Journal of Public Health in Africa最新文献

Acquired drug resistance (ADR) is common among adolescents living with perinatal HIV (APHI) in sub-Saharan Africa (SSA). Personalized management has the potential to improve pediatric antiretroviral therapy (ART), even in the presence of long-term treatment and HIV-1 subtype diversity. We sought to evaluate the effect of HIV-1 mutational profiling on immuno-virological response and ADR among APHI. A cohort-study was conducted from 2018-2020 among 311 APHI receiving ART in Cameroon. Clinical, immunological and virological responses were measured at enrolment (T1), 6-months (T2) and 12-months (T3). Immunological failure (IF: CD4 #x003C;250 cells/mm³), VF (viremia ≥1,000 copies/ml), and ADR were analyzed, with P#x003C;0.05 considered significant. Mean age was 15(±3) years; male-female ratio was 1:1; median [IQR] ART-duration was 36[21-81] months. At T1, T2, and T3 respectively, adherence-level was 66.4, 58.3 and 66.5%; 14 viral clades were found, driven by CRF02_AG (58.6%); ADR-mutations favored increased switch to second-line ART (16.1, 31.2, and 41.9%, P#x003C;0.0001). From T1-T3 respectively, there were declining rates of IF (25.5, 18.9, and 9.83%, P#x003C;0.0001), VF (39.7, 39.9, and 28.2%, P=0.007), and HIVDR (96.4, 91.7, and 85.0%, P=0.099). Predictors of ADR were being on first-line ART (P=0.045), high viremia at enrolment (AOR=12.56, P=0.059), and IF (AOR=5.86, P=0.010). Of note, optimized ART guided by mutational profile (AOR=0.05, P=0.002) was protective. Moreover, full Tenofovir+Lamivudine+Dolutegravir efficacy was predicted in 77 and 62% of APHI respectively after first- and second-line failure. Among APHI in this SSA setting, viral mutational profiling prompts the use of optimized Dolutegravir-based ART regimens, leading to improved immuno-virological response and declining ADR burdens. Thus, implementing personalized HIV medicine in this vulnerable population would substantially improve ART response and the achievement of the 95-95-95 goals in these underserved populations.

Methicillin-resistant Staphylococcus aureus (MRSA) infection is considered one of the nosocomial infections that can infect patients and healthcare workers (HCWs) and negatively affect the quality of care provided in the hospital. Evaluate the knowledge of HCWs regarding the prevention of MRSA infection in Thi-Qar Governorate. A descriptive cross-sectional study was conducted for 362 HCWs randomly selected from four hospitals and distributed as follows: 125 from Nasiriyah Teaching Hospital, 80 from Al-Hussein Teaching Hospital, 80 from Al-Haboubi Teaching Hospital and 77 from Souk Al-Shuyoukh General Hospital during the period from October 1 (2022) to May 1 (2023) and data was collected by using self-reported paper-based questionnaires. Our study showed 68.8% of HCWs enjoyed a moderate level of knowledge, and there was a strong correlation (P-value #x003C;0.05), between knowledge and some sociodemographic and occupational characteristics of the participants, which include age, educational level, job title, years of service and workplace in the hospital. Additionally, a relationship between knowledge and the source of the MRAS information was demonstrated which is a highly significant association between the total knowledge score and the sources of information. The knowledge of MRSA infection prevention among HCWs was moderate.

Maternal mortality can be reduced by strengthening the process of early detection of high-risk pregnancies. However, the lack of knowledge related to high-risk pregnancy is still an obstacle. This study aims to analyze the effect of health education on the knowledge and attitudes of cadres about early detection of high-risk pregnancy in the working area of Health Centre Mamajang Makassar City. Experimental research with a pretest protest design with a control group, involving 80 cadres spread across 20 Integrated Service Posts who were divided into four treatment groups. There was an increase in mean knowledge between the intervention group (P=0.000) and the control group (P=0.002). There was also an increase in attitude between the intervention group (P=0.000). However, there was no improvement in attitude (P=0.475) in the control group. The intervention group through combined video+booklet had the highest mean knowledge score (6.65-13.90) than the groups that received intervention through video (6.60-12.69) or booklet alone (6.75-12.07), respectively. On attitude, the highest average attitude score in the intervention group was the combined video+booklet group (22.0-35.8), video (21.22-34.65) and booklet alone (22.25-34.55). While the average score of the control group on knowledge (6.00-6.95) and attitude (22.60-23.05). The role of health education by involving a combination of both video and booklet media is appropriate as an effort to influence Integrated Service Post cadres in increasing knowledge and attitudes about the early detection of high-risk pregnancies.

Excessive fatigue in adolescents is a growing concern as it impacts various aspects of their lives. Research on its prevalence and contributing factors in specific populations, especially in developing countries, is scarce. This study examines the prevalence of excessive fatigue among Moroccan adolescents and its association with demographic characteristics, parasomnias, depressive symptoms, and academic performance. In this cross-sectional study, we assessed excessive fatigue among 800 Moroccan adolescents (aged 12-20 years) in Settat province, using a comprehensive questionnaire including Pichot's Fatigue Scale (PFS), Patient Health Questionnaire 9 (PHQ-9), parasomnia questionnaire, and demographic questionnaire. The primary outcome was excessive fatigue, while covariates included demographic factors, physical health, regular exercise, depressive symptoms, and specific parasomnias. Associations were analyzed using cross-tabulation analysis, chi-squared tests, and correlation analysis. Excessive fatigue was prevalent in 8.4% of participants. Female adolescents had significantly higher adjusted odds of experiencing excessive fatigue than male adolescents, with an adjusted odds ratio (AOR) of 3.07 [95% CI (1.48, 6.37), P=0.003]. Excessive fatigue was significantly associated with nightmares, sleep paralysis, and hypnagogic hallucinations. A strong positive linear correlation was observed between fatigue and depressive symptoms (r=0.746, P#x003C;0.001). This study highlights the prevalence of excessive fatigue among Moroccan adolescents, emphasizing the importance of addressing gender-specific issues, sleep habits, and mental health support. Further research is needed to understand the underlying mechanisms and explore the role of lifestyle and socio-cultural contexts.

Workplace problems that are likely to increase the risk to our health are referred to as occupational hazards. These problems can be classified as either biological or non-biological. A wide range of these risks, including physical, chemical, and psychological ones, provide challenges for healthcare practitioners. Such risks therefore negatively affect employees, their families, friends, and the country. The purpose of the study is to assess the level of adherence to preventive practices towards occupational hazards in the hospitals of Thi-Qar Governorate and its relationship to the demographic and occupational information of the healthcare workers. A descriptive cross-sectional study was carried out in hospitals Thi-Qar Governorate, During the period from September 5th, 2022 ending on February 10th, 2023, 355 of healthcare workers individuals participated in the study, and the data was collected using self-reported questionnaires and information about practices was collected through a systematic questionnaire developed by the researcher. Regarding the preventive practice of the staff, the results observed that all responses regarding the present results reveal the highest percentage 41.7% of HCWs have a poor practices score, while the lowest percentage 20.8% of them have a moderate practices score. The mean ± SD of the overall practices score was (53.81±17.807) which rested within a moderate level (48-46 score). The results of this study indicate that there is a significant association between the overall practices score and socio-demographic variables (P-value #x003C;0.05). This explained that the participants who age ≤25 years, Education level (Ph.D.), and have no chronic diseases, had higher good practices than other categories. Also, the results of this study indicate that there is a significant association between the overall practices score and occupation characteristics (P-value #x003C;0.05), This explained that the years of work (≥15 years), and, hours of work (≤5 h), had higher good practices than other categories. Most of the employees of the hospitals selected for the sample in Thi-Qar Governorate have 'Moderate' commitments to safety measures with regard to occupational hazards in their surrounding workplaces, The study showed that years of experience, time of work and educational level have a significant impact on practices towards occupational hazards in hospitals.

Neonatal jaundice is a significant cause of neonatal morbidity worldwide and accounts for 75% of hospital readmissions in the first week of life. New-born babies can develop severe neonatal jaundice that may cause irreversible brain damage or even death. To assess the knowledge, attitude and practices of registered nurses on neonatal jaundice among neonates at Neonatal Intensive Care Unit at Windhoek Central hospital. A quantitative, descriptive, cross sectional research design was used. The population was all 34 registered nurses working at Windhoek Central Hospital neonatal intensive care unit. Census sampling was used to include all 34 registered nurses working in the neonatal intensive care unit of the selected hospital due to the limited small number of the population. Data were collected using a self-developed questionnaires that collected socio-demographic information and knowledge, attitudes and practices questions. Data was analysed using SPSS version 27. Descriptive statistics was used to generate frequencies and percentages. The study found that majority of the participants have adequate knowledge, positive attitudes, and good practices regarding neonatal jaundice. The study found that most participants 21 (60%) were aged between 20 to 29 years. Participants have adequate knowledge, positive attitudes, and good practices on neonatal jaundice. The researchers recommends that future studies using different research approaches should be conducted in other regions in Namibia.

Failure to treat many pathogens is a concern. Identifying a priori, patients with potential failure treatment outcome of a disease could allow measures to reduce the failure rate. The objectives of this study were to use the Scoring method to identify factors associated with the tuberculosis unsuccessful treatment outcome and to predict the treatment outcome. A total of 1,529 patients with pulmonary tuberculosis were randomly selected in the city of Douala, Cameroon, this sample was randomly split into two parts: one subsample of 1,200 patients (78%) used as the Development sample, and the remaining of 329 patients (22%) used as the Validation sample. Baseline characteristics associated with unsuccessful treatment outcomes were investigated using logistic regression. The optimal score was based on the Youden's index. HIV positive status, active smoker and non-belief in healing were the factors significantly associated with unsuccessful treatment outcomes (P#x003C;0.05). A model used to estimate the risk of unsuccessful treatment outcome was derived. The threshold probability which maximize the area under the ROC curve was 18%. Patients for whom the risk was greater than this threshold were classified as unsuccessful treatment outcome and the others as successful. HIV positive and active smoking status were associated with death; the non-belief in healing, youth and male gender associated with lost-to-follow-up, TB antecedent and not having TB contact associated with therapeutic treatment failure. To increase the tuberculosis treatment success rate, targeted follow-up could be taken during the treatment for TB patients with previous characteristics.

Over the years, Ghana has made notable strides in adopting digital approaches to address societal challenges and meet demands. While the health sector, particularly the disease surveillance structure, has embraced digitization to enhance case detection, reporting, analysis, and information dissemination, critical aspects remain to be addressed. Although the Integrated Disease Surveillance and Response (IDSR) structure has experienced remarkable growth in digitization, certain areas require further attention as was observed during the COVID-19 pandemic. Ghana during the COVID-19 pandemic, recognized the importance of leveraging digital technologies to bolster the public health response. To this end, Ghana implemented various digital surveillance tools to combat the pandemic. These included the 'Surveillance Outbreak Response Management and Analysis System (SORMAS)', the digitalized health declaration form, ArcGIS Survey123, Talkwalker, 'Lightwave Health information Management System' (LHIMS), and the 'District Health Information Management System (DHIMS)'. These digital systems significantly contributed to the country's success in responding to the COVID-19 pandemic. One key area where digital systems have proved invaluable is in the timely production of daily COVID-19 situational updates. This task would have been arduous and delayed if reliant solely on paper-based forms, which hinder efficient reporting to other levels within the health system. By adopting these digital systems, Ghana has been able to overcome such challenges and provide up-to-date information for making informed public health decisions. This paper attempts to provide an extensive description of the digital systems currently employed to enhance Ghana's paper-based disease surveillance system in the context of its response to COVID-19. The article explores the strengths and challenges or limitations associated with these digital systems for responding to outbreaks, offering valuable lessons that can be learned from their implementation.