Pan African Medical Journal最新文献

Over the last several decades, successful interventions in the health of newborns, infants, and children mean more children survive to become adolescents. There has been a global demand to improve health and care delivery for the adolescent population, guided by the United Nation's Sustainable Development Goals by 2030. However, with this deadline fast approaching and with a rising adolescent population, this demand is ever more critical. Adolescent health requires a similar rights-based approach to ensure equitable distribution of healthcare interventions and service delivery going forward. This scoping review aims to explore the existing landscape of adolescent-responsive healthcare and service delivery in Ghana. It was conducted using the Joanna Briggs Institute (JBI) guidelines and reported according to the PRISMA-Scr standards. We searched the PubMed database from inception through May 2022 using the following search criteria: "Ghana" + "Adolescent" + "Health". A total of 3172 studies were identified based on the search strategy outlined above, out of which 248 met the inclusion criteria. Both quantitative and qualitative analyses were conducted on all 248 studies to help synthesize findings. Overall, this review found that adolescent health care receives significant attention in Ghana, majority of which is focused on sexual and reproductive health (SRH). The studies available were a plethora of cross-sectional methods with large sample sizes, but their limited numbers of longitudinal studies and randomized control trials (RCTs) that could yield more robust evidence. This review is a call to action for a more comprehensive range of youth-driven, youth-responsive studies, interventions, and health programs that represent the whole range of challenges that confront adolescents in Ghana. This increased attention to adolescent needs will support a healthy cohort as they age into adulthood.

Foveolar-type adenomas are very rare lesions, representing approximately 2.7% of duodenal adenomas with gastric phenotype, histologically characterized by tall columnar cells resembling gastric foveolar epithelium and a tubulovillous structure with various degrees of dysplasia. Their risk of progression to adenocarcinoma is related to the size of the polyp and the presence of high-grade dysplasia. The recommended therapeutic approach is the endoscopic resection. our clinical case reports a rare case of a patient in whom gastric foveolar adenoma was incidentally discovered as an 8 mm sessile polyp in the duodenal bulb resected entirely by en-bloc mucosectomy technique. Through this case, we draw attention to the existence of bulbar adenomas, which carry a risk of dysplasia and progression to adenocarcinoma.

Introduction: in Nigeria, studies on mpox among primary healthcare workers are scarce despite increasing incidence of mpox disease between 2017-2022. This study aimed to assess primary healthcare workers knowledge and perception of mpox in Nigeria.

Methods: we conducted a cross-sectional survey among primary healthcare workers in Nigeria (Oyo, Lagos, and Jigawa) to represent different health system capacities and socio-economic contexts. Knowledge of mpox was evaluated in four domains: general knowledge, transmission, signs and symptoms, and prevention and treatment. Each correct response received a score of 1. We categorize the level of knowledge based on the score using the mean score as the cut-off by re-classifying the composite score of respondents for each state into a binary outcome of "good knowledge" if the mean composite score was greater or equals to the mean of overall knowledge score for the three states (16.1), and "poor knowledge" if the mean score equals to sixteen or less than sixteen (≤16). Factors associated with mpox knowledge were explored using multivariable logistic regression at a 5% significance level. Perception of mpox was assessed using five constructs from the health belief model, measured on 3-point Likert scales. Factors associated with each construct were analyzed using Kruskal-Wallis and Mann-Whitney-U tests.

Results: in our study on healthcare workers, 78.3% (n=239) were aware of mpox disease. Their overall knowledge was moderate, particularly regarding transmission. Meanwhile, less than 50% knew mpox can be transmitted through sharing utensils, and 65.3% (n=156) understood contact with infected animals could lead to transmission. Lagos had lower overall knowledge scores (15.3±2.3) compared to Jigawa (16.9±2.3) and Oyo (16.3±2.5) (p<0.001). Perceived susceptibility was similar across states (p=0.127), and 97.5% (n=233) believed mpox can affect anyone, while 47.3% (113) felt they couldn't contract it. Jigawa exhibited higher perceived severity (p<0.001) and barriers to prevention (p<0.001).

Conclusion: primary healthcare workers in all settings had limited knowledge of mpox transmission, with the perception of mpox varying by state and participants' socio-economic characteristics. The responsibility of HCW encompasses a range of activities that include diagnosis, patient care and education, and public health interventions amongst others. Hence it is important to educate HCWs on mpox disease to successfully curtail the spread of mpox.

Introduction: arterial hypertension (AH) is a public health problem in Burkina Faso. Its management is not the sole responsibility of the specialist but requires the participation of all healthcare actors within a care network, with the involvement of those at the forefront. This study aimed to analyse and map the capacity for managing hypertension in Burkina Faso.

Methods: we conducted a cross-sectional online survey among general practitioners in Burkina Faso via social networks. Sampling was carried out voluntarily.

Results: our study involved 182 general practitioners with a sex ratio of 2.7: 1. The average age of the physicians was 31 years with an average professional experience of 2.7 years. The WHO minimum assessment for the management of hypertension was available for 80% of doctors and in 74% of the towns. Most physicians (96%) limited their treatment to antihypertensive dual therapy, frequently prescribing calcium channel blockers (75.8%), converting enzyme inhibitors (51.6%), and diuretics (40.7%). Specialist advice was sought in the event of uncontrolled hypertension (52.8%), with little interaction with specialists: only 20.3% of counter-referrals. Most physicians (93%) wished to participate in an AH management care network, but 98.4% needed training.

Conclusion: Burkina Faso has an uneven distribution of AH management resources. Physicians' skills need to be enhanced to improve the quality of care. Better management of resources and establishing a care network would allow better coordination of activities and improve the management of hypertension.

Introduction: despite the introduction of the Hepatitis B Virus (HBV) vaccine in South Africa in 1995, HBV remains endemic. South Africa's HBV vaccine coverage for the third dose was 71% in 2015. Information on the HBV prevalence in South Africa in recent years is limited, therefore, we estimated HBV prevalence and described annual trends.

Methods: we conducted a retrospective descriptive study of data extracted from the Notifiable Medical Conditions Surveillance System, and estimated HBV prevalence per 100,000 population using the mid-year population estimates obtained from Statistics South Africa, for the 2016-2018 period.

Results: in total, 105 308 laboratory-confirmed HBV cases were analysed, of which 50.2% (53 895/105 308), 95% CI (49.9-50.5) were males. HBV prevalence for males was 34.1 in 2016, 84.1 in 2017, and 72.3 per 100,000 population in 2018. The age group with the highest HBV cases and prevalence were ages 15-49 years having 80.5% (n=84 718), with 52.2 in 2016, 123.3 in 2017, and 99.6 per 100 000 population in 2018. Between 2016 and 2018, South Africa had an overall HBV prevalence of 33.8, 82.6, and 68.8 per 100,000 population, respectively. KwaZulu-Natal province had the highest number of HBV cases with 37.8% (n=39 851) however, Mpumalanga province had the highest HBV prevalence with 73.2 in 2016, 188.8 in 2017, and 126.5 per 100,000 population in 2018.

Conclusion: our results indicated a high HBV prevalence is reflective of the group prior to the HBV vaccine introduction in South Africa.

Infective endocarditis (IE) is one of the most frequent complications of ventricular septal defect (VSD) in adults, but is rarely associated with multiple systemic embolisms and aortic pseudoaneurysms. The authors report a case of a 27-year-old female known to have an asymptomatic neglected VSD. She was admitted to our unit with complaints of prolonged fever and chills. Physical examination detected hyperthermia at 38.7°C and pathognomonic holosystolic murmur detected by cardiac auscultation. Laboratory blood test showed evidence of acute staphylococcus infection and imaging investigations revealed perimembranous restrictive VSD, with vegetations exclusively present in the right heart ventricle, in addition to mycotic aneurysms on the aortic arch and multiple systemic embolis. A targeted antibiotic therapy was initiated along with an urgent heart surgery with a good evolution. This case showcases the need to look for systematically systemic embolism in endocarditis of the right ventricle (RV) associated with a communication of the right and left cavities, and the possibility of an eventual paradoxical embolism within VSD in case of an inverted right to left shunt. Furthermore, it highlights that congenital VSD can be the underlying condition of a severe endocarditis in case of acute staphylococcus bacteremia.

Squamous cell carcinoma (SCC) of the stomach is a rare entity with fewer than 100 cases of primary SCC reported in the literature, while esophageal SCC is prevalent and more common. However, a synchronous squamous cell carcinoma found in the esophagus and stomach remains very uncommon. We present the case of a 64-year-old with a history of dysphagia who had an endoscopy that showed an impassable stenosis of the middle esophagus, with histopathology in favor of an esophagus squamous cell carcinoma. A computed tomography scan (CT-SCAN) then showed an exophytic mass of the lesser curvature of the stomach with the biopsy in favor of a squamous cell carcinoma. Our case report aims to keep in clinicians´ and anaomopathologists´ minds that esophageal SCC may coexist with gastric SCC and that the role of imaging is important in the diagnostic procedure.

Introduction: public health surveillance is the ongoing systematic identification, collection, collation, analysis, and interpretation of disease occurrence and public health event data, to take timely and robust action, such as disseminating the resulting information to the relevant people, for effective and appropriate action. Tuberculosis (TB) is an infectious disease caused by the micro-organism Mycobacterium tuberculosis. The main objective of this study was to describe the operation and performance of the TB surveillance system in a municipality in Ghana during the COVID-19 pandemic.

Methods: this was a cross-sectional study, which employed qualitative and quantitative data collection methods. The process was guided by the Updated Centres for Disease Control and Prevention (CDC) Surveillance System Evaluation Guidelines. The study was conducted in the La Nkwantanang Madina Municipality (LaNMMA).

Results: the system was found to be useful for planning, monitoring, and evaluation of TB control activities as well as the development of priorities for TB control programmes. The system was found to be simple and flexible with good data quality. However, stability, sensitivity (44.2%), predictive value positive (8.7%) and acceptability were all found to be poor. Even though the downstream flow of information was found to be excellent, the upstream flow of information was found to be poor.

Conclusion: it was concluded that the system was performing poorly. The system was not achieving most of the objectives for which it was set up. The Ghana Health Service should take measures to strengthen and improve the LaNMMA TB surveillance system in the post-pandemic era.