AAS Open Research最新文献

Background : Modern contraceptives (MC) are important strategies for reducing unwanted pregnancies, unsafe abortion and maternal mortality, but MC remains low at 18% in Nigeria. Similarly, while there is increasing prevalence of intimate partner violence (IPV) in Nigeria, its effects on contraceptive use remain unclear. This study examined the influence of IPV on MC use, while adjusting for individual- and community-level confounders. Methods : The study utilized 2018 Nigeria Demographic and Health Survey data. We performed multilevel binary logistic regression analysis on 24,973 married women aged 15-49 49 (nested within 1,400 communities), who were sexually active and were not pregnant at the time of the survey. Results : Findings show that use of MC was higher among married women who reported experience of IPV than those without IPV exposure. After adjusting for individual-level and contextual factors, the odds of using MC was significantly higher among women who experienced any form of IPV (OR: 1.61, 95% CI: 1.17-2.21, p<0.005) compared to those who reported no IPV experience. Around one-quarter of the total variance in contraceptive use with respect to the different types of IPV could be explained at the community level. Conclusion : The study provides empirical evidence that there is significant community effect on IPV exposure and women's contraceptive uptake. Attention must therefore be given to the context-specific social and gender norms that affect women's sexual and reproductive health in Nigeria.

Background High-risk sexual behaviors(HRSBs) among young adults are key risk for Sexually Transmitted Infections(STIs), HIV and unplanned pregnancies. WHO has identified the 15-24years age-group as high-risk for STIs. Students at Higher Learning Institutions(HLIs) may be at higher risk because they are free of immediate parental-supervision, are a transient migratory population, probably at peak-years of sexual activity.  In Tanzania, information is limited on sexual and preventive behaviours among young adults in HLIs. We describe risky sexual behaviours and preventive practices among young adults attending HLIs in Mbeya-Tanzania. Methods We conducted a cross-sectional study from March2019 to January2020 among randomly selected students aged 18-24years enrolled in HLIs within Mbeya.  Probability proportional to size was used to determine total student number from each HLI. We used a self-administered questionnaire to collect information on sexual health education, activity, behaviour and STI knowledge. Results Total of 504students were enrolled with mean age of 21.5(SD 1.74)years. Total of 446(88.5%) students reported ever having had sex. Mean-age at first sex was 18.4years and 9.9% reported sexual debut <15years. A higher proportion of male students(57%) reported sexual debut with non-steady partners than females(37.9%). Lack of condom use at sexual debut was reported by 52% of the participants. Consistent condom use during past 4-weeks was reported at 33% and 16.5% among males and females, respectively. About 1 in 10 students reported forced sex by someone they were dating. Sex under the influence of alcohol was reported by 24% of the students.  Nearly 8 in 10 (78.7%) students have heard of STIs, but only 16% were aware STIs can be asymptomatic.  Conclusion STI prevention programs need to recognize young adults in HLIs as at-risk population; and advocate targeted messages to minimize risk to acquiring STIs, counseling and support for those experiencing sexual violence, promote condom use and safer-sex negotiation skills.

Background: The recovery of phenolic compounds is seen as an arduous task because phenolic compounds are available as free aglycones, as sugar or ester conjugates, or as polymers with several monomeric components. This study looks at the optimization of factors that affect the efficiency for the extraction of phenolic compounds from the stem-bark of Funtumia elastica.

Methods: Five independent variables (solvent concentration, time, the temperature, solid-liquid ratio, and pH) of the extraction process were selected. Single factor analysis as well as the response surface method was used to evaluate the impact of the selected factors on the total phenolic content. The effect of the extraction factors on the phenolic content was tested for its statistical significant (p <0.05). For the response surface method, a five/factor, five/level central composite design was used, and a fitted second-order polynomial regression model equation was used to show how the extraction parameters affected the total phenolic recovery.

Results: The predicted value (R² of 0.5917) agreed with the adjusted value (R² of 0.7707). The residuals for response predictions were less than 5%. The optimal factors for the extraction were ethanol concentration of 75.99% v/v, extraction time of 193.86 minutes, temperature of 63.66°C, pH of 5.62, and solid-liquid ratio of 1:21.12 g/mL. Actual overall content of the phenolic compounds was validated at 82.83 ± 3.335 mg gallic acid equivalent (GAE) /g weight of extract, which agreed with the predicted response of 89.467 mg GAE/g of the dried extract under the optimal factors.

Conclusions: The rich phenolic content of stem-bark of Funtumia elastica points to its potential as a functional medicinal product to alleviate diseases caused by oxidative stress such as asthma, breathing disorders, inflammation, and cardiovascular diseases. The results obtained indicate that, the studied optimal conditions support effective phenolics extraction of Funtumia elastica.

Background: Cancer is a highly stigmatized illness associated with profound adverse impact on communities, families and diagnosed individuals. Notwithstanding extensive theorizing since Erving Goffman's classical contributions, health stigma is well explicated in context-specific and situated analysis. The current study explored the manifestations of self and enacted stigma among 20 selected people diagnosed with cancer from rural and urban Zimbabwe, who sought quaternary level of health care services in the capital, Harare. Methods: Phenomenological methodology was enlisted to capture intimate expressions of stigma as expressed about, and by people diagnosed with cancer. Data collection methods used includes semi-structured interviews, key informant interviews and focus group discussions. A semi-structured in-depth interview guide, focus group discussion guide and a key informant interview guide were the tools used to collect the data. Results: The study identified five themes of stigma, indicating pronounced, complex and multiple catalogues of stigma embedded in the existing socio-cultural milieu. Conclusions: This study stands to offer invaluable conceptual schemas and empirical insights on health-related stigma, and may aid in nursing and in the design of educational programs meant to combat health stigma.

The challenge of undernutrition (stunting and wasting) still remains a major health concern in children below 5 years of age in Africa, with the continent accounting for more than one third of all stunted children and more than one quarter of all wasted children globally. Despite the growing evidence on the role of agriculture interventions in improving nutrition, empirical evidence on the impact of livestock intervention on nutrition in Africa is scant. This review is aimed at determining whether livestock interventions are effective in reducing undernutrition in children below five years of age and in pregnant and lactating women in Africa. The review will be conducted according to PRISMA guidelines. Major electronic databases will be searched and complemented with grey and non-indexed literature from google and google scholar, and expert consultation for additional articles and reports. PICO criteria will be used while employing search strategies including MeSH, Boolean search operators and truncation/wildcard symbol to narrow or broaden the search. Articles on effect of livestock interventions on maternal and child nutrition conducted in Africa that meet the set inclusion criteria will be included in the review after critical appraisal by two independent reviewers. A standardized form will be used to extract data from included studies. The extracted data will be summarized and synthesized both qualitatively and quantitatively and key outcomes presented. Evidence generated from the systematic review and meta-analysis will be important for guiding nutrition sensitive livestock interventions and policies on nutrition programming, specifically on how to leverage on livestock interventions to reduce the burden of undernutrition.

Background: Health insurance is a crucial pathway towards the achievement of universal health coverage. In Tanzania, health-financing reforms are underway to speed up universal health coverage in the informal sector. Despite improved Community Health Fund (iCHF) rollout, iCHF enrolment remains a challenge in the informal sector. This study aimed to explore the perspectives of local women food vendors (LWFV) and Bodaboda (motorcycle taxi) drivers on factors that challenge and facilitate their enrolment in iCHF. Methods: A qualitative study was conducted in Morogoro Municipality through in-depth interviews with LWFV (n=24) and Bodaboda drivers (n=26), and two focus group discussions with LWFV (n=8) and Bodaboda drivers (n=8). Theory of planned behaviour (TPB) constructs (attitude, subjective norms, and perceived control) provided a framework for the study and informed a thematic analysis focusing on the barriers and facilitators of iCHF enrolment. Results: The views of LWFV and Bodaboda drivers on factors that influence iCHF enrolment converged. Three main barriers emerged: lack of knowledge about the iCHF (attitude); negative views from friends and families (subjective norms); and inability to overcome challenges, such as the quality and range of health services available to iCHF members and iCHF not being accepted at non-government facilities (perceived control). A number of facilitators were identified, including opinions that enrolling to iCHF made good financial sense (attitude), encouragement from already-enrolled friends and relatives (subjective norms) and the belief that enrolment payment is affordable (perceived control). Conclusions: Results suggest that positive attitudes supported by perceived control and encouragement from significant others could potentially motivate LWFV and Bodaboda drivers to enroll in iCHF. However, more targeted information about the scheme is needed for individuals in the informal sector. There is also a need to ensure that quality health services are available, including coverage for non-communicable diseases (NCDs), and that non-government facilities accept iCHF.