Journal of Public Health in Africa最新文献

Background: New severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may affect diagnostic test accuracy.

Aim: To evaluate the performance of two reverse transcription-polymerase chain reaction (RT-PCR) assays, DaAn Gene and Cepheid, for detecting Delta and Omicron variants.

Setting: Nasopharyngeal samples were collected in Yaoundé, Cameroon, between October 2021 and December 2022.

Methods: Nasopharyngeal samples were tested with both assays. Samples with a cycle threshold (CT) ≤ 28 were sequenced. Cohen's kappa coefficient assessed assay agreement.

Results: We compared 294 samples. At CT ≤ 40, DaAn Gene showed a 59.2% (n = 174/294) positivity rate versus 57.8% (n = 170/294) for Cepheid (χ² = 0.695, p = 0.4044). Agreement was 95.91% (n = 282/294) with κ = 0.95. DaAn Gene showed a 58.2% (n = 171/294) positivity rate versus 54.4% (n = 160/294) for Cepheid at CT ≤ 37 (p = 0.5058), with 95.6% agreement (κ = 0.95). At CT ≤ 33, DaAn Gene was 56.5% (n = 166/294) positive versus 54.1% (n = 159/294) for Cepheid (p = 0.6187), with 96.93% agreement (κ = 0.938). For 167 samples with CT ≤ 28, agreement was 97.0% (κ = 0.97) across variants. These RT-PCR assays effectively detected Delta and Omicron variants.

Conclusion: The emergence of Delta and Omicron variants did not significantly impact the diagnostic performance of these routine RT-PCR assays.

Contribution: This study confirms their continued effectiveness in detecting these variants in this setting.

Background: Vision impairment (VI) affects the quality of life of individuals; it negatively impacts education, mobility and socioeconomic life, leading to dependency. Increased life expectancy is expected to drive a corresponding rise in the prevalence of VI. Timely and effective efforts are required to reduce the burden of VI. Accurate and up-to-date data regarding the prevalence and causes of VI are essential for practical planning to address its challenges and impact. This review therefore presents the prevalence of VI in East Africa.

Aim: This review sought to report the prevalence of VI in East Africa.

Setting: The study was conducted using findings of studies on VI from East Africa.

Method: A search of published literature was conducted using online databases including PubMed, Ovid, Science Direct, Google Scholar, Embase and Medline. The search was restricted to sources published in English and in peer-reviewed journals from January 2010 to November 2023. Only studies that stated the prevalence and causes of VI among the general population during the period in question were included.

Results: Twenty nine studies met the inclusion criteria and were included in this review. The prevalence of VI reported in East Africa by the studies reviewed ranged from 1.6% to 42.1%.

Conclusion: The reported prevalence of VI in East Africa is higher than that reported in other regions of Africa and globally.

Contribution: The review highlights the need for adequate strategies and support to be channelled towards making eye care accessible and affordable in East Africa including the training of more eye health personnel.

Background: Antimicrobial resistance (AMR) is a significant global public health threat that undermines sustainable development. In Benin, high AMR rates to common antibiotics, including last-resort treatments, exacerbate infection outcomes and healthcare costs. Inappropriate antibiotic use worsens this challenge. To address these issues, Benin implemented its National Multisectoral AMR Action Plan 2019-2024.

Aim: This study aims to assess the implementation of Benin's National AMR Action Plan 2019-2024 and identify critical gaps for future updates.

Setting: The evaluation covered six of Benin's 12 departments, engaging stakeholders from human, animal and environmental health sectors.

Methods: A retrospective cross-sectional evaluation was performed from 05 August 2024 to 30 September 2024. Data were collected through a documentary review, standardised questionnaires, semi-structured interviews and group discussions. An executed scoring grid and a Strengths, Weaknesses, Opportunities and Threats analysis were used.

Results: Of the 224 planned activities, 40.18% were not initiated, 31.25% had started, 19.64% were partially executed, 5.36% were nearly completed and only 3.57% were fully implemented. Critical gaps included the lack of a fully operational multisectoral coordination group, limited financial resources, inadequate surveillance systems, insufficient communication and education initiatives and the absence of infection prevention and control (IPC) programmes.

Conclusion: Despite progress in regulatory frameworks, gaps in coordination, resources, surveillance and IPC hinder effective AMR control in Benin. Strengthening governance, communication and addressing other identified gaps are critical for future success.

Contribution: This evaluation provides evidence-based recommendations to update Benin's AMR strategy within a 'One Health' framework.

Background: Despite some improvement, there are still persistent challenges in the area of reproductive and maternal health in Côte d'Ivoire.

Aim: Analysing subnational trends of key indicators of reproductive and maternal healthcare from 2018 to 2020, regarding the targets of the investment case of 2023.

Setting: All 33 health regions and 113 health districts (HDs).

Methods: The analysis was concerned with four indicators: the modern contraceptive prevalence rate (mCPR), the proportion of first antenatal care (ANC1) during the first trimester, the coverage of four antenatal care (ANC4), and the coverage of delivery with a skilled birth attendant (SBA). Using data from the national health information system, we analysed the evolutive trends of each indicator at district level, assessed the performance regarding the 2023 targets, and identified the disparities at districts and regions level. Data were processed using Microsoft Excel, QGIS 3.16 and Stata 15.0 software.

Results: There was a lack of significant progress for mCPR and ANC1 during the first trimester. In 2020, more than two out of three of the HDs were still far from the 2023 target for both indicators. In contrast, there was a clear progression for ANC4 and SBA, with more than 40% of districts having already reached the 2023 target. These evolutive trends were associated with high disparities across HDs and regions.

Conclusion: In spite of positive evolutive trends for some indicators, there are still high disparities at subnational levels.

Contribution: Interventions need to be fully implemented, and progress monitoring should be reinforced and pursued for timely adjustments.

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) was introduced in Zambia to prevent transmission, but it does not protect against sexually transmitted infections (STIs) such as syphilis. Globally, STIs have risen alongside PrEP rollout, posing significant public health concerns that require urgent attention and targeted intervention strategies.

Aim: We examined trends in syphilis incidence and assessed its association with PrEP use, given the increasing global burden of STIs, including among PrEP users between 2021 and 2023.

Setting: Among individuals in Zambia.

Methods: A retrospective database analysis of secondary data was conducted using District Health Information Software 2 (DHIS2), the Ministry of Health's primary data system. Microsoft^® Excel and Stata were used for descriptive statistics and regression analysis to examine potential associations.

Results: From 2021 to 2023, syphilis cases (199 273) and PrEP initiation (436 460) increased annually. Syphilis cases rose from 22% to 46%, while PrEP initiation grew from 22% to 48%. We found a positive association between syphilis incidence and PrEP initiation, with each unit increase in PrEP initiation corresponding to a 0.33-unit rise in syphilis cases (p < 0.001; 95% confidence interval [CI]: 0.25-0.4), underscoring this relationship.

Conclusion: This analysis found a significant positive link between syphilis incidence and PrEP initiation, emphasising the need for integrated HIV and STI management to enhance public health interventions.

Contribution: This study provides valuable insights for policy and programme implications; it highlights the importance of integrating STI prevention into HIV prevention service delivery; an integrated approach is critical to ensure that the country does not regress the achievements made towards HIV epidemic control.

Background: The hepatitis E virus (HEV) is a major global health concern, with an estimated one-third of the human population infected. It is particularly prevalent in developing countries, especially in informal settlements where inadequate sanitation and limited access to clean water contribute to its spread.

Aim: The study aimed to explore and describe community leaders' experiences regarding the spread of HEV in the Havana informal settlement, Khomas region, Namibia.

Setting: This study focused on Havana informal settlement in the Namibian capital of Windhoek, which is in the Khomas region. The Havana informal settlement is predominantly populated with unemployed people.

Methods: Individual in-depth interviews were conducted with 15 community leaders, aged 24 years to 65 years, who were knowledgeable of the spread of HEV in the informal settlement. Thematic qualitative analysis was used to analyse data.

Results: The themes identified included HEV risk awareness, contextual factors influencing the spread of HEV, action drivers for change and actions taken to activate change. Overall, there was a good understanding of HEV, although some individuals in the community held incorrect information and harboured myths and misconceptions about HEV. Inadequate access to water, sanitation facilities and unhygienic cultural practices were identified as primary routes of transmission, fuelled by overcrowding.

Conclusion: The study highlighted the importance of government-private sector cooperation, community health education, access to clean water and improved infrastructure in preventing the spread of HEV. Addressing these factors is essential for overcoming health challenges in informal settlements.

Contribution: This research underscores the critical role of community engagement in mitigating HEV outbreaks in informal settlements.

Background: Stillbirth continues to be a significant global public health issue. Effective coping mechanisms are essential for parents to process their grief and heal after a stillbirth. However, research on how South African parents, particularly in rural areas, cope with stillbirth is limited.

Aim: This study explored the coping mechanisms used by parents following stillbirth, using the Transactional Model.

Setting: The study was conducted in the Mopani District, Limpopo province, South Africa.

Methods: A qualitative exploratory design was employed, involving in-depth interviews with 12 purposively selected parents. Data were collected in the participants' preferred language, Xitsonga, then transcribed, translated into English and thematically analysed using Atlas.ti.

Results: Emotion-focused coping strategies centred on acceptance, avoidance, reframing the loss, sharing experiences of stillbirth, receiving support from healthcare professionals and seeking prayer and spiritual guidance. In contrast, the problem-focused coping strategy involved distraction through meaningful activities.

Conclusion: Despite employing all these strategies, unresolved grief may still impede effective coping.

Contribution: The study emphasises the significance of multidisciplinary care that integrates psychological, social, and spiritual support to address the complex emotional needs of grieving parents.

On 08 December 2024, the World Health Organization (WHO) reported an outbreak of Disease X in the Panzi Health Zone, Kwango province, Democratic Republic of the Congo (DRC). This unknown pathogen, with 406 cases and 31 deaths at the time of its declaration, predominantly affects children under 5 years. Disease X, hypothesised to be a zoonotic ribonucleic acid (RNA) virus, poses significant challenges because of limited healthcare infrastructure, gaps in risk communication and ineffective community engagement. This opinion article aims to explore these challenges and advocate for the urgent need for culturally tailored, inclusive communication strategies that foster trust and empower local communities in responding to outbreaks. Key approaches highlighted include mobilising local leaders, utilising mobile laboratories for decentralised diagnostics and improving sample collection techniques. Drawing on lessons from previous epidemics, such as COVID-19 and Ebola, this article emphasises the importance of robust surveillance systems, community engagement and effective risk communication, skilled health workforce and collaborative management frameworks. Strengthening early warning systems and ensuring equitable access to diagnostic and treatment resources are essential for mitigating future outbreaks of unknown diseases in resource-limited settings.