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Clinicopathological spectrum and outcome of appendicectomy at a South African tertiary hospital: continuing impact of delayed presentation 南非一家三级医院阑尾切除术的临床病理范围和结果:延迟就诊的持续影响
Pub Date : 2024-07-11 DOI: 10.4314/ahs.v24i2.37
Simelane Pb, Kader Ss, Madiba Te
Introduction: Appendicitis is a common surgical emergency, associated with significant morbidity and mortality. Aim: To describe the clinicopathological spectrum and outcome of appendicitis in our setting. Methods: Retrospective descriptive chart review of patients undergoing surgery for appendicitis over two study periods (Group A: 2010-2012 and Group B: 2016-2018). Data collected included demographics, clinical presentation, operative findings and outcome. Results: There were 229 patients in Group A [median age 24 (IQR 18-32) years] and 145 in Group B [median age 28 (IQR 20-36) years]. Median pre-hospital delay was 3 days for Group A 3 (IQR 2-4) and 1 day for Group B 1 (IQR 1-2). Complicated appendicitis occurred in 69 (30.1%) and 37 (25.5%) patients in Group A and B respectively. Post-operative complication rate was 18.3% and 8.3 % in Groups A and B respectively. Postoperative mortality in Group A was 3.5% and 2 1% for Group B. Delay in presentation was associated with increased complicated appendicitis. Conclusion: Complicated appendicitis was seen in one third of the patients in both groups. Delay in presentation persists in our setting and it is associated with complicated appendicitis, which carries an increased morbidity and mortality. Keywords: Appendicitis; complicated appendicitis; treatment outcomes.
简介阑尾炎是一种常见的外科急症,发病率和死亡率都很高。目的:描述本院阑尾炎的临床病理范围和预后。方法:回顾性描述性病历回顾对两个研究期间(A 组:2010-2012 年;B 组:2016-2018 年)接受阑尾炎手术的患者进行回顾性描述性病历审查。收集的数据包括人口统计学、临床表现、手术结果和预后。研究结果A组有229名患者[中位年龄24(IQR 18-32)岁],B组有145名患者[中位年龄28(IQR 20-36)岁]。中位院前延迟时间为:A 组 3 天(IQR 2-4),B 组 1 天(IQR 1-2)。A 组和 B 组分别有 69 名(30.1%)和 37 名(25.5%)患者出现并发阑尾炎。A 组和 B 组的术后并发症发生率分别为 18.3% 和 8.3%。A 组术后死亡率为 3.5%,B 组为 2.1%。结论两组患者中均有三分之一患有并发症阑尾炎。在我们的环境中,延误就诊的现象依然存在,而且它与并发阑尾炎有关,并发阑尾炎的发病率和死亡率都会增加。关键词:阑尾炎;复杂性阑尾炎阑尾炎;复杂性阑尾炎;治疗效果。
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引用次数: 0
Incidence of work-related musculoskeletal pain among Primary Health-care Providers 初级卫生保健提供者中与工作有关的肌肉骨骼疼痛发生率
Pub Date : 2024-07-11 DOI: 10.4314/ahs.v24i2.40
Mubushara Afzal, A. Khan, S. Farooqui
Background: Work related musculoskeletal pain is majorly responsible for decrease in the productivity of occupational work. It is an important work-related problem which is affecting the industrious and effective output of the work. The causes of work-related musculoskeletal pain are complex mesh of interrelated factors that exert their influence simultaneously. Aim: The purpose of this study was to determine the frequency of work- related musculoskeletal pain along with its associated factors amongst the obstetrics and gynecologist (OB/GYN) using a self-designed questionnaire. Methods: This was a cross sectional survey comprising of 196 obstetricians and gynecologists working in different public and private selected clinical settings. To gather data, self-designed questionnaire was used within a period of 4 weeks. Results: The prevalence of work-related musculoskeletal pain was seen in 171 (87.2%) out of 196 subjects, in at least one region and 25 (12.8%) subjects reported no musculoskeletal pain. The symptoms were majorly seen in lower back (59.2%) and leg (37.8%), also neck (27.8%), shoulder (26.0%), arm (12.8%), mid back (16.8) and upper back (9.2%). Conclusion: The results of this study showed that work-related musculoskeletal pain is highly prevalent in obstetrics and gynecologists, and it has a great impact on their daily lives. Keywords: Musculoskeletal pain; obstetrics and gynecology; posture.
背景:与工作相关的肌肉骨骼疼痛是导致职业工作生产率下降的主要原因。它是一个重要的工作相关问题,影响着工作的勤奋和有效产出。与工作有关的肌肉骨骼疼痛的原因是由相互关联的因素组成的复杂网状结构,这些因素同时施加影响。目的:本研究的目的是使用自行设计的调查问卷,确定妇产科医生(OB/GYN)中与工作相关的肌肉骨骼疼痛的频率及其相关因素。调查方法这是一项横断面调查,共有 196 名妇产科医生参加,他们分别在不同的公立和私立临床机构工作。为了收集数据,在 4 周内使用了自行设计的问卷。结果显示在 196 名受试者中,有 171 人(87.2%)至少在一个部位出现过与工作相关的肌肉骨骼疼痛,25 人(12.8%)没有出现过肌肉骨骼疼痛。症状主要出现在下背部(59.2%)和腿部(37.8%),还有颈部(27.8%)、肩部(26.0%)、手臂(12.8%)、中背部(16.8%)和上背部(9.2%)。结论研究结果表明,与工作相关的肌肉骨骼疼痛在妇产科医生中非常普遍,对他们的日常生活造成了很大影响。关键词肌肉骨骼疼痛;妇产科;姿势。
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引用次数: 0
A retrospective study of Crimean-Congo hemorrhagic fever in Iraq 伊拉克克里米亚-刚果出血热回顾性研究
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.8
Doaa Adnan Shaker, Muna Tawfeeq Abd, Nawar Jassim Alsalih, Sinan Ghazi Mahdi, Mohenned Alsaadawi, Ihab Raqeeb Aakef, Tareq Jafaar Aljandeel
Background: CCHF is transmitted via ticks biting and directly by contact with tissue or blood of infected patients or viremicanimals. This study intends to determine the occurrence of CCHF in Iraq between 2015 and 2019. Methods: This study was designed as a retrospective and descriptive cross-sectional study. It was approved the occurrence ofCCHF in Iraq with relation to some epidemiological and demographic data reported in the Iraqi Communicable Diseases ControlCenter (CDC)/zoonotic diseases section between 2015-2019. Results: Out of 206 suspected cases, only 17 were diagnosed as CCHF with a total fatality ratio of 52%, 25%, and 80% in 2015and 2018 respectively. However, no mortality was reported during 2016, 2017, and 2019. The mean age of the patients was 33years± 18 SD, in males mainly (76%). Moreover, the risk groups were 29 %, 23 %, 18 % 12 %, and 6 % for butchers, animaldealers, gainers, both housewives and students and children respectively. Conclusion: Strict precautions and precise surveillance should be implemented to control the disease and protect the communityby improving the diagnosis and treatment of CCHF. The authors recommend another future study to detect the genotypingand sequencing of CCHFV in Iraq. Keywords: Crimean–Congo hemorrhagic fever; Iraq; tick.
背景:CCHF通过蜱虫叮咬和直接接触感染患者或病毒动物的组织或血液传播。本研究旨在确定 2015 年至 2019 年期间伊拉克的 CCHF 发生情况。研究方法:本研究是一项回顾性和描述性横断面研究。它结合伊拉克传染病控制中心(CDC)/动物传染病科报告的 2015-2019 年间一些流行病学和人口统计学数据,对伊拉克 CCHF 的发生情况进行了核准。结果:在 206 例疑似病例中,只有 17 例被确诊为 CCHF,2015 年和 2018 年的总致死率分别为 52%、25% 和 80%。然而,2016 年、2017 年和 2019 年均无死亡病例报告。患者的平均年龄为(33 岁± 18 SD),以男性为主(76%)。此外,屠夫、动物交易者、增益者、家庭主妇、学生和儿童的风险组别分别为 29%、23%、18%、12% 和 6%。结论应采取严格的预防措施和精确的监测来控制该疾病,并通过改善 CCHF 的诊断和治疗来保护社区。作者建议今后再开展一项研究,对伊拉克的 CCHFV 进行基因分型和测序。关键词:克里米亚-刚果出血热克里米亚-刚果出血热;伊拉克;蜱虫。
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引用次数: 0
Prevalence of HIV, HBV and HCV among livestock merchants and slaughterhouse workers in Ibadan, Nigeria 尼日利亚伊巴丹牲畜商人和屠宰场工人的艾滋病毒、乙肝病毒和丙肝病毒感染率
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.4
Adewale V Opayele, Olamide T Arege, Adedayo O Faneye, David O Olaleye, Georgina N Odaibo
Background: Most studies on viral infections among livestock handlers have focused on occupational exposure from inadvertent contact with infected animals. Consequently, little emphasis is given to the effect of their lifestyle on the acquisition of other blood-borne viruses. Objectives: To determine the prevalence and assess risk factors for HIV, HBV and HCV infections among livestock handlers in Ibadan, Nigeria. Methods: Blood samples were collected from 265 livestock handlers between October 2016 to April 2017 in Ibadan. The samples were tested for the presence of antibodies to HIV and HCV; and surface antigen to HBV using ELISA. Structured questionnaire was administered to collect information on risk factors associated with the transmission of these viruses. Data analysis was carried out using Chi-square test and logistic regression to determine the association between risk factors and predictors of infection (p < 0.05). Results: Of 265 participants, 11 (4.2%), 29 (10.9%) and 13 (4.9%) individuals tested positive for HIV, HBV and HCV infections respectively. Two (0.8%) of the participants were coinfected with HIV and HBV while 1(0.4%) was coinfected with both HBV and HCV. Individuals who travelled frequently in the course of Livestock trades had a higher rate of HIV infection. Conclusions: A high Infection with HIV, HBV and HCV is common among the study participants. There is a need for continued surveillance and awareness creation on preventive measures against these viruses. Keywords: Human immunodeficiency virus; viral hepatitis; slaughterhouse workers.
背景:有关家畜饲养人员病毒感染的大多数研究都集中在因无意中接触受感染动物而导致的职业暴露上。因此,人们很少关注他们的生活方式对感染其他血液传播病毒的影响。研究目的确定尼日利亚伊巴丹市牲畜饲养人员感染 HIV、HBV 和 HCV 的流行率并评估其风险因素。方法2016 年 10 月至 2017 年 4 月期间,在伊巴丹收集了 265 名牲畜饲养者的血液样本。使用 ELISA 检测样本中是否存在 HIV 和 HCV 抗体以及 HBV 表面抗原。为了收集与这些病毒传播相关的风险因素的信息,还发放了结构化问卷。采用卡方检验和逻辑回归法进行数据分析,以确定风险因素与感染预测因素之间的关联(P < 0.05)。结果:在 265 名参与者中,分别有 11 人(4.2%)、29 人(10.9%)和 13 人(4.9%)检测出艾滋病毒、乙型肝炎病毒和丙型肝炎病毒感染呈阳性。其中 2 人(0.8%)同时感染了 HIV 和 HBV,1 人(0.4%)同时感染了 HBV 和 HCV。在牲畜交易过程中频繁旅行的人感染艾滋病毒的比例较高。结论研究参与者中艾滋病毒、乙肝病毒和丙肝病毒感染率较高。有必要对这些病毒进行持续监测,并提高人们对预防措施的认识。关键词人类免疫缺陷病毒;病毒性肝炎;屠宰场工人。
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引用次数: 0
Haematological parameter among drug resistant tuberculosis patients in Ibadan 伊巴丹耐药性肺结核患者的血液学参数
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.3
Pelumi Daniel Adewole, Tosin Deborah Ogundipe, Olumuyiwa Samuel Alabi, Abdulrazak Nuhu
Background: Haematological abnormalities are common among tuberculosis patients but there is dearth of information on their value as prognostic markers in multidrug resistant tuberculosis patients. This study examined the association between complete blood count variables and drug resistant tuberculosis. Materials and methods: Nighty (90) consenting adults comprising 30 Drug Resistant Tuberculosis patients (DR-TB), 30 Drug susceptible tuberculosis patients (DS-TB) and 30 healthy participants were recruited in this study. Ethical approval was obtained from Oyo State Ministry of Health Institutional Review Board while patients’ demographic data were collected using structured questionnaire. Five milliliters (5mL) of blood samples were collected in EDTA bottle. Haematological parameters were analysed using impedance technique and Mindary-BG5380 5-part automated system. Result: The mean hemoglobin levels were significantly lower in DR-TB patients (11.70 ± 2.73 g/dL) than in DS-TB patients (8.33 ± 9.56 fL), with a mean difference of -3.37 ± 12.29 g/dL. The mean MCH and MCHC levels were also slightly lower in DR-TB patients (26.17 ± 3.44 pg and 30.41 ± 1.92 g/dL, respectively), but the differences were not statistically significant. The WBC count was similar in both groups (8.20 ± 3.80 × 10^9 /L and 8.45 ± 3.63 × 10^9 /L, respectively). Conclusion: The mean hemoglobin levels were significantly lower in DR-TB patients than in DS-TB patients which may be due to the increased inflammation associated with DR-TB. The WBC count was similar in both groups, suggesting that the immune system is responding similarly to the infection in both DR-TB and DS-TB patients.Recommendation: In the meantime, healthcare providers should be aware of these potential differences and use them to inform their diagnosis and treatment of patients with tuberculosis. Keywords: Haematological parameters; drug resistant tuberculosis; Ibadan.
背景:血液学异常在肺结核患者中很常见,但有关其作为耐多药肺结核患者预后标志物的价值的信息却很少。本研究探讨了全血细胞计数变量与耐药结核病之间的关联。材料和方法本研究征得了 90 名成人的同意,其中包括 30 名耐药性肺结核患者(DR-TB)、30 名药物敏感性肺结核患者(DS-TB)和 30 名健康参与者。研究获得了奥约州卫生部机构审查委员会的伦理批准,并使用结构化问卷收集了患者的人口统计学数据。研究人员用 EDTA 瓶采集了五毫升(5mL)血样。使用阻抗技术和 Mindary-BG5380 5 部分自动系统分析血液学参数。结果DR-TB 患者的平均血红蛋白水平(11.70 ± 2.73 g/dL)明显低于 DS-TB 患者(8.33 ± 9.56 fL),平均差异为 -3.37 ± 12.29 g/dL。DR-TB 患者的 MCH 和 MCHC 平均水平也略低(分别为 26.17 ± 3.44 pg 和 30.41 ± 1.92 g/dL),但差异无统计学意义。两组患者的白细胞计数相似(分别为 8.20 ± 3.80 × 10^9 /L 和 8.45 ± 3.63 × 10^9 /L)。结论DR-TB患者的平均血红蛋白水平明显低于DS-TB患者,这可能是与DR-TB相关的炎症加重所致。两组患者的白细胞计数相似,表明 DR-TB 和 DS-TB 患者的免疫系统对感染的反应相似:建议:与此同时,医疗服务提供者应了解这些潜在的差异,并以此作为诊断和治疗肺结核患者的依据。关键词血液学参数;耐药性结核病;伊巴丹。
{"title":"Haematological parameter among drug resistant tuberculosis patients in Ibadan","authors":"Pelumi Daniel Adewole, Tosin Deborah Ogundipe, Olumuyiwa Samuel Alabi, Abdulrazak Nuhu","doi":"10.4314/ahs.v24i1.3","DOIUrl":"https://doi.org/10.4314/ahs.v24i1.3","url":null,"abstract":"Background: Haematological abnormalities are common among tuberculosis patients but there is dearth of information on their value as prognostic markers in multidrug resistant tuberculosis patients. This study examined the association between complete blood count variables and drug resistant tuberculosis. \u0000Materials and methods: Nighty (90) consenting adults comprising 30 Drug Resistant Tuberculosis patients (DR-TB), 30 Drug susceptible tuberculosis patients (DS-TB) and 30 healthy participants were recruited in this study. Ethical approval was obtained from Oyo State Ministry of Health Institutional Review Board while patients’ demographic data were collected using structured questionnaire. Five milliliters (5mL) of blood samples were collected in EDTA bottle. Haematological parameters were analysed using impedance technique and Mindary-BG5380 5-part automated system. \u0000Result: The mean hemoglobin levels were significantly lower in DR-TB patients (11.70 ± 2.73 g/dL) than in DS-TB patients (8.33 ± 9.56 fL), with a mean difference of -3.37 ± 12.29 g/dL. The mean MCH and MCHC levels were also slightly lower in DR-TB patients (26.17 ± 3.44 pg and 30.41 ± 1.92 g/dL, respectively), but the differences were not statistically significant. The WBC count was similar in both groups (8.20 ± 3.80 × 10^9 /L and 8.45 ± 3.63 × 10^9 /L, respectively). \u0000Conclusion: The mean hemoglobin levels were significantly lower in DR-TB patients than in DS-TB patients which may be due to the increased inflammation associated with DR-TB. The WBC count was similar in both groups, suggesting that the immune system is responding similarly to the infection in both DR-TB and DS-TB patients.Recommendation: In the meantime, healthcare providers should be aware of these potential differences and use them to inform their diagnosis and treatment of patients with tuberculosis. \u0000Keywords: Haematological parameters; drug resistant tuberculosis; Ibadan.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793422","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}
引用次数: 0
Clinicopathological study of otomycosis in a tertiary hospital in South-west Nigeria 尼日利亚西南部一家三级医院耳霉菌病的临床病理学研究
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.9
Olusola A Sogebi, Emmanuel A Oyewole, Olubunmi A Osinupebi
Background: Otomycosis is common in environments with hot, humid weather, and it may be challenging to manage. Objectives: To profile common clinical presentations, the pathogenic fungi, the treatment modalities with responses, and exploreclinical factors associated with having positive fungal culture in Otomycosis. Methods: Retrospective review of patients with Otomycosis. Demographic and clinical parameters, otoscopic findings andmycological study results were recorded. The treatment modalities used and treatment response were summarized. Comparativestatistical analyses of associated factors to positive fungal culture were performed with Chi square test, and Student’s t-test, usingSPSS version 22.0 Results: Total of 71 patients with M: F=1:1.8, mean age 38.5±19.8 years. Average duration of symptoms was 5.4 ±4.6 weeks;common presenting complaint was itchy ear (33.8%). Majority of patients (85.9%) had unilateral ear involvement, 50.0% appliedototopic medications before presentation, 8.5% had multiple co-morbidities. 20 patients had positive fungal culture results; commonfungal isolate was Aspergillus niger 9 (45.0%).Clinical factors associated with positive culture of fungus were age, non-previous use of ototopic drugs, and presence ofco-morbidity. The most common treatment was local ear debridement and use of topical antifungal creams. Majority (91.5%)of the patients responded with resolution of fungal infection. Complications rate was 8.4%. Conclusions: Otomycosis commonly present with itchy ears, the pathogenic fungi commonly being Aspergillus species. Thefactors associated with positive fungal culture were age, non-usage of ototopic agents and presence of co-morbidity. Treatmentmodality used was local debridement and topical antifungal agents, which produced favourable response in most patients. Keywords: Otomycosis; mycology; presentations; treatment; complications; associations.
背景:耳霉菌病常见于天气炎热、潮湿的环境中,其治疗具有挑战性。目的:概述耳霉菌病的常见临床表现、致病真菌、治疗方法及反应,并探讨其临床表现:概述耳霉菌病的常见临床表现、致病真菌、治疗方法及反应,并探讨与真菌培养阳性相关的临床因素。方法:对耳霉菌病患者进行回顾性分析:回顾性分析耳霉菌病患者。记录人口统计学和临床参数、耳镜检查结果和肿瘤学研究结果。总结所使用的治疗方法和治疗反应。使用 22.0 版 SPSS 对真菌培养呈阳性的相关因素进行了比较统计分析,采用卡方检验(Chi Square test)和学生 t 检验(Student's t test):共有 71 名患者,男:女=1:1.8,平均年龄(38.5±19.8)岁。平均病程为(5.4±4.6)周;常见主诉为耳痒(33.8%)。大多数患者(85.9%)为单侧耳部受累,50.0%的患者在发病前使用过异位药物,8.5%的患者合并多种疾病。20名患者的真菌培养结果呈阳性,常见的真菌分离物为黑曲霉9株(45.0%)。与真菌培养呈阳性相关的临床因素包括年龄、未使用过耳穴贴药和合并其他疾病。最常见的治疗方法是局部耳部清创和使用外用抗真菌药膏。大多数患者(91.5%)的真菌感染症状得到缓解。并发症发生率为 8.4%。结论耳霉菌病通常表现为耳朵发痒,致病真菌通常是曲霉菌。真菌培养呈阳性的相关因素包括年龄、未使用耳穴贴敷药物以及合并其他疾病。治疗方法是局部清创和外用抗真菌药物,大多数患者都取得了良好的疗效。关键词耳霉菌病;真菌学;表现;治疗;并发症;关联。
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引用次数: 0
Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese District, Uganda 乌干达卡塞塞区选定医疗机构中客户加入社区客户主导的抗逆转录病毒疗法(CCLAD)的障碍
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.7
Kizito Omona
Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services. Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda. Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide. Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 – 3.270)]. Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low. Keywords: Community client led anti-retroviral therapy delivery (CCLAD); enrolment; health care and public health.
背景:社区患者主导的抗逆转录病毒疗法提供模式(CCLAD)与社区参与度和自主权的提高有关,这种模式可通过减少工作量和提高患者对医疗服务的满意度来改善治疗效果。目的:在乌干达卡塞塞区选定的医疗机构中,探讨符合条件的患者加入 CCLAD 的障碍。材料与方法:采用混合方法对 384 名在卡塞塞区公共医疗机构就诊的 PLWHIV 进行了横断面分析研究。抽样采用简单随机抽样法。采用研究人员发放的问卷调查法和访谈指南收集数据。结果大多数受访者有 253 人(65.9%)尚未加入 CCLAD。这是由于一些与客户相关的因素造成的,如未披露 HIV 血清状况(p=0.040)、向谁披露了 HIV 血清状况(p=0.009)、从未听说过 CCLAD(p=0.000)、对 CCLAD 的描述不正确(p=0.000)、对 CCLAD 的优点(p=0.000)或缺点(p=0.003)了解有限。其他障碍包括:无法接触支持 PLWHIV 接受治疗的组织或团体(p=0.025),以及抗逆转录病毒疗法续药时间[AOR=1.637,95% CI (0.820 - 3.270)]。结论卡塞塞地区的艾滋病毒感染者对CCLAD模式的采用率仍然很低。关键词社区客户主导的抗逆转录病毒疗法(CCLAD);注册;医疗保健与公共卫生。
{"title":"Barriers to enrolment of clients into community client led anti-retroviral therapy delivery (CCLAD) in selected health facilities in Kasese District, Uganda","authors":"Kizito Omona","doi":"10.4314/ahs.v24i1.7","DOIUrl":"https://doi.org/10.4314/ahs.v24i1.7","url":null,"abstract":"Background: Community Client Led Anti-retroviral therapy Delivery (CCLAD) Model has been associated with increased community participation and ownership, which leads to better treatment outcomes with reduced workload and increased client satisfaction of health services. \u0000Aim: To explore the barriers to enrolment of eligible clients into CCLAD in selected health facilities in Kasese District, Uganda. \u0000Materials & methods: Analytical cross-sectional study utilizing mixed method approach was conducted among 384 PLWHIV attending public health facilities of Kasese District. Sampling was done by simple random sampling method. Data was collected using researcher-administered questionnaire method and interview guide. \u0000Results: Most of the respondents 253(65.9%) had not yet enrolled into CCLAD. This was due to some client-related factors such as non-disclosure of HIV sero-status (p=0.040), person to whom HIV sero-status was disclosed to (p=0.009), not having ever heard about CCLAD (p=0.000), incorrect description of CCLAD (p=0.000), limited knowledge of advantages of CCLAD (p=0.000) or disadvantages of CCLAD (p=0.003). Other barriers were; failure to have access to organizations or groups that support PLWHIV to get treatment (p=0.025) and duration of ART refills [AOR=1.637, 95% CI (0.820 – 3.270)]. \u0000Conclusion: Adoption of CCLAD model among PLWHIV in Kasese District is still low. \u0000Keywords: Community client led anti-retroviral therapy delivery (CCLAD); enrolment; health care and public health.","PeriodicalId":94295,"journal":{"name":"African health sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762003","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}
引用次数: 0
Effects of SNPs on TNF-α and IL-10 cytokine expression in TB and HIV patients in the Capricorn district, Limpopo Province, South Africa SNPs 对南非林波波省摩羯座地区肺结核和艾滋病患者 TNF-α 和 IL-10 细胞因子表达的影响
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.2
Mosebo A Manabile, Tibello C Maguga-Phasha, Marema E Makgatho
Background: The impact of Tuberculosis (TB) places an immense burden on the health care system. Infection with HumanImmunodeficiency Virus (HIV) is a significant risk factor in the development and progression of TB disease. Single NucleotidePolymorphisms (SNPs) in the promoter region of Interleukin-10 (IL-10) and Tumour Necrotic Factor-Alpha (TNF-α) may playa major role in the disease mechanism and understanding these mechanisms might prove to be a useful diagnostic tool in evaluatingthe immune regulation and progression of the disease. Objective: This study aimed to determine the relationship between cytokine levels and gene variants of Interleukin-10 and TumourNecrotic Factor Alpha in TB and HIV-infected participants. Methods: Cytokine levels were determined by ELISA, and SNPs were determined by MassArray®. Results: The levels of TNF-α were higher in the TB group than the HIV (p < 0.001) and TB-HIV (p = 0.011) groups, but similar to the TNF-α levels in the control group. In the HIV group, IL-10 levels were higher than those of the TB (p < 0.001) and control groups (p = 0.039), whereas there was no difference between the IL-10 levels in the HIV and the TB-HIV infection groups. The ratio was determined and there were no differences between the four infection groups. In this study, no associations were detected between the circulating plasma levels of TNF-α and IL-10 and their genotypes. Conclusion: Our data showed that the gene variants were not associated with circulating plasma levels of TNF-α and IL-10 in our study population. A pro-inflammatory environment was found in the TB and TB-HIV groups, which is suggesting of bacterial clearance, while an anti-inflammatory environment was found in the HIV group, which suggests the suppression ofviral replication. Keywords: Tuberculosis; Human immunodeficiency virus; interleukin-10.
背景:结核病(TB)的影响给医疗保健系统带来了巨大负担。感染人类免疫缺陷病毒(HIV)是结核病发生和发展的重要风险因素。白细胞介素-10(IL-10)和肿瘤坏死因子-α(TNF-α)启动子区域的单核苷酸多态性(SNPs)可能在疾病机制中扮演重要角色,了解这些机制可能被证明是评估免疫调节和疾病进展的有用诊断工具。研究目的本研究旨在确定肺结核和艾滋病病毒感染者体内细胞因子水平与白细胞介素-10和肿瘤坏死因子α基因变异之间的关系。研究方法细胞因子水平用 ELISA 法测定,SNPs 用 MassArray® 法测定。结果:TNF肺结核组的 TNF-α 水平高于 HIV 组(p < 0.001)和 TB-HIV 组(p = 0.011),但与对照组的 TNF-α 水平相似。在艾滋病毒组中,IL-10 水平高于结核病组(p < 0.001)和对照组(p = 0.039),而在艾滋病毒感染组和结核病-艾滋病毒感染组中,IL-10 水平没有差异。经测定,四个感染组之间的比值没有差异。本研究未发现 TNF-α 和 IL-10 的循环血浆水平与基因型之间存在关联。结论我们的数据显示,在我们的研究人群中,基因变异与TNF-α和IL-10的循环血浆水平无关。在肺结核组和肺结核-HIV组中发现了促炎环境,这表明细菌被清除,而在HIV组中发现了抗炎环境,这表明病毒复制被抑制。关键词结核病;人类免疫缺陷病毒;白细胞介素-10。
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引用次数: 0
Preconception and contraceptive care for women living with HIV/AIDS attending antiretroviral treatment clinics in Lagos State, Nigeria 尼日利亚拉各斯州抗逆转录病毒治疗诊所为感染艾滋病毒/艾滋病的妇女提供的孕前和避孕护理
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.5
Samuel Oyibo, Atariata Oghenewoke, Mary O Balogun, Ugbe Maurice-Joel Ugbe
Background: Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring. Objective: The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria. Methods: This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process. Results: Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), p = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), p = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), p = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), p = 0.002] were significantly related to the utilization of contraceptives. Conclusion: There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS. Keywords: Preconception care; contraceptive care; HIV/AIDS; women.
背景:感染艾滋病毒/艾滋病的妇女与未感染艾滋病毒/艾滋病的妇女一样有生育愿望,随着健康疗法的进步,这些妇女可以现实地生育和抚养未感染艾滋病毒/艾滋病的孩子。孕前保健(PC)是一种专门的干预形式,旨在预防、识别、治疗和管理不利于安全孕产和生育健康后代的生物医学、行为和社会条件。研究目的本研究旨在评估尼日利亚拉各斯州阿利莫肖市抗逆转录病毒治疗诊所的女性艾滋病感染者的孕前和避孕护理情况。研究方法这是一项基于设施的横断面描述性研究,研究对象是在研究地区抗逆转录病毒疗法诊所就诊的 383 名感染艾滋病毒/艾滋病的育龄妇女。在选择过程中使用了概率抽样方法。数据采用描述性统计、卡方检验和单变量逻辑回归进行分析,显著性水平为 5%。选择过程中使用了分层抽样和简单随机抽样。结果只有 37.4% 的受访者接受过最佳的个人电脑服务。20-29 岁[OR =1.716 (95% CI: 1.664, 1.769),p = 0.020]、30-39 岁[OR =1.514 (95% CI: 0.598, 3.831),p = 0.005]、高等教育程度[OR =8.43. (95% CI: 1.41, 18.5), p = 0.020]、单身[OR =2.00 (95% CI: 1.928-2.072), p = 0.002]与使用避孕药具显著相关。结论有必要为感染艾滋病毒/艾滋病的妇女提供结构和指南,以优化PC和避孕药具服务。关键词孕前保健;避孕保健;艾滋病毒/艾滋病;妇女。
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引用次数: 0
Sociodemographic predictors of beliefs about getting HIV infection by witchcraft or supernatural means: A population-based study of 15335 Senegalese women 通过巫术或超自然手段感染艾滋病的信念的社会人口预测因素:对 15335 名塞内加尔妇女进行的人口研究
Pub Date : 2024-04-01 DOI: 10.4314/ahs.v24i1.6
Amr Ehab El-Qushayri, Amira Yasmine Benmelouka
Aim: To provide more insights about beliefs of witchcraft and supernatural means as causes of human immunodeficiency virus(HIV) among women in Senegal. Method: We included eligible women from the demographic and health survey conducted in Senegal during the year 2017. Results: We included 15335 women, of those 620 (4%) thought that they can get HIV through witchcraft or supernaturalmeans. After the adjustment of all available covariates, old age, receiving primary or secondary education, higher wealth index,more frequency of listening to radio, watching television for less than once a week and reading newspaper or magazine for atleast once a week were significantly associated with a reduction in the witchcraft and supernatural means beliefs (p < 0.05).Moreover, rural residence was associated with an increase in the wrong HIV beliefs (p < 0.05). Conclusion: We demonstrated many predictors of the wrong beliefs about getting HIV infection by witchcraft or supernaturalmeans in the Senegalese women. Policymakers should initiate health educational programs in parallel with increasing thesocioeconomic status to limit the HIV transmission. In addition, continuous monitoring of the HIV knowledge in the endemiccountries is crucial to decrease HIV burden. Keywords: HIV; infection; witchcraft; misconception; myths.
目的:进一步了解塞内加尔妇女对巫术和超自然手段作为人类免疫缺陷病毒(HIV)病因的看法。调查方法我们纳入了 2017 年在塞内加尔进行的人口与健康调查中符合条件的妇女。结果:我们纳入了 15335 名妇女,其中有 620 人(4%)认为她们可以通过巫术或超自然手段感染艾滋病毒。在对所有可用协变量进行调整后,年龄较大、接受过小学或中学教育、财富指数较高、收听广播的频率较高、每周看电视少于一次以及每周至少阅读一次报纸或杂志与巫术和超自然手段信仰的减少显著相关(P < 0.05),此外,农村居民与错误的艾滋病信仰的增加相关(P < 0.05)。结论我们发现了许多预测塞内加尔妇女通过巫术或超自然手段感染艾滋病的错误观念。政策制定者应在提高社会经济地位的同时启动健康教育计划,以限制艾滋病毒的传播。此外,持续监测艾滋病流行国家的艾滋病知识对于减少艾滋病负担也至关重要。关键词艾滋病毒;感染;巫术;误解;神话。
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引用次数: 0
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African health sciences
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