Abstract:

Introduction: Over 90% of HIV infections in children are acquired through the mother-to-child transmission route. Mother to child transmission can be prevented through use of efficacious antiretroviral drug regimens and complete avoidance of breastfeeding. This study evaluated the effectiveness of PMTCT program in Benue State, Nigeria.

Methods: This was a retrospective study of infants and children perinatally exposed to HIV aged 6 weeks -18 months from Benue State, Nigeria. 5734 consecutive sample of infants and children identified from the EID laboratory register from January 2017-December 2017 were enrolled for this study. The details of ARV therapy commencement for mother and baby, infant feeding choices, and HIV PCR DNA test results were analyzed using SPSS version 20.

Result: 225 out of 5734 exposed babies tested positive to HIV giving an overall prevalence of 3.9% (95% CI: 3.4 -4.4). When neither mother nor baby received ARVs the prevalence was 33%; when only baby received ARVs the prevalence was 10.8%; when only mother received ARVs the prevalence was 9.1% and when both mother and baby received ARV for PMTCT the prevalence reduced to 1.5%.

Conclusions: This study has shown the usefulness of ARVs as the single most important intervention in PMTCT. There was a high prevalence of HIV among exposed children in our setting, especially if the mother and child pairs did not receive any form of antiretroviral prophylaxis. Therefore, there is need to expand antiretroviral coverage, ensure access of the PMTCT program, and provide effective services to support infected children.

Keywords: prevention of mother-to-child HIV transmission, PMTCT, HIV, antiretroviral prophylaxis.

References:

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http://www.j-hhr.org/article.asp?issn=2321-9157;year=2015;volume=3;issue=1;spage=7;epage=13;aulast=Agboghoroma (Accessed 2 January,2019).

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Abstract:

Breast cancer is the top most cancer in women both in the developed and the developing world. The incidence of breast cancer is increasing in the developing world due to increase life expectancy, increase urbanization and adoption of western lifestyles (WHO 2018). It starts when cells in the breast begin to grow out of control. These cells usually form a tumor that can often be seen on an x-ray or felt as a lump. The tumor is malignant (cancer) if the cells can grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body (American cancer society 2017).

It is the most common cause of death and the most frequently diagnosed cancer among women in 140 of 184 countries worldwide (Mesfin, Dagne, Roza and Hailu, 2016). Globally, over 1.15million cases of breast cancer are diagnosed every year and about 502,000 women have died from the disease each year, making it the second only to lung cancer as the cause of cancer related deaths among women (WHO 2013). The American Cancer Society in 2015 reported an estimated number of new cases of breast cancer in women in the United States to be 231,840 with an estimated death of 40,290.

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Abstract:

Introduction: Road Traffic Accident (RTA) cases are major public health threat worldwide, and without preventative measures are projected to increase over the next 20 years. This study assessed the burden of RTA on the Asante Akyem segment of the Accra-Kumasi trunk road in Ghana.

Methods: Structured questionnaire was used to extract data on RTA cases, which occurred in 2011-2015, from Juaso and Konongo Municipal Motor Traffic Units (MTU) registry. The data collected were analysed descriptively using univariate analysis via Epi info version 7.

Results: There were 774 RTA cases which recorded 1408 injuries with 293 deaths over five-year (2011-2015) period. The RTA cases mostly occurred on Saturdays between 12 noon and 6pm within the months of March and August. Cargo trucks accounted for most of the RTA cases and the commonest mechanism of the RTA cases was head-on collision. Konongo high street and Odumasi 3 lane areas were the most accident-prone locations with the latter accounting for the highest number of casualties. The Yawkwei and Asankare areas, however, have gained notoriety for fatalities.

Conclusions: This study provides an insight into RTA cases as a major public health threat in the Asante Akyem Districts. Most of the causes of RTA seemed to be known, but a multi-sectoral approach will be required to curb the menace. There is the need for all stakeholders including government, the Ghana Private Road Transport Union, road construction engineers, civil society organizations and non-governmental organizations to intensify road traffic and safety education, and enforce road traffic regulations to curtail RTA.

Keywords: Road traffic accident, public health, epidemiology, preventative measures.

References:

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Abstract:

Introduction: West Nile is vulnerable to repeated disease outbreaks due to instability and refugees from South Sudan and Congo. Uganda is implementing integrated disease surveillance (IDSR) and piloting electronic IDSR (eIDSR-CBS) with Global Health Security Agenda, Infectious disease institute (IDI) and HISP-Uganda between January 2018 to February 2019 in West Nile. This study determined utilization and challenges of implementing eIDSR-CBS, whose aim was improving real-time disease reporting and building capacity of surveillance staff in eIDSR-CBS real-time disease reporting.

Methodology: DSFP were trained to train others in eIDSR-CBS, trained other staff, distributed eIDSR-CBS materials and conducted support supervision. In a cross-section evaluation, project documents review and in-depth interviews provided data for utilisation, project relevancy, effectiveness of implementation, collaborations, sustainability, challenges and lessons learned.

Findings: eIDSR-CBS used SMS, Web and Android platforms, DSFP supported 1,071 staff in 256 e-IDSR trainings, supported 82% of 363 facilities, distributed 362 IDSR and 1072 eIDSR-CBS materials and 1953 SMS messages. Of 39 facilities, 79% conduct IDSR, 54% e-IDSR, 92% had IDSR and 98% eIDSR-CBS materials. The project built eIDSR-CBS capacity of staff, enhanced collaboration and communication among s stakeholders, was sustainable with improved skills, utilised existing MoH structures and engaging stakeholders.

Conclusion: Implementing eIDSR-CBS is feasible in existing MoH structures, with cascade-trainings multiplier effect exponentially disseminating eIDSR-CBS knowledge, trainers and staff and effectively creating ownership, responsibility and sustainability. eIDSR-CBS cascading needs scale-up for early disease outbreak detection.

Keywords: SMS (6767) alerting, case-based disease surveillance, integrated disease surveillance, eIDSR-CBS, IDSR, West Nile Region Uganda.

References:

[1].   MOH Uganda. National Health Policy. Kampala: Ministry of Health. 1999. Online at: http://www.healthresearchweb.org/files/National_Health_Policy_1999.pdf, accessed 01 September 2019.

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Abstract:

Background: Independent human and animal disease surveillance creates challenges linking zoonotic diseases outbreaks in either populations, while integration improves simultaneous zoonotic disease reporting and response in both populations. This paper evaluates integration within human and animal surveillance systems and challenges of integrating the two, in West Nile, aiming to improve simultaneous zoonotic disease detection in humans and animals.

Methods: Cross-sectional data from in-depth interviews on integration of core and support surveillance function of human and animal surveillance systems, collected with an integration assessment tool was analysed on integration levels and gaps within and across the two systems.

Findings: Integration was high in human surveillance (0.92); in planning, reporting and outbreak response (1), data processes (0.86), laboratory processes (0.93) and coordination (0.87); but low in animal surveillance (0.56), especially data collection and analysis (0.20). Integration of human varied from animal surveillance systems (0.97 vs. 0.56), especially in data processes (variation of 0.70).

Conclusions: Differential integration of core and support surveillance functions between human and animal surveillance systems challenges zoonotic disease surveillance, in data collection, reporting frequency and lack electronic real-time disease notification for anmals diseases. Human IDSR guidelines provide platform to coordinate animal disease reporting and improving zoonotic diseases surveillance.

Investments focusing on Point-of-Care animal diseases diagnosis, real-time reporting and eIDSR-CBS, reduce delayed animal disease diagnosis. The integration assessment tool is available for adoption to effectively identified integration gaps.

Keywords: Integrated Disease surveillance systems, human and animal disease surveillance systems, zoonotic disease surveillance, West Nile Region Uganda.

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Abstract:

Banking occupations are typically white-collar jobs with long hours of sitting, high workload, little time for breaks, and indulgence in highly processed foods. This lifestyle predisposes bank employees to overweight, obesity, and hypertension, the leading risk factors for cardiovascular disease, the number cause of death globally.

This study was a cross-sectional survey of bank employees across Nigeria conducted in 2018. A census sample consisting of 3013 bankers, who participated in a healthy lifestyle program was processed and analyzed using SPSS. The study explored the prevalence and determinants of overweight, obesity, prehypertension, and hypertension in the banking industry. A questionnaire, interview schedule, and anthropometric and blood pressure tools were used in collecting the primary data.

The age of the participants ranged from 19 to 59 years, 62% were youth (19-39), 38% middle-aged (40-59), 81% men, and 19% women. Senior staff constituted 52.2%, junior 45.4%, and executive 2.4%. The mean age was 38.8 ± 9.0 years, weight 78.75 ± 14.74kg, height 1.71 ± 0.08m, BMI 26.99 ± 4.89kg/m², waist circumference 79.13 ± 26.72m, hip circumference 87.24 ± 28.57cm, waist-hip-ratio 0.91 ± 0.07, systolic blood pressure 129 ± 18mmHg, and diastolic blood pressure 80 ± 12mmHg.

The prevalence of healthy weight was 35.6%, underweight 1.5%, overweight 39.3%, obesity 23.6%, abnormal waist to hip ratio (WHR) 61%, normotension 32.5%, prehypertension 33.9%, and hypertension 27.6%. Overweight was associated with age and location; obesity with age, sex, office status, and location; prehypertension with age and location; and hypertension with age, sex, location, and obesity.

Keyword: Prevalence, Overweight, Obesity, Prehypertension, Hypertension, Banking Industry, Nigeria.

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Abstract:

Introduction: Vaccines are the most effective prevention tools to eliminate or significantly decrease the incidence of many prevalent vaccine-preventable diseases (VPDs). Risk factors associated with parents’ child immunization hesitancy constituted a major difficulty to routine immunization program to prevent and control infant VPDs. Earlier, we reported that parents’ risk perception of infancy vaccination doubtfulness was remarkable after proper evidence-based information, parental infant immunization indecision risks perception translation to strong-willed early-days immunization behaviors remains unsubstantiated.

Methods: We used cross-sectional research method with pilot tested behavioral theories-informed tool to judge whether the observed parental infancy immunization risk acuity actually transformed into risk avoidance to vaccinate their children.

Results: The results of this study (N = 359) showed that all respondents had significant awareness of childhood immunization. Among the respondents, 95% reported high school and above education levels and 54% gainfully employed. After correction for confounding with multivariable logistic regression analysis, study participants that had good risk perception were 4 times as likely to vaccinate their children compared with participants with poor perception, adjusted POR (APOR) = 4.05, CI = 1.12 – 14.73.

Conclusions: The activities of public health professionals empowered parents to progressively perceive and avoid childhood vaccination risks relevant to healthier children. The findings from this study have far-reaching implications for broad beneficial and effective infant morbidity and mortality reduction. Addressing parents’ specific questions and concerns adequately helped make more informed choices to improve complete wellbeing.

Keywords: Parental childhood vaccination hesitancy; effective risk-benefit communication; information seeking/processing; risk perception, Protection motivation; risk avoidance.

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Abstract:

Obesity is a modifiable risk factor for hypertension. Waist-hip-ratio is favored over body mass index for assessing truncal obesity and cardiometabolic risk. Is a product of body mass index and waist-hip-ratio a better predictor of hypertension than waist-hip-ratio?

The objective of this study was to determine the measure of obesity that best predicted hypertension. The study was a cross-sectional survey of 3013 participants across the 36 states of Nigeria and Abuja. The census sampling technique was used to collect the data. The data collecting instruments included measuring tape, stadiometer, weighing scale, and Amron blood pressure monitor. The data was analyzed using X² test and correlation.

The mean body mass index of the participants was 26.99 ± 4.89kg/m², waist circumference 79.13 ± 26.72m, hip circumference 87.24 ± 28.57cm, waist-hip-ratio 0.91 ± 0.07, systolic blood pressure 129 ± 18mmHg, and diastolic blood pressure 80 ± 12mmHg.

Measures of obesity had statistically significant positive correlation with systolic and diastolic blood pressures. The best predictor of hypertension was a product of body mass index and waist-hip-ratio (r .228 and .200), followed by body mass index (r .191 and .180), then waist-hip-ratio (r .187 and .135), waist circumference (r .082 and .089), and lastly hip circumference (r .040 and .060).

A product of body mass index and waist-hip-ratio should be used to assess obesity since it predicts hypertension better than either of the two alone. This study should also be extended to other risk factors of cardiovascular disease like diabetes and dyslipidemia.

Keyword: Body Mass Index, Waist Hip Ratio, Waist Circumference, Hip Circumference, Hypertension.

References:

[1].   Adab, P., Pallan, M., & Whincup, P. H. (2018). Is BMI the best measure of obesity? BMJ, 360, k1274.

[2].   Agbim, U., Carr, R. M., Pickett-Blakely, O., & Dagogo-Jack, S. (2019). Ethnic disparities in adiposity: focus on non-alcoholic fatty liver disease, visceral, and generalized obesity. Current Obesity Reports, 1-12.

[3].   Chrysant, S. G. (2019). Pathophysiology and treatment of obesity‐related hypertension. The Journal of Clinical Hypertension, 21(5), 555-559.

[4].   Fang, H. Y., Liu, D., Zhao, L. Y., Yu, D. M., Zhang, Q., Yu, W. T., & Zhao, W. H. (2018). Epidemiological characteristics of waist circumference and abdominal obesity among Chinese children and adolescents aged 6-17 years. Zhonghua Liu Xing Bing Xue Za Zhi Zhonghua Liuxingbingxue Zazhi, 39(6), 715-719.

[5].   Freisling, H., Arnold, M., Soerjomataram, I., O'Doherty, M. G., Ordóñez-Mena, J. M., Bamia, C., & Tsilidis, K. (2017). Comparison of general obesity and measures of body fat distribution in older adults in relation to cancer risk: meta-analysis of individual participant data of seven prospective cohorts in Europe. British Journal of Cancer, 116(11), 1486.

[6].   Frühbeck, G., Busetto, L., Dicker, D., Yumuk, V., Goossens, G. H., Hebebrand, J., & Toplak, H. (2019). The ABCD of obesity: an EASO position statement on a diagnostic term with clinical and scientific implications. Obesity Facts, 12(2), 131-136.

[7].   Garvey, W. T. (2019). Clinical Definition of overweight and obesity. In Bariatric Endocrinology (pp. 121-143). Springer, Cham.

[8].   Gurunathan, U., & Myles, P. S. (2016). Limitations of body mass index as an obesity measure of perioperative risk. British Journal of Anaesthesia, 116(3), 319-321.

[9].   Hall, J. E., do Carmo, J. M., da Silva, A. A., Wang, Z., & Hall, M. E. (2019). Obesity, kidney dysfunction and hypertension: mechanistic links. Nature Reviews Nephrology, 1.

[10].  Heckman, K. M., Otemuyiwa, B., Chenevert, T. L., Malyarenko, D., Derstine, B. A., Wang, S. C., & Davenport, M. S. (2019). Validation of a DIXON-based fat quantification technique for the measurement of visceral fat using a CT-based reference standard. Abdominal Radiology, 44(1), 346-354.

[11].  Jones, D. J., Lal, S., Gittins, M., Strauss, B. J. G., & Burden, S. T. (2019). Practical measurement of body composition using bioelectrical impedance, air displacement plethysmography and ultrasound in stable outpatients with short bowel syndrome receiving home parenteral nutrition: comparison of agreement between the methods. Journal of Human Nutrition and Dietetics, 32(3), 288-294.

[12].  Kotsis, V., Antza, C., Doundoulakis, G., & Stabouli, S. (2019). Obesity, hypertension, and dyslipidemia. Obesity: Pathogenesis, Diagnosis, and Treatment, 227-241.

[13].  Kutáč, P., Bunc, V., & Sigmund, M. (2019). Whole-body dual-energy X-ray absorptiometry demonstrates better reliability than segmental body composition analysis in college-aged students. PloS One, 14(4), e0215599.

[14].  Lalazar, G. (2015). Central obesity: redefining normal BMI. Science Translational Medicine, 7(316), 316ec209-316ec209.

[15].  Mastroeni, S. S. D. B. S., Mastroeni, M. F., Ekwaru, J. P., Setayeshgar, S., Veugelers, P. J., Gonçalves, M. D. C., & Rondó, P. H. D. C. (2019). Anthropometric measurements as a potential non-invasive alternative for the diagnosis of metabolic syndrome in adolescents. Archives of Endocrinology and Metabolism, 63(1), 30-39.

[16].  Shams-White, M., Chui, K., Deuster, P., McKeown, N., & Must, A. (2019). A Comparison of anthropometric measures with bioelectrical impedance analysis in the classification of overweight and obesity in US military personnel (P21-050-19). Current Developments in Nutrition, 3(Suppl 1).

[17].  Stanford, F. C., Lee, M., & Hur, C. (2019, February). Race, ethnicity, sex, and obesity: is it time to personalize the scale? In Mayo Clinic Proceedings (Vol. 94, No. 2, pp. 362-363). Elsevier.

[18].  Weaver, R. G., Beets, M. W., Brazendale, K., & Hunt, E. (2019). Disparities by household income and race/ethnicity: the utility of BMI for surveilling excess adiposity in children. Ethnicity & Health, 1-16.

[19].  Woo, E. J., & OH, T. I. (2019). Body fat measurement apparatus and method. U.S. Patent Application No. 16/082,566.

Abstract:

Uganda adopted the WHO 2014 test and treat guidelines in 2016, increasing the number of HIV clients diagnosed, started on treatment, and monitored for viral load suppression, against the inadequate health care resources. This has resulted into a low viral load suppression prevalence of 59.6%, and missed appointment of 7.9%. The study determined the occurrence of; poor adherence to HIV treatment, client appointment keeping, and viral load suppression at the study health facilities. The cross-sectional quantitative study was conducted in 4 purposively selected health centres. All files of adult HIV clients who had been in care for at least 6 month and active during October to December 2018 were studied for; missed appointments of more than two weeks, poor adherence to treatment of less than 85%, and unsuppressed viral load above 1000 viral copies per milliliter. 457(14.3%) of 3197 files had at least one of the study HIV care outcomes. Occurrence of the poor HIV care outcomes was the same irrespective of the client’s duration in care. 51 (11.2%) of the client files had poor adherence to treatment, 301(65.9%) had missed appointments for more than two weeks, and 211(46.2%) had unsuppressed viral load. In conclusion, there is no difference in occurrence of the study poor HIV care outcomes based on duration in care. There is limited access to timely viral load tests, hence affecting timely and appropriate decision making.

Keywords: HIV care outcomes of adherence to treatment, appointment keeping and suppressed viral load.

References:

[1].  http://health.go.ug/docs/UAIS2011KEYFINDINGS.pdf

[2].  http://www.afro.who.int/sites/default/files/2017-08/UPHIA%20Uganda%20factsheet.pdf

[3].  MoH (2016). Consolidated guidelines for HIV prevention, and treatment in Uganda 2016.

[4].  WHO, (2013). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. Geneva Switzerland: World Health Organization; 2013. http://apps.who.int/iris/bitstream/10665/85321/1/9789241505727_eng.pdf.

[5].  Setor Kunutsor,1 John Walley,1 Elly Katabira,2 Simon Muchuro,2 Hudson Balidawa,3 Elizabeth Namagala,3 and Eric Ikoona3, (2010). Clinic Attendance for Medication Refills and Medication Adherence amongst an Antiretroviral Treatment Cohort in Uganda: A Prospective Study. Hindawi Publishing Corporation AIDS Research and Treatment Volume 2010, Article ID 872396, 8 pages doi:10.1155/2010/872396.

[6].  Jinja District health report, 2016/17.

Abstract:

Introduction: Typhoid fever is a major public health problem in developing countries. Typhoid fever is transmitted by the feco-oral root through ingestion of contaminated food or water that contains Salmonella typhi. Poor knowledge and risk perception towards typhoid fever contributed to the prolonged transmission of diseases in the community. The aim of this study was to assess knowledge and risk perception towards typhoid fever among Gyadi-Gyadi communities in Kano, Nigeria. Methodology: A community based cross-sectional study was conducted in Gyadi-Gyadi from April, 2019 to May, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: Results: The result shows that 300 participants responded to the questionnaire. 165 respondents (55%) were male and the remaining 135 (45%) were female. Regarding sign and symptom most of 287 (95.7%) of the respondents have answered headache. Concerning risk perception, majority 160 (53.7%) agree that lack of hand washing practice contribute to typhoid fever infection Conclusion: The study revealed that the respondents have good knowledge towards typhoid fever. However, the risk perception status of the respondents towards typhoid fever is poor. Recommendation: Supportive supervision for health extension workers in order to strengthen effective health education to the community on the causes of the diseases and possible preventives measure.

Keywords: Knowledge; Risk Perception; Typhoid Fever, Gyadi-Gyadi, Kano, Nigeria.

References:

[1].   Abucejo P.E, Capeding M.R, Lupisan S.P, Arcay J, Sombrero L T, Ruutu P, Herva E. (September 2001) Blood Culture Confirmed Typhoid Fever in A Provincial Hospital in The Philippines. Southeast Asian J Trop Med Public Health: 32(3):531-536.

[2].   Bara HT. et al. “Knowledge Attitudes and Practices Related to Typhoid” (2016).

[3].   Ethel Osei-Tutu. A Study on Typhoid Fever in Elmina in the Central Region of Ghana 2011” (2011).

[4].   Fauci A.S., Kasper D.L, Longo D.L., Braunwald, Hauser, Jameson, Loscalzo. (2008)

[5].   Harrison's Principles of Internal Medicine, 17th ed.

[6].   Gopalakrishnan V, Sekhar W.Y, Soo E.H, Vinsent R A, Devi S. (2002) Typhoid Fever in Kuala Lumpur and a Comparative Evaluation of Two Commercial Diagnostic Kits for the Detection of Antibodies to Salmonella typhi. Singapore Med J: 43(7):354-358.

[7].   Hosoglu S, Bosnak V, Akalin S, Geyik M F, Ayaz C. (2008) Evaluation of false negativity of the Widal test among culture proven typhoid fever cases. J Infect Developing Countries: 2(6): 475-478.

[8].   JO O., et al. “Prevalence of Salmonellosis among Food Handlers and the Health Implications on the Food Consumers in Lagos State Nigeria”. Journal of Medical Microbiology and Diagnosis 4.2 (2015): 187.

[9].   John A, Luby Stephen P., Mintz Eric D. (2004). The global burden of typhoid fever. Bull World Health Organ: 82(5): 346-353.

[10].  Khanyelele Makhanu E. “Impact of Cultural Factors on the Management of Typhoid Fever in Bungoma County Kenya”. International Journal of Academic Research in Business and Social Sciences 4.5 (2014): 491-499.

[11].  Malisa A and Nyaki H. “Prevalence and constraints of typhoid fever and its control in an endemic area of Singida region in Tanzania”. Journal of Public Health and Epidemiology 2.5 (2010): 93-99. implications

[12].  Morgan DW and Krejcie, RV. (1970). Determining Sample size for research activities of Minnesota: USA.

[13].  Nguri KAB. “Risk Factors Influencing Typhoid Fever Occurrence among the Adults in MainaSlum, Nyahururu Municipality, Kenya”. Academic Journal of Biosciences 4.3 (2016).

[14].  Okore Oghale O., et al. “Prevalence of Malaria and Typhoid Fever Co-Infection: Knowledge, Attitude and Management Practices among Residents of Obuda-Aba, Abia State, Nigeria”. American Journal of Public Health Research 3.4 (2015): 162-166.

[15].  Pang (2008). Typhoid fever research in developing countries. J Infect Developing Countries: 2(6):411.

[16].  Wain J, Hosoglu S. (2008). The laboratory diagnosis of enteric fever. J Infect Developing Countries: 2(6):421-425.

[17].  Willke A, Ergonul O, and Bayar B. (July 2002) Widal test In Diagnosis of Typhoid Fever in Turkey; Clinical and Diagnostic Laboratory Immunology. 9(4): 938–941.

[18].  World Health Organization (2003) Background document: The diagnosis, treatment and Prevention of typhoid fever.

Abstract:

Pakistan was among the pioneers in the developing world to introduce national programs in maternal and child health (MCH) and family planning. However, the pace of development in the social sector could not be maintained over decades of political instability within the country and the perpetually volatile geopolitical situation outside the country.

Despite advances in medical science, infant mortality continues to Pakistan. Given the paucity of reliable information this study was undertaken to examine risk factors associated with infant mortality in Punjab, Pakistan.

A total of 240 respondents (health workers) were recruited for the study using simple random sampling from selected public hospitals in Punjab, Pakistan. These hospitals were selected applying a purposive sampling approach and were used as a study site.

A formal request was made to the authorities of the hospital's understudy for the recruitment/inclusion of respondents (health workers) in the study in order to obtain data.

A pre-tested structured questionnaire was administered to the respondents for primary data collection. The questionnaire was formed under three subheadings: pre-pregnancy factors, antenatal factors and post-natal factors.

Presentation and analysis of data is done using descriptive statistics and chi-square test. Results obtained showed the existence of a highly significant difference between the parameters that were considered in this study. Therefore, it is surmised that the parameters studied under pre-pregnancy, antenatal and post-natal risk factors contribute to infant mortality in Punjab, Pakistan.

Keywords: Infant Mortality, Risk Factors, Pregnancy, IMR.

References:

[1].   Afsheen A, Mushtaq M, Mehreen S, Nosheen J. Pattern of severe acute maternal morbidity at CMH Quetta. Pakistan Armed Forces Med J 2012; 62(3): 258-65.

[2].   Averting Maternal Death and Disability, United Nations Children’s Fund, and United Nations Population Fund special data compilation, 2015.

[3].   AlirezaAnsari-Moghaddam, Simin Sadeghi-Bojd , Mahmoud Imani, Safaneh Movahedinia, Aboozar Pourrashidi A multivariate analysis of factors associated with infant mortality in South-East of Iran Journal of the Pakistan Medical Association (JPMA)October 2014, Volume 64, Issue 10.

[4].   Bhutta Z, Dean S, Imam A, Lassi Z (2011) A systematic review of preconception risks and interventions. Karachi: The Aga Khan University.

[5].   B. Larroque, G. Breart, M. Kaminski, M. Dehan, M. Andre, A. Burguet, H. Grand Jean, B. Ledesert, C. Leveque, F. J. Maillard, "Survival of very Preterm Infants, " A Pop Based Cohort Study, 89 (2):139- 144, 2004.

[6].   Center for Disease Control and Prevention, "Infant Mortality," www. CDC. gov/reproductive health/maternal-infant health/infant mortality. HTML, August 12, 2014.

[7].   Global Health Workforce Statistics database, World Health Organization, Geneva. (http://www.who.int/hrh/statistics/hwfstats/).

[8].   Jyoti Vijay, Kamalesh Kumar Patel Risk factors of infant mortality in Bangladesh. https://doi.org/10.1016/j.cegh.2019.07.003

[9].   K. Wisborg, U. Kesmodel, and T. B. Henrikesen, “Exposure to tobacco smoke in utero and the risk of stillbirth and death in the first year of life,” Am J. Epidermiol, 15; 154 (4): 322-327.2000.

[10].  Maria Volpato Kropiwiec, Selma Cristina Franco, Augusto Randüz do Amaral Factors Associated with Infant Mortality in a Brazilian City with high Human Development Index 2017 Oct-Dec; 35(4): 391–398.

[11].  Megan S Coggeshall. Global, regional, and national levels and causes of maternal mortality during 1990–2013. The Lancet Sept 2014; 384(9947): 980–1004.

[12].  M. Norton, "New Evidence on Birth Spacing: Promising findings for Improving Newborn, Infant, Child, and Maternal Health," International Journal of Gynecology & Obstetrics 89: 1–6, 2005.

[13].  National Population Commission (NPC) [Nigeria] and ICF Macro. Nigeria Demographic and Health Survey 2013. Abuja: NPC and ICF Macro; 2014.

[14].  Nwaokoro Joakin Chidozie1, Ibe Sally N. O., Ihenachor Chinenye A., Emerole Chima O. Nwufo Regina C., Ebiriekwe Sabinus Chidubem, Onwuliri Viola A. Risk Factors Associated with Infant Mortality in Owerri Metropolis, Imo State, Southeastern Nigeria 2015; 3(5-1): 64-71

[15].  O. O. Ayoola, "A Five-year Childhood Mortality of the University College Hospital, Ibadan, Nigeria," West Africa Journal at Med, 24 (2):175-179, 2005.

[16].  Pakistan Demographic and Health Survey 2017 – 2018.

[17].  P. S. Blair, P. J. Flemming, D. Bensley, I. Smith and C. Bacon, "Smoking and the Sudden Infant Death Syndrome: Results from 1993-5 Case Study for Confidential Inquiry into Stillbirths and Deaths in infancy," BMJ, 27; 313 (7051): 195-198, 1996.

[18].  Singh S, Sedgh G, Hussain R (2010) Unintended pregnancy: worldwide levels, trends, and outcomes. Studies in Family Planning 41: 241–250.

[19].  RCOG. Why mothers die 2005-2007. Confidential enquiry into maternal and child health. London: RCOG Press, 2008.

[20].  T. O. Lawoyin, "Risk Factors for Infant Mortality in a Rural Community in Nigeria," The Journal of the Royal Society for the Promotion of Health 121 (2):114-118, 2001.

[21].  United Nations, Department of Economic and Social Affairs, Population Division (2015). World Population Prospects: The 2015 Revision.

[22].  World Health Organization (2010) Package of interventions for family planning, safe abortion care, maternal, newborn and child health. Geneva.

Abstract:

Introduction: Ageing is considered a problem in our society. Old age is the time associated with physical, a psychological and social change which leads to vulnerable conditions to acquire physical, psychological and social health problems. This study aims to find out the health problems among elderly and to determine the factors associated with health problems. So, they need proper physical as well as social care during this period. Methods: A descriptive study was carried out among 40 elderly who were the members of senior societies of ward number 2 Dhangadhi sub-metropolitans. Elderly of aged 65 years & above were selected purposively for the study. Result: The mean age of the elderly were 70 years among them 62% were females. Self-reported chronic illnesses among elderly were hypertension 22%, chronic obstructive pulmonary diseases 19%, diabetes 15%, cardiac problems and joint problems 11 %. Further, 21% had hearing impairment and 11% had vision impairment. Concerning the functional impairment, 51% were partially dependent in performing some of the activities of daily living. Conclusions: Physical health problems that hypertension, chronic pulmonary diseases, diabetes, joint problems are the common. Functional impairment is higher among increased age elderly. Psychological health problems such as cognitive impairment and depression are identified. Experiences of being abused by the family members are also discerned. Hence, it is recommended to plan health promotional strategies for addressing these old age-related health problems. Elderly people should be encouraged to do activities around house or garden that provides glee and light exercise.

Keywords: Seniors citizens, Stress, Depression, Health.

References:

[1].   Bhattarai, Manoj (2014) Mental health and elderly people Nepal Medical Col. J   2014 Vieira, Edgar Ramos PhD; Brown, Ellen EdD; Raue, Patrick PhD journal of Geriatric Physical Therapy:

[2].  WHO (2011), Mental health http://www.who.int/mental_health/management/depression/ definition/en/. Accessed June 18, 2011.

[3].  Park K. (2013), Park's Textbook of Preventive and Social Medicine.22 ed. Jabalpur (India): Banarasidas Bhanot Publisher; 2013

[4].  Geriatric Center Nepal. Baseline Study on Reported Cases of Elder Abuse in Nepali press: 2011; United Graphic Printers.

[5].  Geriatric Center Nepal (GCN). Elderly People (65+) in Nepal on Health, Nutrition and Social Status Focusing on Research Needs. March 2010; Ramchandra Marg; Battisputali-9; Kathmandu, Nepal.

Abstract:

Background: By 2013, Kano State was the hub of polio transmission in Nigeria. Polio campaign monitoring data indicated a high proportion of Oral Polio Vaccine (OPV) refusals were emerging as a major impediment to polio eradication in Nigeria particularly in Kano state. We conducted a qualitative study to identify reasons for OPV refusals and effective methods to improve OPV acceptance.

Methods: We conducted In-depth interview (IDI) using a structured guide. We identified non-compliant households using vaccination tally sheets and interviewed male or female caregivers who had refused OPV for their children at least once in the previous supplemental immunization activities (SIA).

Results: Seventeen interviews were conducted across the LGA. Of the 17 respondents, 13 (76.5%) were males. On the question” Is polio a significant health problem in the community” 14 (82.4%) answered no and explained that it should not be a priority but other more serious and prevalent diseases, 3(17.6%) answered yes and explained that it is a significant health problem since they have seen few cases. On why they refused OPV, about half felt there were other more important community needs, three felt they had no need for OPV and lacked trust in Government, five were worried the vaccine may be harmful. On what would they suggest toward making polio campaign more successful, more than half responded more/proper community awareness.

Conclusion: Misconceptions about OPV is a major cause of OPV refusals. Public enlightenment and aggressive awareness campaigns on OPV should be scaled-up. Government should provide other essential community needs.

Keywords: Assessment, Reasons, OPV refusals, Kano State.

References:

[1].   World Health Organization. Poliomyelitis: intensification of the global eradication initiative. WHA65.5. Geneva, Switzerland: World Health Organization; 2012. Sixty-fifth World Health Assembly. Available at http://apps.who.int/gb/ebwha/pdf_files/wha65/a65_r5-en.pdf.

[2].   Moturi EK, Porter KA, Wassilak SGF, Tangermann RH, Diop OM et al. Progress Toward Polio Eradication — Worldwide, 2013–2014. Morbidity and Mortality Weekly Report (MMWR) May 30, 2014 / 63(21);468-472

[3].   Weekly AFP surveillance update, Pakistan, week 52. Islamabad: World Health Organization; 2011.

[4].   Ten months and counting (report of the Independent Monitoring Board of the Global Polio Eradication Initiative). Geneva: World Health Organization; 2012. Available from:

www.polioeradication.org/portals/0/.../imbreport_january2012.pdf [accessed 30 August 2012].

[5].   Wise J. Final push is needed to tackle last 1% of polio. BMJ 2011; 343: d4685- doi: 10.1136/bmj.d4685 pmid: 21778199.

[6].   Global polio emergency action plan 2012–13: getting Nigeria, Pakistan and Afghanistan back on track. Geneva: World Health Organization; 2012. Available from:

http://www.who.int/immunization/sage/meetings/2012/april/Working_draft_Global_PolioEmergencyActionPlan_04_April_v2.pdf [accessed 10 August 2012].

[7].   National Primary Health Care Development Agency (NPHCDA). 2014 Nigeria Polio Eradication Emergency Plan. 2013;7.

[8].   Iyal HA, Shuaib F, Dauda M, Suleiman A, Braka F, Tegegne SG, Nsubuga P, et al . Assessment of unmet needs to address noncompliant households during polio supplemental immunization activities in Kaduna state, 2014–2016

[9].   Independent Monitoring Board of the Global Polio Eradication Initiative. Every missed child: report of the Independent Monitoring Board of the Global Polio Eradication Initiative. Geneva, Switzerland: World Health Organization, 2012.

http://www.polioeradication.org/portals/0/document/aboutus/governance/imb/6imbmeeting/imb6_report.pdf.

[10].  GLOBAL GUIDELINES Independent Monitoring of Polio Supplementary Immunization Activities (SIA). Independent monitoring guidelines rev 15 Oct. Accessed on 12/10/1018 from URL: http://polioeradication.org/wp- content/uploads/2016/08/IndependentMonitoringGuidelines_20101124.pdf

[11].  Murakami H¹, Kobayashi M², Hachiya M³, Khan ZS⁴, Hassan SQ⁵, Sakurada S⁶.

[12].  Refusal of oral polio vaccine in northwestern Pakistan: a qualitative and quantitative study. Vaccine. 2014 Mar 10;32(12):1382-7. doi: 10.1016/j.vaccine.2014.01.018. Epub 2014 Feb 1.

[13].  Asif Raza Khowaja ^a, Sher Ali Khan ^a, Naveeda Nizam ^a, Saad Bin Omer ^b & Anita Zaidi ^aParental perceptions surrounding polio and self-reported non-participation in polio supplementary immunization activities in Karachi, Pakistan: a mixed methods study. Bulletin of the World Health Organization 2012; 90: 822-830. doi: 10.2471/BLT.12.106260

[14].  Moturi EK, Porter KA, Wassilak SGF, Tangermann RH, Diop OM et al. Progress Toward Polio Eradication — Worldwide, 2013–2014. Morbidity and Mortality Weekly Report (MMWR) May 30, 2014 / 63(21);468-472

[15].  Supplementary immunization [Internet]. Geneva: Global Polio Eradication Initiative, World Health Organization; 2010. Available from:

http://www.polioeradication.org/Aboutus/Strategy/Supplementaryimmunization.aspx [accessed 10 August 2012].

[16].  Key elements for improving supplementary immunization activities for polio eradication. Geneva: World Health Organization; 2000. Available from: http://www.who.int/vaccines-documents/DocsPDF00/www537.pdf [accessed 10 August 2012].

[17].  Nishtar S. Pakistan, politics and polio. Bull World Health Organ 2010; 88: 159-60 doi: 10.2471/BLT.09.066480 pmid: 20428374.

[18].  Shah M, Khan MK, Shakeel S, Mahmood F, Sher Z, Sarwar MB, et al., et al. Resistance of polio to its eradication in Pakistan. Virol J 2011; 8: 457- doi: 10.1186/1743-422X-8-457 pmid: 21962145.

[19].  Evaluation of social mobilization activities for polio eradication. Islamabad: SoSec Study; 2005.

Abstract:

Dengue fever is one of the leading public health problems of tropical and subtropical countries across the world. Transmission dynamics of dengue fever is largely affected by meteorological and environmental factors, and its temporal pattern generally peaks in hot-wet periods of the year. The aim of this study was to fill this research gap by utilizing epidemiological and earth observation data in Kailalai district, one of the frequent dengue outbreak areas of Nepal. This article evaluates the dengue case notification, surveillance, laboratory facilities, collaboration, and how federal government, province government and local government responded to the outbreak. Methods: Qualitative data collections tools are in-depth interview were used to analyze the dengue outbreak response. Participants were sampled purposively, with deliberate selection regarding their experience, to help ensure involvement of the key stakeholders in the dengue surveillance and outbreak response in Kailali district including federal government policy-makers, officials Results: There was a variation in the proportion of cases confirmed by the laboratory, with participants noting that between (10-50) % of dengue cases were confirmed. The study findings demonstrate the extensive limitations existing in a fragile state that need to be addressed before and during a dengue outbreak. Conclusions: Surveillance system of disease is difficult due to geographical access and lack awareness on community people. But dengue is recently emerged in this province and along the country. The political context can affect the financial and trained human resources available to combat dengue. Three level government systems must be engaged to prevent and control of outbreak.

Keywords: Seasonal mosquito induced viral Fever, Dengue fever, Dengue Hemorrhagic Fever, Shock syndrome, preventable.

References:

[1].   WHO and TDR, Dengue Guidelines for Diagnosis, Treatment, Prevention and Control, WHO, Geneva, Switzerland, 2009.

[2].   J. D. Clemens, “Evaluating diagnostics: dengue,” Nature Reviews Microbiology, vol. 8, supplement 12, p. S1, 2010.

[3].   M. G. Guzman, S. B. Halstead, H. Artsob et al., “Dengue: a continuing global threat,” Nature Reviews Microbiology, vol. 8, supplement 12, pp. S7–S16, 2010.

[4].   B. D. Pandey, K. Morita, S. R. Khanal et al., “Dengue virus, Nepal,” Emerging Infectious Diseases, vol. 14, no. 3, pp. 514–515, 2008.

[5].   National Guidelines on Prevention, Management and Control of Dengue, 2019 in Nepal

Abstract:

The prevalence of obesity, a risk factor for non-communicable diseases, is on the increase globally. Body mass index is the most widely used measure of obesity worldwide. Measuring body mass index involves the use of stadiometer, weighing scale, and calculator, or expensive BMI machine. Such instruments may not be available to health professionals in certain areas of the world and so this research asks the question: “Can an ordinary sewing tape measure be used to measure body mass index?”

The aim of this study was to develop a regression equation for calculating body mass index from waist circumference and hip circumference. It used a secondary dataset consisting of 3013 participants of a survey of bank workers across the 36 states of Nigeria and Abuja. The sampling technique was census sampling. The data was collected using a stadiometer, weighing scale, calculator, and BMI machine, and analyzed with SPSS using multiple linear regression.

The participants’ mean body mass index was 26.99±4.89kg/m², waist circumference 79.13±26.72m, and hip circumference 87.24±28.57cm. Multiple linear regression showed that both waist circumference and hip circumference were significant predictors of body mass index and correlated in 43.5% of cases. The formula for calculating body mass index from waist and hip circumferences was given as: BMI = (WC x 0.209) - (HC x 0.132) + 22.009.

This formula is a potential handy public health tool for measuring body mass in disadvantaged communities using an ordinary tailoring tape. Further studies should be conducted to improve on the formula.

Keywords: Body Mass Index, Waist Circumference, Hip Circumference, Regression Formula, Tape Measure.

References:

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[10].  Heslehurst, N., Vieira, R., Akhter, Z., Bailey, H., Slack, E., Ngongalah, L., & Rankin, J. (2019). The association between maternal body mass index and child obesity: A systematic review and meta-analysis. PLoS Medicine, 16(6), e1002817.

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Abstract:

Background: Multi-drug resistant tuberculosis (MDR-TB) is one of the greatest challenges to controlling tuberculosis worldwide, Nigeria inclusive. We conducted a descriptive, cross-sectional study to identify and access the enrollment rate of MDR-TB cases in 2017 in Kano state, north west Nigeria

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

Results: A total of 121 MDR TB cases were managed in the year 2017 in Kano state, of which 115 (95.0%) were identified within the year, 5 (4,1%) were referred in from other states, 1 (0.9%) carried over to the year. Of the 121 cases managed, 82 (67.8%) were males. Of the 121 cases managed in the year 2017, 77 (63.6%) were enrolled, 3 (2.5%) died before enrolment, 5 (4.1%) refused treatment and 14 (11.6%) loss to follow up. The highest number of MDR cases managed, 38 (31.4%) was in Q3 while Q1 had the lowest number of cases managed as 20 (16.5%). Q3 had the highest enrollment rate of 89.5% (34/38) while Q4 had the lowest enrollment rate of 17.9% (5/28).

Conclusions: The MDR TB enrollment rate in Kano state in 2017 is low. Majority of the cases were enrolled in Q3 of the year. There is high rate of loss to follow up. There is need for Kano TBLCP to institute prompt identification of cases for immediate enrollment.

Keywords: Assessment, enrollment rate, Multidrug-resistant tuberculosis, Kano state, north west Nigeria.

References:

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Abstract:

Objectives: Identified factors that contributed to poor retention in care of HIV infected children initiated on Anti-Retroviral Treatment and recommended appropriate improvement strategies.

Study design: A total of 134 individuals were selected using purposive sampling and participated in the Focused Groups Discussions (FGDs), drawn from Caregivers support groups, HIV positive adolescents and health care workers at the ART clinics.

Methods: Exploratory qualitative method using FGD questionnaire guide and retrospective review of secondary cohort clinical data records covering a period of 12 months was conducted using standardized data abstraction forms.

Results: There were few studies that had been conducted in Nigeria to explore enablers of retention in care of HIV positive children. However, similar studies from other settings exited. Barriers to retention in care were the most commonly reported across the FGDs, though enablers were also reported. There was also a significant correlation between participant’s responses and data analyzed from the hospital records.

Conclusion: It was mostly barriers to retention in care that were reported. Some barriers, however, were reported as enablers to retention in care. Caregiver’s role is critical and additional integrated strategies are urgently required to achieve optimum retention in care of children.

Keywords: Retention in care; HIV positive children, Barriers to retention, Enablers to retention, Loss to follow up, Caregivers.

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Abstract:

The recent closing down of schools in some African countries as a result of EBOLA crisis, brought about devastating consequences such as early pregnancies, child labour, forced marriages, physical and sexual abuse to name a few. Designing appropriate interventions for these problems, this study assessed the knowledge, attitudes and preventive practice of Senior Secondary School Students on Ebola Virus Disease (EVD) in Ilaro, Ogun State, Nigeria. The study used a multi-stage and proportionate sampling methods. A total of 460 semi-structured self-administered questionnaires were administered to consenting Senior Secondary School students. The findings of the study revealed that 100 per cent of the respondents had previously heard of EVD. Overall knowledge of EVD was poor 114 (24.8%) and fair for 290 (63%) and good for 56 (12.2%). The relationship between knowledge, practice and attitude score of respondents at their various departments (Science, Art and Commercial) were not statistically significant, setting (p = 0.005). However, the relationship between class of respondents and their attitude towards EVD were statistically significant setting (p = 0.005). Regular hand washing and use of sanitizers were stated as the most useful protective measures against EVD. Based on these findings, it is therefore essential that health education for the students on presentation and prevention of the disease be stressed and routinely taught at schools and the need for government to provide adequate water supply in each school.

Keywords: Attitude, Ebola Virus, Knowledge, Prevention Practice, Students.

References:

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Abstract:

The Uganda National HIV viral load suppression prevalence of 59.6% is below the 95% target. The study conducted in in four health facilities of Jinja district, on 437 files of adult HIV clients with; missed appointments of more than two weeks, poor adherence to treatment of < 85%, and unsuppressed viral load of > 1000 viral copies per milliliter, between January and July 2019, was aimed at determining change packages to improve HIV care in the study health facilities. Data was analyzed using Microsoft excel and the following tested changes using the Deming PDSA cycles were used; Intensified health education, and adherence counseling to all patients with poor adherence, pill counting to harmonize the pills supplied with the appointment date, follow up phone calls to patients who miss appointment, creation of a one stop centre for HIV care, and increased staffing of HIV clinic. Study results showed a 13.6% prevalence of the study HIV care poor outcomes at baseline assessment. 11.8%, 65.2%, and 46.5% of the study client files were due to poor adherence to treatment, two weeks missed appointments, and unsuppressed viral load respectively at baseline assessment and 4.7%, 25.1%, and 31.5% respectively at end line assessment. 80% of the studied clients were retention in care between baseline and end line assessments. In conclusion, there was a positive effect on the patient HIV care out comes.

Keywords: Adherence to treatment, appointment keeping, and viral suppression in HIV care.

References:

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Abstract:

Polycystic Ovarian Syndrome also called Stein-Leventhal Syndrome or chronic oligoanoSvulation is a condition related to hormonal imbalance that can cause menstrual disorders like oligomenorrhea or amenorrhea, infertility, hirsutism, obesity, suffering from prompt increase in weight or having trouble in losing weight and other symptoms in type two diabetes, oily skin, and acne. Most of the cases of PCOS are reported in 20s and 30s with complain of difficulty in becoming pregnant. According to the study, frequency of PCOS in the infertility clinics in Pakistan was 17.6%. In this study Fenugreek (Trigonellafoenum-graecum) was investigated to treat PCOD. The plant was also subjected to different physico-chemical and nutraceutical estimations. The present study is single blind randomized controlled trial in 90 premenopausal women diagnosed with PCOS using fenugreek seed powder, over a period of 90 consecutive days. During the course of study, the subjects were counseled about diet and exercise and were regularly monitored for any associated side effects related to the administration of fenugreek seed powder. Vital clinical estimations in the human subjects were carried out at the start of study and by the end of trail i.e. at day 90. Clinical estimations involved evaluation of BMI, FSH, LH, ovarian size, menstrual regularity and FBG. Overall results revealed that the prolong administration of raw fenugreek seeds in women having PCOS was particularly found effective. Intake of fenugreek seeds for three months had positive effect on regularity of menstrual cycle, maturation of eggs, reducing ovarian volume and infertility.

Keywords: Polycystic Ovaries, Fenugreek, Infertility, Ovarian Size, Menstrual irregularities.

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Abstract:

The study was conducted to determine the prevalence of diabetes and its associated factors in people living with HIV/AIDS receiving Anti-Retroviral Therapy (ART) in Chiradzulu district, Malawi. A hospital-based cross-sectional study was conducted between April and October 2016. Using systematic random sampling, secondary data from patients’ records registered at ART and diabetes clinics were extracted. Categorical variables were compared using Chi-square test, independent samples test was used to compare means and multiple logistic regressions were used to calculate adjusted odds ratios for the effect of potential risk factors on diabetes. Out of 440 participants (10%) were diabetic. After adjusting for other variables, age, BMI, DM family history, hypertension and WHO stage 2 remained significant predictors of diabetes p<0.05. In addition, use of TDF/3TC/ATV/r was also a strong predictor of diabetes mellitus and the adjusted odds ratio (AOR) for TDF/3TC/ATV/r users was 6.08, CI [31.82], P=0.032).

The study concluded that diabetes mellitus is a big concern for people on treatment living with HIV/AIDS. Therefore, the study recommends that HIV/ART exposed patients should be checked for DM regardless of the absence or presence of the common diabetes’ risk factors. For the sake of planning and implementing targeted routine monitoring, diabetes risk factors need proper identification.

Keywords: HIV/AIDS, diabetes mellitus, Antiretroviral therapy, combined antiretroviral therapy, Body mass index, Atazanavir/ ritonavir.

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Abstract:

Background: Tuberculosis (TB) is a chronic infectious disease that has long been one of the major health problems. It affects individuals of all ages and both sexes. Poverty, malnutrition and over-crowded living conditions have been known for decades to increase the risk of developing the disease. According to the Federal Ministry of Health (FMOH) hospital statistics data, TB is the leading cause of morbidity, the third cause of hospital admission (after deliveries and malaria) and the second cause of death in Nigeria after malaria. TB is an obstacle to socio economic development. So, this study is aimed at assessing the knowledge, attitude and practices regarding pulmonary tuberculosis among rural communities of Gulu, Kano, Nigeria. Methods: A community based cross-sectional study was conducted in Gulu from January, 2019 to March, 2019. Data was collected using a pretested structured questionnaire. Descriptive analysis was performed to obtain the frequency distribution of the variables. Results: Among 335 participants, the study showed that the overall level of knowledge was low and the overall attitude and practices related to PTB was highly inadequate. Conclusion: Study respondents had basic awareness about pulmonary TB but knowledge on cause and prevention was inadequate. Their attitude and practices towards TB also need to be improved. Health education activities need to be intensified for the rural population to bring about significant change in their level of awareness on TB.

Keywords: KAP, PTB, Awareness, Gulu, Kano.

References:

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[12].  Implementing the WHO Stop TB Strategy: A Handbook for National Tuberculosis Control Programmes. Geneva: World Health Organization ;(2008). Involvement of communities and patients in tuberculosis care and prevention. Available from: https://www.ncbi.nlm.nih.gov/books/NBK310754/. Accessed 31 May (2018).

[13].  Javaid Ahmed Khan1, Muhammad Irfan1, Amna Zaki1, Madiha Beg1, Syed Fayyaz Hussain1, Rizvi2 N. (2006) Knowledge, Attitude and Misconceptions regarding Tuberculosis.

[14].  Kaona FA, Tuba M, Siziya S, Sikaona L. An assessment of factors contributing to treatment adherence and knowledge of TB transmission among patients on TB treatment. BMC Public Health. (2004); 4:68.

[15].  Kar M, Logaraj M. Awareness, attitude and treatment seeking behaviour regarding tuberculosis in a rural area of Tamil Nadu. Indian J Tuberc. (2010);57(4):226–9.

[16].  Koay TK. Knowledge and attitudes towards tuberculosis among the people living in Kudat District, Sabah. Med J Malaysia. (2004); 59(4):502– 11.

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[18].  Malhotra R, Taneja OK, Dhingra VK, Rajpal S, Mehra M. Awareness Regarding Tuberculosis in A Rural Population of Delhi. Indian J Community Med. (2002); 27(2):62.

[19].  Mesfin MM, Tasew TW, Richard MJ: The quality of tuberculosis diagnosis in districts of Tigray region of northern Ethiopia. Ethiop J Health Dev (2005), 19:13–20.

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Abstract:

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

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

References:

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

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

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

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

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

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

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

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

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

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

Abstract:

This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition (SAM) in children 6 – 59 months in Magumeri local Government area admitted to Magumeri General Hospital – INTERSOS Nigeria Stabilization centre during the period December 2018 to June 2019. A total of 171 children with severe acute malnutrition were identified; 104 of cases were male (60.8%) while 67 (39.2%) were females. The mean age of the admitted children was 15.8 months. Children 36–59 months were least affected. The overall prevalence of severe malnutrition was 4.0%, and the general mortality rate was 3.8% while mortality rate among children with severe malnutrition was 2.9%.

Amongst children admitted with SAM, 126 (73.7%) had marasmus, 30 (17.5%) had kwashiorkor and only 16 (9.4%) were marasmic-kwashiorkor. The highest prevalence rates occurred in February and April. The common clinical presentations were acute diarrhea disease, upper respiratory tract infection, malaria, urinary tract infections, dermatitis, measles, sepsis and pneumonia. Only 14.6% were fully vaccinated, while 49.7% were not vaccinated. Overall 81.9% improved and were discharged, 8.2% were transferred to the University of Maiduguri Teaching Hospital for management of other severe medical complications, 7 % discharged against medical advice and 2.9 % died. In conclusion, the prevalence and mortality among children with SAM at Magumeri Local Government area were high, and the current management strategies were inadequate to cater for the high cases as a result of the crisis in the region.

References:

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[5].   Blossner, Monika, de Onis, Mercedes. Malnutrition: quantifying the health impact at national and local levels. 2005. Available at http://whqlibdoc.who.int/publications/2005/9241591870.pdf.

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Abstract:

Social and cultural beliefs in different communities of Zambia have continued to perpetrate Gender Based Violence and this has affected victims in many ways. The impact of GBV has led to an increase in morbidity and mortality rates globally after its physical, mental, emotional and social inflictions on the victims. This has placed a cost on the quality of life as lifestyle changes occur. Therefore, the aim of this study was to establish the socio-cultural factors that are associated with Gender Based Violence in Chipata City. This study adopted an explorative mixed method design. The study sequentially collected quantitative and qualitative data. Responses were gotten from 381 whose sample was deduced from 1,922 female victims, registered from 2014 to 2016 at the GBV One Stop Centre and Chipata City. The study discussions revealed weak community support, poor relationships, alcohol and poverty as being among the major contributing factors to GBV. Major health effects could either be physical implications like a loss of an organ after assault, unwanted pregnancies and STI infections, whose findings were attributed to spouses/partners. Sensitization, in this case, could help curb the incidences of GBV. On conclusion, the study explored the experiences female survivors in Chipata city have had following Gender Based Violence. Socio-cultural and economic factors fueled GBV and victims mention poverty, substance abuse and inactive law enforcement directly enhancing these acts of violence. The key recommendation is massive sensitization about GBV and reinforcing laws to strengthen the curbing of violence.

Keywords: Gender Based Violence, Intimate Partner Violence, Socio-Cultural Beliefs.

References:

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[8].   Crisman, B., Dykstra, S., Kenny, C., & O'Donnell, M. (2016). The Impact of Legislation on the Hazard of Female Genital Mutilation/Cutting: Regression Discontinuity Evidence from Burkina Faso. Center for Global Development Working Paper (432). Retrieved from http://dx.doi.org/10.2139/ssrn.2840992.

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[10].  Decker, M. R., Latimore, A. D., Yasutake, S., Haviland, M., Ahmed, S., Blum, R. W., & Astone, N. M. (2015). Gender-based violence against adolescent and young adult women in low-and middle-income countries. Journal of Adolescent Health, 56(2), 188-196. Retrieved from https://www.wilsoncenter.org/event/gender-based-violence-sub-saharan-africa-review-demographic-and-health-survey-findings-and.

[11].  Decker, M. R., Lyons, C., Billong, S. C., Njindam, I. M., Grosso, A., Nunez, G. T., . . . Baral, S. (2016). Gender-based violence against female sex workers in Cameroon: prevalence and associations with sexual HIV risk and access to health services and justice. Sex Transm Infect, 92(8), 599-604. Retrieved from http://dx.doi.org/10.1136/sextrans-2015-052463.

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[23].  Gurung, S., & Acharya, J. (2016). Gender-based violence among pregnant women of Syangja District, Nepal. Osong public health and research perspectives, 7(2), 101-107. Retrieved from

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[53].  Simona, S., Muchindu, M., & Ntalasha, H. (2018). Intimate Partner Violence (IPV) in Zambia: Socio-demographic Determinants and Association with Use of Maternal Health Care. International Journal of Social Science Studies, 6(42). Retrieved from

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Abstract:

Difficulty in accessing health care due to inequitable distribution has been a continuous challenge in developing countries. Insurance is a veritable tool for curbing these challenges, as proved in developed countries with assuring results. Nigeria in her efforts to tackle this problem introduced the national health insurance scheme. However, acceptance and satisfaction with the NHIS are obstacles to the achievement of its objectives. The aim of the study is to assess the level of acceptance and satisfaction with the national health insurance scheme among civil servants in Sokoto metropolis. The study was a cross sectional descriptive study conducted in Sokoto metropolis among civil servants who are currently accessing NHIS service. A multi-stage sampling technique was used to select 425 participants. Data was collected using semi-structured self- administered questionnaires and was analyzed using MS Excel Spread sheet 2016. A total 425 respondents were interviewed and their mean age was 41.75 ± 9.3 years and majority were males (282) 66.4%, Most of the respondents (311)73.2% where Hausa/fulani and Muslims (349) 82.1%, the overall Acceptance of NHIS was Good, (272) 64% however only 190 (44.7%) are satisfied with the scheme. The study showed that there is good acceptance of the scheme by civil servants in the metropolis, by the scheme is yet to meet their expectation, thus the poor satisfaction.

Keywords: Acceptance, Satisfaction, NHIS Service, Civil Servants, Sokoto Metropolis, Nigeria.

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Abstract:

Background: The study of hand washing practices in Ntungamo district is part of a larger strategy being implemented in different countries to decrease the prevalence of childhood diarrhea, in the frame work of the global public – private partnership for hand washing with soap.

Purpose: This study of hand washing practices using soap in Ntungamo district aimed at reducing childhood diarrhea prevalence in the district. It represents a preliminary study designed to collect the information necessary to design appropriate strategies to reduce diarrhea prevalence in under five years of age.

Methods: The study used quantitative and qualitative methods to collect data from a representative sample of several supervision areas of Ntungamo district.

 Results: The practice of hand washing after latrine use among the respondents was very low (52%) compared to washing hands before and after meals (77%). The study also revealed a low use of soap during hand washing where (52%) who washed their hands after contact with feces, only 14.6% used soap. Whereas whose who washed their hands while handling food were77%, but out of 77% only 28% used soap

There was no diarrhea reported among respondents that had A-level education and only 20% of those that had post-secondary education reported having diarrhea episodes among the under-five compared to 64% that reported diarrhea among the under-fives for those that had incomplete primary level of education, 57% among the households of functional adult learning graduates and 49% for those that completed primary level of education.

Keywords: Handing washing, Soap, Caregivers, Supervision areas.

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Abstract:

Background: Although the government-initiated interventions to address the risk of diet-related non-communicable diseases, the prevalence of T2DM is still high, we conducted this study to determine the magnitude of T2DM and associated risk factors among health workers in Bariadi Town Council Tanzania.

Methodology: A cross-sectional study approach was applied for 229 participants. Qualitative variable was measured using proportion and quantitative variable were measured using mean and median. Strength of association was assessed by Odds Ratios with their corresponding 95% confidence interval. Both bivariable and multivariable logistic regression was used.

Results: The overall prevalence was found to be 7.9% (95%CI=4.7-12.1). Risk factors for T2DM were found to be sex (OR=4.545, 95%CI: 1.069-19.325), age between 30-41 and 41-50 years (OR=8.08, 95%CI: 1.215-53.741; OR=15.08, 95%CI: 2.315-98.342) and history of raised blood sugar (OR=0.032, 95%CI: 0.006-0.167).

Conclusion: Prevalence of T2DM was found to be high, female having higher than male. Sex, age, history of diabetes had significant association with T2DM. Control efforts should be directed on screening and public nutrition programmes.

Keywords: Diabetes Mellitus; Non-Insulin; Risk factors; prevention.

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Abstract:

This study investigated the socioeconomic determinants of contraceptive use among women of reproductive age in Tarauni local government area of Kano state, Nigeria. The research used descriptive survey design to collect and analyse cross sectional data from the study population with the aid of structured questionnaire that was validated. The population of this study comprised of Women of Reproductive Age- 15-49 living in urban and rural parts of the study area. A total of one hundred and twenty (120) participants, selected through simple and systematic random sampling technique participated in the study. The study data was analysed with SPSS version 20 and presented as frequency tables and simple percentage, while chi-square statistics was used to answer the formulated research hypotheses at a 0.05 level of significance. The findings of this study indicate that religion, cultural norms and occupational status of the woman are strongly associated with the use of family planning by women of reproductive age. However, level of education was not significantly associated with the use of contraceptive in this study. The study recommends that interventions targeting Muslims should recognise the diversity among sects and be more targeted; Family planning messages should target and address cultural beliefs and norms including gender roles that hinder use of contraceptive method among women of reproductive age. Government should provide income generating opportunity for women and expand service delivery points with adequate and affordable products and services to encourage use.

Keywords: Contraception, Contraceptives, Contraceptive use, Family planning, Women of Reproductive age.

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