Journal of Public Health in Africa最新文献

Background: In Senegal, adolescent reproductive health is a public health priority.

Aim: The objective of this research is to identify and analyse the key determinants of modern contraceptive uptake among Senegalese adolescents in 2023.

Setting: The study focused on adolescent family planning in Senegal in 2023.

Methods: The study draws on secondary data from the 2023 Senegal Demographic and Health Survey. The sample comprised 16 583 women aged 15-49 years. Adolescent girls aged 15-19 years represented 4024 individuals. The analysis included descriptive, comparative and multivariable statistical approaches. The outcome variable was binary, indicating whether or not a modern contraceptive method was used. All analyses were conducted using STATA version 15.

Results: Among the adolescent girls surveyed, 19.33% reported having initiated sexual intercourse, with the earliest reported age at sexual debut being 9 years. Additionally, 10.77% had engaged in sexual activity within the 4 weeks preceding the survey, indicating recent sexual activity. However, only 2.05% (n = 80) of these adolescents reported using contraception at the time of the survey. Factors significantly associated with the use of modern contraceptive methods included residing in a rural area (adjusted odds ratio [AOR] = 0.58; 95% confidence interval [CI]: 0.34-0.96), being married (AOR = 20.61; 95% CI: 11.43-37.14), low socioeconomic status (AOR = 2.35; 95% CI: 1.35-4.08), and identifying as Christian (AOR = 3.41; 95% CI: 2.52-18.19).

Conclusion: These findings underscore the need for targeted and context-sensitive sexual and reproductive health interventions. In particular, efforts should prioritise improving access to modern contraception among the most vulnerable subgroups, including adolescent girls living in rural areas, those from socio-economically disadvantaged backgrounds, and unmarried adolescents.

Contribution: This study provides a better understanding of the determinants of family planning among adolescents, which can inform the development of evidence-based health programmes aimed at improving the sexual and reproductive health of Senegalese women.

Background: Knowledge, attitudes, and practices (KAPs) regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) non-pharmaceutical interventions (NPIs) may differ among populations with health vulnerabilities.

Aim: To examine COVID-19 KAPs among Kenyan adolescents and adults with behavioural vulnerability to HIV.

Setting: This study was conducted in Kericho and Homa Bay, Kenya.

Methods: From December 2021 to April 2023, we enrolled participants without HIV aged 14-55 years who reported recent sexually transmitted infection, injection drug use, transactional sex, condomless sex, and/or anal sex with males. A self-administered questionnaire captured sociodemographic data and KAPs. Multivariable robust Poisson regression with purposeful variable selection was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for factors associated with NPI practices.

Results: Among 399 participants (median age 22 years [interquartile range 19-24]), 317 (79.4%) were female. Participants during the Omicron-variant wave were less likely to meet outdoors (PR = 0.85 [95% CI: 0.73-0.98]), reduce shopping (PR = 0.83 [95% CI: 0.73-0.96], and avoid crowds (PR = 0.81 [95% CI: 0.71-0.93]). Believing that mask-wearing prevents SARS-CoV-2 was associated with less meeting outdoors (PR = 0.44 [95% CI: 0.27-0.73]) and reducing shopping (PR = 0.48 [95% CI: 0.31-0.76]), while believing that handwashing prevents SARS-CoV-2 was associated with less crowd avoidance (PR = 0.73 [95% CI: 0.60-0.89]). Perceiving widespread community face mask use was associated with reduced shopping (PR = 1.12 [95% CI: 1.02-1.23]).

Conclusion: Belief in personal NPIs (mask-wearing and handwashing) was associated with decreased practice of social NPIs (meeting outdoors, reducing shopping, and avoiding crowds).

Contribution: Future public health strategies for pandemic response should anticipate risk compensation.

Background: Despite parents' pivotal role in myopia mitigation, published studies investigating parental awareness and knowledge are limited in Ghana.

Aim: Assess parental awareness and knowledge of myopia and related factors to mitigate myopia progression.

Setting: Participants were parents from the Kumasi Metropolis and Bekwai Municipality in the Ashanti region of Ghana.

Methods: A descriptive cross-sectional study was conducted using a semi-structured questionnaire. Participants were selected through a double-staged cluster sampling.

Results: Of 747 participants, 500 (66.93%), reported no prior information about myopia, while 247 (33.07%) indicated awareness. Most of those aware (n = 182, 93.81%) demonstrated adequate knowledge. Predictors of awareness included male gender (odds ratio [OR] = 0.534, p = 0.023), training college (OR = 11.041, p < 0.001) and university education (OR = 21.536, p < 0.001), lower monthly income (Ghanaian cedi [Gh¢] 500.00 - Gh¢999.00; OR = 0.389, p = 0.038) and difficulty seeing afar (OR = 1.90, p = 0.023). Knowledge correlated with male gender (p = 0.036), monthly income (p < 0.001), type of work (p = 0.046) and age group (p = 0.042). Community-based approach was most preferred for myopia awareness creation.

Conclusion: There was low myopia awareness but adequate knowledge levels, which significantly correlated with demographic factors. Community-based approach was the preferred myopia awareness creation mode.

Contribution: The study provides insight into parental perspectives on myopia and reveals the preferred mode of myopia awareness and education in the Ghanaian context.

Background: A peer education programme was developed in response to the tendency of high school students in Rwanda to seek sexual and reproductive health information from peers who are often inadequately informed.

Aim: To assess the effect of Sexual and Reproductive Health Peer Education Programme (SRH PEP) on knowledge and the attitudes of SRH among high school adolescents in Rwanda.

Setting: The study was conducted at selected high schools in Rwanda.

Methods: This pre-test and post-test design study was conducted in two selected high schools. The pre-test data were collected in February 2020, followed by the post-test data in May 2022. A total of 536 students participated in this study. The effect on SRH knowledge and attitudes was measured using a paired t-test.

Results: Of the total 536 questionnaires administered, only 508 were well completed (response rate of 94.7%). After the intervention, there was an increase in knowledge and attitude regarding SRH (M = 15.87 vs 19.9, p < 0.001; M = 7.95 vs 10.66, p < 0.001, respectively). The proportion of correct responses to knowledge and attitude was also significantly improved after the intervention (p < 0.05).

Conclusion: This study underscored the pivotal role of peer-led SRH education programmes as an effective modality for educating adolescents and young adults about SRH. There is a need for integrating structured peer education initiatives into school-based programmes to ensure adolescents receive accurate and reliable SRH information.

Contribution: This study contributes to the field of adolescent SRH by demonstrating the effectiveness of peer education programmes (PEPs) in enhancing knowledge and attitudes among high school students.

Background: Fasting and exercise induce variable physiological changes depending on exercise intensity and nutritional state. Ramadan fasting, with its specific dietary restrictions, presents a unique context for evaluating these effects.

Aim: This study aimed to assess the effect of intermittent anaerobic lactic exercise on variations in haematological parameters in male university athletes.

Setting: Healthy male university sports students, participated in the study, performing intermittent anaerobic lactic exercise before and during Ramadan fasting.

Methods: Ten healthy male university sports students (mean age 18.7 ± 0.6 years) were tested before and after a 30-min basketball game, during Ramadan and in a non-fasting period, with leukocytes (three indicators), red blood cell (RBC) (three indicators) and platelets (two indicators) parameters measured. Data were analysed using two-way analysis of variance to evaluate the effects of fasting, exercise, and their interaction.

Results: The main results of our study showed that lymphocyte percentages decreased (p < 0.005, -26.84%), granulocyte percentages decreased (p < 0.005, -4.09%), haematocrit decreased (p < 0.005, -20.05%), haemoglobin decreased (p < 0.005, -18.02%), and RBC count decreased (p < 0.005, -15.9%) with exercise during Ramadan fasting. However, the percentage of intermediate cells parameter (percentage of intermediate blood cells among white blood cells) increased (p < 0.005, +12.98%) with exercise during Ramadan fasting. No significant haematological variations were observed under normal conditions outside the Ramadan fast.

Conclusion: Intermittent anaerobic exercise during Ramadan fasting significantly alters haematological parameters, suggesting that fasting should be considered in athletes training regimens. These findings are limited b the small sample size (n = 10).

Contribution: This study provides a detailed description of the haematological changes induced by intermittent anaerobic lactic exercise during Ramadan fasting in young male athletes. The findings highlight significant alterations in erythrocyte and leukocyte indices compared with the non-fasting state and underscore the need to consider fasting status when planning training loads, recovery and nutrition strategies for athletes.

Background: Dogs are responsible for rabies virus transmission to humans in up to 99% of cases. Human rabies cases in the eThekwini district have led to human fatalities.

Aim: The aim of this study is to evaluate the knowledge, attitudes and practices (KAP) of household heads (HHs) regarding the management of dog bites in the context of rabies prevention, along with the factors associated with these practices.

Setting: The study was conducted in facility catchment areas that reported > 10 dog bite cases in 2023 in the South region of the eThekwini district, KwaZulu-Natal province.

Methods: This was a cross-sectional survey, including HHs (≥ 18 years). An interviewer-administered questionnaire was used to collect data. Multivariable logistic regression was used to identify associated factors.

Results: A total of 437 HHs were interviewed, including 258 (59%) females. The mean age was 40.6 (standard deviation [s.d.]: 15.7) years. Overall, 411 (94%) (95% confidence interval [CI]: 91.4% - 95.9%] of HHs had poor knowledge, 434 (99%) (95% CI: 98% - 99.8%) showed positive attitudes towards dog bite management and 102 (61%) (95% CI: 55.8% - 64.5%) had poor practices. In multivariable analysis, being aged 31-50 years (adjusted odds ratio [aOR] = 4.1; 95% CI: 0.86-19.3; p = 0.035) and having secondary education (aOR = 0.39; 95% CI: 0.17-0.92; p = 0.031) were associated with good knowledge. Owning a dog (aOR = 17.51; 95% CI: 10.3-29.6, p < 0.001) was associated with good practices towards dog bite management.

Conclusion: It is recommended that the District Ministry of Health enhance public awareness on proper dog bite management and emphasise the importance of dog vaccination.

Contribution: The study highlights inadequate knowledge and poor practices related to dog bite management in rabies prevention. Identifying these gaps is essential for developing targeted health education initiatives, which can support the global objective of eliminating human rabies deaths by 2030.

Background: In Western Africa, the causal relationship between hydropower project implementation and malaria transmission, remains understudied.

Aim: This study assesses whether a causal correlation exists between hydropower development and malaria transmission outcomes across locally affected communities, using malaria incidence and prevalence as key indicators. Malaria incidence is measured as the number of clinical Plasmodium falciparum cases per person, while prevalence is the parasite rate of P. falciparum in children aged 2-10 years. The analysis focuses on P. falciparum given its severity across West Africa, along with the availability of consistent geospatial data.

Setting: The study was conducted in Ghana, Côte d'Ivoire, and Gabon.

Methods: Utilising multivariate Difference-in-Differences (DiD) regression models and geospatial analysis across pre- and post-dam periods, this study evaluates malaria outcomes within 15 km of hydropower sites.

Results: The DiD estimator (Treatment_Post variable) suggests no statistically significant increase in malaria transmission following hydropower project implementation. Estimated effects are insignificant in Côte d'Ivoire (incidence: p = 0.210, prevalence: p = 0.200), Gabon (incidence: p = 0.990, prevalence: p = 0.990), and Ghana (incidence: p = 0.089, prevalence: p = 0.102), indicating no strong causal link at the 5% level. By contrast, environmental and socio-economic variables such as urbanisation, elevation, and climate factors consistently showed strong associations with malaria transmission (p < 0.01).

Conclusion: Hydropower presence alone is not a primary driver of malaria dynamics.

Contribution: This study provides the first large-scale geospatial analysis of malaria trends across hydropower projects in Western Africa, challenging traditional assumptions of a direct causal link and highlighting the need for interventions shaped by environmental and socio-economic factors.

Background: Internet addiction (IA) is prevalent among Nigerian undergraduates. This study seeks to explore the broader mental health consequences of IA among diverse groups of students in Nigerian universities.

Aim: This study aims to assess the prevalence of IA among undergraduates in Lagos State and examine its relationship with health conditions such as depression, anxiety and stress.

Setting: The research was conducted in three public tertiary institutions in Lagos State, involving 830 undergraduates aged 18-24 years.

Methods: This cross-sectional study used a structured questionnaire, incorporating the Internet Addiction Test (IAT) and the Depression, Anxiety and Stress Scale (DASS-21). Chi-square tests determined associations and logistic regression identified predictors of IA. Data analyses were performed using IBM^® SPSS 25.0.

Results: The prevalence of IA was 73.3%. Certain critical predictors of IA emphasised the role of institutional affiliation, living arrangements, purpose and timing of use and duration of daily internet engagement. There were positive correlations between IA and depression (r _s = 0.368), anxiety (r _s = 0.359) and stress (r _s = 0.401).

Conclusion: The study found a high prevalence of IA among undergraduates, with significant associations with depression, anxiety and stress.

Contribution: The findings underscore the need to raise awareness about IA and also highlight the need for context-sensitive, evidence-based interventions and for universities and policymakers to implement strategies that aim at promoting healthier internet usage, improving mental health services and raising awareness of the risks associated with excessive online activities.

Rabies is a fatal neglected tropical zoonotic disease caused by neurotropic viruses of the genus Lyssavirus in the family Rhabdoviridae. We report the disease progression in a 30-year-old woman, in her eighth pregnancy, living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART), who presented with neurological symptoms including aggression, restlessness, fever and vomiting 20 days following rabies exposure through multiple dog bites on the face and upper limbs. She had received a 4-dose regimen of rabies post-exposure prophylaxis (PEP), starting 2 days after exposure, with subsequent doses given 3 and 7 days later, while the 4th dose was administered 20 days after exposure. Wound washing was not performed, and rabies immunoglobulin was not administered as recommended by the World Health Organization for category 3 exposures. The disease rapidly progressed to rabies encephalitis, leading to death within 6 days of admission. Reverse transcriptase polymerase chain reaction (RT-PCR) performed on cerebral spinal fluid (n = 3) and nasopharyngeal swabs (n = 2) confirmed the diagnosis of rabies infection. Although the incubation period and symptomatology did not significantly deviate from documented classical cases, a compromised immunity evidenced by a low cluster of differentiation 4 (CD4) T-cell count of 382, coupled with non-adherence to recommended best practices for wound management and PEP administration, may have influenced the rapid disease progression. This case reveals the need for capacity building in health workers and the community to improve knowledge of rabies post-exposure response in Africa.