance Decomposition (GFEVD)and Impulse Response Functions (IRFs) are employed to trace the dynamic effects of institutional shocks on entrepreneurial outcomes. Self-employment is adopted as a proxy for entrepreneurship, alongside entrepreneurial finance, regulatory quality, government expenditure, education, and control of corruption. The findings indicate that institutional shocks generate heterogeneous short-run and long-run effects on entrepreneurship, with access to finance emerging as the most influential external driver over time. The results further suggest that entrepreneurial outcomes in emerging economies are affected not only by market forces but also by the stability and effectiveness of institutional arrangements. These findings underline the importance of institutional reforms that strengthen governance structures and reduce uncertainty in order to promote sustainable entrepreneurship.
Institutional Shocks Transmission and Impact on Entrepreneurship Development in Developing Economies
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Determinants of Undetectable Viral Load among Recipients of HIV Care in Cross River State, Nigeria: A Mixed-Methods StudyAuthor: Mbeh, O. O.DOI: 10.21522/TIJAR.2014.13.02.Art018
Determinants of Undetectable Viral Load among Recipients of HIV Care in Cross River State, Nigeria: A Mixed-Methods Study
Abstract:
Achieving and sustaining viral load suppression among people living with HIV is essential for improving treatment outcomes and reducing transmission. However, determinants of undetectable viral load remain insufficiently documented in Cross River State, Nigeria, particularly using mixed methods approaches. This study examined socio-demographic and patient-related determinants of undetectable viral load among recipients of HIV care in selected health facilities. A mixed-methods design combined a facility-based cross-sectional survey with qualitative interviews. Quantitative data were collected from 203 HIV-positive clients aged ≥15 years who had been on antiretroviral therapy (ART) for at least six months, while qualitative data were obtained from in-depth interviews with 12 healthcare providers. Descriptive statistics, Chi-square tests, and multivariate logistic regression were used for quantitative analysis, and qualitative data were analyzed thematically. Findings showed that 51.7% of participants achieved undetectable viral load (<50 copies/mL), 27.6% had suppressed viral load (51–999 copies/mL), and 79.3% attained overall viral suppression. ART adherence emerged as the strongest predictor of viral suppression, alongside regular clinic attendance, counselling participation, and use of medication reminders. Conversely, missed doses, treatment interruptions, recreational drug use, and difficulty accessing healthcare significantly reduced the likelihood of viral suppression. Qualitative findings highlighted stigma, economic hardship, transportation barriers, and occasional drug stock-outs as key contextual factors influencing adherence. The study underscores the need for patient-centered interventions that strengthen adherence counselling, improve access to ART, and address structural and socio-economic barriers to optimize viral suppression outcomes in resource-limited settings.
Determinants of Undetectable Viral Load among Recipients of HIV Care in Cross River State, Nigeria: A Mixed-Methods Study
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[14]. Haider, M. R., Brown, M. J., Harrison, S., Yang, C., 2021, Sociodemographic predictors of viral suppression among people living with HIV. AIDS Care, 33(5), 642–650, https://doi.org/10.1080/09540121.2020.1770295
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Epidemiological Profile and Temporal Trends of Cancer Incidence and Mortality in Guyana, 2015-2024: A Ten-Year Registry-Based AnalysisAuthor: Diana Elizabeth KhanDOI: 10.21522/TIJAR.2014.13.02.Art019
Epidemiological Profile and Temporal Trends of Cancer Incidence and Mortality in Guyana, 2015-2024: A Ten-Year Registry-Based Analysis
Abstract:
Cancer constitutes a growing non-communicable disease burden across the Caribbean, yet population-level data from Guyana remain sparse. This study characterises the ten-year epidemiological profile of cancer in Guyana, describing temporal trends in cancer incidence and mortality using national registry data spanning 2015 to 2024. A retrospective descriptive analysis of 8,822 cancer registry records was conducted, examining year of diagnosis, sex, topography, cancer stage, vital status, ethnicity, and geographic region. Descriptive statistics, proportional distributions, and case fatality rates (CFR) were computed. A total of 8,822 cases were registered over the decade, rising nearly threefold from 525 cases in 2015 to 1,635 in 2024. Overall case fatality was 53.8%. Females accounted for 59.1% of cases (n=5,215), while males bore higher mortality (CFR 61.6% vs. 48.8%). Prostate cancer was the leading male malignancy (n=939) and breast cancer the leading female malignancy (n=896). Cervical cancer ranked second in females (n=487). Stage IV disease carried a CFR of 68.1%. East Indians represented the largest ethnic group (31.2%). Region 4 (Demerara-Mahaica) contributed 44.8% of all cases. COVID-19 disruptions in 2020 coincided with a CFR peak of 69.3%, with a gradual decline to 42.8% by 2024. Guyana faces a significant and escalating cancer burden characterised by late-stage presentation, high case fatality, and geographic concentration of services. Strengthening early detection, expanding registry completeness, and developing context-sensitive prediction tools are urgently needed to improve cancer outcomes in this low- and middle-income country (LMIC) setting.
Epidemiological Profile and Temporal Trends of Cancer Incidence and Mortality in Guyana, 2015-2024: A Ten-Year Registry-Based Analysis
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Health Workers‘s Perspective on Health System Barriers to Effective IMNCI Implementation among Health Workers in Chongwe and Lusaka Districts, ZambiaAuthor: Baleke NgambiDOI: 10.21522/TIJAR.2014.13.02.Art020
Health Workers‘s Perspective on Health System Barriers to Effective IMNCI Implementation among Health Workers in Chongwe and Lusaka Districts, Zambia
Abstract:
Since the introduction of the IMNCI strategy in 1995 in Zambia, the Country has achieved good progress in reducing under-five mortality. In spite of its introduction, implementation of IMNCI has not been at its best, the 2018 Zambia’s health facility assessment found that only 45% of health facilities had at least 60% IMNCI trained health workers attending to sick children whereas only 32% of health facilities received at least one supervisory visit during the survey period. Despite IMNCI being a critical strategy for Zambia, very limited evidence exists on health workers’ perspective on key health system barriers for effective implementation of IMNCI. Most of the available evidence has focused on application of IMNCI skills. The study explored health workers perspective on Key health system barriers for implementation of the IMNCI strategy in Chongwe and Lusaka districts. The study employed a descriptive exploratory mixed method design and sequentially collected quantitative and qualitative data. Data was collected from health workers, National and District IMNCI Coordinators and Health facility assessment. The study revealed key health systems factors such as inadequate support, Lack of Budgetary allocation for IMNCI, Poor documentation and recording and Poor leadership and governance as barriers to implementation of IMNCI. This study therefore proposes a focus all Health system building blocks rather than just focusing on service delivery and work force related efforts as an approach that will promote responsive and resilient health systems capable of promoting quality and equitable Universal child health care services and consequently improved wellbeing of children.
Health Workers‘s Perspective on Health System Barriers to Effective IMNCI Implementation among Health Workers in Chongwe and Lusaka Districts, Zambia
References:
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[12]. Pandya, H., Slemming, W., Saloojee, H., 2018, Health system factors affecting implementation of integrated management of childhood illness (IMCI): qualitative insights from a South African province. Health Policy Plan. 2018 March 1;33(2):171-182. doi: 10.1093/heapol/czx154. PMID: 29161375
[13]. Boschi-Pinto, C., Labadie, G., Dilip, R., Oliphant, N., Dalglish, L., Aboubaker, S., Agbodjan-Prince, A., Desta, T., Habimana, P., Butron-Riveros, B., Al-Raiby, J., Siddeeg, K., Kuttumuratova, A., Weber, M., Mehta, R., Raina, N., Daelmans, B., Diaz, T., 2018, Global implementation survey of Integrated Management of Childhood Illness (IMCI): 20 years on. BMJ Open 2018; 8: e 019079. doi:10.1136/bmjopen-2017-019079
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[17]. Kiplagat, A., Musto, R., Mwizamholya, D., Morona, D., 2014, Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania. BMC Public Health 14, 277 (2014). https://doi.org/10.1186/1471-2458-14-277
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Gestational Diabetes Mellitus in Guyana: Clinical Profiles, Obstetric Outcomes, and Predictors of Adverse Events — A Retrospective Cohort AnalysisAuthor: Samantha N.A. KennedyDOI: 10.21522/TIJAR.2014.13.02.Art021
Gestational Diabetes Mellitus in Guyana: Clinical Profiles, Obstetric Outcomes, and Predictors of Adverse Events — A Retrospective Cohort Analysis
Abstract:
Gestational diabetes mellitus (GDM) is a growing metabolic complication of pregnancy with significant public health implications in low- and middle-income countries. This retrospective cohort study characterises the clinical and obstetric profiles of 33 GDM-confirmed mothers who delivered at the Georgetown Public Hospital Corporation (GPHC), Guyana, in January to June 2017, and identifies predictors of adverse maternal and neonatal outcomes. Data were extracted from hospital charts using a standardised abstraction form covering sociodemographic, anthropometric, obstetric, glycaemic, and neonatal variables. The cohort had a mean age of 29.9 ± 6.6 years and was predominantly Afro-Guyanese (60.6%) and urban-dwelling (75.8%). Mean pre-pregnancy body mass index (BMI) was 32.1 ± 10.4 kg/m², with 57.6% classified as overweight or obese. Family history of diabetes was present in 21.2% of participants. Insulin monotherapy or combination regimens were used in 97.0% of cases. Caesarean section rate was 45.5%, and gestational hypertension was the most frequent complication, affecting 36.4% of the cohort. Macrosomia occurred in 15.2% of births (mean birth weight 3,392 ± 676 g). Breastfeeding was initiated by 84.8% of participants. Postpartum metabolic follow-up data were absent across all time points, representing a critical systemic gap. Findings underscore the need for preconception BMI screening, structured postpartum surveillance registries, and culturally tailored non-communicable disease prevention strategies for women with a history of GDM in Guyana.
Gestational Diabetes Mellitus in Guyana: Clinical Profiles, Obstetric Outcomes, and Predictors of Adverse Events — A Retrospective Cohort Analysis
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Telemedicine, Access, and Referral Burden in Guyana’s Hinterland Regions: A Retrospective Study, 2022–2026Author: Aruna FariaDOI: 10.21522/TIJAR.2014.13.02.Art022
Telemedicine, Access, and Referral Burden in Guyana’s Hinterland Regions: A Retrospective Study, 2022–2026
Abstract:
Healthcare access in Guyana’s hinterland regions is constrained by geographic isolation, long travel distances, high transport costs, and limited specialist availability at peripheral facilities. Telemedicine has emerged as a strategy to bridge these gaps by enabling remote consultation, supporting local clinical decision-making, and reducing unnecessary patient referrals. This retrospective descriptive study analyzed annual program data and site-level operational records from the national telemedicine program across Guyana’s hinterland from 2022 to 2026. Key indicators included communities served, telemedicine calls, patient visits, serious cases, critical care encounters, remote ultrasound examinations, medical evacuations, and hospital referrals eliminated. The program expanded from 4 communities in 2022 to 130 in 2026. Telemedicine calls increased from 55 to approximately 2,500, and patient visits from 84 to approximately 25,000. Patient visits per community rose from 21.0 in 2022 to 192.3 in 2026, indicating deepening service intensity beyond geographic expansion. Serious cases increased from 11 to approximately 850, critical care encounters reached approximately 200, and remote ultrasound use grew from 106 in 2024 to approximately 800 in 2026. Hospital referrals eliminated increased from 423 in 2024 to approximately 1,900 in 2026. Medical evacuations remained stable despite growing clinical volumes. These findings indicate that Guyana’s hinterland telemedicine program achieved meaningful improvements in access, supported local management of complex clinical presentations, and contributed to referral burden reduction. Implementation quality and local integration appear to mediate utilization beyond geography alone. Future research should evaluate patient-level outcomes, referral appropriateness, and household cost savings.
Telemedicine, Access, and Referral Burden in Guyana’s Hinterland Regions: A Retrospective Study, 2022–2026
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[8]. Iyengar, P., Mabvakure, B., Yadav, P., Adams, J., 2021, Strengthening last-mile supply chains in low-density settings: Lessons for resilience. Global Health: Science and Practice, 9(Suppl 2), S272–S285, https://doi.org/10.9745/GHSP-D-21-00008
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[20]. Dolea, C., Stormont, L., Braichet, J. M., 2010, Evaluated strategies to increase attraction and retention of health workers in remote and rural areas. Bulletin of the World Health Organization, 88(5), 379–385, https://doi.org/10.2471/BLT.09.070607
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Epidemiological Trends of Dengue Fever Across Administrative Regions of Guyana, 2020–2022: A Cross-Sectional Analysis of Confirmed Case DataAuthor: Allison PetersDOI: 10.21522/TIJAR.2014.13.02.Art023
Epidemiological Trends of Dengue Fever Across Administrative Regions of Guyana, 2020–2022: A Cross-Sectional Analysis of Confirmed Case Data
Abstract:
Dengue fever remains a significant public health burden in Guyana, a low to middle-income country in the Caribbean South American region with a climate highly conducive to Aedes aegypti transmission. This study analyzed confirmed dengue fever case records from Guyana's ten administrative regions for 2020, 2021, and 2022, derived from the Ministry of Health national disease notification system. A total of 9,772 dengue fever cases were recorded over the three-year study period: 1,719 in 2020, 4,384 in 2021, and 3,669 in 2022. The sharpest burden was concentrated in regions 1, 6, and 2, which together accounted for more than 60% of cumulative cases. Adults aged 25–44 years constituted the largest affected age group across all years, accounting for 30.2%-34.1% of annual cases. A marginal female predominance was observed in 2021 and 2022, with females comprising 52.8% and 53.3% of cases, respectively. Region 1 recorded the highest single-year count (1,372 in 2021), while Regions 3 and 5 reported no cases across all years. These findings underscore persistent geographic heterogeneity in dengue transmission, the disproportionate burden in economically active age groups, and the urgent need to strengthen region-specific surveillance and implement integrated vector management strategies in Guyana.
Epidemiological Trends of Dengue Fever Across Administrative Regions of Guyana, 2020–2022: A Cross-Sectional Analysis of Confirmed Case Data
References:
[1]. World Health Organization (WHO), 2023, Global Arbovirus Initiative: Technical paper and operational guidance. WHO, Geneva.
[2]. Alto, B. W., Bettinardi, D., 2013, Temperature and dengue virus infection in mosquitoes. American Journal of Tropical Medicine and Hygiene, 88(4), 784–792.
[3]. Pan American Health Organization (PAHO), 2024, Epidemiological update: Dengue in the Americas. PAHO, Washington, DC.
[4]. World Bank, 2022, Guyana: Country economic memorandum and poverty assessment highlights. World Bank, Washington, DC.
[5]. Douglas, K. O., Payne, K., Sabino-Santos, G., Chami, P., Lorde, T., 2024, The impact of climate on human dengue infections in the Caribbean. Pathogens, 13(9), 756.
[6]. Runge-Ranzinger, S., Kroeger, A., Olliaro, P., McCall, P.J., 2016, Dengue disease surveillance: An updated systematic literature review. Tropical Medicine and International Health, 21(9),
1115–1160.[7]. Baksh, A., Bhagarathi, L. K., Pestano, F., Silva, P. N. D., 2025, Assessing short-term lagged effects of temperature and rainfall on dengue cases in Guyana. International Journal of Mosquito Research, 12(4), 57–65.
[8]. World Health Organization (WHO), 2009, Dengue: Guidelines for diagnosis, treatment, prevention and control. New edition. WHO, Geneva.
[9]. Li, Y., Dou, Q., Lu, Y., Xiang, H., Yu, X., Liu, S., 2020, Effects of ambient temperature and precipitation on the risk of dengue fever: A systematic review and updated meta-analysis. Environmental Research, 191, 110043.
[10]. Bhatt, S., Gething, P.W., Brady, O. J., Messina, J. P., Farlow, A.W., Moyes, C. L., Drake, J. M., et al., 2013, The global distribution and burden of dengue. Nature, 496, 504–507.
[11]. Méndez-Lázaro, P., Muller-Karger, F., Otis, D., McCarthy, M., Peña-Orellana, M., 2014, Assessing climate variability effects on dengue incidence in San Juan, Puerto Rico. International Journal of Environmental Research and Public Health, 11(9), 9409–9428.
[12]. Geraldini, B., Johansen, I.C., Justus, M., 2024, Influence of temperature and precipitation on dengue incidence in Campinas, São Paulo State, Brazil (2013–2022). Revista da Sociedade Brasileira de Medicina Tropical, 57.
[13]. Medina, E., Cogollo, M. R., González-Parra, G., 2024, Prescriptive temporal modeling approach using climate variables to forecast dengue incidence in Córdoba, Colombia. Mathematical Biosciences and Engineering, 21(12), 7760–7782.
[14]. Bowman, L. R., Donegan, S., McCall, P. J., 2016, Is dengue vector control deficient in effectiveness or evidence? Systematic review and meta-analysis. PLoS Neglected Tropical Diseases, 10(3), e0004551.
[15]. Brady, O. J., Bjornstad, O. N., Pigott, D. M., Brownstein, J. S., Hoen, A. G., Hay, S. I., 2019, The many projected futures of dengue. Nature Reviews Microbiology, 17, 580–593.
[16]. Boston, C., Kurup, R., 2017, Estimated effects of climate variables on transmission of malaria, dengue and leptospirosis within Georgetown, Guyana. West Indian Medical Journal.
[17]. Colón-González, F. J., Lake, I. R., Bentham, G., 2013, Climate variability and dengue fever in warm and humid Mexico. American Journal of Tropical Medicine and Hygiene, 88(5), 849–857.
[18]. Gasparrini, A., Armstrong, B., Kenward, M. G., 2010, Distributed lag non-linear models. Statistics in Medicine, 29(21), 2224–2234.
[19]. Hii, Y. L., Zhu, H., Ng, N., Ng, L. C., Rocklöv, J., 2012, Forecast of dengue incidence using temperature and rainfall. PLoS Neglected Tropical Diseases, 6(11), e1908.
[20]. Tun-Lin, W., Burkot, T. R., Kay, B. H., 2000, Effects of temperature and larval diet on development rates and survival of the dengue vector Aedes aegypti in north Queensland, Australia. Medical and Veterinary Entomology, 14(1), 31–37.
[21]. Lee, J., Carabali, M., Lim, J. K., Herrera, V. M., Park, I., Villar, L., et al., 2017, Early warning signal for dengue outbreaks and identification of high risk areas for dengue fever in Colombia using climate and non-climate datasets. BMC Infectious Diseases, 17(1).
[22]. Ramachandran, V. G., Roy, P., Das, S., Mogha, N. S., Bansal, A. K., 2016, Empirical model for calculating dengue incidence using temperature, rainfall, and relative humidity: a 19-year retrospective analysis in East Delhi, India. Epidemiology and Health, e2016052.
[23]. Walker, J., Pyke, A., Florian, P., Moore, F., Smoll, N., Adegbija, O., et al., 2021, Re-emergence of dengue virus in regional Queensland: 2019 dengue virus outbreak in Rockhampton, Central Queensland, Australia. Communicable Diseases Intelligence, 45.
[24]. World Meteorological Organization (WMO), 2024, State of the global climate 2023. WMO, Geneva.
[25]. Besag, J., York, J., Mollié, A., 1991, Bayesian image restoration, with two applications in spatial statistics. Annals of the Institute of Statistical Mathematics, 43(1), 1–20.
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Knowledge, Attitudes, and Practices Related to Cervical Cancer Screening and Traditional Medicine Use among Indigenous Women in Guyana's Region 9: A Baseline Cross-Sectional AssessmentAuthor: Seraiah Arliana Dimple ValidumDOI: 10.21522/TIJAR.2014.13.02.Art024
Knowledge, Attitudes, and Practices Related to Cervical Cancer Screening and Traditional Medicine Use among Indigenous Women in Guyana's Region 9: A Baseline Cross-Sectional Assessment
Abstract:
Cervical cancer is a serious health threat for Indigenous women in Guyana's remote Region 9 (Upper Takutu-Upper Essequibo). To understand why, we spoke with 101 Amerindian women (Makushi and Wapishana), ages 21 to 65, at health centers and community events across the region between November and December 2025. We asked them about their knowledge, attitudes, and practices around cervical cancer screening, HPV, and the use of traditional medicine. Our survey found that the average age of participants was 32.6. While over 60% had an HPV test (with 27.7% testing positive), less than half (44.6%) had ever had a Pap smear. At the same time, traditional medicine plays a major role in their lives. Over 40% of the women consult traditional healers, mostly for women's health issues, and many use both traditional and modern treatments. The biggest hurdles to getting medical care were distance (67.3%), cost (47.5%), and long waits at clinics (41.6%). Our findings point to a critical gap in cervical cancer screening and highlight how central traditional medicine is to healthcare for these communities. This shows an urgent need for health programs that are culturally aware and blend modern and traditional approaches to improve women's health in Region 9.
Knowledge, Attitudes, and Practices Related to Cervical Cancer Screening and Traditional Medicine Use among Indigenous Women in Guyana's Region 9: A Baseline Cross-Sectional Assessment
References:
[1]. Sung, H., Ferlay, J., Siegel, R. L., Laversanne, M., Soerjomataram, I., Jemal, A., Bray, F., 2021, Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA A Cancer Journal for Clinicians, 71(3), 209–249, https://doi.org/10.3322/caac.21660
[2]. Arbyn, M., Weiderpass, E., Bruni, L., de Sanjosé, S., Saraiya, M., Ferlay, J., Bray, F., 2020, Estimates of incidence and mortality of cervical cancer in 2018: A worldwide analysis. The Lancet Global Health, 8(2), e191–e203, https://doi.org/10.1016/S2214-109X(19)30482-6
[3]. Cohen, P. A., Jhingran, A., Oaknin, A., Denny, L., 2019, Cervical Cancer. The Lancet, 393(10167), 169–182, https://doi.org/10.1016/S0140-6736(18)32470-X
[4]. Bruni, L., Albero, G., Serrano, B., Mena, M., Gómez, D., Muñoz, J., Bosch, F.X., de Sanjosé, S., 2019, ICO/IARC Information Centre on HPV and Cancer. Human Papillomavirus and Related Diseases in the World. Summary Report. https://www.hpvcentre.net/statistics/reports/XWX.pdf
[5]. GLOBOCAN, 2020, Cancer Today: Guyana. International Agency for Research on Cancer. https://gco.iarc.fr/today/home
[6]. Forte, J., Melbye, M., Guevara, A., 2018, Health disparities in Indigenous Communities of Guyana. Journal of Rural Health, 34(2), 145–153, https://doi.org/10.1111/jrh.12272
[7]. UNDP Guyana, 2020, Sustainable Development Report: Hinterland Communities of Guyana. United Nations Development Programme. https://www.gy.undp.org/
[8]. World Bank, 2019, Guyana Health Sector Assessment. World Bank Group. https://www.worldbank.org/en/country/guyana
[9]. Robinson, M. M., Zhang, X., 2011, The world medicines situation 2011: Traditional medicines: global situation, issues and challenges. World Health Organization. https://apps.who.int/medicinedocs/documents/s18063en/s18063en.pdf
[10]. WHO, 2019, WHO Global Report on Traditional and Complementary Medicine 2019. World Health Organization, Geneva. https://www.who.int/publications/i/item/978924151536
[11]. Vandebroek, I., Thomas, E., Sanca, S., Van Damme, P., Van Puyvelde, L., De Kimpe, N., 2004, Comparison of Health Conditions Treated with Traditional and Biomedical Health Care in a Quechua Community in Rural Bolivia. Journal of Ethnobiology and Ethnomedicine, 4, 1, https://doi.org/10.1186/1746-4269-4-1
[12]. Picking, D., Younger, N., Mitchell, S., Delgoda, R., 2011, The prevalence of herbal medicine home use and concomitant use with pharmaceutical medicines in Jamaica. Journal of Ethnopharmacology, 137(1), 305–311, https://doi.org/10.1016/j.jep.2011.05.025
[13]. Launiala, A., 2009, How much can a KAP survey tell us about people's knowledge, attitudes and practices? Some observations from medical anthropology research on malaria in pregnancy in Malawi. Anthropology Matters, 11(1), 1–13, https://doi.org/10.22582/am.v11i1.31
[14]. De Sanjosé, S., Diaz, M., Castellsagué, X., Clifford, G., Bruni, L., Muñoz, N., Bosch, F. X., 2007, Worldwide prevalence and genotype distribution of cervical human papillomavirus dna in women with normal cytology: A meta-analysis. The Lancet Infectious Diseases, 7(7), 453–459, https://doi.org/10.1016/S1473-3099(07)70158-5
[15]. Torres-Cintrón, C. R., Ortiz, A. P., Tortolero-Luna, G., Pérez-Irizarry, J., Zavala, D., 2020, Disparities in cervical cancer incidence and mortality by race/ethnicity and rurality in Puerto Rico. Cancer epidemiology, biomarkers and prevention, 29(10), 2072–2079, https://doi.org/10.1158/1055-9965.EPI-19-1454
[16]. Ginsburg, O., Bray, F., Coleman, M. P., Vanderpuye, V., Eniu, A., Kotha, S. R., 2017, The global burden of women's cancers: A grand challenge in global health. The Lancet, 389(10071), 847–860, https://doi.org/10.1016/S0140-6736(16)31392-7
[17]. Heinrich, M., Mah, J., Amirkia, V., 2020, Alkaloids used as medicines: Structural phytochemistry meets biodiversity—An update and forward look. Molecules, 26(7), 1836, https://doi.org/10.3390/molecules26071836
[18]. Atanasov, A. G., Zotchev, S. B., Dirsch, V. M., Supuran, C. T., 2021, Natural products in drug discovery: Advances and opportunities. Nature Reviews Drug Discovery, 20(3), 200–216, https://doi.org/10.1038/s41573-020-00114-z
[19]. Cumberbatch, M., Goulbourne, C., Rampersaud, J., 2019, Barriers to cervical cancer screening in the caribbean: A systematic review. West Indian Medical Journal, 68(3), 267–273.
[20]. Islami, F., Goding Sauer, A., Miller, K. D., Siegel, R. L., Fedewa, S. A., Jacobs, E. J., 2018, Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA: A Cancer Journal for Clinicians, 68(1), 31–54, https://doi.org/10.3322/caac.21440
[21]. Ministry of Health Guyana, 2020, National Cancer Control Plan 2020–2025. Ministry of Health, Georgetown, Guyana.
[22]. Bosch, F. X., Lorincz, A., Muñoz, N., Meijer, C. J. L. M., Shah, K. V., 2002, The causal relation between human papillomavirus and cervical cancer. Journal of Clinical Pathology, 55(4), 244–265, https://doi.org/10.1136/jcp.55.4.244
[23]. Lewis-Bell, K., Subhan, F., Mungrue, K., 2013, Cervical cancer in trinidad and tobago. West Indian Medical Journal, 62(3), 237–241.
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[25]. Newman, D. J., Cragg, G. M., 2020, natural products as sources of new drugs over the nearly four decades from 01/1981 to 09/2019. Journal of Natural Products, 83(3), 770–803, https://doi.org/10.1021/acs.jnatprod.9b01285
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Awareness, Implementation of Climate Change Mitigation Measures, Adaptative Practices and Challenges Faced by Rural Farmers of Lebialem Division in The South West Region of CameroonAuthor: Fietsop Ernestine NkemtahDOI: 10.21522/TIJAR.2014.13.02.Art025
Awareness, Implementation of Climate Change Mitigation Measures, Adaptative Practices and Challenges Faced by Rural Farmers of Lebialem Division in The South West Region of Cameroon
Abstract:
Climate change is severely affecting agriculture worldwide, and rural farmers in Lebialem Division are particularly vulnerable. Most of them rely on rain-fed farming, making them highly susceptible to unpredictable weather patterns like irregular rainfall, prolonged dry seasons, and extreme heat. To develop an effective and sustainable solutions, it is essential to understand how these farmers perceive climate change, what actions they are taking, and the challenges they encounter. A descriptive cross-sectional approach was used. Data were collected from eight villages across the three subdivisions using a multistage sampling technique. Data were analyzed using SPSS. Key statistical indicators used included Adjusted Odds Ratios (AORs), 95% Confidence Intervals (CI), and p-values. Farmers in Lebialem were highly aware (92,3%) of climate change with age group 41–50 (AOR = 7.50 (95% CI: 1.52–37.10; p = 0.014) more likely to be aware through daily experiences, even if they lack formal scientific understanding. They were actively involved in mitigation practices (87.1%) like planting trees, using mulch, organic manure, and avoiding bush burning, efforts which are often rooted in traditional knowledge. Adaptation strategies included crop diversification, irrigation, and planting crop varieties (84.1%). However, these efforts faced serious challenges such as poor tree survival rates, financial constraints, limited water access and unpredictable weather. Traditional leaders and NGOs offer support, but broader assistance remains limited. Rural farmers in Lebialem are committed to addressing climate change by combining indigenous practices with modern techniques. However, challenges limit their success. Strengthening institutional support, improving technical training, and providing financial resources are key to building resilience and ensuring food security in the region.
Awareness, Implementation of Climate Change Mitigation Measures, Adaptative Practices and Challenges Faced by Rural Farmers of Lebialem Division in The South West Region of Cameroon
References:
[1]. Intergovernmental Panel on Climate Change, 2021, Climate change 2021: The physical science basis. Cambridge University Press.
[2]. Food and Agriculture Organization of the United Nations, 2021, The impact of disasters and crises on agriculture and food security. FAO.
[3]. World Health Organization, 2021, Climate change and health. WHO.
[4]. World Bank, 2020, Climate-smart agriculture in Africa. World Bank.
[5]. Molua, E. L., 2019, Climate variability and agricultural vulnerability in Cameroon. Environmental Economics and Policy Studies, 21(2), 315–334.
[6]. Yengoh, G. T., Ardö, J., Olsson, L., Tengberg, A., 2020, The role of agriculture in climate change adaptation in Sub-Saharan Africa. Springer.
[7]. Smith, P., Bustamante, M., Ahammad, H., et al., 2014, Agriculture, forestry and other land use (AFOLU). Climate Change 2014: Mitigation of Climate Change. Cambridge University Press.
[8]. Thornton, P. K., Ericksen, P. J., Herrero, M., Challinor, A. J., 2019, Climate variability and vulnerability to climate change. Global Change Biology, 25(11), 3907–3923.
[9]. Lobell, D. B., Schlenker, W., Costa-Roberts, J., 2019, Climate trends and global crop production since 1980. Science, 333(6042), 616–620.
[10]. Pretty, J., Bharucha, Z. P., 2019, Sustainable intensification in agricultural systems. Annals of Botany, 114(8), 1571–1596.
[11]. Altieri, M. A., Nicholls, C. I., 2020, Agroecology and the reconstruction of a post-COVID-19 agriculture. Journal of Peasant Studies, 47(5), 881–898.
[12]. Nyong, A., Adesina, F., Elasha, B. O., 2019, The value of indigenous knowledge in climate change mitigation and adaptation strategies in Africa. Mitigation and Adaptation Strategies for Global Change, 12(5), 787–797.
[13]. Gbegbelegbe, S., Serem, J., Stirling, C., et al., 2020, Smallholder farmers’ adaptation to climate change. Food Policy, 89, 101802.
[14]. Deressa, T. T., Hassan, R. M., Ringler, C., 2019, Perception of and adaptation to climate change by farmers in Africa. Journal of Agricultural Science, 149(1), 23–31.
[15]. Mase, A. S., Gramig, B. M., Prokopy, L. S., 2019, Climate change beliefs, risk perceptions, and adaptation behavior among U.S. farmers. Climate Risk Management, 15, 9–20.
[16]. Mulwa, C., Marenya, P., Rahut, D. B., 2021, Smallholder farmers’ perceptions of climate change. Climate and Development, 13(3), 231–245.
[17]. Zakari, S., Ying, L., Song, B., 2023, Factors influencing farmers’ awareness of climate change. Sustainability, 15(4), 2876.
[18]. Nkengafac, V., Ndzi, E. S., Njukang, P. N., 2020, Farmers’ perception of climate variability in rural Cameroon. Journal of Environmental Studies, 28(3), 445–457.
[19]. Musah, A. B., Abdul-Rahaman, A., Donkoh, S. A., 2023, Constraints to climate adaptation among smallholder farmers. African Journal of Agricultural Research, 18(2), 156–168.
[20]. Mupangwa, W., Nyagumbo, I., Liben, F. M., 2022, Climate adaptation barriers in Southern Africa. Climate Policy, 22(6), 789–804.
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[25]. Food and Agriculture Organization of the United Nations, 2019, The gender gap in agriculture. FAO.
[26]. Ngum, N., Kimengsi, J. N., Balgah, R. A., 2020, Gender and climate change adaptation in Cameroon. International Journal of Climate Change Strategies and Management, 12(3), 315–332.
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Strategies to Reduce the Increasing Risk Factors and Rate of Terminal Diseases Among Youths in Oji River, Udi and Environs in Enugu State, NigeriaAuthor: Ikeonwueme Peace ObikaDOI: 10.21522/TIJAR.2014.13.02.Art026
Strategies to Reduce the Increasing Risk Factors and Rate of Terminal Diseases Among Youths in Oji River, Udi and Environs in Enugu State, Nigeria
Abstract:
Terminal diseases including advanced cancers, chronic kidney disease, severe cardiovascular diseases, liver failure, and chronic respiratory illnesses are increasingly observed among young populations in developing regions. In Oji River, Udi and surrounding communities of Enugu State, Nigeria, youth exposure to unhealthy lifestyles, substance abuse, environmental pollution, poor healthcare access, and weak preventive services may accelerate progression into irreversible disease states. This study assessed major risk factors driving terminal diseases among youths in Oji River, Udi and environs, and proposed evidence-based strategies for reducing future terminal disease burden. Data were analyzed using SPSS version 25. Chi-square tests were applied to determine associations between risk exposures and self-reported chronic symptoms (p < 0.05). Out of 400 questionnaires distributed, 378 were correctly completed (response rate: 94.5%). Risk factors identified included frequent alcohol consumption (47.6%), cigarette smoking (18.5%), illicit drug use (13.2%), low physical activity (56.4%), unhealthy dietary practices (61.1%), and high reliance on self-medication (68.2%). Environmental exposure to smoke, fumes and waste-burning pollution was reported by 41.5%. Screening practices were poor: blood pressure checks (22.8%), blood glucose checks (14.0%), and hepatitis screening (11.6%). Chi-square analysis showed significant associations between smoking/pollution exposure and persistent cough/breathlessness (p < 0.05). Terminal disease risks among youths in Oji River and Udi are increasing due to modifiable behavioral and environmental exposures coupled with poor preventive health utilization. Interventions such as routine screening programs, youth-targeted health education, improved primary healthcare access, environmental pollution regulation, and stronger control of alcohol and tobacco use are urgently needed.
Strategies to Reduce the Increasing Risk Factors and Rate of Terminal Diseases Among Youths in Oji River, Udi and Environs in Enugu State, Nigeria
References:
[1]. World Health Organization., 2022, Non-communicable diseases: Key facts. WHO Fact Sheets. 2022;1(1):1-8. https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
[2]. Beaglehole, R., Bonita, R., Horton, R., Adams, C., Alleyne, G., Asaria P., 2011. Priority actions for the non-communicable disease crisis. The Lancet. 377(9775):1438-1447. https://doi.org/10.1016/S0140-6736(11)60393-0
[3]. Federal Ministry of Health Nigeria, 2016, National Strategic Plan of Action on Prevention and Control of Non-Communicable Diseases. FMOH Publication. 2016;1(1):178. https://extranet.who.int/ncdccs/ Data/NGA_D1_National%20NCD%20Policy.pdf
[4]. Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton P., 2018, The Lancet Commission on global mental health and sustainable development. The Lancet. 392(10157):1553-1598. https://doi.org/10.1016/S0140-6736(18)31612-1
[5]. Osemene, K. P., Lamikanra, A., 2012, A study of the prevalence of self-medication practice among university students in Southwestern Nigeria. Tropical Journal of Pharmaceutical Research. 11(4):683-689. https://doi.org/10.4314/tjpr.v11i4.21
[6]. Oyewole, O, E., Atinmo, T., 2015, Nutrition transition and chronic disease risk in Nigeria. African Journal of Food, Agriculture, Nutrition and Development. 15(1):9832-9848. https://www.ajfand.net/Volume15/No1/OyewoleAtinmo.pdf
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[9]. Stanaway, J. D., Afshin, A., Gakidou, E., Lim, S. S., Abate, D., 2018, Global burden of chronic kidney disease and associated risk factors. The Lancet. 392(10153):1789-1858. https://doi.org/10.1016/S0140-6736(18)32252-0
[10]. Pope, C. A., Dockery, D. W., 2006, Health effects of fine particulate air pollution: Lines that connect. Journal of the Air & Waste Management Association. 56(6):709-742. https://doi.org/10.1080/10473289.2006. 10464485
[11]. Adebowale, A. S., Fagbamigbe, A. F., Bamgboye, E. A., 2012, Prevalence and determinants of late presentation to healthcare facilities in Nigeria. BMC Health Services Research. 12(1):152-160. https://doi.org/10.1186/1472-6963-12-152
[12]. Sawyer, S. M., Azzopardi, P. S., Wickremarathne, D., Patton, G. C., 2018, The age of adolescence. The Lancet Child & Adolescent Health. 2(3):223-228. https://doi.org/10.1016/S2352-4642(18)30022-1
[13]. Bloom, D. E., Cafiero, E. T., Jané-Llopis, E., Abrahams-Gessel, S., 2011, The global economic burden of noncommunicable diseases. World Economic Forum Report. 2011;1(1):1-46. https://www.weforum.org/reports/the-global-economic-burden-of-non-communicable-diseases
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Prevalence of Non -Adherence to Tuberculosis Therapy and Associated Factors among Patients with Pulmonary Tuberculosis at Mwananyamala Regional Referral Hospital, Dar- es- salaamAuthor: Mbeya B.DOI: 10.21522/TIJAR.2014.13.02.Art027
Prevalence of Non -Adherence to Tuberculosis Therapy and Associated Factors among Patients with Pulmonary Tuberculosis at Mwananyamala Regional Referral Hospital, Dar- es- salaam
Abstract:
This study aimed to assess the prevalence of non- adherence to Tuberculosis therapy and associated factors among patients with pulmonary Tuberculosis at Mwananyamala Regional Referral Hospital, Dar es Salaam. It was a cross-sectional study involving Tuberculosis (TB) patients who attended the outpatient clinic at Mwananyamala Regional Referral Hospital. The sample size of this study consisted of 422 participants who were selected through systematic random sampling. Data collection was done by using structured questionnaires incorporated in Open Data Kit (ODK); in addition, the TB treatment card and the Morisky Medical Adherence scale (MMS) were also used. Data analysis was done by Statistical Package for the Social Sciences (SPSS) version 16.0 to find the proportion of respondents choosing different responses. The study findings indicated that most patients adhere to TB treatment by 98%, and only 2% did not adhere to TB treatment. Factors associated with adherence, such as TB drugs’ side effects and non-compliance, did not influence non-adherence. The study recommends the same modality of treatment to continue to maintain the adherence level of TB patients. This study has implications for all stakeholders involved in TB patients’ management. The practical and theoretical implications provide the benefits of the study to the government, non-governmental organizations, and research organizations.
Prevalence of Non -Adherence to Tuberculosis Therapy and Associated Factors among Patients with Pulmonary Tuberculosis at Mwananyamala Regional Referral Hospital, Dar- es- salaam
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Artemisinin Partial Resistance in Sub-Saharan Africa: Epidemiological Patterns, Molecular Markers, and Implications for Malaria ControlAuthor: Hamad NnimboDOI: 10.21522/TIJAR.2014.13.02.Art028
Artemisinin Partial Resistance in Sub-Saharan Africa: Epidemiological Patterns, Molecular Markers, and Implications for Malaria Control
Abstract:
Artemisinin partial resistance (ART-R) represents a growing concern for malaria control in Sub-Saharan Africa. This narrative review synthesizes current evidence on the epidemiology, molecular markers, therapeutic efficacy, transmission dynamics, and surveillance of ART-R. Structured searches of peer-reviewed literature and grey sources published between 2020 and 2025 were conducted, focusing on clinical studies of artemisinin-based combination therapy (ACT) efficacy, PfKelch13 (PfK13) mutations, and surveillance reports. Data were extracted descriptively and synthesized thematically across four domains: emergence patterns, molecular markers and phenotypic expression, treatment efficacy and partner drug susceptibility, and transmission and surveillance capacity. Validated PfK13 mutations associated with ART-R, including R561H, C469Y, A675V, and R622I, have emerged independently across Sub-Saharan African countries. While delayed parasite clearance is observed with these mutations, first-line ACTs continue to show high cure rates in many settings, reflecting the combined activity of artemisinin derivatives and partner drugs. Candidate PfK13 mutations and markers of altered partner drug susceptibility have also been reported, highlighting potential emerging vulnerabilities in the ACT framework. Prolonged parasite clearance may increase the window of transmission, particularly in low to moderate transmission settings. Surveillance capacity is expanding but remains uneven, with gaps in genomic monitoring, timely reporting, and integration into policy processes. Overall, ART-R in Sub-Saharan Africa remains focal and of low prevalence, with limited evidence of widespread clinical impact. Strengthening integrated molecular and therapeutic surveillance, improving data-to-policy translation, and implementing targeted interventions in high-risk areas are critical to prevent wider dissemination and sustain ACT effectiveness, thereby supporting malaria control gains across the region.
Artemisinin Partial Resistance in Sub-Saharan Africa: Epidemiological Patterns, Molecular Markers, and Implications for Malaria Control
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Exploration of Mothers and Caregivers’ Perspectives on Vaccination Dropout among Children Aged 12-23 Months in The Gambia: Using Thematic Analytical ApproachAuthor: Baboucarr BoyeDOI: 10.21522/TIJAR.2014.13.02.Art029
Exploration of Mothers and Caregivers’ Perspectives on Vaccination Dropout among Children Aged 12-23 Months in The Gambia: Using Thematic Analytical Approach
Abstract:
In recent years, full childhood routine immunisation coverage has fallen by 5% to levels not seen since 2008; between 2019 and 2021, 67 million children were under-vaccinated. We aimed to identify and describe the determinants of vaccination drop-out from the perspectives of mothers and caregivers. In The Gambia, vaccination coverage has improved from 76% in 2015 to 85% in 2020-21. However, this coverage is still behind the target set by the Global Vaccine Action Plan (GVAP) of 90% and 80% coverages for all antigens at the national and district levels respectively by 2020. These disparities highlight systemic barriers and the need to identify determinants of dropout to guide targeted interventions. The study was conducted in Upper River Region (rural) and West Coast Health Region 2 (semi-urban), selected for their historically high dropout rates (6.1% and 7.5% respectively). We conducted focus group discussions with community stakeholders, including mothers’ clubs and traditional communicators, to gain deeper insights into social and structural influences on vaccination dropout. Findings of the study revealed that caregivers generally possessed adequate awareness of the purpose and benefits of childhood vaccination and widely associated vaccination with disease prevention, child survival and development. Health workers emerged as the most credible and influential source of vaccination information, seconded by community-based actors such as village health workers and local leaders. Interventions should therefore be tailored to address drivers of dropout in communities. Service quality, timeliness and reliability need to be improved, and tailored messaging and awareness creation are needed.
Exploration of Mothers and Caregivers’ Perspectives on Vaccination Dropout among Children Aged 12-23 Months in The Gambia: Using Thematic Analytical Approach
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Vaccine Acceptance, Hesitancy, and Uptake Determinants in the African Mpox Response: A Systematic Review and Meta-AnalysisAuthor: Charles Ugochukwu IbenemeDOI: 10.21522/TIJAR.2014.13.02.Art030
Vaccine Acceptance, Hesitancy, and Uptake Determinants in the African Mpox Response: A Systematic Review and Meta-Analysis
Abstract:
The 2024 Public Health Emergency of International Concern (PHEIC) declaration for mpox exposed a critical demand-side gap in Africa’s vaccination response. Despite the Africa CDC and WHO-led Access and Allocation Mechanism (AAM) delivering over 1.9 million doses to African nations, uptake in several high-burden settings remained well below target coverage levels. A systematic review and meta-analysis following PRISMA 2020 guidelines pooled data from 18 studies (120-source evidence base, 2016–2026) using the DerSimonian–Laird random-effects model with Freeman–Tukey double arcsine transformation. Databases searched included PubMed/MEDLINE, Embase, Scopus, and grey literature from WHO, Africa CDC, and UNICEF. Subgroup analyses were conducted by subregion and outbreak phase; meta-regression examined determinants including trust in health authorities, prior vaccination history, education level, and misinformation exposure. Study findings showed pooled vaccine acceptance across 14 studies was 0.58 (95% CI: 0.52–0.64; I² = 89%). Pooled hesitancy was 0.32 (95% CI: 0.27–0.38; I² = 89%). East Africa had the highest subregional acceptance (64%; 95% CI: 57–71%) and Central Africa the lowest (49%; 95% CI: 41–57%). Trust in health authorities (OR 2.1), prior vaccination history (OR 1.8), higher education (OR 1.5), and misinformation exposure (OR 0.6) were the strongest determinants. Peak outbreak phase was associated with higher uptake (67%; 95% CI: 59–74%) versus early phase (49%; 95% CI: 42–56%). Conclusion: Vaccine acceptance in Africa averages below 60%, with one-third of populations expressing hesitancy. Demand generation must operate alongside supply-side scale-up through trust-based communication, community engagement, and targeted misinformation responses.
Vaccine Acceptance, Hesitancy, and Uptake Determinants in the African Mpox Response: A Systematic Review and Meta-Analysis
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Leveraging Artificial Intelligence (AI) to Improve Trade and Commerce Efficiency in GuyanaAuthor: Visham BudhooDOI: 10.21522/TIJAR.2014.13.02.Art031
Leveraging Artificial Intelligence (AI) to Improve Trade and Commerce Efficiency in Guyana
Abstract:
The "Digital Guyana" initiative centers on AskGov, an AI platform providing 24/7 consultancy to bridge the gap between remote entrepreneurs and central regulation. By simplifying complex filings like the Local Content Act via mobile devices, the government ensures small businesses can navigate legal frameworks previously accessible only to large firms. Once integrated, these businesses leverage predictive logistics to align production with global demand. Agencies like the GRDB and GuySuCo use AI-equipped drones and modeling to monitor crop health, reducing chemical waste by 15% and stabilizing supply chains against seasonal constraints. This precision is mirrored in the oil and gas sector. Digital Twins on vessels like the Liza Unity optimize maintenance through real-time virtual modeling, while AI-powered underwater vehicles provide high-resolution seabed mapping for low-impact resource extraction. Industrial efficiency further drives SME growth via modernized financial services. Institutions like Republic Bank now use AI credit scoring to analyze non-traditional data, unlocking capital for businesses without formal credit histories. This allows manufacturers like DDL to adopt dynamic pricing tools for international competition. Further, to ensure ethical growth, the EPA utilizes real-time AI monitoring to track offshore production and waste. By automating Local Content Act compliance, the government ensures expansion translates into fair employment for the Guyanese workforce. Finally, advancements are secured within Silica City, where 3D AI models of power grids and drainage systems predict koker/sluice failures, ensuring infrastructure remains resilient against climate change.
Leveraging Artificial Intelligence (AI) to Improve Trade and Commerce Efficiency in Guyana
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Therapeutic Potential of Berberine in Lung Cancer: A Systematic Review and Meta- Analysis of Preclinical StudiesAuthor: Prabhavathy Devi Narayanan DossDOI: 10.21522/TIJAR.2014.13.02.Art032
Therapeutic Potential of Berberine in Lung Cancer: A Systematic Review and Meta- Analysis of Preclinical Studies
Abstract:
Berberine, a natural isoquinoline alkaloid, has demonstrated anticancer properties in various malignancies. This systematic review and meta-analysis evaluated the efficacy of berberine specifically in lung cancer preclinical models. We conducted a comprehensive literature search across PubMed, Web of Science, and Scopus. From 427 initially identified publications, three high-quality preclinical studies met inclusion criteria, providing data on 172 experimental animals for tumor volume analysis and 134 animals for tumor weight assessment. Berberine significantly inhibited tumor volume (SMD -1.5140, 95% CI: -2.0164 to - 1.0116; p<0.0001) and tumor weight (SMD -2.0546, 95% CI: -2.5484 to -1.5607; p<0.0001) in experimental lung cancer models. Considerable heterogeneity was observed across studies (I²=92.1% for tumor volume, I²=87.6% for tumor weight). Mechanistically, berberine exhibited p53-dependent antitumor activity, demonstrated oral bioavailability through dietary administration, and functioned as a small-molecule immune checkpoint inhibitor by reducing PD-L1 expression on tumor cells.Berberine demonstrates significant antitumor activity in lung cancer models through multiple complementary mechanisms. Despite the robust preclinical evidence, the limited number of included studies necessitates further investigation through standardized protocols and carefully designed clinical trials to evaluate berberine's potential as an adjunctive or alternative therapy for lung cancer.
Therapeutic Potential of Berberine in Lung Cancer: A Systematic Review and Meta- Analysis of Preclinical Studies
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[12]. Ni, L., Li, Z., Ren, H., Kong, L., Chen, X., Xiong, M., Zhang, X., Ning, B. and Li, J., 2022, Berberine inhibits non‐small cell lung cancer cell growth through repressing DNA repair and replication rather than through apoptosis. Clinical and Experimental Pharmacology and Physiology, 49(1), 134–144.
[13]. Chen, Q. Q., Shi, J. M., Ding, Z., Xia, Q., Zheng, T. S., Ren, Y. B., Li, M. and Fan, L. H., 2019, Berberine induces apoptosis in non-small-cell lung cancer cells by upregulating miR-19a targeting tissue factor. Cancer Management and Research, 11, 9005–9015. https://doi.org/10.2147/CMAR.S207677.
[14]. Andersen, M. S., Kofoed, M. S., Paludan-Müller, A. S., Pedersen, C. B., Mathiesen, T., Mawrin, C., et al., 2024, CRIME-Q-A unifying tool for critical appraisal of methodological (technical) quality, quality of reporting and risk of bias in animal research. BMC Medical Research Methodology, 24(1), 306.
[15]. Schwarzer, G., 2022, Meta-analysis in R. Systematic Reviews in Health Research: Meta-analysis in Context, 510–534.
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Determinants of Vaccination Dropout among Children in the Gambia: A Mixed-Method Comparison of Urban and Rural Health RegionsAuthor: Baboucarr BoyeDOI: 10.21522/TIJAR.2014.13.02.Art033
Determinants of Vaccination Dropout among Children in the Gambia: A Mixed-Method Comparison of Urban and Rural Health Regions
Abstract:
The dropout rate is the proportion of vaccine recipients who have not completed their vaccination schedules. In The Gambia, vaccination dropout persists despite rising immunization coverage from 76% in 2013 to 85% in 2020. The 2020 DHS reports high initial uptake of multi-dose vaccines (98–99%), but final-dose completion drops to 92–95%. These disparities highlight systemic barriers and the need to identify determinants of dropout to guide targeted interventions. This study employed a mixed-methods approach, combining a quantitative unmatched case–control design with a qualitative component. In the quantitative phase, mothers of children who completed the routine immunization schedule (controls) compared with mothers of children who experienced vaccination dropout (cases). The qualitative component included in-depth interviews with mothers from both groups to explore contextual factors, perceptions, and lived experiences related to vaccination completion. The findings indicated that maternal education was consistently associated with vaccination dropout. Children from households in the poorest wealth quintile were more likely to drop out of routine immunization compared with those in the highest wealth quintile. Maternal age was also significantly associated with vaccination dropout. Geographic access played an important role: shorter distance to health facilities was associated with lower dropout rates, while limited access to nearby health services contributed to higher vaccination dropout. Identifying the factors associated with dropout is essential for designing targeted interventions. Strengthening community-based outreach, improving service accessibility, and promoting maternal health service use may help reduce dropout and enhance immunization outcomes.
Determinants of Vaccination Dropout among Children in the Gambia: A Mixed-Method Comparison of Urban and Rural Health Regions
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Navigating the Allocation–Administration–Uptake Continuum: Health System Determinants of Mpox Vaccine Utilization Gaps in AfricaAuthor: Charles Ugochukwu IbenemeDOI: 10.21522/TIJAR.2014.13.02.Art034
Navigating the Allocation–Administration–Uptake Continuum: Health System Determinants of Mpox Vaccine Utilization Gaps in Africa
Abstract:
Despite over 1.9 million mpox vaccine doses being formally allocated to African countries by 2025, Africa CDC data indicate utilization rates of approximately 63% for MVA-BN and 25% for LC16m8 vaccines, representing a substantial allocation-to-administration gap. This paper examines structural, regulatory, health-system, and socio-behavioural determinants of vaccination continuum gaps in Africa’s mpox response. A systematic review and mixed-methods synthesis of 120 studies (2016–2026) was conducted following PRISMA 2020 guidelines. A random-effects meta-analysis (DerSimonian–Laird) pooled utilization rates across nine eligible studies. Determinants were synthesised narratively using the WHO Health Systems Framework and Consolidated Framework for Implementation Research (CFIR). Cross-country disparities were analysed by setting type and regulatory readiness tier. The pooled vaccine utilization rate was 0.76 (95% CI: 0.71–0.81; I² = 81%), indicating a mean utilization gap of approximately 24%. Utilization ranged from 82–90% in stable urban settings to 55–70% in conflict-affected contexts. Regulatory readiness strongly moderated outcomes: countries with high readiness achieved pooled uptake of 66% compared to 46% in low-readiness settings. An integrated cascade model emerged: structural constraints drive the allocation gap; governance and health-system readiness determine the administration gap; and socio-behavioural factors shape the uptake gap. Three country readiness tiers were identified with distinct gap profiles. Closing Africa’s mpox vaccination gap requires simultaneous interventions across all continuum stages. Evidence-based recommendations include risk-based allocation algorithms, regulatory harmonisation through AVAREF and AMA, cold-chain investment, workforce surge capacity, and community trust-building. Governance and system readiness are the critical mediators of vaccination performance.
Navigating the Allocation–Administration–Uptake Continuum: Health System Determinants of Mpox Vaccine Utilization Gaps in Africa
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