Information about COVID-19: Lessons learned from Mali

Introduction. In Mali, information related to COVID-19 is regularly shared by the coordination board against COVID-19 through daily official press releases and situation reports. The goal of this study was to analyze data related to the tested samples; and the confirmed, contacts, recovered and dead cases in order to take lessons for the future. Population and methods. Data from the first 100 days after the detection of the first cases in Mali were collected and recorded on an Excel file before they got analyzed using SPSS 25.0 software. Analyses were descriptive and correlational. Results. We included 14938 tested samples, 2260 confirmed cases, 12864 contact cases, 1502 recovered cases and 117 deaths were reported during the first 100 days of the epidemic. There was a positive correlation between the number of confirmed cases; and the number of tested samples, the number of recovered cases and the number of deaths. These results suggest that the number of confirmed cases increase with the number of tested samples. Conclusion. These results call for more testing and encourage the identification, location and follow-up of COVID-19 cases. They can also be used to support the improvement of data quality and the response to COVID-19. As a result, they can contribute to improve population health

South Africa's COVID-19 Tracing Database: Risks and rewards of which doctors should be aware

In response to the COVID-19 pandemic, South Africa (SA) has established a Tracing Database, collecting both aggregated and individualised mobility and locational data on COVID-19 cases and their contacts. There are compelling public health reasons for this development, since the database has the potential to assist with policy formulation and with contact tracing. While potentially demonstrating the rapid facilitation through technology of an important public service, the Tracing Database does, however, infringe immediately upon constitutional rights to privacy and heightens the implications of ethical choices facing medical professionals. The medical community should be aware of this surveillance innovation and the risks and rewards it raises. To deal with some of these risks, including the potential for temporary rights- infringing measures to become permanent, there are significant safeguards designed into the Tracing Database, including a strict duration requirement and reporting to a designated judge. African states including SA should monitor this form of contact tracing closely, and also encourage knowledge-sharing among cross-sectoral interventions such as the Tracing Database in responding to the COVID-19 pandemic

Cochrane, evidence-based medicine and associated factors: A cross-sectional study of the experiences and knowledge of Ethiopian specialists in training

Introduction: Evidence-based healthcare is a core competency for practicing healthcare practitioners and those in speciality training. In sub-Saharan Africa, little is known about the teaching of evidence-based medicine (EBM) in residency program. This survey evaluated the experiences and knowledge of Cochrane, EBM and associated factors among Ethiopian specialists in training.Methods: A convenient sample of trainee specialists completed a pretested self-administered survey. The majority (93%) were ≤30 years old, males (63%) and 41% in paediatrics speciality. The associations of categorical variables with EBM knowledge was assessed by Fisher's exact or Chi-Square tests. Covariates contributing to EBM knowledge were identified using multivariate logistic regression analysis.Results: Eighty-three trainees participated in the survey (response rate 88.2%). About 75% have heard aboutCochrane but no one recognized Cochrane South Africa. Only 25% of the trainees knew the Cochrane Library but none used it in clinical practice. Most (78%) have heard of EBM, 15% had attended EBM course, 96% wanted to attend EBM course and 81% had positive attitudes to EBM. Trainees EBM knowledge was associated withawareness of Cochrane [Adjusted odds ratio (AOR) = 8.5, 95% Confidence interval (CI) 1.3­54.6, P = 0.02], EBM (AOR = 51.2, 95% CI 2.7­960.8, P = 0.009), and being in third year training (AOR = 28.4, 95% CI 1.9­427.2, P = 0.02). The promotion of EBM in residency hospital (AOR = 22.2, 95% CI 2.2­223.8, P = 0.008) and being aware of Cochrane (AOR = 4.8, 95% CI 1.1­21.7, P = 0.04) were predictors of positive attitude. Familiarity with Cochrane Library was influenced by EBM knowledge (AOR = 6.6, 95% CI 1.4­31.5, P = 0.02) and perceived organization barrier to accessing the resource (AOR = 3.2, 95% CI 1.03­10.1, P = 0.04). Conclusion: Ethiopian trainee specialists lacked formal EBM training, awareness and use of the Cochrane Library. To improve the healthcare quality and patient outcomes, EBM education should be integrated into residency curricula

EMJ series on statistics and methods: normal distribution and the central limit theorem

This second article in the EMJ Series on Statistics and Methods dwells on the basics of sampling distribution of' variables', which are presented in detail in the preceding article in this Issue of the Ethiopian Medical Journal (EMJ). The present article highlights recommended routines that need to be undertaken in order to understand information collected in a particular study before embarking on doing complex statistical analyses. It underscores the importance of descriptive statistics as a means to getting insights into data quality and learn about the scale and distribution of different variables in a data set. The article emphasizes the need for assessing the sampling distributions of variables as a prerequisite to making decide on selection of appropriate statistical techniques for in a data set. It describes salient features of a normally distributed random variable and touches on some other probability distributions commonly used in epidemiological studies. The article also describes the central limit theorem highlighting salient points on its conceptual basis in understanding sampling distributions of sample means and the implications of using normal distribution to make inference about the population based on summary measures from a sufficiently large sample

Prevalence of Hepatitis B Virus Infection in Nigeria; 2000-2013: A Systematic Review and Meta-Analysis

Vaccination against the hepatitis B virus (HBV) in the West African nation of Nigeria is lower than many Sub-Saharan African countries. In Nigeria; HBV is reported to be the most common cause of liver disease. However; the extent of HBV exposure among Nigerians at average risk is unknown. Our aim; therefore; was to accurately estimate the HBV prevalence for the country and the prevalence for specific subgroups. We used electronic databases to select systematic reviews and meta-analyses from 2000 to 2013. Forty-six studies were included (n = 34;376 persons). We used a random effects meta-analysis of cross-sectional and longitudinal studies to generate our estimates. The pooled prevalence of HBV in Nigeria was 13.6 (95 confidence interval [CI]: 11.5; 15.7). The pooled prevalence ( [95 CI]) among subgroups was: 14.0 (11.7; 16.3) for blood donors; 14.1 (9.6; 18.6) for pregnant women attending antenatal clinics; 11.5 (6.0; 17.0) for children; 14.0 (11.6; 16.5) among adults; and 16.0 (11.1; 20.9) for studies evaluating adults and children. HBV prevalence in Nigeria varied by screening method [ (95 CI)]: 12.3 (10.1; 14.4) by using enzyme-linked immunosorbent assay; 17.5 (12.4; 22.7) by immunochromatography; and 13.6 (11.5; 15.7) by HBV DNA polymerase chain reaction. HBV infection is hyperendemic in Nigeria and may be the highest in Sub-Sahara Africa. Our results suggest that large numbers of pregnant women and children were exposed to HBV from 2000 to 2013. Increased efforts to prevent new HBV infections are urgently needed in Nigeria

Surgical Care Delivery at University Teaching Hospital of Kigali: A Patient Satisfaction Survey

Background: Patient satisfaction is an important quality assurance measure in the delivery of health care. Objectives: The objectives were to assess current patient's degree of satisfaction; to document the main reasons for non-satisfaction and identify potential areas for improvement in surgical care delivered at CHUK. Methods: We conducted a prospective cross sectional survey on patients attending a tertiary surgical unit in Rwanda. For 6 weeks; 10 to 20 patients were randomly included in the study after an informed consent. A pre-established questionnaire was filled and descriptive statistics used to analyze the data using SPSS 16.02 and Excel computer programs. Results: 80 patients have been recruited and accepted to be part of the study. The overall satisfaction was 94. 93.8 have been well oriented.78.8 well received. 90 judged the consultation time enough. 96.87 reported having been respected during consultation. 84.37 of those who underwent surgery reported having received a postoperative fitness check appointment. Asked to mark their surgeon after consultation or on discharge; the patients gave an average note of 9.5 over 10. However 52.5 waited for more than 3hours before seeing a doctor in OPD clinic. For those who underwent surgery; only 58.53 were told indications for surgery; and no patient (0) was told eventual complications. 41.46 were not given appointment for elective surgery; 62.5 patients were not satisfied by information received on their disease and its management. 96.87 patients were not included in the treatment plan decision making. Conclusion: The overall patients 'satisfaction attending CHUK surgical facilities was 94. Clinical and nonclinical factors including waiting time; patient-care provider interactions; patient-centered care concept; and management of Rendez-vous have been identified as areas to be improved

Facteurs associes aux longs intervalles intergenesiques au Senegal. Analyse approfondie de l'EDS-MICS 2010-2011

Cette etude examine comment certains couples senegalais atteignent un intervalle intergenesique long malgre une prevalence contraceptive de 13; toutes methodes; parmi les femmes en union et contribue a en determiner les facteurs explicatifs et leur poids relatif. Les facteurs les plus importants sont dans l'ordre: 1) desir de la derniere grossesse; 2) duree de l'amenorrhee post-partum; 3) age au deces de l'avant-dernier enfant; 4) abstinence post-partum; 5) niveau d'education du mari; et 6) survenance de deces fotal. Des recommandations sont faites par rapport a l'acces aux services de planification familiale et a la reduction de la mortalite infanto-juvenile. Des pistes de recherches futures sont aussi avancees

A descriptive analysis of emergency department overcrowding in a selected hospital in Kigali, Rwanda

Introduction:Emergency Centre (EC) overcrowding is a global concern. It limits timeous access to emergency care; prolongs patient suffering; compromises quality of clinical care; increases staff frustration and chances of exposing staff to patient violence and is linked to unnecessary preventable fatalities. The literature shows that a better understanding of this phenomenon may contribute significantly in coming up with solutions; hence the need to conduct this study in Rwanda.Methods:A quantitative descriptive design; guided by the positivist paradigm; was adopted in this study. Self-administered questionnaires were distributed to 40 nurses working in the EC. Only 38 returned questionnaires; thus making the response rate 95.Results:The findings revealed that EC overcrowding in Rwanda is characterised by what is considered as reasonable waiting time for a patient to be seen by a physician; full occupancy of beds in the EC; time spent by patients placed in the hallways waiting; and time spent by patients in waiting room before they are attended. Triggers of EC overcrowding were classified into three areas: (a) those associated with community level services; (b) those associated with the emergency centre; (c) those associated with inpatient and emergency centre support services. Discussion:A number of recommendations were made; including the Ministry of Health in Rwanda adopting a collaborative approach in addressing EC overcrowding with emergency trained nurses and doctors playing an active role in coming up with resolutions to this phenomenon; conducting research that will lead to an African region definition of EC overcrowding and solutions best suited for the African context; and increasing the pool of nurses with emergency care training

Health information systems in Africa: descriptive analysis of data sources, information products and health statistics

Objective To identify key data sources of health information and describe their availability in countries of the World Health Organization (WHO) African Region. Methods An analytical review on the availability and quality of health information data sources in countries; from experience; observations; literature and contributions from countries. Setting Forty-six Member States of the WHO African Region. Participants No participants. Main outcome measures The state of data sources; including censuses; surveys; vital registration and health care facility-based sources. Results In almost all countries of the Region; there is a heavy reliance on household surveys for most indicators; with more than 121 household surveys having been conducted in the Region since 2000. Few countries have civil registration systems that permit adequate and regular tracking of mortality and causes of death. Demographic surveillance sites function in several countries; but the data generated are not integrated into the national health information system because of concerns about representativeness. Health management information systems generate considerable data; but the information is rarely used because of concerns about bias; quality and timeliness. To date; 43 countries in the Region have initiated Integrated Disease Surveillance and Response. Conclusions A multitude of data sources are used to track progress towards health-related goals in the Region; with heavy reliance on household surveys for most indicators. Countries need to develop comprehensive national plans for health information that address the full range of data needs and data sources and that include provision for building national capacities for data generation; analysis; dissemination and use

Expenditures on health research in sub-Saharan African countries: results of a questionnaire-based survey

Objective To estimate the sources of funds for health research (revenue) and the uses of these funds (expenditure). Design A structured questionnaire was used to solicit financial information from health research institutions. Setting Forty-two sub-Saharan African countries. Participants Key informants in 847 health research institutions in the 42 sub-Saharan African countries. Main outcome measures Expenditure on health research by institutions; funders and subject areas. Results An estimated total of US$ 302 million was spent on health research by institutions that responded to the survey in the World Health Organization (WHO) African Region for the biennium 2005-2006. The most notable funders for health research activities were external funding; ministries of health; other government ministries; own funds and non-profit institutions. Most types of health research performers spent significant portions of their resources on in-house research; with medical schools spending 82 and government agencies 62. Hospitals spent 38 of their resources on management; and other institutions (universities; firms; etc.) spent 87 of their resources on capital investment. Research on human immunodeficiency virus/tuberculosis and malaria accounted for 30 of funds; followed by research on other communicable diseases and maternal; perinatal and nutritional conditions (23). Conclusions Research on major health problems of the Region; such as communicable diseases; accounts for most of the research expenditures. However; the total expenditure is very low compared with other WHO regions

Research output of health research institutions and its use in 42 Sub-Saharan African countries: results of a questionnaire-based survey

OBJECTIVE:To describe and analyse research output from surveyed national health research institutions in Africa.DESIGN: The survey used a structured questionnaire to solicit information from 847 health research institutions in 42 countries of the World Health Organization African Region.SETTING:Eight hundred and forty-seven health research institutions in 42 sub-Saharan African countries.PARTICIPANTS: Key informants from the health research institutions.MAIN OUTCOME MEASURES: Volume, type and medium of publications, and distribution of research outputs.RESULTS:Books or chapters for books accounted for the highest number of information products published (on average 16.7 per respondent institution), followed by patents registered in country (8.2), discussion or working papers (6.5) and conference proceedings (6.4). Publication in a peer-reviewed journal constituted only a minor part of research output (on average about 1 paper per institution). Radio and TV broadcasts on health research accounted for the highest number of products issued by institution staff (on average 5.5 per institution), followed by peer-reviewed journals indexed internationally (3.8) or nationally (3.1). There were, on average, 1.5 press releases, 1.5 newspaper or magazine articles, and 1.4 policy briefs per institution. Over half of respondent institutions (52%) developed briefs and summaries of articles to share with their target audiences, 43% developed briefs for possible actions and 37% provided articles and reports upon request. Only a small proportion of information products produced were available in institutional databases.CONCLUSIONS:The research output of health research institutions in the Region is significant, but more effort is needed to strengthen research capacity, including human and financial resources

Research and its governance in health research institutions in Sub-Saharan African countries: results of a questionnaire-based survey

Objective:To describe governance and stewardship of research in health research institutions in the World Health Organization (WHO) African Region. Design: A structured questionnaire was used to solicit information on governance and stewardship from health research institutions. Setting: Forty-two Member States of the WHO African Region. Participants: Key informants from the respondent health research institutions in the respondent sub-Saharan African countries. Main outcome measures: Institutions' participation in setting the national health research agenda. Institutional research priorities; scientific reviews and governance structure. Results: During the previous 12 months; the heads of 49 of respondent health research institutions participated in the setting or coordination of national research priorities. The most frequently cited priorities for contributing to or performing research were improving health programmes; producing new knowledge; influencing health policies and conducting operational research. For 78 of respondent institutions; scientific review was required for research funded directly by the institution; and for 73 of respondent institutions; scientific review was required for research not funded by the institution. However; most respondent institutions did not have written policies or guidelines; either for the scientific review of proposals (70) or regarding conflict of interest on scientific review committees (80). Conclusions: Some health research institutions demonstrate good practice in terms of the establishment of structures and processes for governance and stewardship; many others do not. There is a need for the strengthening of the stewardship capacity of research institutions in the Region

Management of dental anxiety: a survey of Nigerian dentists

Background: Dental anxiety is a major issue with respect to provisions of and access to dental care. We evaluated the knowledge and management of anxiety among Nigerian dentists. Materials and Methods: The study population included 192 Nigerian dentists recruited during an annual national dental conference in Abuja. The conference was a meeting point for dentists with post graduation experience ranging between 1 and 32 years and from different part of the country. They completed a structured questionnaire on dental anxiolysis. Data analysis was performed using SPSS version 16. Results: Of the interviewed dentists; 122 (55.1) practiced in teaching hospitals and 24 had their specialization in child dental health. A total of 34 (19.8) dentists had been exposed to formal trainings on the practice of dental anxiolysis. Of this number; 66 had basic life support training and only 11.8 had refresher training programs. The most preferred route of administration of anxiolytic drugs was oral (57.3). Most of the respondents were of the view that dental anxiolysis should not be instituted for all dental patients. Conclusion: The interviewed Nigerian dentists were knowledgeable and managed dental anxiety. Although some of them had no formal training on dental anxiolysis; the major consensus is that dental anxiolysis should not be instituted for all dental patients

Assessing the Validity and Appropriateness of Audio Computer-Assisted Self-Interviews in Urban; Disadvantaged Cape Town Communities

Those who study sexual behaviour often rely on self-reported information from surveys. However; results from surveys may be inaccurate due to social desirability bias (SDB). One way to combat SDB is to change the mode of inquiry. Typically surveys are conducted using face-to-face-interviewing. The use of audio computer-assisted self-interviewing (ACASI) has been proposed as a better alternative. There is evidence from Africa; that use of ACASI may elicit more adequate reporting of sensitive sexual behaviours. Here we describe a sexual behaviour survey we conducted in three disadvantaged communities of Cape Town using ACASI methods

A South African database of samples analysed for the presence of asbestos

Background: Asbestos mining and other activities have left a legacy of environmental contamination. Asbestos was used in a large number of manufactured products but little is documented about the nature and location of these products. Compliance with asbestos regulations depends on accurate identification of the presence of asbestos. The National Institute for Occupational Health (NIOH) has been identifying asbestos for regulatory purposes since 2003. Objective: To analyse a database of samples submitted for asbestos analysis to the NIOH. Methods: Asbestos was identified using scanning electron microscopy and energy dispersive spectroscopy. The data were analysed using STATISTICA version 11. Results: From 2003 to 2012; 1514 samples were analysed. Asbestos was identified in 59.9 of the bulk samples and crocidolite was present in 45.4 of these. Information about samples containing asbestos; including their origin and associated activities; are described. Conclusions: Although asbestos is no longer mined or used in South Africa; workers remain at risk of exposure due to asbestos-containing materials which persist in the environment. Knowledge of these materials gained from routinely collected data may assist in the safe removal of asbestos and prevent further adverse health =effects

SASOHN remuneration survey

SASOHN is frequently asked to recommend remuneration packages for occupational nursing practitioners (OHNPs). A survey was commissioned through Deloitte Consulting to ascertain the remuneration for OHNPs employed permanently; the hourly rate charged by self-employed OHNPs and the rate paid through a healthcare service provider. A questionnaire designed by Deloitte was refined and approved by SASOHN for distribution. Deloitte processed the data and compiled remuneration tables. These include information pertaining to hourly rates from 318 respondents. The sample is not reflective of the industry due to a response rate of only 17;7The number of employees for whom healthcare was being provided varied considerably within the sample. The average number of employees in a company for whom healthcare was provided was 3308 (range 11 to 35 000) employees. The minimum number of employees managed by a single OHNP varied from 40 to 3000. Further research into these ratios is required. Data analysis revealed little consistency in the rates charged. It is noted that the least variation is found in the hourly rates for permanent employees

Occupational health and safety management systems - a review of practices in enterprises in Botswana

Unsafe working conditions create heavy burdens in workplaces and on the wellbeing of workers. Despite this; Occupational Health and Safety Management Systems (OHSMS) to reduce accidents and diseases in workplaces remain inadequate in many countries; including Botswana. An exploratory cross-sectional study; using secondary data; was undertaken to establish OHSMS practices in various industrial sectors in Botswana. The results showed that a quarter (27.6) and about half of small and medium enterprises (SMEs); respectively; and just over half (60) of large enterprises; have existing OHSMS. Only 29.2 of enterprises had an OHS policy statement. The elements of OHSMS were not uniformly implemented across all enterprises; with SMEs faring poorly. However; 71.1 of enterprises reported provision of induction courses. OHSMS is not widely practiced in Botswana; raising concerns for worker wellbeing; particularly in SMEs. Further research is needed to identify gaps and the development of a coherent OHSMS for the country

Effectiveness of Data Collection and Information Transmission Process for Disease Notification in Anambra State; Nigeria

Background: Disease surveillance and notification (DSN) has been shown to be weak in Nigeria; thus; its inability to promptly detect and control epidemics.Objective: To examine the completeness and timeliness of data collection and information transmission process for DSN in the Anambra state.Materials and Methods: The study was of cross-sectional design and employed the multistage sampling method to select 270 health workers who are involved in DSN in Anambra state. Data were collected by a mix method of interviewer administered questionnaire and observational checklist preceded by key informant interviews and desk review.Results: One hundred (43.9) health workers reported regular supply of Integrated Disease Surveillance and Response (IDSR) forms; 25 and 16.2 reported it was irregular and usually out of stock; respectively. Most facilities (81.5) were the least correct; while out-patient register (88.9) was the most correct. Only 10.0 of health facilities submitted completed forms 5 days after completion; 88.9 of them submitted completed IDSR002 forms within 2 days of completion; while the remainder was submitted 4 days later.Conclusion: The health workers were not operating the DSN system in the State to optimal functionality. Recommendations were therefore made for the periodic training-retraining of health personnel on DSN; improved funding; provision of logistics; improved supervision; and feedback of information