Most at-risk populations: contextualising HIV prevention programmes targeting marginalised groups in Zanzibar, Tanzania

According to a 2009 UNAIDS report the HIV/AIDS prevalence rate in Zanzibar; Tanzania; is low in the general population (0.6); but high among vulnerable groups; specifically sex workers (10.8); injecting drug users (15.1; and men who have sex with men (12.3). In response to this concentrated epidemic; the Government of Zanzibar; international and local non-profit organisations have focused their prevention activities on these marginal populations. Although these efforts are beneficial in terms of disseminating information about HIV/AIDS and referring clients to health clinics; they fail to address how the socio-economic status of these groups places them at a greater risk for contracting and dying from the virus. Furthermore; there is an absence of qualitative research on these populations which is needed to understand the challenges these groups face and to improve the effectiveness of interventions. Through interviews with employees of government agencies and non-profit organisations; medical professionals; vulnerable populations and HIV/AIDS patients; this paper used a political economy of health and syndemic framework to examine how local realities inform and challenge HIV/AIDS programmes in Zanzibar

Disaster Risk Management: A Strategy for the Health Sector in the African Region

The WHO African Region continues to be challenged by frequent natural and man-made emergencies causing injury; death; population displacement; destruction of health facilities and disruption of services; often leading to disasters. The frequency and magnitude of emergencies and disasters have increased since the adoption; in 1997; of the Regional Strategy on Emergency Preparedness and Response. In addition several global initiatives developed since 2005; including the World Health Assembly resolution WHA64.10 (Strengthening national health emergency and disaster management capacities and resilience of health systems) adopted in 2011; have focused on disaster risk management (DRM) as the approach to containing and minimizing the impact of emergencies. WHO has recognized the need for Member States to formulate policies and legislation; and develop capacities in order to institutionalize DRM in the health sector. An assessment conducted in 2011 revealed that most countries in the Region lack these policies; capacities and legislation. This regional strategy proposes that Member States strengthen DRM by developing appropriate laws and policies; building adequate capacities in ministries of health; assessing and mapping the risks from a health sector perspective; assessing the level of safety of; and applying standards to; hospitals and other health facilities; building community resilience; strengthening preparedness; developing national standards for response; and strengthening evidence and knowledge management. This will ensure that the health system has been prepared and will be able to provide adequate health sector response to emergencies and reduce their likelihood of becoming disasters

Compliance amongst Asthma Patients Registered for an Asthma Disease Risk-Management Programme in South Africa

The study attempted to identify the factors that influence compliance amongst 1039 members and their dependants of a particular medical aid scheme in South Africa who were registered for an asthma disease risk-management (DRM) programme. The sample consisted of 200 systematically selected individuals or their dependants. A quantitative; exploratory; and descriptive study was undertaken. Questionnaires for completion were posted to the individuals or their dependants. The Statistica 7.1 computer program was used to analyse the data. Most asthma patients did not comply with the DRM programme because they lacked knowledge of the programme. Asthma patients' compliance with the DRM programme can be enhanced by the sustained; positive attitudes of their health providers and case managers; better promotion of the programme; and by involving the patients to a greater extent in the long-term management of their disease. Asthma patients require education about healthy lifestyles that would empower them to successfully manage their condition; which would prevent or at least reduce asthma attacks and/or hospital admissions

HIV-infection as a self-reported risk factor for attempted suicide in South Africa

Objective: The aim of this study was to examine variables associated with recently diagnosed HIV-infection as a self-reported attempted suicide risk factor. Method: The study cohort consisted of 112 general hospital in-patients who attempted suicide because of HIV-infection. All the patients were subject to a comprehensive mental state examination and administration of a semi-structured questionnaire to obtain biographical; sociodemographic and other relevant information. Pearson uncorrected Chi-square (X2) or Fisher's Exact Probability Test were used to analyze data utilising Epicalc 2000; version 1.02. Results: Most patients expressed a heterosexual preference. The average age was 34.9 years. Females predominated and in both genders depression and substance abuse (mainly alcohol-related) accounted for the most common psychiatric diagnoses. Less than half of the patients were married. Partner relational problems was a statistically significant variable. The most prevalent co-morbid stressors were poor social support; fear of disclosure/stigmatization and socio-economic pressures. Cognitive deficits included problems with cognitive flexibility; concentration and memory. Based on estimated national suicidal behaviour prevalence rates; a descriptive HIV-related attempted suicide rate of 67.2 per 100 000 and an increased risk for attempted suicide of 13.33to 18.87were calculated. Conclusion: HIVinfection can be an underestimated suicide risk factor. Effective management and prevention programmes should include as imperatives early diagnosis of HIV-related suicidal behaviour; recognition of underlying psychopathology; neurocognitive deficits; associated stressors; the dynamics of partner relationship problems; as well as cultural awareness and sensitivity. Potential neurocognitive complications that can act as additional risk factors require further research

Accidents et incidents au cours de l'anesthesie en chirurgie programmee a l'hopital Gabriel Toure

Determiner l'incidence des accidents et incidents au cours de l'anesthesie programmee; la nature des evenements indesirables (EI) et identifier les moments de survenue des accidents et incidents d'anesthesie. Methodologie; il s'agit d'une etude transversale des accidents et incidents au cours de l'anesthesie et dans les 48 heures post-operatoires survenus de Mars a Aout 2004 sur lessites d'anesthesie programmee de l'hopital Gabriel TOURE de Bamako

Organisation de la prevention dans les professions d'imprimerie a Abidjan

L'imprimerie est un ensemble de techniques utilisees pour imprimer un texte; un dessin sur un support donne ( papier; metal; tissu; plastique) a partir de differents procedes d'impression que sont la typographie; l'offset; l'heliogravure; la serigraphie et la flexograpflie. La prevention des risques professionnels doit faire partie des preoccupations quotidiennes des acteurs de sante et securite au travail. C'est donc; dans le but de contribuer a une meilleure organisation de la prevention des risques dans celle profession que nous avons fait cette etude transversale. L'enquete realisee dans 27 imprimeries; avec le responsable d'entreprise ou le directeur des ressources humaines; nous a permis de faire les constats suivants: *la predominance de petites imprimeries: 88;89pour cent emploient moins de 24 personnes. *le nombre d'imprimeries immatriculees a la CNPS est de 18(66;67pour cent). Elles font partie du SYNTDIPCI. *le CHSCT existe dans 3 imprimeries; mais n'est fonctionnel que dans une seule ou elle tient sa reunion une fois par trimestre. *l'hygiene generale des locaux demeure insuffisante. *les EPI utilises sont les blouses et les chaussures fermees dont l'entretien reste a la charge des travailleurs. *le service de sante n'existe que dans 07 imprimeries. *toutes les imprimeries utilisent les memes produits : solvants; diluants; encres et siccatif. *une seule imprimerie a un programme de formation et d'information sur les risques professionnels. *18 imprimeries beneficient des prestations des organismes de prevention. Au ternie de ce travail nous formulons des suggestions relatives a une meilleure organisation de la prevention des risques dans cette profession. A partir de ce travail; d'autres etudes pourraient etre menees de facon specifique aux risques