Pan African Medical Journal最新文献

Introduction: cervical cancer is a significant health challenge in Kenya and sub-Saharan Africa, with high mortality linked to late presentation and low awareness. Despite its prevalence, preventive interventions like human papillomavirus (HPV) vaccination face low utilization. Religious leaders play a pivotal role in influencing health decisions, yet their attitudes toward HPV vaccination remain understudied. Therefore, this study aims to determine religious leaders' willingness to promote HPV vaccine uptake in Mavoko Sub-County, Machakos County, Kenya.

Methods: a cross-sectional study involving 198 religious leaders chosen through systematic random sampling method was done in the month of December 2023 in Machakos County, Kenya. Data on socio-demographics and attitudes towards HPV vaccination were collected using structured, self-administered questionnaires. Attitudes were gauged on 11 statements. Analysis was performed using IBM SPSS 22.0, employing descriptive statistics and Chi-square tests to assess associations, with significance set at p < 0.05. Results were visually presented using tables, charts and graphs.

Results: the study had a 96.6% response rate. Majority were male (51.5%), Protestant Christians (48%), and pastors (29.8%). Most participants had positive attitudes towards the HPV vaccine, with no significant socio-demographic associations found.

Conclusion: the study reveals positive attitudes among religious leaders towards promoting HPV vaccine uptake among their congregants. Despite some concerns and misconceptions, the majority of participants expressed willingness to advocate for vaccination.

Introduction: due to the inability of low-income populations to access nutritious foods or basic education, these groups usually consume unhealthy diets, which frequently lead to nutrition issues like obesity, malnutrition, and other health morbidities. The purpose of the study was to evaluate the nutritional knowledge, dietary practices, nutritional status, and factors influencing the dietary habits of low-income persons living in a rural constituency in Southern Nigeria.

Methods: a cross-sectional study was carried out on 419 consenting low-income adults (18 years and older) using a simple random technique, in order to collect data on their socio-demographic traits, nutritional knowledge, dietary practices, and nutritional status. Statistical Package for Social Sciences (SPSS) version 22.0 was used to analyze the data generated.

Results: the respondents´ the average age was 40.9 ± 15.68 years while 224 (53.5%) of those surveyed were females. The proportion of responders with a secondary education was highest 279 (66.6%). The most common occupation among respondents was farming 151 (36.1%) and petty trading 135 (32.2%). Overall, 314 (74.9%) of low-income adults had poor dietary habits, and 245 (60.6%) had poor nutrition knowledge. Occupation and gender were significantly associated with nutritional status P<0.05. The majority of respondents 56.2% (235) were overweight or obese, and multivariate logistic regression analysis shows that respondents with concern about gaining weight were more likely to be overweight or obese (OR=1.065, 95% CI=0.832-1.363).

Conclusion: the findings from the study indicate that inadequate nutritional knowledge and poor dietary habits, reflected in respondents' body weight are likely to increase the risk of non-communicable diseases, necessitating the need for nutritional education among rural populations.

Proximal connection anomalies of the coronary arteries to the aorta represent a rare pathology, with an angiographic prevalence close to 1%. The prognosis of this condition is contingent upon its anatomical form. Some instances are linked to sudden deaths, while others may be associated with myocardial ischemia. Utilizing computed tomography (CT) coronary angiography as the optimal imaging tool, one can identify the origin and course of the ectopic artery. Current guidelines suggest surgical correction as the primary intervention for symptomatic abnormalities when a risky form is identified. To enhance the management of these anomalies, the establishment of comprehensive multicenter observational registers is imperative. Our study, a retrospective analysis spanning two years, focuses on 10 cases of proximal connection anomalies of coronary arteries to the aorta diagnosed in the Cardiology department of the Mohammed V Military Hospital of Rabat. By presenting this series and conducting a literature review, we elucidate the anatomical, epidemiological, physiopathological, clinical, angiographic, and CT angiography features of these anomalies, along with insights into therapeutic management.

Introduction: school-based physical activity (PA) programs such as The Daily Mile (TDM) might be vital in the prevention and treatment of mental health problems in adolescents in low-income countries. The aim of this single-arm non-controlled pilot intervention study was to investigate TDM on symptoms of anxiety and depression in adolescents aged 16-17 years in Uganda.

Methods: The Daily Mile (TDM) took place between February and April 2022. In total 177 adolescents (62.7% girls) completed the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 Questionnaire (GAD-7) pre and post-12 weeks TDM.

Results: moderate effect sizes were found for reductions in PHQ-9 (Cohen´s d=-68, 95% CI=-0.84 to -0.52, P<0.001) and GAD-7 (Cohen´s d=-0.54, 95%CI=-0.68 to -0.38, P<0.001) following TDM. In those with at least mild symptoms, large effect sizes were observed for reductions in PHQ-9 (Cohen´s d=-0.94, 95%CI=-1.14 to -0.72, P<0.001) and GAD-7 (Cohen´s d =-0.85, 95% CI=-1.07 to -0.62, P<0.001) following TDM. The prevalence of mild depression dropped from 70.1% to 50.8% and moderate depression from 28.2% to 15.3%, while the prevalence of mild anxiety dropped from 54.8% to 38.4%, and moderate anxiety from 21.5% to 10.7% (all P<0.001). Rates of severe depression and anxiety did not drop significantly.

Conclusion: The Daily Mile (TDM) might potentially reduce mild and moderate symptoms of anxiety and depression in school-going adolescents in low-income countries such as Uganda. For more severe cases, additional support is needed.

Maxillary intraosseous hemangiomas are rare benign vascular lesions, accounting for less than 1% of all primary bone tumors. Clinical examination often reveals a hard, painless swelling mass that is rarely pulsatile. Imaging not only helps to make a positive diagnosis but also contributes to therapeutic management. We report a case of a left maxillary intra osseous hemangioma Some authors have proposed exclusive embolization as a treatment for maxillary angiomas, but this requires several sessions for complete devascularization.

Introduction: major external structural birth defects (MESBDs) are known to exert an enormous economic burden on individuals and health services; however, they have been vastly underprioritized as a public health problem in settings where cost analyses are limited. This study aimed at conducting a cost analysis of outpatient services for MESBDs in selected hospitals in Kiambu County, Kenya.

Methods: a cross-sectional descriptive survey was conducted in four hospitals selected for providing outpatient corrective and rehabilitative services to the under-fives. An ingredient approach was used to gather data retrospectively on the cost drivers for castings, bracings, and tendonectomies from healthcare providers' perspectives for a one-year time horizon from January 1^st, 2018, to December 31^st, 2018. Prevalence-based morbidity data were extracted from outpatient occupational therapy clinic registers, whereas staff time was gathered through face-to-face inquiries. Associated cost drivers of 349 cases were quantified, valued using prevailing market prices, and categorized as recurrent costs. The unit economic costs were calculated as average costs, expressed in U.S. dollars, and inflated to the U.S. dollar Consumer Price Index from January 2018 to December 2018.

Results: the unit economic cost of all the cases was estimated at $1,139.73; $1,143.51 for neural tube defects (NTDs), $1,143.05 for congenital talipes equinovarus (CTEV), and $1,109.81 for congenital pes planus.

Conclusion: the highest economic burden of MESBDs was associated with NTDs, and CTEV, respectively. We recommend further research to estimate the economic costs of MESBDs among school-going pupils to inform the equitable allocation of resources for health and childhood developmental programs.

Introduction: pre-eclampsia affects an estimated 8% of pregnant women and contributes to over 12% of global maternal deaths. High-sensitivity C-reactive protein (hs-CRP) is a potential marker of pre-eclampsia. However, little is known about hs-CRP levels in women with pre-eclampsia in Zambia. This study examined whether hs-CRP levels differ between women who develop pre-eclampsia compared with controls overall and in subgroups of women living with and without HIV.

Methods: a case-control study was conducted among 40 pregnant women who developed preeclampsia (cases) and 40 normotensive pregnant women (controls) living with (n=20) and without HIV (n=20) at women and newborn hospital from February to May 2022. Standard ELISA kits were used to determine hs-CRP levels. The conditional logistic regression model calculated the odds ratios for hs-CRP and other predictor variables with their 95% confidence intervals.

Results: the median hs-CRP levels were higher among the cases than controls (7.84mg/ml vs 6.13mg/ml, p<0.001). Similar hs-CRP levels were observed among pre-eclamptic women living with HIV on antiretroviral therapy (ART) compared to HIV-negative women (7.92mg/ml vs 7.17mg/ml, p=0.862). On the other hand, normotensive women living with HIV on ART had different hs-CRP levels than HIV-negative women (6.60mg/ml vs 3.96mg/ml, p<0.001). Multivariable conditional logistic regression showed that pregnant women with higher levels of hs-CRP (AOR=1.01, 95% CI=1.01, 1.01) were more likely to have pre-eclampsia after adjusting for significant predictors. Pre-eclampsia was less likely among women living with HIV on ART (AOR=0.26, 95% CI=0.07, 0.99), married (AOR=0.15, 95% CI=0.03, 0.71), and multiparous (AOR=0.16, 95% CI=0.03, 0.80).

Conclusion: high-sensitivity C-reactive protein levels were higher among the cases than controls. However, similar levels were observed in the subgroup of women living with HIV on ART. Participants with high hs-CRP levels had the highest odds of preeclampsia, suggesting that hs-CRP may be useful in predicting preeclampsia.

Introduction: chronic haemodialysis patients are a vulnerable population significantly affected by the COVID-19 pandemic, which has had a severe impact on people with co-morbidities and immune system depression, which increases the risk of infection and of developing severe form of COVID-19. The purpose of this study is to assess the impact of the COVID-19 pandemic on the mental health and quality of life of chronic haemodialysis patients.

Methods: we conducted a descriptive cross-sectional survey among 175 chronic hemodialysis patients using the Mini International Neuropsychiatric Interview Moroccan Arab Version 5.0.0 scale, the Perceived Stress Scale, and the Quality of Life Scale for Chronic Hemodialysis Patients (KDQOL-SFTM 1.3).

Results: one hundred and seventy-five (175) participants were recruited, of whom 76 patients had COVID-19. COVID-19 infection was significantly associated with age (p=0.018), psychiatric disorders (p=0.00), a history of suicide attempts (p=0.006) and high-stress levels (p=0.01). The quality of life of chronic haemodialysis patients was significantly impaired in patients with COVID-19 (p=0.00), especially in subjects who were elderly (p=0.034), lived alone (p=0.004), had a history of organic (p=0.04), psychiatric (p=0.00), or substance abuse issues (p=0.003), as well as in patients with a symptomatic form (p=0.001), complications (p=0.00), or hospitalisation secondary to COVID-19 (p=0.00), and those with severe stress (p=0.00).

Conclusion: the mental health and quality of life of chronic haemodialysis patients were mainly negatively influenced during the COVID-19 pandemic.

Invasive fungal infections (IFI) are emerging opportunistic diseases that occur mainly in immunocompromised patients. Our study aimed to analyze the epidemiology of IFIs in patients with hematological malignancies, and the prognostic factors. Our retrospective study included patients hospitalized in the hematology department between January 1^st, 2010, and August 31^st, 2020, and in whom the diagnosis of IFI was made according to the EORTC criteria 2008. We found 29 IFIs among 6989 admissions (0.4%). IFIs were proven in 16 cases and probable in 13 cases. The median age was 35 years. The sex ratio was 0.9. The predominant IFI was invasive pulmonary aspergillosis (n=14) followed by fungemia (n=13). Candida albicans was the most isolated species in blood cultures (5/9). The mortality rate was 48%. In multivariate analysis, disease status, time to start antifungal treatment, and lactate levels are significant factors of excess mortality. IFIs are responsible for significant morbidity and mortality. The challenge lies in the precocity of starting the treatment as well as the vigilance given to the factors of poor prognosis.