S. Musabwasoni, Gerard Nyiringango, Peace Uwambaye, Madeleine Mukeshimana, Eugene Ngoga, T. Uhawenimana, Priscile Musabirema, Laetitia Ishimwe Bazakare, Vincent Sezibera, D. Mukamana, Marie Klingberg-Allvin, Stephen Rulisa, O. Bazirete
BackgroundAlthough safe abortion is a human right, some research indicates that abortion can be considered a life event that could trigger an adverse psychological reaction, including mental ill health, particularly in vulnerable women. Unplanned pregnancies and abortions affect women’s mental and physical health while increasing psychological risk; hence, measures are needed to improve the quality of life (QoL) of women post termination of pregnancy (ToP). The purpose of this study was to explore the psychological effects of abortion on women provided with this service in Rwanda, and factors surrounding QoL after service provision.MethodsAn interpretive description design was used. Focus group discussions were used to hear the voices of 30 women and girls who had sought ToP services. The six steps of interpretive description together with framework analysis guided the analysis.ResultsFrom responses provided by the participants with experience of ToP services five themes and six sub-themes were generated, (1) Ambivalence with mixed feelings and uncertainty, anger, wonder, and frustration; (2) Insecurity and abortion stigma, with judgement and inadequacy; (3) Personalized care with respectful care and dignity and self-reliance; (4) Lack of connection with relationships, coping, and a sense of belonging; (5) Wellness and preferences for care with hope and positive physical health. ConclusionThe lack of psychological support post ToP negatively affects QoL and indicates an opportunity to include a psychological support package in the ToP service provision, which is the predictor of positive mental health to improve QoL in Rwanda.Rwanda J Med Health Sci. 2024;7(1):116-130
背景虽然安全堕胎是一项人权，但一些研究表明，堕胎可被视为一种生活事件，可能引发不良的心理反应，包括精神疾病，尤其是对弱势妇女而言。意外怀孕和人工流产会影响妇女的身心健康，同时增加心理风险；因此，需要采取措施改善终止妊娠（ToP）后妇女的生活质量（QoL）。本研究旨在探讨卢旺达妇女接受人工流产服务后的心理影响，以及与提供服务后的 QoL 有关的因素。研究采用了解释性描述设计，通过焦点小组讨论倾听了 30 名寻求堕胎服务的妇女和女孩的心声。解释性描述的六个步骤和框架分析为分析提供了指导。结果从有过 ToP 服务经历的参与者的回答中，产生了五个主题和六个次主题：（1）矛盾心理，包括混合感受和不确定性、愤怒、惊奇和沮丧；（2）不安全感和堕胎耻辱，包括判断和不足；（3）个性化护理，包括尊重护理、尊严和自立；（4）缺乏与人际关系的联系、应对和归属感；（5）健康和对护理的偏好，包括希望和积极的身体健康。结论 ToP 后缺乏心理支持会对 QoL 产生负面影响，这表明有机会在提供 ToP 服务时纳入心理支持一揽子计划，这是卢旺达改善 QoL 的积极心理健康的预测因素。
{"title":"Psychology of Abortion: A Qualitative Exploration of Women’s Quality of Life after Termination of Pregnancy Service Provision","authors":"S. Musabwasoni, Gerard Nyiringango, Peace Uwambaye, Madeleine Mukeshimana, Eugene Ngoga, T. Uhawenimana, Priscile Musabirema, Laetitia Ishimwe Bazakare, Vincent Sezibera, D. Mukamana, Marie Klingberg-Allvin, Stephen Rulisa, O. Bazirete","doi":"10.4314/rjmhs.v7i1.9","DOIUrl":"https://doi.org/10.4314/rjmhs.v7i1.9","url":null,"abstract":"BackgroundAlthough safe abortion is a human right, some research indicates that abortion can be considered a life event that could trigger an adverse psychological reaction, including mental ill health, particularly in vulnerable women. Unplanned pregnancies and abortions affect women’s mental and physical health while increasing psychological risk; hence, measures are needed to improve the quality of life (QoL) of women post termination of pregnancy (ToP). The purpose of this study was to explore the psychological effects of abortion on women provided with this service in Rwanda, and factors surrounding QoL after service provision.MethodsAn interpretive description design was used. Focus group discussions were used to hear the voices of 30 women and girls who had sought ToP services. The six steps of interpretive description together with framework analysis guided the analysis.ResultsFrom responses provided by the participants with experience of ToP services five themes and six sub-themes were generated, (1) Ambivalence with mixed feelings and uncertainty, anger, wonder, and frustration; (2) Insecurity and abortion stigma, with judgement and inadequacy; (3) Personalized care with respectful care and dignity and self-reliance; (4) Lack of connection with relationships, coping, and a sense of belonging; (5) Wellness and preferences for care with hope and positive physical health. ConclusionThe lack of psychological support post ToP negatively affects QoL and indicates an opportunity to include a psychological support package in the ToP service provision, which is the predictor of positive mental health to improve QoL in Rwanda.Rwanda J Med Health Sci. 2024;7(1):116-130","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"23 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140697412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Tengera, P. Meharry, A. Nkurunziza, J. Rugema, Yolanda Babenko-Mould, Stephen Rulisa, Laetitia Nyirazinyoye
BackgroundAntenatal care (ANC) helps ensure the best health conditions of the mother and foetus during pregnancy. However, achieving optimal ANC attendance and adherence to the World Health Organization (WHO) recommendations remains a global challenge, with significant disparities in attendance rates. A qualitative study was conducted exploring pregnant women's perspectives of various enablers to their attendance and adherence to recommended ANC visits in Rwanda. MethodsThis exploratory qualitative study involved 22 pregnant women attending ANC in four public health centres in the Eastern province, of Rwanda. An interview guide with semi-structured questions was used to gather information about the moderators of ANC attendance and adherence among pregnant women. Data were audio-recorded and transcribed verbatim, and thematic analysis was used to categorize themes under the five-level Social Ecological Model (SEM).ResultsEarly recognition of pregnancy, financial stability, and female participation in decision-making were identified as intrapersonal enabling factors of ANC attendance and adherence; spousal support was identified as an interpersonal enabling factor; community health workers, and community relationships as community enabling factors; availability and cost of ANC services as institutional enabling factors; and media campaign, community outreach as public policy enabling factors contributing to the pregnant women's attendance and adherence to ANC visits.ConclusionEnablers at multiple levels affect women’s attendance and adherence to ANC visits. It is essential to consider each level when implementing effective strategies to maximize ANC attendance and adherence to the WHO recommendations in order to improve maternal- foetal well-being in Rwanda.Rwanda J Med Health Sci. 2024;7(1):101-115
{"title":"Exploring Perceptions about Enablers of Women’s Attendance and Adherence to the Recommended Antenatal Care Visits in Rwanda: A Qualitative Study","authors":"O. Tengera, P. Meharry, A. Nkurunziza, J. Rugema, Yolanda Babenko-Mould, Stephen Rulisa, Laetitia Nyirazinyoye","doi":"10.4314/rjmhs.v7i1.8","DOIUrl":"https://doi.org/10.4314/rjmhs.v7i1.8","url":null,"abstract":"BackgroundAntenatal care (ANC) helps ensure the best health conditions of the mother and foetus during pregnancy. However, achieving optimal ANC attendance and adherence to the World Health Organization (WHO) recommendations remains a global challenge, with significant disparities in attendance rates. A qualitative study was conducted exploring pregnant women's perspectives of various enablers to their attendance and adherence to recommended ANC visits in Rwanda. MethodsThis exploratory qualitative study involved 22 pregnant women attending ANC in four public health centres in the Eastern province, of Rwanda. An interview guide with semi-structured questions was used to gather information about the moderators of ANC attendance and adherence among pregnant women. Data were audio-recorded and transcribed verbatim, and thematic analysis was used to categorize themes under the five-level Social Ecological Model (SEM).ResultsEarly recognition of pregnancy, financial stability, and female participation in decision-making were identified as intrapersonal enabling factors of ANC attendance and adherence; spousal support was identified as an interpersonal enabling factor; community health workers, and community relationships as community enabling factors; availability and cost of ANC services as institutional enabling factors; and media campaign, community outreach as public policy enabling factors contributing to the pregnant women's attendance and adherence to ANC visits.ConclusionEnablers at multiple levels affect women’s attendance and adherence to ANC visits. It is essential to consider each level when implementing effective strategies to maximize ANC attendance and adherence to the WHO recommendations in order to improve maternal- foetal well-being in Rwanda.Rwanda J Med Health Sci. 2024;7(1):101-115","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"2000 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140718765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chance Christian Ndahiriwe, Juliette Gasana, Jacques Nshimiyimana, Charlotte Bavuma, Emmy Bucyana, Cedrick Manirafasha, Jean de Dieu Bugingo, M. Tuyizere, Reverien Rutayisire, Samuel Ntakirutimana, Joanitah Kemigisha, Jonas Ruzirakuvuka, Maryse Umugwaneza, Jean Claude Habineza, L. Mukaruzima, Celestin Twizere, D. Tumusiime
BackgroundType 2 diabetes has become a public health concern, representing more than 90%of all types of diabetes and affecting 536.6 million people worldwide in 2021. It isa disabling condition and is considered a major risk factor for developing chroniccomplication such as cardiovascular diseases if not well controlled. Studies haveshown that individuals with diabetes can make a positive impact on the outcomesof their disease by participating to their healthcare. Contextualized innovative andeffective applications are needed to facilitate individuals with diabetes to participateto their care.AimTo assess the effectiveness of Smartphone Application “GororokApp” in monitoringof glucose control among type 2 diabetes individuals.Materials & MethodsA Randomized Controlled Trial (RCT) was used to assess the effectiveness of smartphoneapplication (GororokApp) in monitoring of glucose control for self-management bythe patients with type 2 diabetes in Rwanda. Participants in intervention group usedthe GororokApp and recorded their blood glucose measurements and received healthcare advice remotely while the control group continued routine care. The participantswere followed up over a period of 12 weeks. The primary outcomes were glycatedhaemoglobin, and daily blood glucose measurements.ResultsAfter 12 weeks of follow up, the intervention and control, groups demonstrateddifference of changes in glycated haemoglobin; whereby in the intervention groupthe glycated haemoglobin reduced from 8.45±2.93 to 6.89±1.86 (p ≤ 0.001),whereas in the control group the glycated haemoglobin increased from 7.12±2.52 to 8.14±2.17 (p ≤0.001).ConclusionThe smartphone application “GororokApp” is effective in self-monitoring andmanagement of the daily blood glucose levels in intervention group to achievetreatment targets of blood glucose and glycated haemoglobin among individualswith type 2 diabetes.Rwanda J Med Health Sci. 2024;7(1):79-88
{"title":"Effectiveness of Smartphone Application “Gororokapp” for Type 2 Diabetes Patients’ Self-Management in Rwanda: A Randomized Controlled Trial","authors":"Chance Christian Ndahiriwe, Juliette Gasana, Jacques Nshimiyimana, Charlotte Bavuma, Emmy Bucyana, Cedrick Manirafasha, Jean de Dieu Bugingo, M. Tuyizere, Reverien Rutayisire, Samuel Ntakirutimana, Joanitah Kemigisha, Jonas Ruzirakuvuka, Maryse Umugwaneza, Jean Claude Habineza, L. Mukaruzima, Celestin Twizere, D. Tumusiime","doi":"10.4314/rjmhs.v7i1.6","DOIUrl":"https://doi.org/10.4314/rjmhs.v7i1.6","url":null,"abstract":"BackgroundType 2 diabetes has become a public health concern, representing more than 90%of all types of diabetes and affecting 536.6 million people worldwide in 2021. It isa disabling condition and is considered a major risk factor for developing chroniccomplication such as cardiovascular diseases if not well controlled. Studies haveshown that individuals with diabetes can make a positive impact on the outcomesof their disease by participating to their healthcare. Contextualized innovative andeffective applications are needed to facilitate individuals with diabetes to participateto their care.AimTo assess the effectiveness of Smartphone Application “GororokApp” in monitoringof glucose control among type 2 diabetes individuals.Materials & MethodsA Randomized Controlled Trial (RCT) was used to assess the effectiveness of smartphoneapplication (GororokApp) in monitoring of glucose control for self-management bythe patients with type 2 diabetes in Rwanda. Participants in intervention group usedthe GororokApp and recorded their blood glucose measurements and received healthcare advice remotely while the control group continued routine care. The participantswere followed up over a period of 12 weeks. The primary outcomes were glycatedhaemoglobin, and daily blood glucose measurements.ResultsAfter 12 weeks of follow up, the intervention and control, groups demonstrateddifference of changes in glycated haemoglobin; whereby in the intervention groupthe glycated haemoglobin reduced from 8.45±2.93 to 6.89±1.86 (p ≤ 0.001),whereas in the control group the glycated haemoglobin increased from 7.12±2.52 to 8.14±2.17 (p ≤0.001).ConclusionThe smartphone application “GororokApp” is effective in self-monitoring andmanagement of the daily blood glucose levels in intervention group to achievetreatment targets of blood glucose and glycated haemoglobin among individualswith type 2 diabetes.Rwanda J Med Health Sci. 2024;7(1):79-88","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"38 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140732220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dieudonne Kayiranga, Darius Gishoma, Gallican Nshogoza Rwibasira, Eric Remera, Michael V Relf, D. Mukamana
BackgroundHIV is a chronic disease with a potentially negative impact on quality of life.Globally, adolescents with HIV (AWH) face incredible challenges related to theirgrowth, social interactions, and well-being. The experiences and choices of AWHin Rwanda are poorly known.ObjectiveThe current study explored the lived experiences of AWH in Rwanda using aninterpretive phenomenological approach.MethodsA purposive and snowball sampling was used to recruit twenty AWH from fivehealth centers. A semi-structured interview guide was used to conduct in-depthinterviews from April to August 2022. All interviews were recorded, and field noteswere taken. The recorded interviews were transcribed verbatim, translated inEnglish, and analyzed using Interpretative phenomenological analysis (IPA).ResultsThree main themes and nine subthemes emerged from data: burden of HIV(existential crisis, experiences with stigma, keep it a secret), owning my story(awareness of having HIV, making decisions) and successful living with HIV(features of successful living, continuum of self-acceptance, behavioural impact,social interaction).ConclusionThe AWH face challenges related to HIV condition and develop strategies toovercome challenges that hinder their well-being. Results provide valuable insightsthat inform targeted interventions and support programs, ultimately promotingthe well-being of AWH.Rwanda J Med Health Sci. 2024;7(1):63-78
背景艾滋病毒是一种对生活质量具有潜在负面影响的慢性疾病。在全球范围内，感染艾滋病毒的青少年（AWH）在成长、社会交往和福祉方面面临着令人难以置信的挑战。本研究采用解释性现象学方法，探讨卢旺达感染艾滋病病毒的青少年的生活经历。研究采用有目的的滚雪球式抽样，从五个健康中心招募了 20 名感染艾滋病病毒的青少年。2022 年 4 月至 8 月期间，采用半结构式访谈指南进行了深入访谈。所有访谈均有录音，并做了现场记录。结果从数据中发现了三个主要主题和九个次主题：HIV 负担（存在危机、污名化经历、保守秘密）、拥有我的故事（对感染 HIV 的认识、做出决定）和成功的 HIV 感染者生活（成功生活的特征、自我接受的连续性、行为影响、社会交往）。研究结果为有针对性的干预措施和支持计划提供了宝贵的信息，最终促进了艾滋病病毒感染者和艾滋病病人的福祉。
{"title":"Lived Experiences of Adolescents with HIV in Rwanda: A Phenomenology Study","authors":"Dieudonne Kayiranga, Darius Gishoma, Gallican Nshogoza Rwibasira, Eric Remera, Michael V Relf, D. Mukamana","doi":"10.4314/rjmhs.v7i1.5","DOIUrl":"https://doi.org/10.4314/rjmhs.v7i1.5","url":null,"abstract":"BackgroundHIV is a chronic disease with a potentially negative impact on quality of life.Globally, adolescents with HIV (AWH) face incredible challenges related to theirgrowth, social interactions, and well-being. The experiences and choices of AWHin Rwanda are poorly known.ObjectiveThe current study explored the lived experiences of AWH in Rwanda using aninterpretive phenomenological approach.MethodsA purposive and snowball sampling was used to recruit twenty AWH from fivehealth centers. A semi-structured interview guide was used to conduct in-depthinterviews from April to August 2022. All interviews were recorded, and field noteswere taken. The recorded interviews were transcribed verbatim, translated inEnglish, and analyzed using Interpretative phenomenological analysis (IPA).ResultsThree main themes and nine subthemes emerged from data: burden of HIV(existential crisis, experiences with stigma, keep it a secret), owning my story(awareness of having HIV, making decisions) and successful living with HIV(features of successful living, continuum of self-acceptance, behavioural impact,social interaction).ConclusionThe AWH face challenges related to HIV condition and develop strategies toovercome challenges that hinder their well-being. Results provide valuable insightsthat inform targeted interventions and support programs, ultimately promotingthe well-being of AWH.Rwanda J Med Health Sci. 2024;7(1):63-78","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140728719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hasanain Faisal Ghazi, Taqi Mohammed Jwad Taher, T. Hasan
Background Globally and in Iraq, vitamin D insufficiency is becoming more of a problem. Knowledge is crucial in preventing deficiency and future consequences. The current study intends to investigate the general population's knowledge about vitamin D in Baghdad, Iraq.MethodsA cross-sectional online study including 1,011 residents of Baghdad, Iraq, was carried out. To choose participants, a non-probability convenience sampling method was applied. Knowledge questionnaires with 17 items were taken from earlier research. Fisher exact and Chi-Square were utilized to identify associations between the variables.Results The overall prevalence of good knowledge among participants was 74.3%. About 48.8% did blood tests before to check vitamin D levels. Around half of respondents (47.1%) did take vitamin D supplements before. The level of good knowledge among respondents was 74.3%. Multivariable logistic regression model showed that respondents taking vitamin d supplements had better knowledge (AOR; 2.241, 95 CI: 1.701-3.444). Conclusion People living in Baghdad have a good knowledge level about Vitamin D but more health education and promotion are needed to address specific issues like dietary sources and, the best season to get vitamin D as the majority did not know it. Rwanda J Med Health Sci. 2024;7(1):89-100
背景 在全球和伊拉克，维生素 D 不足正日益成为一个问题。了解相关知识对于预防维生素 D 缺乏症及其未来后果至关重要。本研究旨在调查伊拉克巴格达普通民众对维生素 D 的了解程度。研究方法：本研究进行了一项横断面在线调查，调查对象包括伊拉克巴格达的 1011 名居民。在选择参与者时，采用了非概率方便抽样法。知识调查问卷包含 17 个项目，均来自早期研究。利用费雪精确法和 Chi-Square 来确定变量之间的关联。约 48.8%的受访者在检测维生素 D 水平前进行过血液检测。约半数受访者（47.1%）曾服用维生素 D 补充剂。受访者对维生素 D 的了解程度为 74.3%。多变量逻辑回归模型显示，服用维生素 D 补充剂的受访者对维生素 D 的了解程度更高（AOR；2.241，95 CI：1.701-3.444）。结论 生活在巴格达的人们对维生素 D 有较好的了解，但由于大多数人不知道维生素 D 的来源和最佳摄入季节等具体问题，因此需要开展更多的健康教育和宣传活动。卢旺达医学健康科学》，2024；7（1）：89-100
{"title":"Knowledge about Vitamin D among General Population in Baghdad City","authors":"Hasanain Faisal Ghazi, Taqi Mohammed Jwad Taher, T. Hasan","doi":"10.4314/rjmhs.v7i1.7","DOIUrl":"https://doi.org/10.4314/rjmhs.v7i1.7","url":null,"abstract":"Background Globally and in Iraq, vitamin D insufficiency is becoming more of a problem. Knowledge is crucial in preventing deficiency and future consequences. The current study intends to investigate the general population's knowledge about vitamin D in Baghdad, Iraq.MethodsA cross-sectional online study including 1,011 residents of Baghdad, Iraq, was carried out. To choose participants, a non-probability convenience sampling method was applied. Knowledge questionnaires with 17 items were taken from earlier research. Fisher exact and Chi-Square were utilized to identify associations between the variables.Results The overall prevalence of good knowledge among participants was 74.3%. About 48.8% did blood tests before to check vitamin D levels. Around half of respondents (47.1%) did take vitamin D supplements before. The level of good knowledge among respondents was 74.3%. Multivariable logistic regression model showed that respondents taking vitamin d supplements had better knowledge (AOR; 2.241, 95 CI: 1.701-3.444). Conclusion People living in Baghdad have a good knowledge level about Vitamin D but more health education and promotion are needed to address specific issues like dietary sources and, the best season to get vitamin D as the majority did not know it. Rwanda J Med Health Sci. 2024;7(1):89-100","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"39 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140729421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BackgroundPreterm birth contributes to significant neonatal and under-five mortality and morbidities. This study assessed the risk factors associated with preterm births at a tertiary teaching hospital in Dar es Salaam, Tanzania. MethodsCase-control study to compare risk factors of preterm birth amongst 140 women with preterm deliveries as cases and 280 women with term deliveries as controls. A structured interviewer-administered questionnaire was used. Univariate and multivariable logistic regression analyses were done using STATA version 17 software. ResultsThe proportion of preterm deliveries was 17.9%. Women with less than four antenatal visits were three times more likely to have a preterm birth than those with four or more attendances (aOR 3.6, 95% CI 1.95–6.57, P < 0.001). The odds of preterm birth increased among women who experienced antepartum haemorrhage (aOR 25.7, 95% CI 12.72–52.03, P < 0.001), pre-eclampsia/eclampsia (aOR 29.9, 95% CI 7.78–115.41, P < 0.001) and preterm membrane rupture (aOR 62.8; 95% CI 23.51–168.21, P < 0.001). Among multiparous women, short interpregnancy intervals, prior preterm birth, or stillbirth increased the odds of preterm birth.ConclusionPoor antenatal attendance, obstetric complications, and premature rupture of membranes were among the identified risk factors. All could be addressed by quality antenatal care. Rwanda J Med Health Sci 2023;6(3):335-345
背景早产是导致新生儿和五岁以下儿童死亡和发病的重要原因。本研究评估了坦桑尼亚达累斯萨拉姆一家三级教学医院中与早产相关的风险因素。方法：以 140 名早产妇女为病例，280 名足月分娩妇女为对照，对早产的风险因素进行病例对照研究。研究采用了结构化访谈问卷。使用 STATA 17 版软件进行了单变量和多变量逻辑回归分析。结果 早产比例为 17.9%。产前检查少于四次的妇女早产的几率是产前检查四次或四次以上的妇女的三倍（aOR 3.6，95% CI 1.95-6.57，P < 0.001）。产前大出血（aOR 25.7，95% CI 12.72-52.03，P＜0.001）、先兆子痫/子痫（aOR 29.9，95% CI 7.78-115.41，P＜0.001）和胎膜早破（aOR 62.8；95% CI 23.51-168.21，P＜0.001）的产妇早产几率增加。在多产妇中，孕间隔短、曾有过早产或死胎会增加早产的几率。所有这些都可以通过高质量的产前保健来解决。卢旺达医学健康科学 2023；6（3）：335-345
{"title":"Risk Factors Associated with Preterm Birth at a Tertiary Teaching Hospital in Dar es Salaam, Tanzania: An Unmatched Case-Control Study","authors":"M. R. Njunwa, Helga Naburi, F. A. Al-beity","doi":"10.4314/rjmhs.v6i3.7","DOIUrl":"https://doi.org/10.4314/rjmhs.v6i3.7","url":null,"abstract":"BackgroundPreterm birth contributes to significant neonatal and under-five mortality and morbidities. This study assessed the risk factors associated with preterm births at a tertiary teaching hospital in Dar es Salaam, Tanzania. MethodsCase-control study to compare risk factors of preterm birth amongst 140 women with preterm deliveries as cases and 280 women with term deliveries as controls. A structured interviewer-administered questionnaire was used. Univariate and multivariable logistic regression analyses were done using STATA version 17 software. ResultsThe proportion of preterm deliveries was 17.9%. Women with less than four antenatal visits were three times more likely to have a preterm birth than those with four or more attendances (aOR 3.6, 95% CI 1.95–6.57, P < 0.001). The odds of preterm birth increased among women who experienced antepartum haemorrhage (aOR 25.7, 95% CI 12.72–52.03, P < 0.001), pre-eclampsia/eclampsia (aOR 29.9, 95% CI 7.78–115.41, P < 0.001) and preterm membrane rupture (aOR 62.8; 95% CI 23.51–168.21, P < 0.001). Among multiparous women, short interpregnancy intervals, prior preterm birth, or stillbirth increased the odds of preterm birth.ConclusionPoor antenatal attendance, obstetric complications, and premature rupture of membranes were among the identified risk factors. All could be addressed by quality antenatal care. Rwanda J Med Health Sci 2023;6(3):335-345","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":" 36","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvester Walles, Emmanuel Z. Chona, M. Ndile, Fatina B. Ramadhani
BackgroundOver the past decade, the magnitude and intensity of reported natural and human-made disasters have been rising globally with substantial mortality and long-term morbidity. ObjectivesTo assess the health care providers´ knowledge, attitude and practices towards disaster and emergency preparedness at Ligula Regional Referral Hospital in Mtwara, Tanzania.MethodsA descriptive and analytical cross-sectional study was conducted among 94 health care providers; and a stratified sampling technique was employed to recruit the participants. Bivariate and multivariable regression analyses were performed using IBM SPSS Statistics for Windows version 25.0 (IBM Corp, Armonk, NY, USA) to determine the association between independent and dependent variables. A P < 0.05 was considered statistically significant.Results More than half 50 (53.2%) and more than three-quarters 75 (79.8%) of the participants had adequate knowledge and positive attitude towards disaster and emergency preparedness respectively. Younger participants aged 20–29 years had 5.252 (95% CI 1.313–21.016) times higher odds of having adequate knowledge of disaster and emergency preparedness than the older groups. ConclusionsMore disaster and emergency preparedness training programs and clinical simulations are needed to enhance the competencies of health care providers in handling disastrous events efficiently.Rwanda J Med Health Sci 2023;6(3):303-314
背景在过去的十年中，全球范围内报告的自然和人为灾害的规模和强度都在上升，造成了大量死亡和长期发病。方法 对 94 名医疗服务提供者进行了描述性和分析性横断面研究，并采用分层抽样技术招募参与者。使用 IBM SPSS Statistics for Windows 25.0 版（IBM Corp, Armonk, NY, USA）进行了二元和多元回归分析，以确定自变量和因变量之间的关联。结果 超过半数的 50 名参与者（53.2%）和超过四分之三的 75 名参与者（79.8%）分别对防灾和应急准备有足够的了解和积极的态度。年龄在 20-29 岁的年轻参与者对灾害和应急准备有充分了解的几率比年龄较大的群体高 5.252 倍（95% CI 1.313-21.016）。结论需要更多的灾难和应急准备培训项目和临床模拟，以提高医疗服务提供者有效处理灾难性事件的能力。 卢旺达医学健康科学 2023；6（3）：303-314
{"title":"Knowledge, Attitude and Practices of Health Care Providers towards Disaster and Emergency Preparedness in Mtwara, Tanzania","authors":"Silvester Walles, Emmanuel Z. Chona, M. Ndile, Fatina B. Ramadhani","doi":"10.4314/rjmhs.v6i3.4","DOIUrl":"https://doi.org/10.4314/rjmhs.v6i3.4","url":null,"abstract":"BackgroundOver the past decade, the magnitude and intensity of reported natural and human-made disasters have been rising globally with substantial mortality and long-term morbidity. ObjectivesTo assess the health care providers´ knowledge, attitude and practices towards disaster and emergency preparedness at Ligula Regional Referral Hospital in Mtwara, Tanzania.MethodsA descriptive and analytical cross-sectional study was conducted among 94 health care providers; and a stratified sampling technique was employed to recruit the participants. Bivariate and multivariable regression analyses were performed using IBM SPSS Statistics for Windows version 25.0 (IBM Corp, Armonk, NY, USA) to determine the association between independent and dependent variables. A P < 0.05 was considered statistically significant.Results More than half 50 (53.2%) and more than three-quarters 75 (79.8%) of the participants had adequate knowledge and positive attitude towards disaster and emergency preparedness respectively. Younger participants aged 20–29 years had 5.252 (95% CI 1.313–21.016) times higher odds of having adequate knowledge of disaster and emergency preparedness than the older groups. ConclusionsMore disaster and emergency preparedness training programs and clinical simulations are needed to enhance the competencies of health care providers in handling disastrous events efficiently.Rwanda J Med Health Sci 2023;6(3):303-314","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"50 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Maurice Kanyoni, Nilsson‐Wikmar Lena, Phillips Joliana, David K Tumusiime
BackgroundTraumatic spinal cord injury (TSCI) affects quality of life (QoL) depending on the severity and access to rehabilitation. A good QoL is of paramount importance for TSCI survivors all over the world. ObjectiveTo assess the QoL of TSCI survivors after one year.MethodsAdults were included who by the time of injury were 18 years or above and registered in a previous epidemiological study. “The International Spinal Cord Injury Quality of Life” standard data set was used to collect data and assess overall QoL (range 0-30) and three domains: satisfaction with life as a whole, physical- and psychological health (range 0-10). A telephone interview was conducted with 58 participants. ResultsThe overall mean score of QoL was 13.12 (SD 7.17), satisfaction with life as a whole 3.91 (SD 2.73), psychological health 5.36 (SD 2.95), and physical health 3.84 (SD 2.59). Marital status significantly influenced overall QoL (P = 0.031) and its two domains; satisfaction with life as a whole (P = 0.037) and satisfaction with physical health (P = 0.022). Linear regression analysis showed that being married or widowed predicted poor QoL.ConclusionLow scores of overall QoL and its domains implying poor QoL and marital status may play a role, hence it is important to take it into consideration when treating patient with TSCI. Rwanda J Med Health Sci 2023;6(3):326-334
背景创伤性脊髓损伤（TSCI）对生活质量（QoL）的影响取决于其严重程度和康复机会。良好的生活质量对全世界的创伤性脊髓损伤（TSCI）幸存者都至关重要。目标评估脊髓损伤幸存者一年后的生活质量。方法纳入受伤时年满 18 周岁并在以前的流行病学研究中登记过的成年人。采用 "国际脊髓损伤生活质量 "标准数据集收集数据并评估整体生活质量（范围 0-30）和三个领域：对整体生活的满意度、身体健康和心理健康（范围 0-10）。对 58 名参与者进行了电话访谈。结果 QoL 的总平均值为 13.12（SD 7.17），整体生活满意度为 3.91（SD 2.73），心理健康为 5.36（SD 2.95），身体健康为 3.84（SD 2.59）。婚姻状况对总体 QoL（P = 0.031）及其两个领域（对整体生活的满意度（P = 0.037）和对身体健康的满意度（P = 0.022））有明显影响。线性回归分析表明，已婚或丧偶预示着 QoL 较差。结论：总体 QoL 及其领域得分较低意味着 QoL 较差，而婚姻状况可能在其中起作用，因此在治疗 TSCI 患者时必须考虑到这一点。卢旺达医学健康科学》2023;6(3):326-334
{"title":"Quality of Life after Traumatic Spinal Cord Injury in Rwanda, the Impact of Personal and Contextual Factors: A Follow-Up Exploratory Study","authors":"Maurice Kanyoni, Nilsson‐Wikmar Lena, Phillips Joliana, David K Tumusiime","doi":"10.4314/rjmhs.v6i3.6","DOIUrl":"https://doi.org/10.4314/rjmhs.v6i3.6","url":null,"abstract":"BackgroundTraumatic spinal cord injury (TSCI) affects quality of life (QoL) depending on the severity and access to rehabilitation. A good QoL is of paramount importance for TSCI survivors all over the world. ObjectiveTo assess the QoL of TSCI survivors after one year.MethodsAdults were included who by the time of injury were 18 years or above and registered in a previous epidemiological study. “The International Spinal Cord Injury Quality of Life” standard data set was used to collect data and assess overall QoL (range 0-30) and three domains: satisfaction with life as a whole, physical- and psychological health (range 0-10). A telephone interview was conducted with 58 participants. ResultsThe overall mean score of QoL was 13.12 (SD 7.17), satisfaction with life as a whole 3.91 (SD 2.73), psychological health 5.36 (SD 2.95), and physical health 3.84 (SD 2.59). Marital status significantly influenced overall QoL (P = 0.031) and its two domains; satisfaction with life as a whole (P = 0.037) and satisfaction with physical health (P = 0.022). Linear regression analysis showed that being married or widowed predicted poor QoL.ConclusionLow scores of overall QoL and its domains implying poor QoL and marital status may play a role, hence it is important to take it into consideration when treating patient with TSCI. Rwanda J Med Health Sci 2023;6(3):326-334","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139207674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leonidah Kwamboka Amaya, Anita Bella Collins, Nelson Mokaya Nyauma
BackgroundPoorly controlled postoperative pain remains a significant challenge. Music is a safe, inexpensive, non-invasive intervention that can be used in managing pain in surgical patients.ObjectivesTo evaluate effectiveness of music intervention as an adjuvant therapy in attenuating postoperative pain among patients with tibia/fibula fractures.MethodologyA cross-sectional pre-test, post-test intervention study design was utilized to conduct a study involving 20 tibia-fibula patients, divided equally into intervention and control groups. Self-selected music was administered for 20 minutes to the intervention group once on day-3 after surgery. Data was collected using a demographic questionnaire and Visual Analogue Scale (VAS).Data was analyzed using SPSS software version 29.0. Descriptive statistics analyzed continuous and categorical data. T-test compared means of physiologic parameters and pain levels in pre-and post-intervention. ANCOVA established the relationship between music and post-intervention pain levels.FindingsUse of music alongside conventional therapy significantly reduced pain in the intervention group than in the control group (P = 0.014). Music had no statistically significant impact on the physiological parameters.ConclusionMusic therapy is effective as an adjuvant therapy for pain management and can therefore reduce the use of analgesics among surgical patients.Rwanda J Med Health Sci 2023;6(3):290-302
{"title":"Music as an Adjuvant Therapy in Postoperative Pain and Physiologic Parameters: Pre-Test, Post-Test Intervention Study","authors":"Leonidah Kwamboka Amaya, Anita Bella Collins, Nelson Mokaya Nyauma","doi":"10.4314/rjmhs.v6i3.3","DOIUrl":"https://doi.org/10.4314/rjmhs.v6i3.3","url":null,"abstract":"BackgroundPoorly controlled postoperative pain remains a significant challenge. Music is a safe, inexpensive, non-invasive intervention that can be used in managing pain in surgical patients.ObjectivesTo evaluate effectiveness of music intervention as an adjuvant therapy in attenuating postoperative pain among patients with tibia/fibula fractures.MethodologyA cross-sectional pre-test, post-test intervention study design was utilized to conduct a study involving 20 tibia-fibula patients, divided equally into intervention and control groups. Self-selected music was administered for 20 minutes to the intervention group once on day-3 after surgery. Data was collected using a demographic questionnaire and Visual Analogue Scale (VAS).Data was analyzed using SPSS software version 29.0. Descriptive statistics analyzed continuous and categorical data. T-test compared means of physiologic parameters and pain levels in pre-and post-intervention. ANCOVA established the relationship between music and post-intervention pain levels.FindingsUse of music alongside conventional therapy significantly reduced pain in the intervention group than in the control group (P = 0.014). Music had no statistically significant impact on the physiological parameters.ConclusionMusic therapy is effective as an adjuvant therapy for pain management and can therefore reduce the use of analgesics among surgical patients.Rwanda J Med Health Sci 2023;6(3):290-302","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139197531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beata Sangwayire, Michael Habtu, Raphael Ndahimana, Japheths Ogendi
BackgroundGlobally, HIV/AIDS continues to be a serious public health issue. In Sub-Saharan Africa, the incidence of new HIV infections among adolescent girls and young women (AGYW) is gradually rising. Despite efforts being made, the high HIV infection positivity rate of 5% in Kigali among adolescent girls and young women continues to be a cause for concern.Objective To assess factors associated with new HIV infection among AGYW in Kigali. MethodsThe study used a case-control design, whereby cases were AGYW confirmed to HIV positive, while controls were AGYW confirmed to be HIV negative. Using SPSS Version 26, bivariate and multivariable logistic regression analyses were performed to identify HIV infection-associated factors. ResultsThe majority 748 (96.6%) of the study participants were in the age category of 20-24 years and 487(63.2%) were single. Multivariable logistic regression model showed the following factors as independent predictors: being employed (aOR: 1.43; 95% CI: 1.02–2.03), being resident of Kicukiro (aOR: 1.59; 95% CI: 1.07–2.36), history of commercial sex worker (aOR: 2.04; 95% CI: 1.29–3.22) and having multiple sexual partners (aOR: .05; 95% CI: 1.41–2.98.ConclusionPublic health interventions from key policymakers are needed to strengthen public health strategies of commercial sex workers to reduce new HIV infection including raising awareness through education for HIV Prevention.Rwanda J Med Health Sci 2023;6(3):280-289
背景在全球范围内，艾滋病毒/艾滋病仍然是一个严重的公共卫生问题。在撒哈拉以南非洲地区，少女和年轻妇女（AGYW）中新感染艾滋病毒的发病率正在逐步上升。尽管已经做出了努力，但基加利少女和年轻女性中高达 5%的 HIV 感染阳性率仍然令人担忧。方法 该研究采用病例对照设计，病例为经确认为 HIV 阳性的 AGYW，对照为经确认为 HIV 阴性的 AGYW。使用 SPSS 26 版进行了双变量和多变量逻辑回归分析，以确定艾滋病毒感染的相关因素。结果 748 名（96.6%）研究参与者的年龄在 20-24 岁之间，487 名（63.2%）为单身。多变量逻辑回归模型显示，以下因素是独立的预测因素：就业（aOR：1.43；95% CI：1.02-2.03）、基库基罗居民（aOR：1.59；95% CI：1.07-2.36）、商业性工作者史（aOR：2.04；95% CI：1.29-3.22）和有多个性伴侣（aOR：......；95% CI：1.02-2.03）。结论：需要主要政策制定者采取公共卫生干预措施，加强商业性工作者的公共卫生策略，以减少新的 HIV 感染，包括通过教育提高对 HIV 预防的认识。
{"title":"Factors Associated with New HIV Infection among Adolescent Girls and Young Women in the City Of Kigali Rwanda","authors":"Beata Sangwayire, Michael Habtu, Raphael Ndahimana, Japheths Ogendi","doi":"10.4314/rjmhs.v6i3.2","DOIUrl":"https://doi.org/10.4314/rjmhs.v6i3.2","url":null,"abstract":"BackgroundGlobally, HIV/AIDS continues to be a serious public health issue. In Sub-Saharan Africa, the incidence of new HIV infections among adolescent girls and young women (AGYW) is gradually rising. Despite efforts being made, the high HIV infection positivity rate of 5% in Kigali among adolescent girls and young women continues to be a cause for concern.Objective To assess factors associated with new HIV infection among AGYW in Kigali. MethodsThe study used a case-control design, whereby cases were AGYW confirmed to HIV positive, while controls were AGYW confirmed to be HIV negative. Using SPSS Version 26, bivariate and multivariable logistic regression analyses were performed to identify HIV infection-associated factors. ResultsThe majority 748 (96.6%) of the study participants were in the age category of 20-24 years and 487(63.2%) were single. Multivariable logistic regression model showed the following factors as independent predictors: being employed (aOR: 1.43; 95% CI: 1.02–2.03), being resident of Kicukiro (aOR: 1.59; 95% CI: 1.07–2.36), history of commercial sex worker (aOR: 2.04; 95% CI: 1.29–3.22) and having multiple sexual partners (aOR: .05; 95% CI: 1.41–2.98.ConclusionPublic health interventions from key policymakers are needed to strengthen public health strategies of commercial sex workers to reduce new HIV infection including raising awareness through education for HIV Prevention.Rwanda J Med Health Sci 2023;6(3):280-289","PeriodicalId":315881,"journal":{"name":"Rwanda Journal of Medicine and Health Sciences","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139200391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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