Beatrice Aleyo Muzame, Elizabeth Omukunda, David H Mulama, Patrick Okoth
Background: Malaria is the leading cause of mortality in sub-Saharan Africa. Objective: The study assessed the effect of socio-economic factors on high malaria prevalence in a peri-urban setting in Vihiga County, Western Kenya highlands aimed at strengthening implementation of cost-effective malaria control strategies at household level. Method: A longitudinal study was carried out in the study area from December 2019 to November 2020. From patients who presented themselves at Mbale Provincial Rural Training health center for various treatments, 768 malaria confirmed patients were recruited and signed consent before the study commenced. Data was collected using microscopy and structured questionnaires used to stratify malaria patients into socio-economic status and their residence. Data was presented through graphs, frequency, analyzed using linear regression and correlation. P-value ≤ 0.05as considered statistically significant. Results: Linear regression analysis showed effect of socio-economic factors on malaria prevalence was statistically significant, R2 = 0.061, [F (7,760) = 7.063], p < 0.0001). Level of education, wealth, land size, house type and house ventilation were statistically significant to malaria prevalence as opposed to salary and household size. Conclusion: Socio-economic factors influenced malaria prevalence in the study area. Implementation of cost-effective malaria control strategies should be strengthened at household level. Keywords: Malaria prevalence; socio-economic factors; malaria control strategies; mosquitoes breeding sites; household level.
{"title":"Effect of socio-economic factors on malaria prevalence in a Peri-urban setting in Vihiga County, Western Kenya Highlands","authors":"Beatrice Aleyo Muzame, Elizabeth Omukunda, David H Mulama, Patrick Okoth","doi":"10.4314/ahs.v24i2.19","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.19","url":null,"abstract":"Background: Malaria is the leading cause of mortality in sub-Saharan Africa. \u0000Objective: The study assessed the effect of socio-economic factors on high malaria prevalence in a peri-urban setting in Vihiga County, Western Kenya highlands aimed at strengthening implementation of cost-effective malaria control strategies at household level. \u0000Method: A longitudinal study was carried out in the study area from December 2019 to November 2020. From patients who presented themselves at Mbale Provincial Rural Training health center for various treatments, 768 malaria confirmed patients were recruited and signed consent before the study commenced. Data was collected using microscopy and structured questionnaires used to stratify malaria patients into socio-economic status and their residence. Data was presented through graphs, frequency, analyzed using linear regression and correlation. P-value ≤ 0.05as considered statistically significant. \u0000Results: Linear regression analysis showed effect of socio-economic factors on malaria prevalence was statistically significant, R2 = 0.061, [F (7,760) = 7.063], p < 0.0001). Level of education, wealth, land size, house type and house ventilation were statistically significant to malaria prevalence as opposed to salary and household size. \u0000Conclusion: Socio-economic factors influenced malaria prevalence in the study area. Implementation of cost-effective malaria control strategies should be strengthened at household level. \u0000Keywords: Malaria prevalence; socio-economic factors; malaria control strategies; mosquitoes breeding sites; household level.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Onah, C. Idoko, Aliyu Kai'gama, Siyaka Abdulateef
Background: Antiretroviral therapy is expected to produce sustained viral load reduction and a rise in CD4 cell count, both of which are important clinical markers of immune recovery. There is contrasting clinical evidence of CD4 stability among patients on long term therapy, which is a major challenge in poor resource settings. This study aims to evaluate CD4 cell recovery among patients on four regimens who have been on long term antiretroviral therapy Methods: This was a retrospective cohort study using data from the medical records of patients on four antiretroviral regimens. A three year record of CD4 cell count of 405 randomly selected subjects was extracted for analysis. Results: The increase of CD4 cells was between 65.6 – 82.1% of baseline values, with the highest rise occurring with Efavirenz based regimens. Among patients who achieved target CD4 cell counts ≥ 500 cells/ml, there was further increase of between 22.2 – 34.1% compared to baseline values. The percentage of patients with incomplete immune recovery still remain high among patients on the four regimens 65.9 – 77.8%. Conclusion: Immune reconstitution continue to occur among patients, however a significant proportion of patients fail to achieve and sustain target CD4 target on the long term. Keywords: CD4 recovery; different HAART regimens; Nigerian tertiary healthcare facility.
{"title":"A comparative assessment of CD4 recovery in a cohort of patients on different HAART regimens in a Nigerian tertiary healthcare facility","authors":"P. Onah, C. Idoko, Aliyu Kai'gama, Siyaka Abdulateef","doi":"10.4314/ahs.v24i2.3","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.3","url":null,"abstract":"Background: Antiretroviral therapy is expected to produce sustained viral load reduction and a rise in CD4 cell count, both of which are important clinical markers of immune recovery. There is contrasting clinical evidence of CD4 stability among patients on long term therapy, which is a major challenge in poor resource settings. This study aims to evaluate CD4 cell recovery among patients on four regimens who have been on long term antiretroviral therapy \u0000Methods: This was a retrospective cohort study using data from the medical records of patients on four antiretroviral regimens. A three year record of CD4 cell count of 405 randomly selected subjects was extracted for analysis. \u0000Results: The increase of CD4 cells was between 65.6 – 82.1% of baseline values, with the highest rise occurring with Efavirenz based regimens. Among patients who achieved target CD4 cell counts ≥ 500 cells/ml, there was further increase of between 22.2 – 34.1% compared to baseline values. The percentage of patients with incomplete immune recovery still remain high among patients on the four regimens 65.9 – 77.8%. \u0000Conclusion: Immune reconstitution continue to occur among patients, however a significant proportion of patients fail to achieve and sustain target CD4 target on the long term. \u0000Keywords: CD4 recovery; different HAART regimens; Nigerian tertiary healthcare facility.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Henrietta U Okafor, N. Mbanefo, Vivian N Muoneke, Israel O Odetunde, Samuel N Uwaezuoke, Grace Agu, Edmund N Ossai, Josephat M Chinawa
Background: Acute Kidney Injury (AKI) in children is increasingly being recognized as a major problem in resource poor countries like Nigeria. In our own setting where resources for renal replacement therapy are limited, it becomes expedient to identify the cases early, ascertain the common causes and challenges in management. This will inform early interventions and strategies for prevention. Objectives: This study sought to describe the trends,causes and outcomes in the management of AKI among children attending pediatric nephrology unit of the University of Nigeria Teaching Hospital. Methods: A retrospective cross- sectional study whereby case folder of children with discharge diagnosis of AKI seen in the pediatric nephrology unit of the University of Nigeria Teaching Hospital in Southeast Nigeria. Results: 51 case folders fulfilled the inclusion criteria. The age range was 0.8-16 with a mean of 5.3±4.6. There was male predominance with M:F ratio of 2.2:1.The commonest presenting feature was fever (78.4%). Majority (82.9%) came in with greater than and equal to stage 2 AKI (KDIGO) , with mean creatinine value of 494.6±367.44 μmmol. Sepsis and malaria were common associated diagnoses. Eight patients (11.8%) were dialyzed and mortality was 3.9%. Conclusion: Febrile illnesses such as malaria and sepsis are the commonest cause of AKI in this study and this occurs between the ages of 1 and 9 years. Few of these children with AKI benefited form dialysis. Mortality is low and outcome in this study seems good Keywords: Children; AKI; renal replacement therapy; prevention.
背景：在尼日利亚等资源贫乏的国家，儿童急性肾损伤（AKI）日益被视为一个主要问题。在我国，肾脏替代疗法的资源有限，因此及早发现病例、确定常见病因和管理方面的挑战成为当务之急。这将为早期干预和预防战略提供依据。研究目的本研究旨在描述在尼日利亚大学教学医院儿科肾病科就诊的儿童中发生 AKI 的趋势、原因和处理结果。方法：回顾性横断面研究：回顾性横断面研究，对尼日利亚东南部的尼日利亚大学教学医院儿科肾病科就诊的出院诊断为 AKI 的儿童进行病例夹。结果51份病例符合纳入标准。年龄范围为0.8-16岁，平均年龄为5.3±4.6岁。最常见的症状是发烧（78.4%）。大多数患者（82.9%）的急性肾功能缺损程度大于或等于2期（KDIGO），平均肌酐值为494.6±367.44 μmmol。败血症和疟疾是常见的相关诊断。八名患者（11.8%）接受了透析治疗，死亡率为 3.9%。结论在这项研究中，疟疾和败血症等发热性疾病是导致急性肾脏缺血的最常见原因，且多发于1至9岁的儿童。这些患有缺氧性肾损伤的儿童中，只有极少数能从透析中获益。这项研究的死亡率较低，结果良好：儿童；AKI；肾替代疗法；预防。
{"title":"Trends, causes and outcomes of Acute Kidney Injury (AKI) among children attending University of Nigeria Teaching Hospital, Ituku-Ozalla Enugu","authors":"Henrietta U Okafor, N. Mbanefo, Vivian N Muoneke, Israel O Odetunde, Samuel N Uwaezuoke, Grace Agu, Edmund N Ossai, Josephat M Chinawa","doi":"10.4314/ahs.v24i2.43","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.43","url":null,"abstract":"Background: Acute Kidney Injury (AKI) in children is increasingly being recognized as a major problem in resource poor countries like Nigeria. In our own setting where resources for renal replacement therapy are limited, it becomes expedient to identify the cases early, ascertain the common causes and challenges in management. This will inform early interventions and strategies for prevention. \u0000Objectives: This study sought to describe the trends,causes and outcomes in the management of AKI among children attending pediatric nephrology unit of the University of Nigeria Teaching Hospital. \u0000Methods: A retrospective cross- sectional study whereby case folder of children with discharge diagnosis of AKI seen in the pediatric nephrology unit of the University of Nigeria Teaching Hospital in Southeast Nigeria. \u0000Results: 51 case folders fulfilled the inclusion criteria. The age range was 0.8-16 with a mean of 5.3±4.6. There was male predominance with M:F ratio of 2.2:1.The commonest presenting feature was fever (78.4%). Majority (82.9%) came in with greater than and equal to stage 2 AKI (KDIGO) , with mean creatinine value of 494.6±367.44 μmmol. Sepsis and malaria were common associated diagnoses. Eight patients (11.8%) were dialyzed and mortality was 3.9%. \u0000Conclusion: Febrile illnesses such as malaria and sepsis are the commonest cause of AKI in this study and this occurs between the ages of 1 and 9 years. Few of these children with AKI benefited form dialysis. Mortality is low and outcome in this study seems good \u0000Keywords: Children; AKI; renal replacement therapy; prevention.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Motorcycle crash injuries (MCIs) cause mortality and exert financial cost, globally. However, there is paucity of information on cost and length of stay of motorcycle injuries. Objective: To assess factors influencing medical costs and length of stay (LOS) of motorcycle crash injuries presenting in hospitals in Kisumu city, Methods: This was a cross-sectional study in which all 1073 motorcycle injury cases were enrolled over a period of six months. A pre-tested, questionnaire was used to collect data. Data were analysed using Analysis of Variance (ANOVA), logistic regression and multivariable regression analysis. P-value < 0.05 considered significant. Results: A total of 1073 motorcycle injury visits were made to the hospitals during the study period of which 46.0% were admitted. The total medical cost for motorcycle injury patients was Kshs. 19, 134,877 (USD 191348.77). The mean LOS was 19.8 days (1-235 days). Injuries requiring surgical intervention, higher injury severity score, and helmet non-use were significantly associated with higher medical cost and length of stay. Conclusion: Motorcycle injuries are a major cause of hospital use and present significant economic burden. Surgical intervention, injury severity and non-helmet use were the major predictors of length of stay and medical costs. Keywords: Motorcycle injuries; length of stay; cost; predictors; severity.
{"title":"Predictors of medical cost and Length of stay of motorcycle injury patients presenting to hospitals in Kisumu City, Kenya","authors":"Wilberforce Cholo, W. Odero, Japheths Ogendi","doi":"10.4314/ahs.v24i2.41","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.41","url":null,"abstract":"Background: Motorcycle crash injuries (MCIs) cause mortality and exert financial cost, globally. However, there is paucity of information on cost and length of stay of motorcycle injuries. \u0000Objective: To assess factors influencing medical costs and length of stay (LOS) of motorcycle crash injuries presenting in hospitals in Kisumu city, \u0000Methods: This was a cross-sectional study in which all 1073 motorcycle injury cases were enrolled over a period of six months. A pre-tested, questionnaire was used to collect data. Data were analysed using Analysis of Variance (ANOVA), logistic regression and multivariable regression analysis. P-value < 0.05 considered significant. \u0000Results: A total of 1073 motorcycle injury visits were made to the hospitals during the study period of which 46.0% were admitted. The total medical cost for motorcycle injury patients was Kshs. 19, 134,877 (USD 191348.77). The mean LOS was 19.8 days (1-235 days). Injuries requiring surgical intervention, higher injury severity score, and helmet non-use were significantly associated with higher medical cost and length of stay. \u0000Conclusion: Motorcycle injuries are a major cause of hospital use and present significant economic burden. Surgical intervention, injury severity and non-helmet use were the major predictors of length of stay and medical costs. \u0000Keywords: Motorcycle injuries; length of stay; cost; predictors; severity.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marnie Abeshouse Marnie Abeshouse, Linda P Zhang, Callie Horn, Allen T Yu, Moses Binoga Bakaleke, Angellica Giibwa, Daniel Haik B, Michael L Marin, Jerome D Waye, Joseph Okello Damoi
Background: The availability of upper endoscopy (UE) is limited in many rural low- and middle-income countries (LMIC). Few studies have evaluated use of elective endoscopies to address esophago-gastric diseases in remote Eastern Uganda. Objective: This research assesses the impact of introducing UE on diagnosing gastrointestinal diseases endemic to the area. Methods: This is a retrospective, cross sectional, single center study evaluating patients who received elective UE from Kyabirwa Surgical Center in rural Eastern Uganda, between 2020 to 2022. Primary outcome variables were presenting symptoms, endoscopic diagnoses and respective treatments. Results: 350 endoscopies were performed for 333 patients, (1:1 male-to-female ratio, average age 48). Abnormalities were found on endoscopy in 73% of patients, revealing diagnoses of esophageal cancer (16.4%, N=64), gastritis (16.7%, N=65), hiatal hernia (8.7%, N=34), esophagitis (7.4%, N=29), ulcer (6.2%, N=24), and candidiasis (5.1%, N=20). Most patients presented with epigastric pain alone (40%, N=133) or dysphagia (39%, N=130). 51% of patients with dysphagia had esophageal cancer on endoscopy, of which 28.1% had an interval palliative stent placed. Conclusions: The introduction of UE into a rural LMICs is possible and can verify baseline prevalence of endemic upper gastrointestinal diseases. Confirmation of diagnosis by endoscopy can direct medical management and interventional therapy. Keywords: Diagnostic and therapeutic upper endoscopy; ambulatory surgery center; rural Eastern Uganda.
{"title":"The impact of introducing The impact of introducing diagnostic and therapeutic upper endoscopy in an ambulatory Surgery Center in Rural Eastern Uganda diagnostic and therapeutic upper endoscopy in an ambulatory Surgery Center in Rural Eastern Uganda","authors":"Marnie Abeshouse Marnie Abeshouse, Linda P Zhang, Callie Horn, Allen T Yu, Moses Binoga Bakaleke, Angellica Giibwa, Daniel Haik B, Michael L Marin, Jerome D Waye, Joseph Okello Damoi","doi":"10.4314/ahs.v24i2.44","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.44","url":null,"abstract":"Background: The availability of upper endoscopy (UE) is limited in many rural low- and middle-income countries (LMIC). Few studies have evaluated use of elective endoscopies to address esophago-gastric diseases in remote Eastern Uganda. \u0000Objective: This research assesses the impact of introducing UE on diagnosing gastrointestinal diseases endemic to the area. \u0000Methods: This is a retrospective, cross sectional, single center study evaluating patients who received elective UE from Kyabirwa Surgical Center in rural Eastern Uganda, between 2020 to 2022. Primary outcome variables were presenting symptoms, endoscopic diagnoses and respective treatments. \u0000Results: 350 endoscopies were performed for 333 patients, (1:1 male-to-female ratio, average age 48). Abnormalities were found on endoscopy in 73% of patients, revealing diagnoses of esophageal cancer (16.4%, N=64), gastritis (16.7%, N=65), hiatal hernia (8.7%, N=34), esophagitis (7.4%, N=29), ulcer (6.2%, N=24), and candidiasis (5.1%, N=20). Most patients presented with epigastric pain alone (40%, N=133) or dysphagia (39%, N=130). 51% of patients with dysphagia had esophageal cancer on endoscopy, of which 28.1% had an interval palliative stent placed. \u0000Conclusions: The introduction of UE into a rural LMICs is possible and can verify baseline prevalence of endemic upper gastrointestinal diseases. Confirmation of diagnosis by endoscopy can direct medical management and interventional therapy. \u0000Keywords: Diagnostic and therapeutic upper endoscopy; ambulatory surgery center; rural Eastern Uganda.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lisa Singh, Varsha Bangalee, Serisha Ramasir, Lehlohonolo John Mathibe
Background: Multidrug-resistant tuberculosis (MDR-TB) is a prevalent health burden, both in South Africa and globally. The treatment of MDR-TB is both complex and difficult as multiple drugs have to be used concurrently in order to achieve good treatment outcomes for patients. However, there is a lack in the evidence regarding the incidences of specific adverse effects of these drugs. Objective: The main aim/objective of this study was to investigate and compare reported specific adverse drug reactions (ADRs) associated with kanamycin, capreomycin, amikacin and bedaquiline in MDR-TB patients. Methods: Secondary data collected over a period of 12 months were sourced from a public access data base, VigiAccessTM, and analysed. Results: There was a steep increase in adverse drug reactions reported for kanamycin with the main adverse reactions being hypoacusis, deafness and tinnitus cases, along with vomiting, nausea and diarrhoea. With capreomycin, there were increases in asthenia and hypoacusis although the latter showed a plateau after some point. Rash and pruritus increased along with cases of death with amikacin and there were reports of prolonged QT interval in the electrocardiogram of patients on bedaquiline in addition to nausea, vomiting and diarrhoea. Conclusion: There are many specific adverse effects associated with kanamycin, capreomycin, amikacin and bedaquiline. The number of cases of the specific adverse effects also increased with time. Therefore, VigiAccessTM provides a good platform for reporting and awareness of specific adverse effects associated with MDR-TB therapy. This is a vital stepping stone for further research. Keywords: Kanamycin; Amikacin; Capreomycin; Bedaquiline.
{"title":"Adverse effects associated with Kanamycin, Amikacin, Capreomycin and Bedaquiline -a VigiAccessTM study","authors":"Lisa Singh, Varsha Bangalee, Serisha Ramasir, Lehlohonolo John Mathibe","doi":"10.4314/ahs.v24i2.8","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.8","url":null,"abstract":"Background: Multidrug-resistant tuberculosis (MDR-TB) is a prevalent health burden, both in South Africa and globally. The treatment of MDR-TB is both complex and difficult as multiple drugs have to be used concurrently in order to achieve good treatment outcomes for patients. However, there is a lack in the evidence regarding the incidences of specific adverse effects of these drugs. \u0000Objective: The main aim/objective of this study was to investigate and compare reported specific adverse drug reactions (ADRs) associated with kanamycin, capreomycin, amikacin and bedaquiline in MDR-TB patients. \u0000Methods: Secondary data collected over a period of 12 months were sourced from a public access data base, VigiAccessTM, and analysed. \u0000Results: There was a steep increase in adverse drug reactions reported for kanamycin with the main adverse reactions being hypoacusis, deafness and tinnitus cases, along with vomiting, nausea and diarrhoea. With capreomycin, there were increases in asthenia and hypoacusis although the latter showed a plateau after some point. Rash and pruritus increased along with cases of death with amikacin and there were reports of prolonged QT interval in the electrocardiogram of patients on bedaquiline in addition to nausea, vomiting and diarrhoea. \u0000Conclusion: There are many specific adverse effects associated with kanamycin, capreomycin, amikacin and bedaquiline. The number of cases of the specific adverse effects also increased with time. Therefore, VigiAccessTM provides a good platform for reporting and awareness of specific adverse effects associated with MDR-TB therapy. This is a vital stepping stone for further research. \u0000Keywords: Kanamycin; Amikacin; Capreomycin; Bedaquiline.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141835039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Girmatsion Fisseha Abreha, Abiodum O Ilesanmi, Adesina Oladokun, Araya Abrha Medhanyie
Background: Early sexual initiation is defined as an experience of first sexual intercourse before the age of 18 years. Young girls in sub-Saharan countries initiate sex at early age and are suffering from unintended pregnancy, and related sexual and reproductive health problems. Objectives: To assess the association of early sexual intercourse with early high birth rate, abortion and under-five child death among young girls in Ethiopia. Methods: This study used the Ethiopian Demographic Health Survey (EDHS) data from 2000 to 2016. A total of 12,002 sexually active young women aged 15-24 years pool data were used. Binary logistic regression model was used to assess the association between dependent (early sexual initiation) and independent variables and presented using adjusted odd ratio with 95% CI. Results: Young girls started sexual intercourse as early as 10 years. The young women with high birth rate [4.74, 95% CI (3.53-6.37)], those ever terminated pregnancy [1.77, 95% CI (1.25-2.52)], and had child death history [1.48, 95% CI (1.15-1.91)] were positively associated with early sexual intercourse. Conclusion: Early sexual initiation among young women is associated with early motherhood, high fertility, child death and poor reproductive health outcomes. Education program on contraceptives and condom accessibility are critical. Keywords: Early sexual intercourse; consequences; Ethiopia.
背景：过早开始性生活的定义是在 18 岁之前经历第一次性交。撒哈拉以南国家的少女过早开始性生活，导致意外怀孕以及相关的性健康和生殖健康问题。研究目的评估埃塞俄比亚少女过早发生性行为与高出生率、流产和五岁以下儿童死亡之间的关系。研究方法本研究使用了 2000 年至 2016 年的埃塞俄比亚人口健康调查（EDHS）数据。共使用了 12002 名 15-24 岁性生活活跃的年轻女性的数据。使用二元逻辑回归模型评估因变量（过早开始性行为）与自变量之间的关联，并使用调整后的奇数比和 95% CI 表示。结果少女早在 10 岁时就开始了性生活。高出生率[4.74，95% CI (3.53-6.37)]、曾终止妊娠[1.77，95% CI (1.25-2.52)]和有儿童死亡史[1.48，95% CI (1.15-1.91)]的年轻女性与过早发生性行为呈正相关。结论年轻女性过早开始性行为与早育、高生育率、儿童死亡和不良生殖健康结果有关。有关避孕药具和安全套的教育计划至关重要。关键词过早性行为；后果；埃塞俄比亚。
{"title":"Effect of early sexual initiation on early high fertility, termination of pregnancy and child death in Ethiopia using Ethiopian DHS 2000-2016","authors":"Girmatsion Fisseha Abreha, Abiodum O Ilesanmi, Adesina Oladokun, Araya Abrha Medhanyie","doi":"10.4314/ahs.v24i2.29","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.29","url":null,"abstract":"Background: Early sexual initiation is defined as an experience of first sexual intercourse before the age of 18 years. Young girls in sub-Saharan countries initiate sex at early age and are suffering from unintended pregnancy, and related sexual and reproductive health problems. \u0000Objectives: To assess the association of early sexual intercourse with early high birth rate, abortion and under-five child death among young girls in Ethiopia. \u0000Methods: This study used the Ethiopian Demographic Health Survey (EDHS) data from 2000 to 2016. A total of 12,002 sexually active young women aged 15-24 years pool data were used. Binary logistic regression model was used to assess the association between dependent (early sexual initiation) and independent variables and presented using adjusted odd ratio with 95% CI. \u0000Results: Young girls started sexual intercourse as early as 10 years. The young women with high birth rate [4.74, 95% CI (3.53-6.37)], those ever terminated pregnancy [1.77, 95% CI (1.25-2.52)], and had child death history [1.48, 95% CI (1.15-1.91)] were positively associated with early sexual intercourse. \u0000Conclusion: Early sexual initiation among young women is associated with early motherhood, high fertility, child death and poor reproductive health outcomes. Education program on contraceptives and condom accessibility are critical. \u0000Keywords: Early sexual intercourse; consequences; Ethiopia.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Despite it being treatable and preventable, morbidity from diarrhoeal disease still remains one of the leading killers of young children in developing countries. Objectives: To examine the effect of breastfeeding and maternal characteristics on diarrhoea morbidity among 0-2 years old children in Namibia. Methods: A quantitative cross-sectional study design with a multivariable log-binomial model was used to examine the effect of breastfeeding and maternal characteristics on diarrhoea morbidity among 0-2 year old children from data collected from the 2013 NDHS. Results: Breastfeeding and maternal related characteristics such as breastfeeding status, sharing toilet facilities with other households, total children ever born, health insurance cover and main language spoken in home had lower risks on child diarrhoea morbidity, while characteristics such as type of place of residence, highest educational level, electricity & refrigerator in the household, religion, wealth index, type of mosquito bed net(s) slept under last night, mother's age at first birth, current age of child, child’s residency and drugs taken for intestinal parasites in last 6 months had higher risks and region had mixed risks. Conclusions: Since studies have shown that the possibility of reducing the risk of morbidity related to diarrhoeal infections in children requires well-informed parents, all relevant organizations and governmental ministries that deals with health services and children’s well-being should make use of mass media like radio and television to constantly spread consistent messages on breastfeeding and advocate for better implementation of sanitation and hygiene practices among mothers with children aged 0-2 years, especially in rural and poorest areas of the Kavangos (East/West) and Caprivi/Zambezi regions. Keywords: Breastfeeding; diarrhoea; log-binomial model; maternal characteristics; child diarrhoea morbidity; Namibia.
{"title":"Effect of breastfeeding and maternal characteristics on diarrhoea morbidity among children aged 0-2 years in Namibia","authors":"Opeoluwa Oyedele","doi":"10.4314/ahs.v24i2.33","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.33","url":null,"abstract":"Background: Despite it being treatable and preventable, morbidity from diarrhoeal disease still remains one of the leading killers of young children in developing countries. \u0000Objectives: To examine the effect of breastfeeding and maternal characteristics on diarrhoea morbidity among 0-2 years old children in Namibia. \u0000Methods: A quantitative cross-sectional study design with a multivariable log-binomial model was used to examine the effect of breastfeeding and maternal characteristics on diarrhoea morbidity among 0-2 year old children from data collected from the 2013 NDHS. \u0000Results: Breastfeeding and maternal related characteristics such as breastfeeding status, sharing toilet facilities with other households, total children ever born, health insurance cover and main language spoken in home had lower risks on child diarrhoea morbidity, while characteristics such as type of place of residence, highest educational level, electricity & refrigerator in the household, religion, wealth index, type of mosquito bed net(s) slept under last night, mother's age at first birth, current age of child, child’s residency and drugs taken for intestinal parasites in last 6 months had higher risks and region had mixed risks. \u0000Conclusions: Since studies have shown that the possibility of reducing the risk of morbidity related to diarrhoeal infections in children requires well-informed parents, all relevant organizations and governmental ministries that deals with health services and children’s well-being should make use of mass media like radio and television to constantly spread consistent messages on breastfeeding and advocate for better implementation of sanitation and hygiene practices among mothers with children aged 0-2 years, especially in rural and poorest areas of the Kavangos (East/West) and Caprivi/Zambezi regions. \u0000Keywords: Breastfeeding; diarrhoea; log-binomial model; maternal characteristics; child diarrhoea morbidity; Namibia.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Callistus OA Enyuma, Abdullah E Laher, M. Moolla, Motara Feroza, G. Olorunfemi
Introduction: The outcome of paediatric emergency care is essential to the attainment of child-targeted sustainable development goals. We assessed the quality of paediatric emergency care among 34 tertiary Paediatric Emergency Departments (PED) in Nigeria. Methods: We conducted a cross-sectional process audit of recruited 34 PEDs in Nigeria. A paper questionnaire developed from the validated AAP/IFEM Guidelines for Care of Children in the ED was used to collect information on the PED settings, the processes of care and measurable patient outcome. Association between the regions, hospital volume category and other institutional attributes was conducted using chi-square, Results: The median (IQR) of paediatric visits and admissions to PEDs were 187.5 (120 - 300) and 107.5 (67 - 131) respectively. Over two-thirds (73.6 %,) of the PEDs had no set target Time-To-Physician consultation and the median (IQR) Length-of-Hospital Stay was 48 (0-72) hours.The majority of centres (90%) had patient safety tools but point-of-care-diagnostics (POCDs) were grossly deficient (23.5%). The mean protocol utilization score was 8.7 out of a maximum score of 34.The national crude death rate was 33.8 per 1000 children and there was no statistically significant relationship between the crude death rate and volume of hospital visits, (p-value=0.45) or geopolitical zones (p-value = 0.68). Conclusion: There was nationwide poor protocol utilization and non-availability of POCDs coupled with a high mortality rate at the PEDs. Development and utilization of locally relevant protocols and improvement in the availability of POCDs are essential. Keywords: Paediatrics; Emergency Department; Nigeria; quality of care; National survey.
{"title":"A National survey describing the quality of care in Paediatric Emergency Departments of Tertiary Hospitals in Nigeria","authors":"Callistus OA Enyuma, Abdullah E Laher, M. Moolla, Motara Feroza, G. Olorunfemi","doi":"10.4314/ahs.v24i2.35","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.35","url":null,"abstract":"Introduction: The outcome of paediatric emergency care is essential to the attainment of child-targeted sustainable development goals. We assessed the quality of paediatric emergency care among 34 tertiary Paediatric Emergency Departments (PED) in Nigeria. \u0000Methods: We conducted a cross-sectional process audit of recruited 34 PEDs in Nigeria. A paper questionnaire developed from the validated AAP/IFEM Guidelines for Care of Children in the ED was used to collect information on the PED settings, the processes of care and measurable patient outcome. Association between the regions, hospital volume category and other institutional attributes was conducted using chi-square, \u0000Results: The median (IQR) of paediatric visits and admissions to PEDs were 187.5 (120 - 300) and 107.5 (67 - 131) respectively. Over two-thirds (73.6 %,) of the PEDs had no set target Time-To-Physician consultation and the median (IQR) Length-of-Hospital Stay was 48 (0-72) hours.The majority of centres (90%) had patient safety tools but point-of-care-diagnostics (POCDs) were grossly deficient (23.5%). The mean protocol utilization score was 8.7 out of a maximum score of 34.The national crude death rate was 33.8 per 1000 children and there was no statistically significant relationship between the crude death rate and volume of hospital visits, (p-value=0.45) or geopolitical zones (p-value = 0.68). \u0000Conclusion: There was nationwide poor protocol utilization and non-availability of POCDs coupled with a high mortality rate at the PEDs. Development and utilization of locally relevant protocols and improvement in the availability of POCDs are essential. \u0000Keywords: Paediatrics; Emergency Department; Nigeria; quality of care; National survey.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Allan Komakech, Jonathan Izudi, J. Kamulegeya, Freda L Aceng, James Acaye, Edirisa Juniour Nsubuga, Petranilla Nakamya, D. Kadobera, Lilian Bulage, Benon Kwesiga, Alex R Ario
Background: Uganda started AstraZeneca COVID-19 vaccination in March 2021 but information about adverse events is limited. We assessed adverse events following AstraZeneca vaccination among adults in Greater Kampala, Uganda. Methods: In this cross-sectional study, we systematically sampled persons who had received ≥1 dose of the AstraZeneca vaccine and collected data between March and April 2021 through telephone interviews. We defined adverse events as any untoward medical occurrence after vaccination and serious adverse events as any event leading to hospitalization, persistent disability >28 days, death, or congenital anomaly. Results: Of 374 participants aged 20-85 years, the prevalence of adverse events was 76.5%. Common adverse events included injection site redness and hadache; no serious adverse event was reported. Participants aged 20–29 years (Adjusted odds ratio (AOR) 4.58; 95% confidence interval (CI): 1.92–10.95), 30-39 years (AOR 3.69; 95% CI: 1.81–7.51) and 40-49 years (AOR 2.78; 95% CI 1.26–4.90) were more likely to develop adverse events compared to those aged ≥50 years. Conclusion: Adverse events are prevalent, largely among those aged <50 years; serious adverse events are rare. Persons aged <50 years should be targeted for surveillance of adverse events alongside appropriate health education and counselling. Keywords: Adverse events; assessment; COVID-19; Greater Kampala; Uganda.
{"title":"Adverse events associated with AstraZeneca COVID-19 vaccine among adults in Greater Kampala, Uganda: a cross-sectional study","authors":"Allan Komakech, Jonathan Izudi, J. Kamulegeya, Freda L Aceng, James Acaye, Edirisa Juniour Nsubuga, Petranilla Nakamya, D. Kadobera, Lilian Bulage, Benon Kwesiga, Alex R Ario","doi":"10.4314/ahs.v24i2.12","DOIUrl":"https://doi.org/10.4314/ahs.v24i2.12","url":null,"abstract":"Background: Uganda started AstraZeneca COVID-19 vaccination in March 2021 but information about adverse events is limited. We assessed adverse events following AstraZeneca vaccination among adults in Greater Kampala, Uganda. \u0000Methods: In this cross-sectional study, we systematically sampled persons who had received ≥1 dose of the AstraZeneca vaccine and collected data between March and April 2021 through telephone interviews. We defined adverse events as any untoward medical occurrence after vaccination and serious adverse events as any event leading to hospitalization, persistent disability >28 days, death, or congenital anomaly. \u0000Results: Of 374 participants aged 20-85 years, the prevalence of adverse events was 76.5%. Common adverse events included injection site redness and hadache; no serious adverse event was reported. Participants aged 20–29 years (Adjusted odds ratio (AOR) 4.58; 95% confidence interval (CI): 1.92–10.95), 30-39 years (AOR 3.69; 95% CI: 1.81–7.51) and 40-49 years (AOR 2.78; 95% CI 1.26–4.90) were more likely to develop adverse events compared to those aged ≥50 years. \u0000Conclusion: Adverse events are prevalent, largely among those aged <50 years; serious adverse events are rare. Persons aged <50 years should be targeted for surveillance of adverse events alongside appropriate health education and counselling. \u0000Keywords: Adverse events; assessment; COVID-19; Greater Kampala; Uganda. ","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141834856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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