Impact of COVID -19 on population health and economic wellbeing in Ethiopia: A national pilot survey

Introduction: The COVD-19 pandemic has resulted in unprecedented global health and economic crisis, particu-larly in countries struggling with poverty. We conducted a national survey to understand the economic and health impacts of COVID-19 in Ethiopia. Methods: A pilot, population-based, cross-sectional survey was conducted among adults randomly selected from the Ethio Telecom list of mobile phone numbers. Participants underwent a comprehensive phone interview about the impact of COVID-19 on their economic well-being and the health-related risks associated with COVID-19. Results: Of 4,180 calls attempted, 1194 were answered, of which a successful interview was made with 614 par-ticipants. COVID-19 affected the family income of 343 [55.9%] participants, 56 [9.1%] lost their job, 105 [17.1%] perceived high stress in their household, and 7 [1.14%] reported death in their family in the past month. The odds of having a decreased income due to COVID-19 were 2.4 times higher among self-employed [adjusted odds ratio (AOR) 2.4, 95% CI (1.58-3.77)] and 2.8 times higher among unemployed [AOR 2.8, 95% CI (1.35-5.85)] participants. Two-hundred twenty-one [36%] participants had comorbidity in their household with hypertension, 72 [11.7%], diabetes,50 [8.1%], asthma, 48 [7.8%], and other chronic diseases, 51 [8.4%]. Forty-six [7.5%] participants had COVID-like symptoms in the previous month, where cough, headache, and fatigue were the most com-mon.

Tooth size discrepancy in different malocclusion groups in Libya: a pilot study

Background: Orthodontists need to evaluate intermaxillary tooth size discrepancy (TSD) prior to initiating treatment in order to achieve a stable treatment. Thus, the aim of the present study was to determine the prevalence of TSD in Libyan subjects among different malocclusion groups. Methods: A sample of 60 dental casts of Libyan subjects with different types of malocclusions (Class I, Class II div 1 and Class III) were included in the study. Each malocclusion group (20 dental casts) included equal numbers of males and females, 12-17 years of age. Mesio-Distal tooth measurements were extracted to compute the anterior and overall TSD ratios. Paired Student t-test was used to detect significant discrepancies between the paired teeth measurements. Analysis of Variance (ANOVA) and Tukey Honestly tests were undertaken to detect significant discrepancies among the malocclusion groups. Results: Paired t-test revealed that there were no significant discrepancies between the paired tooth widths except for the upper first molars, upper first premolars, lower lateral incisors and lower canines (P<0.010). ANOVA found no significant differences in the mean anterior TSD ratio in regard to malocclusion groups. However, a significant disparity was noticed in the mean overall TSD ratio among the different malocclusion categories (P<0.04). Conclusion: Statistically significant TSD between the examined malocclusion groups were observed only in the mean overall TSD ratio

Is South Africa Advancing towards National Health Insurance? The Perspectives of General Practitioners in One Pilot Site

Background. The launch of the National Health Insurance (NHI) White Paper in December 2015 heralded a new stage in South Africa's advancement towards universal health coverage. The 'contracting in' of private sector general practitioners (GPs); though only one component of the overall reformed system; is nevertheless crucial to address staff shortages and capacity; and also to realise the broader vision of a single unified; integrated system.Objective. To report on the views and experiences of GP providers tasked with implementing the reforms at one pilot site; Tshwane District in Gauteng Province; providing an insight into the practical challenges the NHI scheme faces in implementation.Methods. The study was qualitative in nature; using a combination of convenience and purposeful sampling to recruit participants. A thematic analysis of the data was conducted using Nvivo 10 software.Results. The overall experiences of the GPs exposed a number of problems with the pilot.These included frustration with lack of appropriate infrastructure and equipment in NHI facilities; difficulties integrating into the facilities and lack of professional autonomy; as well as unhappiness with contracting arrangements. Despite strong support for the idea of NHI; there was general scepticism that private doctors would embrace the scheme on the scale required.Conclusion. The study suggests that the current pilots are still a long way from the vision of a single; integrated health system. While it may be argued that the pilots are not themselves the completed NHI; the findings suggest that it will take much longer to establish than the timeline envisaged by government

Staff and Patient Perceptions of Noise in SA Hospitals - a Pilot Study

Background: Noise in hospitals can negatively affect users. Guideline noise levels for hospital wards are stipulated by the World Health Organization (WHO) and a South African National Standard (SANS). Studies show that few hospitals comply with the guidelines but limited research in South Africa means that conditions in local hospitals are unknown. The objective of this pilot study was to compare measured noise levels with guideline and perceived noise levels in general hospital wards. Methods: Measured and perceived noise levels were assessed; using data obtained from sound level meter readings and questionnaires; respectively; in four hospitals.Results: None of the hospitals complied with the guidelines; with an average Leq;24hr of 53.4 dBA. Yet; most users did not perceive the environment to be excessively noisy. At two of the hospitals it emerged that noise is more disturbing for staff than for patients.Conclusions: The results did not yield the predicted perceptions of noise in hospitals. Further research on a larger sample is required to confirm findings; particularly pertaining to the difference in perceptions between staff and patients

Upper extremity injury management by non-physician emergency practitioners in rural Uganda: a pilot study

Introduction: Improper management of and resultant poor outcomes from upper extremity injuries can be economically devastating to patients who rely on manual labour for survival. This is a pilot study using the Quick DASH Survey (disabilities of arm; shoulder and hand); a validated outcome measurement tool. Our objective was to assess functional outcomes of patients with acute upper extremity injuries who were cared for by non-physician clinicians as part of a task-shifting programme. Methods :This pilot study was performed at the Karoli Lwanga Hospital Emergency Centre (EC) in Uganda. Patients were identified retrospectively by querying the EC quality assurance database. An initial list of all patients who sustained traumatic injury (road traffic accident; assault) between March 2012 and February 2013 was narrowed to patients with upper extremity trauma; those 18 years and older; and those with cellular phone access. This subset of patients was called and administered the Quick DASH. The results were subsequently analysed using the standardised DASH metrics. These outcome measures were further analysed based upon injury type (simple laceration; complex laceration; fracture and subluxation). Results :There were a total of 25 initial candidates; of which only 17 were able to complete the survey. Using the Quick DASH Outcome Measure; our 17 patients had a mean score of 28.86 (range 5.0-56.8). Conclusions : When compared to the standardised Quick DASH outcomes (no work limitation at 27.5 vs. work limited by injury at 52.6) the non-physician clinicians appear to be performing upper extremity repairs with good outcomes. The key variable to successful repair was the initial injury type. Although accommodations needed to be made to the standard Quick DASH protocol; the tool appears to be usable in non-traditional settings

A Qualitative Pilot Study of Food Insecurity among Maasai Women in Tanzania

Background: Food insecurity is an ongoing threat in rural sub-Saharan Africa and is complicated by cultural practices; the rise of chronic conditions such as HIV and land use availability. In order to develop a successful food security intervention program; it is important to be informed of the realities and needs of the target population. The purpose of this study was to pilot a qualitative method to understand food insecurity based on the lived experience of women of the Maasai population in the Ngorongoro Conservation Area of Tanzania. Methods: Short semi-structured qualitative interviews with 4 Maasai women. Results: Food insecurity was present in the Maasai community: the participants revealed that they did not always have access to safe and nutritious food that met the needs of themselves and their families. Themes that emerged from the data fell into three categories: Current practices (food sources; planning for enough; food preparation; and food preservation); food Insecurity (lack of food; emotions; coping strategies; and possible solutions); and division (co-wives; food distribution; and community relationships). Conclusion: This pilot study suggested the presence of food insecurity in the Maasai community. Larger sample studies are needed to clarify the extent and severity of food insecurity among this population. Having a detailed understanding of the various aspects of the food insecurity lived experience could inform a targeted intervention program

Bone density and depression in premenopausal South African women: a pilot study

Objective: It is posited that the effect of depression on BMD is dependent on the severity of depression. Conflicting evidence exists regarding this possible association. This study investigated the association between depression and low bone mineral density (BMD). Methods: The hypothesis was investigated in a random sample of volunteers (n=40) and in premenopausal female psychiatric patients (n=5) diagnosed with recurrent severe major depression. The outcome measures were BMD (DEXA); depression (Beck Depression Inventory and Psychological General Well-being Scale) and 24-hour saliva cortisol levels (ELISA). In a comparison of women (4 of the 40 i.e. ""control"" subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD; depression; saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in the psychiatric patients only. Results: In the random - non clinical - sample of women (n=40); 26 exhibited normal BMD and 14 exhibited low BMD. Depressive symptoms and cortisol levels were not significantly different between these two groups. Women with severe recurrent major depression(n=5) exhibited lower median BMD T-scores; higher overall bone turnover and higher 24-hour cortisol levels compared to ""control"" subjects (n=4). The psychiatric patients also exhibited elevated IL-1 levels. Conclusion: The effect of depression on BMD may be dependent on the depression severity. IL-1 and cortisol are possible mediators in depression-induced BMD loss

Psychological Distress and Adherence to Highly Active Anti-Retroviral Therapy (HAART) in Uganda: a Pilot Study

Background: Mental health related risk factors for non-adherence to highly active anti-retroviral therapy (HAART) have not been investigated in Uganda and yet adherence is critical to the success of the current scale up in the provision of HAART to HIV positive individuals in rural areas of Uganda. Objective: To determine whether psychological distress is a risk factor for non-adherence to HAART among HIV positive individuals. Method: One hundred twenty-two HIV positive adult individuals receiving care from an Urban HIV clinic were enrolled in the study. Participants were screened for psychological distress with the Self Report Questionnaire (SRQ-20). Adherence was assessed using the self report method. Multivariate logistic regression analysis was used to determine whether psychological distress is a risk factor for non-adherence to HAART adjusting for various socio-demographic and clinical factors. Results: Psychological distress and living in isolation were significantly associated with non-adherence to HAART after adjusting for other demographic and clinical variables [OR=3.66; 95CI (1.39 - 9.78) and OR=9.80; 95CI (2.27 - 18.70)] respectively. Among HIV positive individuals who were receiving additional treatment for a mental disorder; psychological distress was not significantly associated with non-adherence to HAART [OR= 1.25; 95CI (0.30 - 5.20)] Conclusion: Regular screening and management of psychological distress may prevent further complications in HIV positive individuals in Uganda

HIV/AIDS Awareness among Traders in Port-Harcourt; Rivers State; Nigeria

A pilot study was carried out involving 193 market traders randomly selected from the three markets in the Port Harcourt metropolis; of Rivers State; Nigeria. A questionnaire was administered to investigate the HIV/AIDS awareness of these traders. Fifty (50) percent of the respondents were in the age range of 21 to 30 years; 69were single and 95were Christians. The results indicate that the traders were knowledgeable about HIV/AIDS. However; there were some misconceptions. Though highly sexually active; only 18considered themselves at risk of contracting or having contracted the virus. The news media scored highest as a source of HIV/AIDS information. A high percentage (56) of the respondents claimed that their sexual behaviours have not been altered as a result of the HIV/AIDS awareness but 73will now advise/ use a condom. It appears that these traders will now exercise caution in negotiating new sexual relationships. It is recommended that awareness be scaled up; considering that majority of these traders are not literate; are making meager incomes and therefore might be tempted to consider sex; as a means of augmenting these meager incomes

Family Functioning and Suicidal Ideation/Behaviour in Adolescents: a Pilot Study

Objective: The main aim of this study was to explore the associations between specific aspects of family functioning and adolescent suicidal ideation/behaviour. Method: Participants were 87 high school students (43 male and 44 female) aged between 14 and 16 years of age. They completed a questionnaire measuring various aspects of family functioning and suicidal ideation/behaviour. The specific dimensions of family functioning assessed were: connection; psychological control and behavioural regulation in the parent-adolescent relationship; family conflict and family structure. Results: The results of t-test and chi-square analyses indicated that adolescents who reported suicidal ideation or behaviour in the previous year experienced lower levels of connection and regulation and higher levels of conflict and psychological control in the parent-child relationship than non-suicidal adolescents. Family structure and interparental conflict were not significantly associated with suicidal ideation/behaviour. Conclusions: The quality of relationships between adolescents and both of their parents may be important in distinguishing South African adolescents with recent suicidal ideation/behaviour from non-suicidal

A community-based investigation of the avoidable factors of maternal mortality in Nigeria: the pilot experience

"Background: Reduction of maternal mortality is one of the major goals of several recent international conferences and has been included within the Millennium Development Goals. However; because measuring maternal mortality is difficult and complex; reliable estimates of the dimensions of the problem are not generally available and assessing progress towards the goal is difficult in some countries. Reliable baseline data are crucial to effectively track progress and measure that targets or goals of reducing maternal mortality have been met. Objectives:The objectives of this pilot study were: to test adequacy of research instruments; to improve research techniques; to determine an appro- priate workload; to determine the time required for interviews; and to assess the feasibility of a (full-scale) study/ survey. Methods:This pilot study was conducted between 11th April and 22nd April 2005. 420 houses were visited and interviews of 420 respondents between the ages of 15-49 were conducted in a randomly pre-selected Local Government Area of Oyo state using a structured instrument developed using the principles of the Sisterhood Method. Results:There was willingness of the public to participate in the study. The response rate was 100.There was no issue raised as regards the structure;wording and translation of the question- naire.This pilot study uncovered local political problems and other issues that may be encountered during the main study. Conclusions:The pilot raised a number of fundamental issues related to the process of designing the research instrument; identifying and recruiting Data Collectors; training and supervision of Data Collectors and the research project; gaining access to respondents and obtaining support and approval from ""gate- keepers"".This paper highlights the lessons learned and reports practical issues that occurred during pilot study."

Use of the 1996 Griffiths Mental Development Scales for Infants: a Pilot Study with a Black; South African Sample

Objectives: Over the last few years; researchers have made a significant effort to address the need for more reliable and valid assessment measures for South Africa. The objective of this study was to acquire empirical data regarding the use and application of the Griffiths Mental Development Scales with Black South African infants. Methods: Specifically; the study aimed to make a preliminary cross-cultural comparison of the performance of Black South African infants and the British normative sample of the Griffiths Scales (Huntley 1996). The South African sample consisted of 40 infants aged between 13 and 16 months; with approximately equal numbers of boys and girls. Results: The finding was that the South African sample performed significantly better than the British norm group on the Eye-Hand Co-ordination Scale (Scale D) and the Performance Scale (Scale E); while the norm group scored significantly higher on the Personal-Social Scale (Scale B). Conclusion: The implications of these results are discussed in the paper

Translating Research into Policy: The case of Orphans and Vulnerable Children in South Africa

Policies are often developed without taking into account social science research findings and recommendations; despite the plethora of such research studies. This is largely because researchers and policy makers often work in isolation; yet if they worked synergistically they could have a significant impact on implementing interventions known to work to improve the lives of populations. Several approaches have been advanced to encourage policy makers to take heed of scientific findings and to urge scientists to take into account the needs of policy makers in designing their research agenda.This paper aims to illustrate how policy has been informed using the case study of the Orphans and Vulnerable Children project in South Africa. It further highlights the successes and challenges encountered thus far with this project. In some countries; particularly those of the north; there has been major progress in bridging this gap between research and policy; however; in developing countries much remains to be done

Telemedicine Pilot Project

Telemedicine is the use of Telecommunication to provide medical and health Care at distance. This includes diagnosis; transfer of medical data; consultation; treatment; education and administration among others. The Telemedicine Pilot Project under the Minsitry of Health; Mulago National Referral Hospital and mengo Hospitals has been connected and is now operational. This project is co-ordianted by the National Telemedicine Steering Committee composed of: Dean makerere Medical School; Director Mulago Hospital; Director Development and Planning (Uganda Telecommunication Limited) UTL; Assistant Commissioner HIM/CME; Medical Superintendent Mengo Hospital and others. This Committee is to be reviewed and expanded at the end of the pilot project

Development of a WHO child care facility schedule (CCFS) : a pilot collaborative study

This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens