African health sciences最新文献

Introduction: Adverse pregnancy outcomes represent a major public health challenge in developed and resource-limited countries. Globally, approximately 60-80% of neonatal deaths occur in low birth weight infants, and more than 2 million infants die before birth each year and the burden of the problem is significant in Ethiopia. Therefore, the aim of this study was to determine the combined incidence and risk factors for poor birth outcomes in Ethiopia.

Method: International databases (PubMed, Google scholar, web of science and scopus) were searched. A funnel plot and Begg test were used to see the publication bias. The heterogeneity of studies was checked using I-square statistics with a cut of point 75% and the Newcastle Ottawa (NCO) quality assessment tool was applied to ensure the quality of the included articles. A random-effect model was applied to pool the adverse birth outcome. The sub-group analysis and Meta-regression analysis were conducted by region in the country and year of publication to control heterogeneity and to show variation.

Result: A total of 16636 study participants were used to estimate the pooled prevalence of adverse fetal outcomes. The overall pooled prevalence of adverse fetal outcomes in Ethiopia was 28 (95% CI; 24-32; 12 = 97.44 percent, Pv= 0.001). Low birth weight 10.06% (95% CI; 7.21-12.91) and preterm birth 8.76% (95% CI; 5.4-12.11) were the most common adverse birth outcome at the national level. Rural in residency (AOR = 2.31; 95% CI: 1.64-3.24), lack of antenatal care follow up (AOR = 3.84; 95% CI: 2.76-5.35), pregnancy-induced hypertension (AOR = 7.27; 95% CI: 3.95-13.39), advanced maternal age ≥ 35(AOR = 2.72; 95% CI: 1.62-4.58, and having current complication of pregnancy (AOR = 4.98; 95% CI: 2.24-11.07) were the factors associated with adverse birth outcome.

Conclusion: The pooled prevalence of adverse fetal outcomes in Ethiopia was high. Rural in residency, lack of antenatal care follow up, pregnancy-induced hypertension, advanced maternal age ≥ 35, and having current complications of pregnancy were the factors associated with adverse fetal outcome.

Systematic review registration: Identifier: CRD42022327072.

Background: The global prevalence of hypertension has been on the increase in urban areas. Therefore, this study was aimed at establishing the prevalence and predictors of hypertension (HTN) among the adults of Bududa town council in order to inform the way forward on the prevention strategies.

Methods: A mixed methods approach with a convergent parallel design was used. The quantitative arm involved 365 randomly selected participants, while the qualitative arm included 24 hypertensive patients. Quantitative data were analyzed at univariate, bivariate, and multivariate levels (p < 0.05), and thematic analysis was applied to the qualitative data.

Results: The prevalence of HTN was 33.97% and was associated with age ≥ 40 years (AOR 0.2; 95% CI 0.13-0.36; p=0.000), high salt intake (AOR:0.4; 95%CI:0.24-0.78; P=0.005), sedentary life style (AOR: 0.5; 95% CI: 0.30-0.89; p=0.017), inappropriate source of information about the risk factors to hypertension, knowledge on primary prevention, antihypertensive side effects, stroke and poor adherence to antihypertensive.

Conclusion: Hypertension remains a major public health issue in Bududa Town Council, closely linked to modifiable behaviors and limited risk awareness, including poor preventive knowledge, treatment non-adherence, and inadequate access to reliable health information.

Background: Internally displaced children are at risk of not receiving the general health services they require, since they have health needs that are unique to those of adults. Therefore, the first step in designing intervention programs for them is to determine their mental health status.

Objectives: This study determined the relationship of sociodemographic factors with the prevalence of depression and PTSD among internally displaced children in Nigeria.

Methods: A descriptive correlational research design was adopted for the study using adapted versions of the Child PTSD Symptom Scale (CPSS) and the child version of the Revised Child Anxiety and Depression Scale - RCADS (Depression Subscale). Frequency, percentage, binary logistic regression and chi-square were used for data analysis.

Results: Findings showed that the participants (n=474) comprised 55.3% male and 44.7% female children, with 85.9% having a low household income. The prevalence rate of PTSD and depression among displaced children was 79.7% and 84.8%, respectively. More than a third (47.5%) of the children were severely depressed, with more male (28.2%) than female children (21.2%) having moderately severe depression. A greater proportion of male (39.3%) than female (30.7%) children had severe PTSD. Functional impairment due to PTSD was found in 90.7% of the children. At a 95% confidence interval, age and gender did not significantly predict the prevalence of depression and PTSD among internally displaced children in Nigeria (OR < 1 and P > 0.05). At p<0.05, demographic characteristics of the children, such as parents' education, household size and housing size, correlated significantly with the prevalence of PTSD and depression among them.

Conclusions: Findings of this study suggest a high prevalence of depression and PTSD among displaced children in Nigeria and therefore call for the government to make available counselling and rehabilitation services to all IDPs, especially the children, to improve their mental health.

Background: Water, sanitation, and hygiene (WASH) are 3 interconnected drivers of waterborne diseases. This study investigated the WASH status of Amansea and Ugwuoba Livestock Market Settlements (LMSs).

Methods: Data on drinking water sources, sanitation and hygiene practices were obtained from randomly selected households in Amansea (140) and Ugwuoba (248) LMSs. In addition, the drinking water samples (borehole and commercial sachet water) were collected monthly (September 2020 - August 2021) from the LMSs for bacteriological analysis.

Results: Of the 388 households surveyed, 195 (50%) had access to improved drinking water sources in both LMSs. The households in Amnsea had more of improved drinking water sources compared to those in Ugwuoba (67.1%; 94/140 vs 40.7%; 101/248). Most households in Amansea (64.3%; 90/140) and Ugwuoba (58.5%; 145/248) LMSs practiced open defecation. Large proportions of households in Amansea (75.3%, 61/81) and Ugwuoba (55.0%, 77/140) had inadequate hygiene facilities. The borehole samples had a mean total and faecal coliform counts of 26 CFU/100 mL and 35 CFU/100 mL, respectively, which was undetected in the commercial sachet water.

Conclusion: Fewer households in Ugwuoba than Amansea had access to improved drinking water. Most of the households in both LMSs do not have access to improved sanitation, and sanitation facilities. The faecal pollution of the borehole water sources suggests the needs for treatment of drinking water to prevent any possible waterborne outbreak in the area. Further, increased access to improved drinking water, sanitation, and sanitation facilities in both LMSs should be promoted by the relevant government agency.

Objectives: We aimed to explore the incidence rate of respiratory tract infection (RTI) in patients after surgery under general anesthesia and to analyze its risk factors and nursing countermeasures.

Methods: The clinical data of 136 patients treated from June 2020 to June 2022 were retrospectively analyzed. The incidence rate of RTI within 3 d after surgery was recorded. They were divided into an infection group and a non-infection group. The distribution of pathogenic bacteria was observed, and their clinical data.

Results: RTI occurred in 16 of 136 cases (11.76%) after surgery under general anesthesia. Eighteen strains of pathogenic bacteria were cultured from these 16 cases, including Gram-negative bacteria in 13 cases (72.22%), Gram-positive bacteria in 4 cases (22.22%), and fungi in 1 case (5.56%). In the infection group, the proportions of patients with histories of smoking and lung surgery and orotracheal intubation were higher than those of the non-infection group, and the extubation time was later (P<0.05). History of smoking, orotracheal intubation, delayed extubation, and history of lung surgery were risk factors for RTI after surgery under general anesthesia (OR>1, P<0.05).

Conclusion: History of smoking, orotracheal intubation, delayed extubation, and history of lung surgery may increase the risk of RTI after surgery under general anesthesia.

Purpose: This paper aimed to explore the effects of cross-theoretical model-based family empowerment health education on health behavior and blood pressure control in young stroke patients.

Method: A total of 142 young stroke patients who met the inclusion and exclusion criteria, were admitted to the neurosurgery department of a Tertiary Grade A hospital in Tianjin. In detail, there were 71 cases each in the control group and experimental group. The control group was given routine health education intervention, while the experimental group was received family empowerment health education intervention according to the proposed cross-theoretical model. These two groups' health behaviors, behavioral stage changes, and blood pressure of the patients in the above-mentioned two groups before and after the intervention were compared systemically.

Results: The score of healthy behavior in the experimental group was higher than that in the control group (P < 0.05), the behavioral stage change in the experimental group was better than that in the control group (P < 0.05), and the positive feeling of the primary caregivers of young stroke patients in the experimental group was much better than that in the control group (P < 0.01).

Conclusion: Cross-theoretical model-based family empowerment health education could effectively improve patient health behavior and promote patients' behavioral change, and increase the positive perception of their primary caregivers.

Background: Breast and cervical cancer screening uptake remains limited in Ghana despite the public health importance of cancer screening. This study examines factors that influence this behavior.

Methods: Secondary analyses of the 2022 Ghana Demographic and Health Survey (GDHS) were conducted. A total of 9,489 women between the ages of 25 to 49 years were evaluated for clinical breast examination (CBE) and cervical cancer screening (CCS) uptakes. Univariable and multivariable logistic regressions were fitted to examine factors that influence women utilization of CBE and CCS.

Results: Women in the richer and richest quintiles of wealth index were 40% (AOR=1.40; 95%CI: 1.00 - 1.97) and 118% (AOR=2.18; 95%CI: 1.51 - 3.16) significantly more likely to attain CBE compared to women in the poorest quintile. Women with secondary and higher education were 2.02 times (AOR=2.02; 95%CI: 1.59 - 2.56) and 4.94 times (AOR=4.94; 95%CI: 3.61 - 6.76) as likely to attain CBE compared to women with no education. Women with health insurance were 85% (AOR=1.85; 95%CI: 1.37 - 2.52) more likely to attain CBE compared to women without health insurance. Similar results were found on the associations between wealth index, educational level and health insurance status and CCS uptake.

Conclusion: CBE and CCS uptakes were significantly higher in women with higher wealth index, higher education, and health insurance highlighting potential disparities in access to and utilization of preventive services in Ghanaian women. Tailoring policies to address the poverty burden will likely lead to an increase in breast and cervical cancer screening uptakes and potentially better health outcomes.

Background: The adoption of Electronic Medical Records (EMR) in Nigeria has been slow despite the benefits. Health worker perception is pertinent in promoting its adoption.

Objectives: To assess the perception and barriers to EMR use among physicians and nurses in general hospitals in Lagos, Nigeria.

Methods: This was a descriptive cross-sectional study utilizing multistage sampling to select 293 respondents. Data was collected using a self-administered questionnaire, analysed and presented as frequency tables. Chi-squared test determined association with EMR perception with level of significance at p ≤ 0.05.

Results: The mean age of the respondents was 36.6 ± 10.2 years. Majority of the respondents (69.3%) were female. Most respondents (98.6%) had positive perception of EMR. Major barriers to the use of EMR highlighted by the respondents included insufficient computers (90.8%), inconsistent power supply (87.0%), hardware or software failure (85.7%), and poor internet (84.7%). There was significant association between respondents age group and EMR perception (p = 0.018).

Conclusion: There was a predominantly positive perception of EMR among healthcare workers in Lagos, despite significant barriers such as inadequate infrastructure and inconsistent power supply. Strategic investments in technology, reliable electricity, and internet connectivity are needed for enhancing EMR adoption and optimizing healthcare delivery.

Background: Lower limb bone infection, particularly when combined with large segmental bone defects, poses significant challenges in treatment, often resulting in recurrence and complications. Traditional methods like surgical debridement and bone transplantation exhibit limited efficacy and high postoperative complications.

Purpose: The objective of this study was to investigate the efficacy of modified iliac bone graft combined with antibiotic bone cement in the treatment of lower limb bone infection complicated with large segment bone defect.

Method: The clinical data of 50 patients with lower limb bone infection complicated with large segment bone defect who received modified iliac bone graft combined with antibiotic bone cement technique in our hospital from January 2018 to December 2022 were retrospectively analyzed. All patients were treated with modified iliac bone graft combined with antibiotic bone cement technique and received postoperative antibiotic therapy. The patients were followed up after the operation, and the therapeutic effect and complications were recorded.

Results: The healing rate and healing time of the group with antibiotic cement were better than those of the control group without antibiotic cement in infection scope, infection event, deep infection, superficial infection and overall infection (P<0.05). Multiple Logistic regression analysis showed that infection range, BMI and postoperative C-reactive protein were independent risk factors for surgical efficacy (P<0.05), while the effects of weight, height, preoperative C-reactive protein, operative time and combined antibiotic therapy were not statistically significant (P>0.05). All patients completed fracture union within 3 months after surgery. All patients returned to normal lower limb function 6 months after surgery. At 12 months, follow-up showed no recurrence of infection or pain at the fracture site in all patients.

Conclusion: Modified iliac bone graft combined with antibiotic bone cement is an effective method for the treatment of lower limb bone infection complicated with large segment bone defect, which has significant therapeutic effect and low complication rate. Large-scale experiments are needed to further evaluate whether this method is recommended.

Background information: Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis that primarily affects the lungs but can also affect other parts of the body. Pulmonary TB is an infectious disease caused by Mycobacterium tuberculosis, which manifests in the lungs.

Methodology: A case-control study that uses multi-stage sampling technique was used to select 216 respondents (108 TB Patients and 108 non-TB Patients). Respondent were interviewed using pre-test semi structured self-administered questionnaires, univariate and bivariate analysis was done using Statistical Package for Social Sciences (SPSS) with P value set as P < 0.05.

Result: The mean age of cases is 43.9 years, while it is 42 years for controls. However, age does not show a statistically significant association with TB status. There are more males in both the cases (78.6%) and controls (78.6%). There are no significant differences in TB status between single, married, divorced, separated, and widowed individuals. Odd of having tuberculosis is influenced by cigarettes and alcohol bottles consumed per day (p = 0.009 for cigarettes and p = 0.122 for alcohol bottles), having HIV (P less than 0.05).

Conclusion: This study concludes that the development of pulmonary tuberculosis is influenced by a range of factors, including lifestyle habits, comorbid conditions such as HIV/AIDs and being diabetics. Effective control requires collaboration among various stakeholders and lifestyle modification. Public health campaigns could also be used to raise awareness about the link between smoking and TB.