Abstract:

The uptake of modern contraceptive services in South Sudan is poor across all regional, social, economic and political divides. Hence, this study aimed to assess demographic, knowledge, attitude and perception related factors on uptake of modern contraceptive among women of reproductive age in Aweil State hospital. A cross-sectional design was conducted among 411 women of reproductive age. Data was collected through face-to-face interviews using structured questionnaires and analyzed with SPSS software. The lifetime Uptake of contraceptive use was calculated as the proportion of women who had ever used any modern family planning method. Logistic regression model was applied to identified factors influencing contraceptive use (at the significance level p < 0.05). The result revealed that the lifetime uptake of modern contraceptive methods was 15.3% [injectables (5.8%), implants (5.1%), pills (3.2%), male condoms (0.7%), and emergency contraceptives (0.5%)]. Multivariable analysis showed that discussing contraceptives with a spouse (aOR=98.34), having spousal approval (aOR=38.12), high level of education (OR=9.45), having good knowledge (aOR=3.367) and a positive perception (aOR=1.665) increased usage. Mothers intending to have more children were less likely to use them (aOR=0.187). Hence, the study revealed a very low uptake of modern contraceptives among women of reproductive age, which was significantly associated with being good spousal communication and approval, receiving information from health facilities and maintaining positive perceptions towards modern contraceptives are associated with increased contraceptive use. The study recommends the Ministry of Health to promote modern contraceptive education by integrating family planning into broader health education and community health initiatives.

References:

Abstract:

Introduction of new vaccines (Measles-Rubella second dose [MR2], Inactivated Polio Vaccine second dose [IPV2], Hepatitis B Birth Dose [HepB-BD], and Yellow Fever [YF]) is a major milestone in strengthening Uganda’s Expanded Programme on Immunization (EPI). Assessing performance and system readiness for new vaccine adoption is essential for achieving Immunization Agenda 2030 (IA2030) goals and ensuring long-term sustainability. This study evaluated national, district, and facility-level readiness using the WHO Post-Introduction Evaluation (PIE) framework, focusing on logistics, cold chain capacity, human resources, supervision, and coordination mechanisms. A mixed-methods design was used. Quantitative data were extracted from national, district, health facility, and community PIE tools. Descriptive statistics, readiness scoring, and logistic regression explored determinants of coverage performance. Qualitative data from key informant interviews and facility-level observations were analyzed thematically. Findings were triangulated across data sources to ensure validity. Data-use permission was obtained from relevant authorities. National cold-chain functionality stood at 83.7%, with higher performance in Central and Western regions. Supervision frequency, logistics adequacy, and staff training were significant predictors of new vaccine coverage (p < 0.05). Qualitative findings highlighted strong partner coordination but persistent challenges in preventive maintenance, workload pressure, and staffing gaps. Despite operational successes, regional disparities remained particularly in remote Northern and Eastern districts. Uganda’s immunization system demonstrates strong readiness and capacity to integrate new vaccines into routine immunization. However, sustainability requires improved financing, enhanced supervision, stronger cold-chain maintenance systems, and targeted support for underserved regions. Findings contribute practical evidence for policy planning, Gavi Joint appraisal processes, and future vaccine introductions.

References:

[1].   World Health Organization, 2013, Global Vaccine Action Plan 2011–2020. Geneva: WHO.

[2].   World Health Organization, 2023, Immunization Agenda 2030: Progress Report. Geneva: WHO.

[3].   UNICEF, 2023, State of the World’s Children: Vaccination. New York: UNICEF.

[4].   WHO. New Vaccine Post-Introduction Evaluation (PIE) Tool. Who/Ivb/1003 [Internet]. 2010;1–66. Available from: http://whqlibdoc.who.int/hq/2010/WHO_IVB_10.03_eng.pdf

[5].   Gavi, The Vaccine Alliance, 2024, Uganda Joint Appraisal Report. Geneva: Gavi.

[6].   Akwiri, A., Mwangi, J., Njoroge, G., 2023, Post-introduction evaluation of MR2 in Kenya. East African Journal of Public Health, 20(3), 224–238.

[7].   Mboera, E., Tadesse, E., Berhane, Y., 2022, Strengthening immunization services in Africa. BMJ Global Health, 7(5), e008221.

[8].   Reid, M. J. A., Vallières, E., Ousman, K., 2023, Health system fragility in Africa. BMJ Global Health, 8(4), e010512.

[9].   Adeyanju, G. C., et al., 2022, Drivers of vaccine hesitancy in Africa. BMC Public Health, 22(1), 2044.

[10].  PATH, 2023, Health Systems Strengthening for Vaccine Introduction. Nairobi: PATH.

[11].  World Health Organization, 2024, Post-Introduction Evaluation Guidelines. Geneva: WHO.

[12].  WHO Regional Office for Africa, 2022, Progress toward vaccine equity in Africa. Brazzaville: WHO AFRO.

[13].  World Bank, 2022, Strengthening Health System Resilience in Africa. Washington, DC: World Bank.

[14].  UNICEF and World Health Organization, 2023, Behavioural and Social Drivers of Vaccination Framework. Geneva: WHO.

[15].  Kamya, C., et al., 2023, Spatial inequality in Uganda’s routine immunization. Journal of Public Health in Africa, 14(2), 123–138.

[16].  Okello, A., et al., 2022, Determinants of immunization service uptake in Northern Uganda. BMC Health Services Research, 22, 954.

[17].  Rosenstock, I. M., 1974, Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335.

[18].  Limbu, Y. B.; Gautam, R. K.; Pham, L., 2022, The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review. Vaccines, 10, 973. https://doi.org/10.3390/vaccines10060973

[19].  Rogers, E. M., 2003, Diffusion of Innovations, 5th ed. New York: Free Press.

[20].  UNICEF Supply Division, 2023, Cold Chain Equipment Status Report. Copenhagen: UNICEF.

Abstract:

The vaccination is a fundamental pillar of disease prevention. As part of strengthening its Expanded Program on Immunization (EPI), Burkina Faso recently introduced two new vaccines in 27 pilot districts : the malaria vaccine (VAP) and the human papilloma virus (HPV) vaccine. Despite this progress, vaccination coverage remains below national targets in several districts. Based on lessons learned from the introduction of new vaccines in other African countries, we conducted an assessment of the challenges related to the acceptability and availability of these vaccines in three selected districts (Manga, Kampti, and Koupela). Mixed-methods study, combining qualitative and quantitative approaches, was conducted in three health districts. The qualitative component explored the knowledge, perceptions, and attitudes of parents of target children regarding vaccination against malaria and cervical cancer. Data were collected using Kobo Collect and analyzed with NVivo. Some participants (13/15) had their children vaccinated against HPV, while two parents had children who were not vaccinated. Furthermore, most parents mentioned reluctance towards this vaccine within their communities; hesitation linked to rumors, lack of information, and sociocultural perceptions. In conclusion, the Improving vaccine acceptability and availability requires strengthening community communication, improving the quality of reception, and supplying facilities with vaccines and inputs according to their needs

References:

[1].   Diop, et al., 2017, Innovations en vaccinologie: enjeux et perspectives pour l’Afrique. Pan Afr Med J 26. https://doi.org/10.11604/pamj.2017.26.235.11527

[2].   Shattock, et al., 2024, Contribution of vaccination to improved survival and health: modelling 50 years of the Expanded Programme on Immunization. The Lancet S014067362400850X. https://doi.org/10.1016/S0140-6736(24)00850-X.

[3].   Kaur, G., Casey, R. M., Patel, J. C., Bloem, P., Walldorf, J. A., Hyde, T. B., 2023, Status of New Vaccine Introduction - Worldwide, 2016-2021. MMWR Morb Mortal Wkly Rep 72, 746–750. https://doi.org/10.15585/mmwr.mm7227a2

[4].   MacDonald, N., Mohsni, E., Al-Mazrou, Y., Kim Andrus, J., Arora, N., Elden, S., Madrid, M.-Y., Martin, R., Mahmoud Mustafa, A., Rees, H., Salisbury, D., Zhao, Q., Jones, I., Steffen, C. A., Hombach, J., O’Brien, K. L., Cravioto, A., 2020, Global vaccine action plan lessons learned I: Recommendations for the next decade. Vaccine 38, 5364–5371. https://doi.org/10.1016/j.vaccine.2020.05.003

[5].   Sambala, E. Z., Wiyeh, A. B., Ngcobo, N., Machingaidze, S., Wiysonge, C. S., 2019, New vaccine introductions in Africa before and during the decade of vaccines - Are we making progress? Vaccine 37, 3290–3295. https://doi.org/10.1016/j.vaccine.2019.05.002.

[6].   Osoro, C. B., Ochodo, E., Kwambai, T. K., Otieno, J. A., Were, L., Sagam, C. K., Owino, E. J., Kariuki, S., Ter Kuile, F. O., Hill, J., 2024, Policy uptake and implementation of the RTS,S/AS01 malaria vaccine in sub-Saharan African countries: status 2 years following the WHO recommendation. BMJ Glob Health 9, e014719. https://doi.org/10.1136/bmjgh-2023-014719.

[7].   Adeyanju, G. C., Essoh, T.-A., Sidibe, A. R., Kyesi, F., Aina, M., 2024, Human Papillomavirus Vaccination Acceleration and Introduction in Sub-Saharan Africa: A Multi-Country Cohort Analysis. Vaccines 12, 489. https://doi.org/10.3390/vaccines12050489.

[8].   Kiendrébéogo, J. A., Sidibe, A. R. O., Compaoré, G. B., Nacanabo, R., Nawaz, S., Schuind, A. E., Clark, A., 2023, Cost-effectiveness of human papillomavirus (HPV) vaccination in Burkina Faso: a modelling study. BMC Health Serv Res 23, 1338. https://doi.org/10.1186/s12913-023-10283-3.

[9].   Meda, Z. C., Hien, H., Traore, T. I., Ouattara, C. A., Ramde, Z., Ilboudo, B., Some, D. A., Ouattara, S., 2024, Factors associated with positive human papillomavirus (HPV) test results in cervical precancer screening: a cross-sectional study at Souro Sanou National Teaching Hospital (SSNTH) in Bobo Dioulasso, Burkina Faso. BMC Public Health 24, 2900. https://doi.org/10.1186/s12889-024-20389-w.

[10].  Diendéré, J., Kiemtoré, S., Coulibaly, A., Tougri, G., Ily, N. I., Kouanda, S., 2023, Low attendance in cervical cancer screening, geographical disparities and sociodemographic determinants of screening uptake among adult women in Burkina Faso : results from the first nationwide population-based survey. Rev Epidemiol Sante Publique 71, 101845. https://doi.org/10.1016/j.respe.2023.101845.

[11].  Zabre, P., Sagna, T., Ouedraogo, R., Simpore, J., 2024, Epidemiological profile of human papillomavirus infections and cervical cancer prevention among sexually active women in Burkina Faso: Literature Review. MRAJ 12. https://doi.org/10.18103/mra.v12i11.5883.

[12].  Wilson, R., 2021, HPV vaccine acceptance in West Africa: A systematic literature review. Vaccine 39, 5277–5284. https://doi.org/10.1016/j.vaccine.2021.06.074.

[13].  Naba, C., Ishidaira, H., Magome, J., Souma, K., 2024, Exploring the Potential of Soil and Water Conservation Measures for Climate Resilience in Burkina Faso. Sustainability 16, 7995. https://doi.org/10.3390/su16187995.

[14].  Pison, G., Poniakina, S., 2024, The population of the world (2024). Population & Societies 626, 1–8. https://doi.org/10.3917/popsoc.626.0001.

[15].  Zongo, D., Tiendrebeogo, J. M. A., Ouedraogo, W. M., Bagayan, M., Ouedraogo, S. H., Bougouma, C., Nassa, C., Serme, M., Naré, D., Zida, A., 2025, Epidemiological situation of schistosomiasis in 16 districts of Burkina Faso after two decades of mass treatment. PLOS Neglected Tropical Diseases 19, e0012858. https://doi.org/10.1371/journal.pntd.0012858

[16].  Guenou, et al., 2024, Acceptability and Feasibility of Human Papillomavirus Vaccine Introduction in Cameroon: A Mixed-Methods Study. Cureus 16, e60723. https://doi.org/10.7759/cureus.60723.

[17].  Tran, et al., 2023, Understanding barriers and motivations to papillomavirus vaccination in a middle school in Reunion Island. Eur J Obstet Gynecol Reprod Biol 285, 17–23. https://doi.org/10.1016/j.ejogrb.2023.03.033.

[18].  Guillaume, et al., 2023, Acceptability of an integrated school-based HPV vaccination program within two districts of Tanzania: A qualitative descriptive study. PLOS Global Public Health 3, e0001394. https://doi.org/10.1371/journal.pgph.0001394.

[19].  Wilson, R. J., Leigh, L., Bah, H., Larson, H. J., Clarke, E., 2023, HPV vaccination acceptance and perceptions related to fertility and population control in the Gambia: An anthropological analysis. Vaccine 41, 3647–3654. https://doi.org/10.1016/j.vaccine.2023.04.072.

[20].  Fisher, et al., 2024, Information needs of ethnically diverse, vaccine-hesitant parents during decision-making about the HPV vaccine for their adolescent child: a qualitative study. BMC Public Health 24, 91. https://doi.org/10.1186/s12889-023-17540-4.

Abstract:

The migration of registered nurses from Saint Vincent and the Grenadines to wealthy countries such as the United Kingdom and the United States of America raises concerns. This is a multidimensional subject that can only be completely investigated with a hybrid approach. This study aimed to identify the factors associated with nurse emigration from SVG and to examine its implications for the nursing profession and health sector. A sequential explanatory mixed-method design was employed between October 2024 and April 2025. Quantitative data were collected using structured paper-based and online questionnaires from 103 registered nurses. Qualitative data were obtained through in-depth interviews with 20 purposively selected participants. Quantitative data were analyzed using SPSS version 26, while thematic analysis was applied to qualitative data. Quantitative findings revealed a statistically significant association between religion and migration (χ²(12) = 21.753, p = 0.040), and regression analysis identified economic incentives as a significant predictor of outward migration (p = 0.008). Qualitative analysis identified inadequate salaries, unfavorable working conditions, limited career advancement, political interference, influence of family abroad, and dissatisfaction with governance as key drivers of migration. Nurse migration from SVG is primarily driven by economic and systemic health system factors rather than sociodemographic characteristics alone. Improving remuneration, working conditions, merit-based promotion, and nurse involvement in policy development is essential to strengthening retention and sustaining the national healthcare workforce.

References:

[1].   World Health Organization, 2010, Global Code of Practice on the International Recruitment of Health Personnel.

[2].   International Organization for Migration (IOM), 2017, Migration in the Caribbean: Current Trends, Opportunities And Challenges. Working Paper 1. San José, Costa Rica: International Organization for Migration (IOM).

[3].   Searchlight Newspaper, 2022 ,Nursing shortage hits the local health system Retrieved from: https://www.searchlight.vc/news/2023/01/13/nursing-shortage-hits-local-healthsystem/#:~:text=A%20nursing%20shortage%20has%20hit,of%20the%20SVG%20Community%20College

[4].   Searchlight Newspaper , 2022, staff shortage as nurses leave hospital services Retrieved from: https://www.searchlight.vc/front-page/2022/04/01/staff-shortage-as-nurses-leavehospitalservices/#:~:text=So%20far%2C%20for%202022%2C%20there,four%20nursing%20assistants%20have%20resigned

[5].   Milton Cato Memorial Hospital Staff Development Unit, 2023, Nursing Statistics.

[6].   Milton Cato Memorial Hospital – Saint Vincent and the Grenadines. (n.d.). Business View Caribbean.Retrievedfrom:https://businessviewcaribbean.com/milton-cato-memorial-hospital-saint-vincent/

[7].   Braun, V., & Clarke, V., 2006, Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

[8].   Buchan, J., Parkin, T., & Sochalski, J., 2005, International nurse mobility: Trends and policy implications. Bulletin of the World Health Organization, 83(8), 587–594.

[9].   Thomas, P., 2006, The international migration of Indian nurses. International Nursing Review, 53(4), 277–283.

[10].  Perrin, M. E., Hagopian, A., Sales, A., & Huang, B., 2007, Nurse migration and its implications for Philippine hospitals. International Nursing Review, 54(3), 219–226.

[11].  El-Jardali, F., Dimassi, H., Dumit, N., Jamal, D., & Mouro, G., 2009, A national cross-sectional study on nurses' intent to leave and job satisfaction in Lebanon: implications for policy and practice. BMC Nursing, 8, 13.

[12].  Troy, P. H., Wyness, L. A., & McAuliffe, E., 2007,Nurses' experiences of recruitment and migration from developing countries: A phenomenological approach. Human Resources for Health, 5, 15–17.

[13].  Greenwood, M. J.,1997, Internal migration in developed countries, Elsevier, Volume 1, Part B.

[14].  Rogers, A., & Castro, L. J., 1981, Model migration schedules RR-81-030.

[15].  King. R., & Skeldon, R., 2010, ‘Mind the Gap’ Integrating Approaches to Internal and International Migration. Journal of Ethnic and Migration Studies, 36, 10: 1619-1646.

[16].  Connor, P., 2010, Contexts of immigrant receptivity and immigrant religious outcomes: the case of Muslims in Western Europe, «Ethnic and Racial Studies», XXXIII, 3, pp. 376-403.

[17].  Pew Research Center, 2012, Faith on the move. The religious affiliation of international migrants. Retrieved from: Faith-on-the-move.aspx.

[18].  Hirschman, C., 2004, The Role of Religion in the Origins and Adaptation of Immigrant Groups in the United States. International Migration Review. 28:1206–34.

[19].  Foner, N., & Alba, R., 2008, Immigrant Religion in the U.S. and Western Europe: Bridge or Barrier to Inclusion? International Migration Review, 42, 360-392. https://doi.org/10.1111/j.1747-7379.2008.00128.x

[20].  Szabo, S., Nove, A., Matthews, Z., Bajracharya, A., Dhillon, I., Singh, D. R., Saares, A., & Campbell, J., 2020, Health workforce demography: A framework to improve understanding of the health workforce and support achievement of the sustainable development goals. Human Resources for Health, 18(1), 1–10.

[21].  WHO, 2018, Five- year action plan for health employment and inclusive economic growth (2017– 2021). WHO Press. https://apps.who.int/ iris

[22].  Spurlock, D., 2020, The nursing shortage and the future of nursing education is in our hands. Journal of Nursing Education, 59(6), 303– 304. https://doi.org/10.3928/01484834-20200520-01

[23].  De Veer, A. J., Den Ouden, D.-J., & Francke, A. L., 2004,Experiences of foreign European nurses in The Netherlands. Health Policy, 68(1), 55–61.

[24].  Chikanda, A., 2005, Nurse migration from Zimbabwe: Analysis of recent trends and impacts. Nursing Inquiry, 12(3), 162–174.

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[30].  Beaton, M., & Walsh, J., 2010, Overseas recruitment: Experiences of nurses immigrating to Newfoundland and Labrador, 1949–2004. Nursing Inquiry, 17(2), 173–183.

[31].  Larsen, J. A., Allan, H. T., Bryan, K., & Smith, P., 2005, Overseas nurses' motivations for working in the UK: globalization and life politics. Work Employment Society, 19 (2), 349-368.

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Abstract:

Differences in knowledge and practices related to vitamin D may reduce the effectiveness of preventive interventions. The study is carried out to assess nurses and patients’ knowledge, practices, and attitudes toward vitamin D in tertiary healthcare facility. Nurses and patients of such tertiary care hospital-based units above 18 years were included in the cross-sectional study. A validated questionnaire was used to extract the personal characteristics of the samples and to assess knowledge, practices, and attitudes with regard to vitamin D The data were analyzed using SPSS version 25 with independent t-tests, chi-square tests, analysis of variance (ANOVA) at p < 0.05 level. Nurses demonstrated a higher level of knowledge compared to patients, particularly in the domains of calcium absorption and bone health, as well as dietary sources of vitamin D. Both groups expressed positive perceptions of vitamin D, and nurses exhibited a higher degree of consensus regarding their responsibility to educate patients. A discrepancy was observed between nurses' and patients' perceptions regarding the assessment of vitamin D levels, with 46.6% of nurses reporting that they routinely assess their patients' levels. The study showed that less than half of the patients followed the recommended practices. Only a few of them took supplements and got enough sun. The results showed a strong connection between age and education levels, on one side, and knowledge, attitudes, and actions, on the other. Both patients and nurses had trouble applying vitamin D in practice, but nurses had more knowledge and were more positive about it.

References:

[1].   Vitamin, D., 2017, Fact sheet for health professionals. Natl. Institutes Heal. Off. Diet. Suppl. Available online:

https://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

[2].   Zareef, T. A., Jackson, R. T., 2021, Knowledge and attitudes about vitamin D and sunlight exposure in premenopausal women living in Jeddah, and their relationship with serum vitamin D levels. Journal of Health, Population and Nutrition, 40(1), 38. Doi:10.1186/s41043-021-00263-w.

[3].   Lamberg-Allardt, C., 2006, Vitamin D in foods and as supplements. Progress in biophysics and molecular biology, 92(1), 33-38, Doi:10.1016/j.pbiomolbio.2006.02.017.

[4].   Darling, A. L., 2020, Vitamin D deficiency in western dwelling South Asian populations: an unrecognised epidemic. Proceedings of the Nutrition Society, 79(3), 259-271, Doi:10.1017/S0029665120000063.

[5].   Marcinowska-Suchowierska, E., Kupisz-Urbańska, M., Łukaszkiewicz, J., Płudowski, P., Jones, G., 2018, Vitamin D toxicity–a clinical perspective. Frontiers in endocrinology, 9, 550, Doi:10.3389/fendo.2018.00550.

[6].   Roth, D. E., Abrams, S. A., Aloia, J., Bergeron, G., Bourassa, M. W., Brown, K. H., Whiting, S. J., 2018, Global prevalence and disease burden of vitamin D deficiency: A roadmap for action in low‐and middle‐income countries, 1430(1):44-79, Doi:10.1111/nyas.13968

[7].   Neale, R. E., Lucas, R. M., Byrne, S. N., Hollestein, L., Rhodes, L. E., Yazar, S., Olsen, C. M., 2023, The effects of exposure to solar radiation on human health. Photochemical & Photobiological Sciences, 22(5), 1011-1047, Doi:10.1007/s43630-023-00375-8.

[8].   Dominguez, L. J., Farruggia, M., Veronese, N., Barbagallo, M., 2021, Vitamin D sources, metabolism, and deficiency: available compounds and guidelines for its treatment. Metabolites, 11(4), 255, Doi:10.3390/metabo11040255.

[9].   Pilz, S., März, W., Cashman, K. D., Kiely, M. E., Whiting, S. J., Holick, M. F., Zittermann, A., 2018, Rationale and plan for vitamin D food fortification: a review and guidance paper. Frontiers in endocrinology, 9, 373, Doi:10.3389/fendo.2018.00373.

[10].  Barakat, M., Abdulrazzaq, S. B., Raad, D., Omar, A., Kamal, A., Alzayer, R., Al-Najjar, M. A., 2025, Factors Affecting the Knowledge, Attitude and Practice of Vitamin D Supplement Use among Adults: a Multi-Arab Countries Study. Journal of Epidemiology and Global Health, 15(1), 1-14, Doi:10.1007/s44197-025-00482-y.

[11].  Al Hadhrami, R. S., Al Kaabi, R., Al Shuaibi, H. J., Al Abdulsalam, R. S., 2024, Assessment of vitamin D-related knowledge, attitudes and practices among Sultan Qaboos University students in Oman: a cross-sectional study. BMJ Public Health, 2(1), Doi:10.1136/bmjph-2023-000539.

[12].  Akhtar, A., Nasir, S., Muhammad, W., Masood, R., Mansoor, S., Ali, S. M., 2025, Exploring Perceptions of Vitamin D Awareness among Clinicians in Local Health Facilities of Pakistan: A Mixed-Method Study. Journal of the Dow University of Health Sciences (JDUHS), 19(2), 94-104, Doi:10.36570/jduhs.2025.2.2392.

[13].  Ghazi, H. F., Taher, T. M. J., Hasan, T. N., 2024, Knowledge about Vitamin D among General Population in Baghdad City. Rwanda Journal of Medicine and Health Sciences, 7(1), 89-100, Doi:10.4314/rjmhs.v7i1.7.

[14].  Wilandika, A., Pandin, M. G. R., Yusuf, A., 2023, The roles of nurses in supporting health literacy: a scoping review. Frontiers in public health, 11, 1022803, Doi:10.3389/fpubh.2023.1022803.

[15].  Moghadam, M. R., Shajari, A., Rahimi, M., 2022, Knowledge and practices related to vitamin D among healthcare workers: A cross-sectional study. Nutrients, 14(6), 1254, Doi:10.3390/nu14061254.

[16].  Elsamani, E., Almushait, M., Alzahrani, A., Alotaibi, N., 2020, Knowledge, attitude, and practice regarding vitamin D deficiency among Saudi population. Journal of Family Medicine and Primary Care, 9(8), 4376–4382, Doi:10.4103/jfmpc.jfmpc_558_20.

[17].  Bouillon, R., Marcocci, C., Carmeliet, G., Bikle, D., White, J. H., Dawson-Hughes, B., Lips, P., Munns, C. F., 2019, Skeletal and extraskeletal actions of vitamin D: Current evidence and outstanding questions. Endocrine Reviews, 40(4), 1109–1151, Doi:10.1210/Er.2018-00126.

[18].  Holick, M. F., 2017, The vitamin D deficiency pandemic: Approaches for diagnosis, treatment, and prevention. Reviews in Endocrine and Metabolic Disorders, 18(2), 153–165, Doi:10.1007/s11154-017-9424-1.

[19].  Mekonnen, W., Feleke, Y., Desalegn, Y., Tarekegne, G., Lambisso, B., Haidar, J., Zewede, T., 2020, Knowledge, attitude and practice of health care workers on measuring adult vitamin D level, diagnosis of deficiency, and management of consequent health conditions in three ecologies of Ethiopia: A cross-sectional study. BMC nutrition, 6(1), 77, Doi:10.1186/s40795-020-00404-0.

[20].  Yadav, S., Mishra, P. R., Rajalekshmi, R., Gopinath, B., Aggarwal, P., Ramaswami, A., Sharma, M., 2024, Assessment of Serum Vitamin D Levels and Evaluation of Knowledge, Attitude, and Practices of Vitamin D Deficiency among Emergency Health-care Workers at a Tertiary Care Center in North India: A Prospective Cross-sectional Study. Indian Journal of Medical Specialities, 15(1), 35-41, Doi:10.4103/injms.injms_119_23.

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Abstract:

Agriculture plays a crucial role in Jamaica’s economy, with some parishes serving as a major hub for crop production. A recent survey of farmers in South Central Jamaica examined pesticide usage practices in ready-to-eat vegetable farming. Twenty-nine farmers participated, most of whom were male, middle-aged, and had secondary-level education with over a decade of farming experience. Findings revealed that all farmers relied on multiple pesticides, with half using insecticides, herbicides, and fungicides together. While most followed label instructions and consistently used protective gear, comprehension of technical terms such as “Maximum Residual Limit” was limited. Farmers showed stronger awareness of pre-harvest intervals, drawing knowledge from labels and training programs. The findings highlight both strengths, such as adherence to safety practices, and gaps in knowledge dissemination. It calls for enhanced education, standardized guidelines, and policy development to safeguard public health while supporting sustainable agriculture in Jamaica. The study concluded that although farmers demonstrated significant experience and a commitment to safety, there are still gaps in knowledge dissemination and training. It further underscores the need for improved educational initiatives and standardized practices to reduce health risks, highlighting the importance of ongoing research and policy development to promote sustainable agriculture and public health in Jamaica.

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Abstract:

Objective: The study aims to determine the histopathological findings in patients with chronic Hepatitis B infection and their relationship to liver function tests. Materials and methods: A total of 200 HBV-positive patients aged 16 years or older who attended the gastroenterology unit of the Federal University Teaching Hospital, Lafia, were recruited using convenience sampling. The socio-demographic characteristics were recorded; venous blood was sampled for HBV serological marker testing using Enzyme-linked immunosorbent assay kits; a Tru-Cut biopsy needle was used for liver biopsy; and liver pathology was assessed using a magnetic resonance imaging machine. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 23.0. The results were presented in the table, with a significance level of p < 0.05. Results: The mean age of patients was 34.87 ± 10.78 years. There were (70.5%) males, and (29.5%) females. Histology results revealed ballooning degeneration (9.5%), Fibrosis (5.5%), inflammation (6.0%), Steatosis and ground-glass (1.5%), fatty liver and necrosis (1.0%). The liver function test revealed that (15.0%), (52.5%), (32.5%), and (6.5%) had elevated platelet prothrombin ratio, international normalization ratio, protein, and albumin, with (35.5%), (44.0%), and (29.0%) had elevated alkaline phosphatase, alanine transaminase (ALT), and aspertase transaminase (AST). The patient with normal AST had the greatest ballooning compared with those with elevated AST (13.6% vs 4.5%), a difference that was statistically significant.  Patients with normal ALT had higher inflammation than those with high ALT (9.2% vs 1.4%), with a statistically significant difference (p=0.033). Conclusion: Liver biopsy will be recommended for patients with chronic hepatitis B showing normal AST and ALT levels.

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Abstract:

Hepatitis B (HBV) and Hepatitis C (HCV) are major viral infections affecting the liver and contribute significantly to global morbidity and mortality. Healthcare workers (HCWs) and medical students are particularly vulnerable to these infections due to frequent exposure to blood, sharp instruments, and bodily fluids during clinical practice. Identifying the burden of these infections among these groups is important for strengthening infection prevention policies and targeted interventions. A cross-sectional study was conducted to determine the seroprevalence of HBV and HCV among three cohorts: HCWs with at least one year of clinical experience, first-year medical and paramedical students with minimal clinical exposure, and final-year medical, nursing, and paramedical students with multiple clinical placements. Participants were screened for HBV and HCV serological markers using Enzyme-Linked Immunosorbent Assay (ELISA) technique and panel rapid test kits, and potential risk factors were collected. Statistical Package for Social Sciences (SPSS) version 25 was used to get proportions and binary logistic regression for associations. A total of 374 participants were included, 51.3% HCWs and 48.7% students. The overall seroprevalence of HBV was 4.8% (95% CI:2.9-7.4), with the highest prevalence observed among final-year students (9.3%, 95% CI:8.8-9.9), compared with 3.7% (95% CI:1.0-7.1) among first-year students and 3.6% (95% CI:1.5-7.3) among HCWs. The overall prevalence of HCV was 2.1% (95% CI:0.9-4.2), with slightly higher prevalence among students (2.7%;95% CI:0.3-9.3) than among HCWs (1.6%;95% CI:0.3-4.5). No demographic or occupational factors were significantly associated with HBV or HCV seropositivity. This study demonstrated a relatively low seroprevalence of HBV and HCV among healthcare workers and medical and paramedical students. Strengthening screening, vaccination programs, and infection prevention strategies is essential to protect these high-risk groups.

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[20].  Tadesse, S., Munshea, A., Gelaw, B., Peshu, N., Tesfa, E., Mekonnen, F., Tefera, M. M., Kahsu, G., Endalamaw, D., Kramvis, A., Adugna, M., & Wandiga, S., 2025, Prevalence of hepatitis B virus infection and its associated factors in Ethiopia: a recent systematic review and meta-analysis. BMC infectious diseases, 25(1), 749. https://doi.org/10.1186/s12879-025-11150-8

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[24].  Lungosi, M. B., Muzembo, B. A., Mbendi, N. C., Nkodila, N. A., Ngatu, N. R., Suzuki, T., Wada, K., Mbendi, N. S., & Ikeda, S., 2019, Assessing the prevalence of hepatitis B virus infection among health care workers in a referral hospital in Kisantu, Congo DR: a pilot study. Industrial Health, 57(5), 621–626. https://doi.org/10.2486/indhealth.2018-0166

[25].  Babiker, L. M., Idriss, A. I., Idriss, E. I., & Kheirelsid, F. E., 2025, Knowledge, Attitude, and Practice of the Medical Students of the University of Medical Sciences and Technology Towards Hepatitis B Virus Infection. Cureus, 17(7), e88402. https://doi.org/10.7759/cureus.88402

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Abstract:

Human Immudeficiency Virus (HIV) transmission remains a global public health challenge particularly among healthcare workers (HCWs). HCWs are susceptible to occupational exposures because they often handle blood and body fluids or contaminated materials. This retrospective cross-sectional study aimed to determining the HCWs’ HIV exposure characteristics, adherence to occupational postexposure prophylaxis (PEP) and seroconversion rate. Information was extracted from all the 114 medical records of HCWs who sought for PEP at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between 2011 and 2023. The data comprised sociodemographic details, exposure characteristics, adherence to PEP and seroconversion rate at 6 months. The HCWs age ranged from 20 to 59 years with a mean age of 32.34 ± 8.757 years. The females were 51.8%. Medical doctors (30.7%) were the most exposed to HIV, follow by the laboratory scientists 15.8% and nurses 14.9%. Types of exposure were mostly needle stick injury (80.7%), blood/body fluid splashes (14.9%), and cuts from sharps (4.4%). Majority of these exposures were high risk, 79%. High proportion of HCWs 85.1% started PEP within the recommended 72 hours. The study showed low adherence rate of 67.5%, and poor post-PEP HIV screening. No seroconversion was observed among the HCWs who completed follow-up. Dolutegravir-based regimen showed significant association (p=0.026) with improved adherence to PEP. The flaws noticed in this study should provide bases for the stakeholders and hospital policy makers to formulate policies that will improve HCWs safety. Hospital administrators should create more awareness about hospital policies and procedures when HIV exposure occurs.

References:

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[15].  Olanrewaju, F. O., Oripelaye, M. M., Ajani, A. A., Enitan, A. O., 2022, Evaluation of HIV Non-occupational Post-exposure Prophylaxis Utilisation in a Tertiary Health Facility in Nigeria. Rwanda J Med Health Sci, 5(3):264-275.

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Abstract:

Tuberculosis (TB) contact investigation is a key strategy recommended by the World Health Organisation (WHO) to help detect cases early, increase preventive treatment, and reduce TB transmission. Even though many countries have adopted these policies, putting them into practice is still limited in places with high TB rates. This review brings together global evidence and highlights important areas such as how programs are run, what works well, ongoing challenges, and where more research is needed. The review covers thirty studies from different settings, including household and community interventions, digital tools, programs led by community health workers, public–private partnerships, and integrated service models. TB contact investigation has been effective in finding more cases and increasing preventive treatment. Household-based strategies work well but have not been widely expanded. Using community contact clusters could help find more cases in high-burden areas, but this can require a lot of resources. Digital tools might make the process more efficient and improve data quality if they are adapted to local needs. Programs led by community health workers can reach more people, but they often cost a lot to run. Expanding TB contact investigation can help with early detection and prevention if enough resources are provided. However, there are still many operational, social, and health system barriers that make it hard to implement these programs widely. To put the evidence into practice, ongoing investment, stronger health systems, local adaptation, and real involvement of affected communities are needed.

References:

[1].   Amour, M., Joseph, P., Ngowi, J., et al., 2025, Detect early TB infection, evaluate contacts for TB (DETEC-TB) – a protocol for a prospective cohort study on active case finding for tuberculosis disease and tuberculosis infection source tracing. BMC Infect Dis, 25, 1588.

[2].   Katamba, A., Gupta, A. J., Turimumahoro, P., Ochom, E., Ggita, J. M., Nakasendwa, S., ... & Davis, J. L., 2023, A user-centred implementation strategy for tuberculosis contact investigation in Uganda: protocol for a stepped-wedge, cluster-randomised trial. BMC Public Health, 23(1), 1568.

[3].   Fox, G. J., Dodd, P. J., & Marais, B. J., 2019, Household contact investigation to improve tuberculosis control. The Lancet. Infectious diseases, 19(3), 235–237.

[4].   Tsogt, B., Sambuu, T., Purevsuren, Y., Munkhbaatar, S., Batsuren, P., et al., 2025, Multidrug-resistant tuberculosis household contact screening and management by community healthcare workers in Mongolia: a prospective implementation study. The Lancet Regional Health–Western Pacific, 63.

[5].   Shaikh, B. T., Laghari, A. K., Durrani, S., Chaudhry, A., & Ali, N., 2022, Supporting tuberculosis program in active contact tracing: a case study from Pakistan. Infectious Diseases of Poverty, 11(02), 72-76.

[6].   Satyanarayana, S., Pretorius, C., Kanchar, A., Garcia Baena, I., Den Boon, S., Miller, C., et al., 2023, Scaling up TB screening and TB preventive treatment globally: key actions and Healthcare Service costs. Tropical Medicine and Infectious Disease, 8(4), 214.

[7].   Borgen, K., Koster, B., Meijer, H., Kuyvenhoven, V., van der Sande, M., & Cobelens, F., 2008, Evaluation of a large-scale tuberculosis contact investigation in the Netherlands. European Respiratory Journal, 32(2), 419-425.

[8].   Fatima, R., Qadeer, E., Yaqoob, A., Haq, M. U., Majumdar, S. S., et al., 2016. Extending ‘contact tracing’into the community within a 50-metre radius of an index tuberculosis patient using Xpert MTB/RIF in Urban, Pakistan: did it increase case detection? PLoS One, 11(11), e0165813.

[9].   Ha, Y. P., Littman-Quinn, R., Antwi, C., Seropola, G., Green, R. S., Tesfalul, et al., 2013, A mobile health approach to tuberculosis contact tracing in resource-limited settings. In MEDINFO 2013 (pp. 1188-1188). IOS Press.

[10].  Cook, V. J., Shah, L., & Gardy, J., 2012, Modern contact investigation methods for enhancing tuberculosis control in aboriginal communities. International Journal of Circumpolar Health, 71(1), 18643.

[11].  Cook, V. J., Shah, L., Gardy, J., & Bourgeois, A. C., 2012, Recommendations on modern contact investigation methods for enhancing tuberculosis control. The International Journal of Tuberculosis and Lung Disease, 16(3), 297-305.

[12].  Abelti, E., Dememew, Z., Gebreyohannes, A., Alemayehu, Y., Terfassa, T., Janfa, T., et al., 2025, Community-based tuberculosis preventive treatment among child and adolescent household contacts in Ethiopia. Tropical Medicine and Infectious Disease, 10(4), 102.

[13].  Ketema, L., Dememew, Z. G., Assefa, D., Gudina, T., Kassa, A., Letta, T., et al., 2020, Evaluating the integration of tuberculosis screening and contact investigation in tuberculosis clinics in Ethiopia: A mixed method study. PLoS One, 15(11), e0241977.

[14].  Ha, Y. P., Tesfalul, M. A., Littman-Quinn, R., Antwi, C., Green, R. S., Mapila, T. O., et al., 2016, Evaluation of a mobile health approach to tuberculosis contact tracing in Botswana. Journal of Health Communication, 21(10), 1115-1121.

[15].  Gupta, A. J., Turimumahoro, P., Ochom, E., Ggita, J. M., Babirye, D., Ayakaka, I., et al., 2023, mHealth to improve implementation of TB contact investigation: a case study from Uganda. Implementation Science Communications, 4(1), 71.

[16].  Turimumahoro, P., Tucker, A., Gupta, A. J., Tampi, R. P., Babirye, D., Ochom, E., et al., 2022, A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting. PLoS One, 17(4), e0265033.

[17].  World Health Organization, 2024, Funding a tuberculosis-free future: an investment case for screening and preventive treatment. World Health Organization.

[18].  Sheshi, M., Odume, B., Chukwuogo, O., Ogbudebe, C., Gordon, I., Useni, S., et al., 2025, Impact of social franchising on TB contact investigation and uptake of TB preventive therapy. Public Health Action, 15(3), 108-112.

[19].  Lemaire, J. F., Cohn, J., Kakayeva, S., Tchounga, B., Ekouévi, P. F., et al., 2024, Improving TB detection among children in routine clinical care through intensified case finding in facility-based child health entry points and decentralized management: A before-and-after study in Nine Sub-Saharan African Countries. PLOS Global Public Health, 4(2), e0002865.

[20].  Mapuranga, T., Timire, C., Ncube, R. T., Dube, S., Mlilo, N., Chiteve, C., et al., 2025. Optimization of Case Finding and Preventive Treatment Among Household Contacts of People with Tuberculosis in Zimbabwe. Tropical Medicine and Infectious Disease, 10(12), 347.

[21].  Fox, G. J., Barry, S. E., Britton, W. J., Marks, G. B., 2013, Contact investigation for tuberculosis: a systematic review and meta-analysis. The European Respiratory Journal, 41(1), 140–156.

[22].  Jo, Y., Gomes, I., Flack, J., Salazar-Austin, N., Churchyard, G., Chaisson, R. E., et al., 2021, Cost-effectiveness of scaling up short course preventive therapy for tuberculosis among children across 12 countries. EClinical Medicine, 31.

[23].  Chukwuogo, O., Daniel, O., Ihesie, A., Eneogu, R., Odume, B., Agbaje, A., et al., 2025. Knowledge, enablers, and barriers to TB preventive treatment among health care workers. Public Health Action, 15(3), 113–117.

[24].  Martinez, L., Seddon, J. A., Horsburgh, C. R., Lange, C., Mandalakas, A. M., Seddon, J., et al., 2024, Effectiveness of preventive treatment among different age groups and Mycobacterium tuberculosis infection status: a systematic review and individual-participant data meta-analysis of contact tracing studies. The Lancet Respiratory Medicine, 12(8), 633-641.

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Abstract:

Roadside entombments remain critical non-municipal water sources in rural Jamaica, serving both residents and commercial operators who harness water for resale. This study integrates findings from a seasonal descriptive analysis conducted prior to Hurricane Melissa with post-hurricane water quality assessments in Craig Hill and Cozy Nook. Pre-hurricane data revealed consistent microbial contamination across seasons, with total coliforms detected in 100% of samples, while physiochemical parameters such as pH and total dissolved solids (TDS) remained within national limits. Seasonal variation showed higher microbial loads during wet months, reflecting increased runoff and pathogen transport. Post-hurricane results demonstrated elevated heterotrophic plate counts and a significant increase in TDS in Craig Hill, suggesting contamination from soil erosion and infrastructural disruption. Together, these findings underscore the chronic vulnerability of rural water supplies to microbial contamination and their acute susceptibility to disaster impacts. The study aimed to assess the seasonal and post-hurricane variations in the quality and safety of non-municipal drinking water sources in East Rural St. Andrew, Jamaica (Craig Hill and Cozy Nook).The findings highlights the urgent need for a national water governance policy that includes the management of non-municipal water sources, and other policy reform which includes health education that will safeguard public health and advance Jamaica’s progress toward achieving the United Nations Sustainable Development Goal 6 by the year 2030.

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