African health sciences最新文献

Background: Uganda, like many other nations, faces a double burden of communicable and non-communicable diseases due to the severe impacts of HIV, antiretroviral therapy, and the increasing number of HIV-positive individuals.

Objective: To determine the factors that influence the quality of life among HIV patients with NCDs receiving antiretroviral therapy in Wakiso District, Uganda.

Methods: A cross-sectional survey was conducted in Wakiso, Uganda, among HIV patients with NCDs receiving antiretroviral therapy and drug refills from Community Drug Distribution Points (CDDP). 219 participants completed questionnaires between November 2019 and December 2020. The factors assessed as predictors included health promotion, community support system, patient monitoring, age, sex, education level, and marital status. The diagnosis of NCDs was based on documented evidence ofiabetes Mellitus (DM) and Hypertension (HT); fasting blood sugar >7.0 mmol/L (126 mg/dl) for DM, and blood pressure > 140/90mmhg for HT. Data analysis included descriptive statistics, path analysis, and Structural Equation Modeling (SEM), which were used to verify and test the model.

Results: The research found that most HIV patients were female (61.6%), aged 40 or older (94.5%), with secondary school or less education (69.4%). 54.8% were single. Community-based NCD services, such as health promotion (β=0.58, P=0.006), community support system (β=0.24, p<0.001), and patient monitoring system (β=0.46, p<0.001), directly influenced the quality-of-life improvements, along with other factors like education level (β=0.76, p<0.001) and marital status (β=0.57, P=0.002).

Conclusion: The quality of life for HIV-positive individuals with NCDs in Wakiso district requires strengthening community-integrated HIV-NCD interventions to improve the overall quality of life for these individuals.

Background: Healthcare trainees are at high risk of acquiring the Hepatitis B Virus (HBV).

Objective: We aimed to evaluate the HBV vaccination status among medical intern doctors and nurses in Uganda.

Methods: We conducted a cross-sectional study of medical interns (doctors and nurses) working in three national referral hospitals in Uganda. Self-reported vaccination status was classified into "fully vaccinated", "partially vaccinated," and "not vaccinated."

Results: A total of 186 participants were enrolled in the study. More than half of the participants were from Mulago National Referral Hospital (n=110, 59.14%), were male (n=103, 55.38%), and were medical intern doctors (n=127, 68.28%). The majority of the medical interns (n=166, 89.0%) had received at least one dose, but n=97 (58.43%) reported receiving all three recommended doses of the HBV vaccine. Forgetfulness (n=8, 30.8%) and cost of the vaccine (n=8, 30.8 %) were the main reasons some participants were unvaccinated.

Conclusion: The completion rate of the HBV vaccination schedule among medical interns was low. It is essential to establish systems that require medical interns to have completed their HBV vaccination before starting their medical internship.

Background: A key feature of asthma is hypoxia, which triggers erythropoietin (EPO) production to stimulate erythropoiesis and compensate for oxygen deficits. This study investigates the impact of asthma controller medications on erythropoietic response by evaluating serum EPO levels and reticulocyte counts among asthma patients at Murtala Muhammad Specialist Hospital, Kano.

Methodology: This study is a comparative cross-sectional study involving 180 participants, comprising 60 asthmatics on controller medications, 60 treatment-naive patients with asthma, and 60 apparently healthy controls. Serum EPO levels were determined by ELISA, while complete blood count (CBC) and reticulocyte count were determined by automated hematology analyzer and manual method, respectively.

Results: The study revealed significant differences in EPO levels (p = 0.00001), reticulocyte counts (p = 0.0004), and hematological parameters (p = 0.009) among the three groups. Treatment-naive asthmatics exhibited elevated reticulocyte counts (2.50 (IQR: 3.50)) and EPO levels (38.88 mIU/mL (IQR: 25.6 mIU/mL)), suggesting enhanced erythropoiesis in response to hypoxia. In contrast, asthmatics on controller medications showed a negative correlation (ϱ = - 0.564) between EPO levels and reticulocyte counts, indicating a potential suppressive effect of corticosteroids on erythropoiesis.

Conclusion: Asthma is associated with increased erythropoietin production; it is however suppressed by inhaled corticosteroid therapy.

Background: Constrictive pericarditis is a rare but important cause of diastolic heart failure. Its uniqueness lies in the fact that surgery (pericardiectomy) remains the mainstay of treatment. Globally, the leading causes of constrictive pericarditis include idiopathic, mediastinal irradiation, post cardiac surgery and tuberculosis.

Methods: Patients who underwent pericardiectomy at our tertiary hospital between January 2019 and December 2024 were retrospectively studied with the aim of discussing our experience with the procedure and its outcomes. Data including baseline demographics, preoperative conditions, intraoperative details, and postoperative outcomes were collected from clinical records and analysed.

Results: Thirteen patients had total pericardiectomy during the period under review. The median age was 28 years with dyspnoea and ascites being the most common symptoms. Most patients (61.6%) presented in NYHA class III and IV and were above ASA II classification at the time of surgery. Pericardiectomy was done via median sternotomy and without cardiopulmonary bypass in all cases, with an average surgery duration of 284.5 mins. Postoperative complications included low cardiac output, acute kidney injury, coagulopathy, and prolonged pleural effusion. Median duration of intensive care unit (ICU) stay was 2days and there was 1 mortality. At twelve months follow up, more than 90% of surviving patients were in NYHA class I or II.

Conclusion: Pericardiectomy offers symptomatic relief to patients with constrictive pericarditis. Early identification of this disease would prevent disease progression and offer improved outcomes.

Background: The safety of iso-osmolar contrast media (IOCM) in patients at risk of contrast-induced kidney injury (CIAKI) is not well-established.

Objective: To determine the incidence of CIAKI among high-risk adult patients undergoing iso-osmolar contrasted Computed Tomography (CT) scans.

Methods: A prospective descriptive cohort study of patients at high risk of CIAKI was done. Questionnaires were used to collect clinical and examination findings. Blood samples were collected at baseline and at 48 hours post-administration of IOCM to assess changes in serum creatinine. Those found to have a ≥ 0.5mg/dl absolute increase in serum creatinine from the baseline within 48 hours of contrast administration were considered to have developed CIAKI. Pearson's Chi-square test was used to compare patients with and without CIAKI. Logistic regression models were used to determine associations of CIAKI.

Results: The cumulative incidence of CIAKI was 9% (20/223), (95%CI - 5.8451-13.5215). No factors were independently associated with CIAKI in this study.

Conclusion: The incidence of CIAKI among high-risk adult patients undergoing CT scans was 9%. There were no factors significantly associated with CIAKI.

Background: Despite being the most effective way to prevent unintended pregnancies and related complications, modern contraceptive use in Uganda remains low compared to the national target. We aimed to assess the knowledge and factors associated with the current use of modern contraceptive among young people aged 10-24 in central and western Uganda.

Methods: This was a cross-sectional study that collected data from 289 in- and out-of-school young people aged 10-24 years in five districts of western and central Uganda. Modified Poisson regression was used to determine the factors associated with the current use of modern contraceptive use.

Results: Overall, 62.6% (181) of the respondents knew about modern contraceptives. Current use of modern contraceptives was 58.5% (169). Current use of modern contraceptives was associated with being aged 20-24 (Adj. PRR= 0.69, 95%CI; 0.52-0.90), p=0.007; not residing with someone as a sexual partner (Adj. PRR=0.71, 95%CI; 0.57-0.88), p=0.002; and being a student (Adj. PRR=1.37, 95% CI; 1.04-1.79), p=0.023.

Conclusion: Young people aged 10-24 in central and western Uganda were well-informed about modern contraceptives, especially injectables and condoms, but less knowledgeable about emergency contraceptives. Students used modern contraceptives more than non-students, while those aged 20-24 and not cohabiting with partners were less likely to use them. Awareness campaigns for 20-24-year-olds and those living with partners are necessary to increase usage.

Introduction: Several studies have shown that woodworkers present with frequent respiratory symptoms and reduced lung volume and airflow values, including FVC, FEV1, FEV1/FVC, and PEFR, than controls from the general population. However, other studies have reported no significant negative health effects of wood dust on the respiratory system. The effect of wood dust on pulmonary function depends on the wood species, phytochemicals present in the wood, and the concentration level of ambient air wood dust. The ambient air dust concentration level at the wood workshops may depend on the humidity and ventilation at the workshops. This study aimed at assessing the pulmonary function of woodworkers exposed to mixed tropical hardwoods in Kumasi, Ghana.

Method: The study was conducted among woodworkers, teachers, and security men located in Kumasi. A cross-sectional, clustered, and convenient sample of 195 adult male workers (96 woodworkers and 99 non-wood workers) were enrolled for the study. Pulmonary function assessment was carried out using an adapted version of the British Medical Research Council's (MRC) questionnaire on respiratory symptoms and apirometer (Alpha Vitalograph) for lung function testing. The relative humidity and the level of wood dust exposure to woodworkers were measured using the personal exposure meter (PATS+: Berkeley Air Monitoring Group) from the Environmental Protection Authority.

Results: The mean percentage relative humidity in the workshop was 68%, and the ambient air wood dust concentration ranged between 0.003 and 1.02 mg/m³. Respiratory symptoms prevalent at the workplace among woodworkers ranged between 8-76% (p<0.05). The VC and FVC values were significantly low in the woodworkers (p>0.05).

Conclusion: The study revealed that woodworkers exposed to mixed tropical hardwood dust without personal protection equipment showed an increase in the prevalence of rhinitis and sneezing and a significant reduction in the VC and FVC values at the workplace.

Background: Cobalamin deficiency has been implicated as a contributor to anaemia in HIV disease. This study aimed to determine cobalamin status among antiretroviral therapy (ART)-naive HIV-infected patients with anaemia.

Methods: A cross-sectional study was conducted and two categories of participants were recruited: ART-naive HIV-positive patients with anaemia (Group A) and HIV-negative individuals with anaemia (Group B). Socio-demographic and medical history was obtained. Methylmalonic acid (MMA) levels (an indirect measure of cobalamin level) was carried out by ELISA method. Full blood count was determined using haematology autoanalyser. CD4 count were done only on HIV-infected subjects using cyflowmeter. Data was analysed with SPSS software, version 20.

Results: A total of 180 participants comprising 126 group A and 54 group B, aged between 18 and 60 years were studied. Cobalamin deficiency (indicated by high MMA level) was found to be significantly higher among group A participants (p=0.001). There was negative correlation between haemoglobin level and MMA (r= -0.147) (p= 0.547), as well as between CD4 count and MMA (r= -0.327) (p= 0.171), though not statistically significant. The age group commonly infected by HIV was 31 to 40years (42.1%). More females were affected with HIV disease with male to female ratio of 1:3.5.

Conclusion: HIV-infection is associated with cobalamin deficiency and so contribute to anaemia of HIV infection. Larger population studies are recommended to ascertain the veracity of these findings.

Background: Infant Feeding Practices (IFPs) and Nutritional Status (NS) of children between 6 - 23 months have been a matter of concern, and these were investigated in a rural community in Nigeria.

Methods: Data were collected from 368 mothers with children 6-23 months. IFPs and anthropometry were investigated among the children. Wasting (WHZ), stunting (HAZ), and underweight (WAZ); Exclusive Breastfeeding (EBF), Minimum Meal Frequency (MMF), and Mean Dietary Diversity (MDD) were determined. Data were analyzed using descriptive statistics and logistic regression, and significance was set at p<0.05.

Results: Wasting was 22.9%, 28.3% stunted, and 17.1% underweight. Children without EBF were thrice more likely to be wasted (OR = 3.454, 95%CI = 1.667 - 7.156), twice more likely to be stunted and underweight (OR = 2.189, 95%CI = 0.975 - 4.918). Those with low MMF were thrice more likely to be wasted (OR = 3.451, 95%CI = 1.798 - 6.622) and twice more likely to be stunted (OR = 1.674, 95%CI = 0.868 - 3.227). Those with low MDD were thrice more likely to be stunted (OR = 3.295, 95%CI = 0.856 - 12.683) and underweight (OR = 3.295, 95%CI = 0.856 - 12.683). Caregivers with unskilled occupations, who earn lower income, are younger in age, with a lower education level are associated with a higher likelihood of having children with wasting, stunting and underweight.

Conclusion: EBF, MMF, and MDD affected the NS of children 6-23 months in the study area.

Objectives: Postpartum hemorrhage is a significant barrier to the achievement of Sustainable development goal 3.1, given that it is associated with more than a quarter of all maternal mortality cases. Traditional birth attendants (TBAs), who are outlawed in many countries, including Uganda inclusive, attend to about 33% of all births globally. The objective of this study was to explore the management practices of primary postpartum hemorrhage among traditional birth attendants in Iganga district.

Methods: The study used a case phenomenological qualitative exploratory design, targeting traditional birth attendants. Snowballing was used to select participants and engage them in-depth interviews. Data collected was analyzed thematically, with the induction approach.

Results: It was found that TBAs carried out PPH assessment using three methods; quantification of blood lost using household cups, vital assessment and visual assessment. Visual assessment was the most dominant. Postpartum hemorrhage resuscitation practices mainly rotated around the use of warm water. They did not carry resuscitation. The treatment interventions used were: use of herbal medicine and referral of severe cases to hospital.

Conclusion: TBAs in Iganga district visually assess postpartum hemorrhage but they do not conduct resuscitation procedures. They use herbal uterotonics in the treatment of postpartum hemorrhage alongside with referral to hospital.