The Assessment of Gastric Antral Wall Thickness in Helicobacter pylori Gastritis by Abdominal Ultrasonography, Case-Control Study (2016-2018)

Abdominal ultrasonography is effective in the visualization of gastric wall layers and measuring its thickness. The study aimed to assess gastric antral wall thickness in patients with H. pylori gastritis by abdominal ultrasonography and to study its predictive value in detecting H. pylori gastritis.

Assessing infant and young child feeding priorities to inform the development of a nutrition social and behaviour change communication (SBCC) strategy during a pandemic threat

Objectives: This study was undertaken to identify stakeholder needs and wants in relation to an Infant and Young Child Feeding, Social and Behaviour Change Communication (SBCC) strategy for the 16 Southern African Development Community (SADC) member states during Covid-19 lockdowns and travel restrictions.Design: A rapid-assessment mixed-methods approach using qualitative and quantitative studies was adopted. Secondary data sources supported in-field findings. Setting/Subjects: Qualitative approaches included 17 key informant interviews from 7 SADC member states. Quantitative methods of an online survey elicited feedback from 61 participants from 11 SADC member states.Outcome measures: More strategic, best practice, infant and young child feeding SBCC programmes are recommended in SADC.Results: Programme challenges included increased demands on health systems from Covid-19, poor attitudes and beliefs toward IYCF behaviours, the dual burden of undernutrition and overnutrition, and financial and human resource capacity challenges to implement and evaluate SBCC campaigns at scale. Opportunities were also identified for improved detection,better meeting IYCF nutritional needs from locally sourced foods, training and capacity building for greater engagement of front-line field staff, effective policy development to support parent-friendly hospitals and workplaces, and improved regional integration. Conclusions: The needs assessment demonstrated that priority programme planning can continue while the health sector deals with a pandemic threat. The adaptation to virtual support provided a variety of learnings for research designs, data collection and analysis, albeit over an extended timeframe of six months. A number of innovative approaches were identified in the resultant SBCC strategy for SADC along with opportunities for regional efficiencies in adapting existing, best practice SBCC creative and programming approaches.

Needs assessment for a formal emergency medicine residency program in southern Madagascar

Introduction:World Health Organization data for Madagascar reveal that the nation's under age five mortality rate is 56/1000, and that its maternal mortality rate is 440/100,000. Malaria, leprosy, plague, and tuberculosis remain significant communicable disease threats. Malnutrition rates are improving but continue to impact negatively on the general health of the Malagasy population, especially in the southern region with its 1.9 million inhabitants. There are no emergency medicine (EM) training programs to serve the southern half of Madagascar, which has a large urban population in Fianarantsoa. This study aimed to assess the need for and potential feasibility of an emergency medicine training program in southern Madagascar. Methods:We met with the institutional leadership on site at the university hospital in Fianarantsoa. A needs assessment was performed on multiple domains. Domain 1: existing hospital infrastructure and its physical plant and emergency centre (EC) space allotment. Domain 2: existing clinical and technological resources. Domain 3: educational resources and the existing curriculum for EM. Domain 4: medical student educational program and availability of prospective residency candidates. Domain 5: pre-hospital care and emergency medical services.Results: The size of the EC is adequate for the current census. Clinical resources are typical of many developing countries, with significant need for technological advancement and support, which we delineate in the body of our paper. There is an existing curriculum in Antananarivo and in Majanga, as well as one available through the African Federation for Emergency Medicine. The medical school in the area is relatively new, with graduating classes numbering approximately 30. There is no organised pre-hospital care system, no 9-1-1 equivalent, and no pre-hospital treatment from within metropolitan Fianarantsoa. Conclusions:While the needs assessment indicates substantial need for emergency medicine development in southern Madagascar, the yield (particularly for the metropolitan Fianarantsoa area) would serve the population well

Determination of visual portfolio for surgeons overseas assessment of surgical needs Nigeria study: Consensus generation through an e-Delphi process

Background: Surgery as a public health priority has received little attention until recently. There is a significant unmeasured and unmet burden of surgical illness in low- and middle-income countries (LMICs). Our aim was to generate a consensus among expert pediatric surgeons practicing in LMICs regarding the spectrum of pediatric surgical conditions that we should look out for in a community-based survey for Surgeons OverSeas Assessment of Surgical Needs Nigeria study. Materials and Methods: The Delphi methodology was utilized to identify sets of variables from among a panel of experts. Each variable was scored on a 5-point Likert scale. The experts were provided with an anonymous summary of the results after the first round. A consensus was achieved after two rounds, defined by an improvement in the standard deviation (SD) of scores for a particular variable over that of the previous round. We invited 76 pediatric surgeons through e-mail across Africa but predominantly from Nigeria. Results: Twenty-one pediatric surgeons gave consent to participate through return of mail. Thirteen (62%) answered the first round statements and 8 (38%) the second round. In general, the strength of agreement to all statements of the questionnaire improved between the first and second rounds. Overall consensus, as expressed by the decrease in the mean SD from 0.84 in the first round to 0.68 in the second round, also improved over time. The strength of consensus improved for 23 (74%) of the statements. The strength of consensus decreased for the remaining 8 (26%) of statements. Out of the 31 consensus-generating statements, 16 (51%) scored high agreement, 13 (42%) scored low agreement, and 2 (15%) scored perfect disagreement. Conclusion: We have successfully identified the pediatric surgical conditions to be included in any community survey of pediatric surgical need in an LMIC setting

A description of the self-perceived educational needs of emergency nurses in Durban, KwaZulu-Natal, South Africa

Introduction:Emergency nurses are usually the first to interact with critically ill patients and victims of violence and injuries, and require advanced skills and knowledge to manage such patients. Inadequate training prevents nurses from providing optimal emergency care, and it is important to investigate if there are any skills and competencies lacking in these emergency nurses. We sought to describe the self-perceived educational needs of emergency nurses in Durban, South Africa.Methods:A descriptive quantitative survey was conducted with nurses working in four emergency centres (two state, and two privately funded hospitals) in Durban, South Africa.Results:The survey questionnaire was distributed with a response rate of 79% (n = 128). Almost half the respondents (48%, n = 61) scored less than the mean score of 29, thus indicating lower competency levels. The majority of respondents (67%, n = 85) perceived themselves as highly competent in basic skills (e.g. assess breathing, administer oxygen, assess circulation). Less than half the respondents (45%, n = 57) perceived themselves as highly competent in the intermediate skills (e.g. control haemorrhage, assist with endotracheal intubation, manage shock). A large number of respondents (46%, n = 59) perceived themselves as least competent in advanced skills (e.g. defibrillation/cardioversion, interpreting an echocardiogram [ECG]). The mean score obtained for educational need was 100, thus reflecting a high educational need, and more than half the respondents (62%, n = 79) scored higher than the mean score of 100 for educational needs. The lowest score was 41. Thirty percent (n = 38) of the respondents scored 117, indicating educational needs for all the competencies listed. Overall, 72% (n = 92) agreed that emergency education was a need.Discussion:The study emphasises the need for support systems for educational development of emergency nurses. Further training in specific skills and competencies may enhance emergency care provided. There is a growing need for ongoing educational development of emergency nurses in South Africa

An assessment of knowledge of relationship between periodontal disease with pregnancy outcome and fertility among some pregnant women in Nigeria

Objective: There had been reports that link periodontal disease with complications associated with pregnancy outcomes such as preeclampsia, pre-term birth and low-birth weight, with individuals that have worse periodontal disease having worse pregnancy outcome. Similar relationship has also been reported between periodontal disease and sperm count, with worse periodontal disease associated with poorer periodontal health. The objective of the study was to assess the knowledge of pregnant women on the possibility of this relationship between pregnancy, fertility and periodontal disease.Methods: A cross sectional questionnaire-based survey was conducted among 201 pregnant women at the antenatal clinic of the University College Hospital, Ibadan, Nigeria. Interviewer-administered questionnaire was used in assessing respondent's knowledge of the possible relationship between pregnancy outcome, sperm count and periodontal disease.Results: a total of 201 pregnant women with mean age of 30.69±4.04 years were interviewed. More of the respondents that have visited a dentist for treatment before the interview agreed that poor oral hygiene can affect sperm count in men, which was statistically significant (p= .001). Also, more respondents that have visited a dentist before agreed that gum disease can predispose to low-birth weight in women (p= .008).Conclusion: although many of the respondents that agreed as to the possible relationship between periodontal disease and pregnancy outcome had been to a dentist for treatment before, many of them, including those that have been to a dentist before, are either not aware of the possibility of the relationship or they totally disagreed with the possibility of the relationship. This suggest that dental professionals need to do more in the area of possible relationship and means of preventing periodontal disease especially amidst women of child-bearing age

Assessment of Oral Health Problems among the Elderly Populace of Ikibiri Community; Yenagoa Local Government Area of Bayelsa State and Possible Solutions

Background: This research work was aimed at assessing the oral health problems of the elderly populace of Ikibiri community; Bayelsa State as well as determining possible solutions to these problems.Method: A descriptive study design was carried out on 100 respondents comprising of elderly individuals of Ikibiri community; Yenagoa Local Government Area of Bayelsa State between the ages of 60 - 110 years. Interviewer - based questionnaires assessing the presence of specific oral health problems as well as delivery of oral health services were used as our instrument for data collection.Results: Bleeding gums (52); toothache (44); and oral sores (42) were found to be the major oral health problems being experienced by the population under study and these were mostly attributed to the absence of a dentist (95); absence of a dental clinic (94) as well as the absence of oral health education to the community (87).Conclusion: Oral health problems are undoubtedly present among the elderly individuals of Ikibiri community; Yenagoa LGA; Bayelsa State which was attributed to the absence of dental personnel; dental facilities and oral health education. It was however recommended that Ikibiri community be provided with dental personnel and facilities as well as the provision of oral health education to the entire populace of Ikibiri; which would indeed reduce the burden of oral health problems among the elderly in this community

Educational needs and causes of false diagnosis of atypical squamous cells of unknown significance at a university hospital

The entity of atypical squamous cells of undetermined significance (ASCUS) in The Bethesda System 2001 for reporting cervical cytology is characterized by equivocal diagnosis, poor reproducibility and debatable management. This retrospective study was done to analyse the causes of false ASCUS if any and identify the educational needs as part of quality assurance programme. Cervical smears of all ASCUS cases reported over the one-year period were reviewed by the Cytopathologist. Relevant clinical data was retrieved. ASCUS was the most common type of abnormality representing 43.0 % cases among 294 abnormal smears reported during study period. 16.0% cases were found to be non ASCUS on review. The main four causes of over use of ASCUS diagnosis were poor quality smears and cellular atypia associated with Candida infection, atrophy and squamous metaplasia. Educational measures are being undertaken to avoid over diagnosis and improve the patient management (Afr J Reprod Health 2011; 15[1]: 111-114)

Continuing education in geriatrics for rural health care providers in Uganda: A needs assessment

Population trends in developing countries show an increasing population of older adults (OAs), especially in rural areas. The purpose of this study was to explore the geriatrics continuing education needs of health care providers (HCPs) working in rural Uganda. The study employed a descriptive design to collect data from HCPs working in Apac district, a rural district in northern Uganda. The 240 HCPs (mean age 33.8±10.5 years) from whom data were collected were nurses (52%), physician assistants (17%), social workers (12%), laboratory technologists (10%) and physicians (10%). Self-administered questionnaires composed of the Palmore's Facts on Aging Quiz (FAQ1) and Kogan's attitude towards old people (KAOP) scale were used for data collection. Results. Most HCPs (63%) regularly cared for OAs but their professional education did not include geriatric-specific courses (69%). The majority of HCPs had a poor or fair geriatric knowledge (88%) (FAQ1 mean score 11.6±2.3), but had a positive attitude towards OAs (80%) (KOAP mean score 115.9±11.5). Positive attitude was associated with personal experiences with OAs and a desire for a future career in geriatrics (p≤0.05). Conclusion. In Uganda training curricula for health professionals have not evolved to address the changing demographic trends showing increasing numbers of OAs. Consequently, there is a significant knowledge gap in certain aspects of health care, such as geriatrics, among currently practising HCPs. There is need for tailored geriatrics continuing education programmes to bridge the knowledge and skill gaps to ensure quality health care for OAs

Voices from the Epidemic

"This is a result of a ""needs assessment"" towards the development of a community/home care programme for people suffering from HIV -related disease; care givers; counsellors and community leaders. This study was conducted from September to December 1991"

Assessment of the capacity of the health services to provide emergency obstetric care in Sofala Province: final report of the needs assessment

"Maternal mortality is a serious health problem in Mozambique. While the last DHS survey did not calculate exactly the maternal mortality ratio in the country; careful estimates indicate the MMR to be between 500 and 1500 deaths per 100 000 live births. Even with these important differences in estimation; the problem is being recognised as an important one for the health planners and the donors in the country. Mozambique has made a commitment to reduce the maternal mortality in the country. In 1998 a first general Safe Motherhood needs assessment was done which was followed in the same year by a systematic review of the causes of maternal deaths. ollowing this dynamism within the ministry of health a national strategy to reduce the maternal morbidity and mortality and neonatal mortality was formulated in 1999 and adopted in 2000; the ""...Estrategias para a reducao da morbimortalidade materna e neonatal"". This document forms the basis for formulating interventios and it is based on strengthening the health services with the concept of the provision of obstetric care (basic and comprehensive) with an adequate referral system; community involvement and an improved data collection system."

Avaliacao das necessidades e da disponibilidade e utilizacao dos cuidados obstetricos de emergencia na Provincia de Sofala: relatorio final da avaliacao das necessidades ano 2000

A mortalidade materna e um serio problema de saude em Mocambique. Durante o ultimo censo nao se calculou a taxa exacta da mortalidade materna no pais; tendo sido cuidadosamente estimada estar entre 5000 e 1500 por 100.000 nados vivos. Mesmo com estas importantes diferencas nas estimativas; foi reconhecido como um problema importante para os planificadores e para os doadores no pais. Mocambique comprometeu-se na reducao da mortalidade meterna no pais. Em 1998 foi realizada a primeira avaliacao das necessidades seguida de uma revisao sistematica das causas das mortes maternas no mesmo ano. Acompanhando este dinamismo; o Ministerio da Saude foi formulada a estrategia nacional para a reducao da mortalidade materna e neonatal em 1999 e adoptada no ano 2000. Este documento forma as bases para a formulacao das intervencoes e esta baseada no reforcos servicos de saude com os conceitos de prestacao de cuidados obstetricos (basicos e completos) com um adequado sistema de referencia; envolvimento comunitario e um sistema de colheita de dados melhorado

Assessment of capacity of the health services to provide emergency obstetric care in Gaza Province: final report of the needs assessment

"Maternal mortality is a serious health problem in Mozambique. While the last census in 1997 and the DHS did not calculate exactly the maternal ratio in the country; caraful estimates indicate the MMR to be between 500 and 1500 deaths per 100.000 live births; but no reference is given. The only reliable information that is available is from a sisterhood survey done in 1991; only published in 1995. Even with these important differences in estimation; the problem is being recognised as an important one for the health planners and the donors in the country. Mozambique has made a clear commitment to reduce the maternal mortality in teh country. In 1998 a first nation-wide Safe Motherhood needs assessment was done; which was followed in the same year by a systematic review of the causes of 90 maternal deaths. Follewed this dynamism within the Ministry of Health; a national strategy to reduce the maternal morbibity and mortality and neonatal mortality was formulated in 1999 and adopted in 2000; the document was launched as the: ""Estrategia para a reducao da morbimortalidade materna e neonatal"". This document forms the basis for formulating interventios to reduce maternal mortality in Mozambique. It is based on strengthening the health services with the concept of the provision of obstetric care (basic and comprehensive) with an adequate referral system; community involviment and an improved data collection system."

Avaliacao da capacidade dos servicos da saude na prestacao dos cuidados obstetricos na Provincia de Gaza; Mocambique: relatorio final da avaliacao das necessidades

"A mortalidade materna e um serio problema de saude em Mocambique. Durante o ultimo censo; realizado em 1997 o Inquerito Demografico de Saude (IDS) nao calculou a taxa exacta da mortalidade materna; mas estimou com muito cuidado estar entre 500 e 1500 por 100.000 nados vivos sem contudo ter disponibilizado nenhuma referencia. A unica informacao credivel e do estudo realizado pela ""Sisterhood Survey"" em 1991 e publicada somente em 1995; Apesar destas diferencas nas estimativas; a mortalidade materna e perinatal foi reconhecida como um problema importante para os planificadores e para os doadores no pais. Mocambique comprometeu-se claramente para a reducao da mortalidade meterna no pais. Em 1998 foi realizada a primeira avaliacao das necessidades para uma Maternidade Segura nacional seguida no ano de sistematica revisao das causas de 90 mortes maternas. Acompanhando este dinamismo; o Ministerio da Saude formulou a Estrategia Nacional para a Reducao da Morbilidade e Mortalidade Materna e Neonatal em 1999 e adoptada no ano 2000 e que foi lancada como "" ... Estrategia para a Reducao da Morbimortalidade Materna e Neonatal""... Este documento forma as bases para a formulacao das intervencoes para a reducao da mortalidade materna em Mocambique e esta baseada no reforco dos servicos de saude com os conceitos de prestacao de cuidados obstetricos (basicos e completos) com um adequado sistema de referencia; envolvimento da comunidade e uma melhoria de colheita de dados."

Need assessment of the availability and use of the emergency obstetric care in Tete Province: final report of needs assessment

"Maternal mortality is a serious health problem in Mozambique. While the last census in 1997 and the DHS did not calculate exactly the maternal mortality ratio in the country; careful estimates indicate the MMR to be between 500 and 1500 deaths per 100.000 live births; but no reference is given. The only reliable information that is available comes from a sisterhood survey done in 1995. Even with these important differences in estimation of the exact figure of the maternal mortality; the problem is being recongised as an important one for the health planners aand the donors in the country. Mozambique has made a clear commitment to reduce the maternal mortality in the country. In 1998 a first nation-wide Safe Motherhood needs assessment was done; which was followed in the same yaer by a systematic review of the causes of 90 maternal deaths. Following thisdynamism within the Ministry of Health; a national strategy to reduce the maternal morbidity and maternal and neonatal mortality was formulated in 1999 and adopted in 2000; the document was launched as the: ""...Estrategias para a reducao da morbimortalidade materna e neonatal"". This document forms the basis for formulating interventions to reduce maternal mortality in Mozambique. It is based on strengthening the health services with the concept of the provision of obstetric care (basic and comprehensive) with an adequate referral sistem; community involviment and an improved data collection sistem."

Avaliacao da capacidade dos servicos de saude para a prestacao dos servicos dos cuidados obstetricos essenciais na Provincia de Tete; Mocambique: relatorio final da avaliacao das necessidades

"A mortalidade materna e um serio problema de saude em Mocambique. Durante o ultimo censo; realizado em 1997 o Inquerito Demografico de Saude (IDS) nao calculou com exactidao a taxa da mortalidade materna no pais; mas estimou com muito cuidado estar entre 500 e 1500 por 100.000 nados vivos; sem contudo ter nenhuma referencia. A unica informacao credivel e disponivel e do estudo realizado pela ""Sisterhood Survey"" e publicada em 1995. Mesmo com estas importantes diferencas nas estimativas sobre os numeros exactos da mortalidade materna foi reconhecida como um problemas importantes para os planificadores de saude e os doadores no pais. Mocambique comprometeu-se claramente para a reducao da mortalidade meterna no pais. Em 1998 foi realizada a primeira avaliacao das necessidades para uma Maternidade Segura nacional; seguida no mesmo ano de uma sistematica revisao das causas de 90 mortes maternas. Acompanhando este dinamismo; o Ministerio da Saude desenhou a Estrategia Nacional para a Reducao da Morbilidade e Mortalidade Materna e Perinatal em 1999 que foi adoptada em 2000 e foi lancada como ""...Estrategias para a reducao da morbimortalidade materna e neonatal"". Este doumento forma as bases para a formulacao das internvecoes para a reducao da mortalidade materna em Mocambique. Esta baseada no reforco dos servicos de saude com os conceitos da provisao de Cuidados Obstetricos (basicos e completos) com um sistema de referencia adequado; envolvemento da comunidade e uma melhoria no sistema de colheita de dados."