Present situation, prospects and suggestions of acupuncture-moxibustion in Namibia / 中国针灸

This article introduces the present development status, medical insurance charges, publicity and influence, legislation and practice of acupuncture-moxibustion in Namibia, and proposes some countermeasures for the current problems in the development of acupuncture-moxibustion in Namibia. Namibia has passed legislation of acupuncture-moxibustion and incorporated acupuncture-moxibustion into the medical insurance system in March 2020. The acupuncture-moxibustion will enter the fast track of development, but the acupuncture-moxibustion education, training and cooperation, talent cultivation mode, reimbursement scope of medical insurance, and standardization construction still need to be steadily improved and strengthened.

Hepatitis E in Namibia: A Historical Review

Namibia has had three outbreaks of Hepatitis E Virus (HEV), in 1983, 1995 and 2017. HEV is particularly dangerous to pregnant women. The objective of this study was to present a thorough review of the history of HEV in Namibia; the genotypes which have appeared since 1983, and the possible reasons for the nationwide spread of HEV that has occurred since 2017. MATERIALS AND METHODS As this is a review article, no primary research data will be presented. However, an exhaustive literature study has been undertaken and there will be in-depth discussion of the findings of primary researchers in Namibia and elsewhere. RESULTS The first two episodes were confined to the Rundu area. The 1983 outbreak may have been genotype 1; that of 1995 contained genotypes 1 and 2. The genotype of 2017 episode has not been clearly established. Increased road traffic may have spread HEV during 2017-2020. Lack of clean water and washing facilities, and lack of awareness of what causes HEV, are the main factors in spreading it. CONCLUSIONS AND RECOMMENDATIONS There remain challenges to the containment of HEV. A recent government initiative to stop COVID-19 has helped slow its progress. Both infections are propagated by poor hygienic practice and lack of clean water.

Epidemiology and factors associated with diarrhoea among children under five years of age in the Engela District in the Ohangwena Region, Namibia

Background: Diarrhoea remains a public health problem and an important cause of morbidity and mortality amongst children, mainly in low- and middle-income countries. In Namibia, the national prevalence of diarrhoea was 17%; it was responsible for 5% of all deaths in children under 5 years old and is the second leading cause of death. Aim: The purpose of this study was to assess the epidemiology and factors associated with acute diarrhoea amongst children less than 5 years of age in Engela district in the Ohangwena region, Namibia. Setting: The study was conducted in Ohangwena Region in Namibia which extends east to west along the borders of the southern part of Angola. Methods: A cross-sectional study was conducted. A structured questionnaire was administered through face-to-face interviews. Descriptive statistics were used to describe the socio-demographic and epidemiological data of diarrhoea and logistic regression analysis was used to determine the factors associated with the prevalence of diarrhoea. Results: The study found a prevalence of 23.8% for diarrhoea in the 2 weeks period preceding the survey amongst children aged under 5 years. The prevalence of diarrhoea was statistically significantly associated with children (p < 0.05). The strongest predictor of the prevalence of diarrhoea was the residential area 'informal settlement', with an odds ratio of 36.42. This implies that children living in the informal settlement are 36.42 times at risk of contracting diarrhoea as compared to those living in other residential areas. Conclusion: epidemiology; factors; diarrhoea; under-5 years children; Engela district; Ohangwena region; Namibia

Historia en tiempo real de las bacterias del siglo XXI: gigantes y marcianas / Real time history of 21st century bacteria: giants and martians

Resumen Hemos denominado bacterias del siglo XXI a dos tipos de extrañas y maravillosas criaturas del Reino Protista, descubiertas entre los últimos años del siglo pasado y los días que hoy vivimos: las bacterias gigantes y las de un posible origen marciano. En su búsqueda, audaces investigadores han viajado a tierras distantes y peligrosas, acampando en lugares desolados y descendiendo a las profundidades marinas, actividades que llamamos investigación aventura. Presentamos como ejemplos una expedición al Mar Rojo, buscando el gigantesco Epulopiscium; una temporada en el lago Mono, California, en pos de una bacteria con arsénico en su ADN; un patrullaje en el Ártico, para encontrar bacterias petrificadas en un meteorito marciano; sin olvidar que el tranquilo laboratorio también puede ser un lugar peligroso, porque toda investigación es una aventura.

We denominate "21st century bacteria" two types of strange and amazing creatures from the kingdom Protista, discovered between the last years of the twentieth and the present days: the giant bacteria and those with a possible Martian origin. Searching for them, bold investigators have travelled to distant and hostile lands, desolate places and deep waters, performing a kind of investigation that we only can describe as "investigation-adventure". This paper presents expeditions to the Red Sea, fishing the Epulopiscium; to Lake Mono, searching a bacteria able to growth with arsenic; to the Antarctic Circle, finding a meteorite with petrified alien microorganisms; and… to the quiet laboratory, a not less dangerous place.

Year 2019, Pray for 30 Years Olds, Germany, Namibia, and JKACAP

No abstract available.

Modifiable factors within the prevention of mother-to-child transmission programme associated with failure to prevent HIV transmission in the Onandjokwe district of Namibia

Background: Ending new paediatric HIV infections continues to be a global health priority. Cuba and other countries have demonstrated that elimination of mother-to-child transmission is possible through Prevention of Mother to Child Transmission (PMTCT) interventions. As Namibia works on improving PMTCT there is a need to identify the local modifiable factors to achieve zero new HIV infections.Aim: This study aimed to identify the modifiable factors within the PMTCT programme, which contributed to the acquisition of HIV infection among children.Setting: The study was carried out in the Onandjokwe District, Northern Namibia.Methods: A descriptive audit was undertaken of 59 medical records of mothers and their children under two years, who acquired HIV despite the PMTCT programme between 2014 and 2016.Results: The study found that overall HIV transmission was only 2%, but 80% of the paediatric HIV infections could be prevented by implementing the existing Namibian PMTCT recommendations. Overall 61% of modifiable factors were related to mothers,30% to health workers and 10% to the health system. The top three modifiable factors were the mother defaulting on ART during pregnancy or breastfeeding, the health worker not intervening when the mother failed the first-line ART regimen,and poor coordination of care between the hospital and primary care.Conclusion: Although overall transmission is low with the PMTCT programme, the majority of remaining HIV infections among children under two years could be prevented by addressing the modifiable factors identified in this study

Analysing disability policy in Namibia: an occupational justice perspective

Background: The Namibian disability policy of 1997 has not been reviewed for about 20 years, which has raised concerns with persons with disabilities and stakeholders in the fields of disability and rehabilitation. In March 2017, the government publicised its intention to review the policy. Thus, this study's purpose was to generate evidence that can contribute to the development of a more current disability policy that will promote occupational justice.Objectives: The aim of the study was to develop an alternative disability policy option for Namibia and to present outcomes and trade-offs using a policy analysis approach while applying the occupational justice framework to gather evidence.Method: A qualitative research design and Bardach's eightfold path approach to policy analysis were used. Critical disability theory provided the theoretical framework. The occupational justice framework was the conceptual framework for the study. Evidence from preceding phases of this study and appropriate literature was utilised to construct possible disability policy alternatives in Namibia, set evaluative criteria, project outcomes and confront trade-offs.Results: Three main disability policy alternatives emerged: access policy, support policy and universal coverage policy. Access policy had the fewest trade-offs, and the support policy had the most trade-offs in the Namibian context. Access policy was projected to foster occupational participation among persons with disabilities.Conclusion: Results have implications for selecting disability policy alternatives that promote occupational participation and justice among persons with disabilities in Namibia.Furthermore, the study has implications for advancing the practice of occupational justice in disability policy formulation

Challenges faced by parents of children with learning disabilities in Opuwo, Namibia

Background: Parenting children with learning disabilities requires a high level of knowledge and access to resources, information and services.In developing countries, however, these resources and services are not always available. Parents in Namibia, a developing country, therefore face challenges addressing children's learning and other developmental disabilities, including challenges related to preventative and supportive interventions.Objective: This research focuses on challenges faced by parents as they parent children with learning disabilities in Opuwo, Namibia. Method: In-depth interviews were conducted with eight parents regarding the challenges they face in parenting their children with learning disabilities. Thematic analysis enabled the researchers to identify, analyse and report on themes that emerged from the qualitative interview data.Results: Analysis of the interviews indicated that some participants had only a vague understanding of learning disabilities, as they did not have access to essential knowledge about this phenomenon. They also lacked an awareness of the availability of programmes, services and policies meant to benefit their children with learning disabilities. Participants voiced that they, their children with learning disabilities and community members have stereotypes and prejudices regarding learning disabilities. In this study, most of the children with learning disabilities were raised by single, unemployed parents who seemed to have access to less support from external sources than married couples parenting children with learning disabilities. These single parents are usually not married and because of lack of financial support from the other parent, the majority of them indicated that they struggle to meet the financial and material needs of their children.Conclusion: The researchers concluded that the participants in this study experience a range of challenges in parenting their children with learning disabilities. The main challenges emanate from financial instability, as well as lack of knowledge regarding services and programmes for children with learning disabilities. This lack of knowledge on the part of participants could indicate poor policy education by policy implementers at grass-roots level

Distribution of hepatitis B virus infection in Namibia

Background. Namibia regards hepatitis B virus (HBV) infection as a public health problem and introduced hepatitis B vaccinations for infants during 2009. However, information on HBV infection in the country remains limited, and effective public health interventions may be compromised in the absence of adequate evidence-based data. Available data from the World Health Organization (WHO) estimate that 15 - 60% of the normal population in many African countries may be positive for one or more of the HBV serological markers.Objective. To investigate the distribution of HBV infection in Namibia, using available laboratory data for 2013.Methods. A cross-sectional descriptive study was conducted using pre-existing electronic laboratory data on HBV infection. The data were retrieved from the central Namibia Institute of Pathology laboratory in Windhoek during January - December 2013. Tests were done on the following three main groups: (i) pregnant women during routine antenatal care (ANC) visits; (ii) patients with HIV/AIDS during antiretroviral therapy clinic visits; and (iii) any other individual suspected of having HBV infection.Results. Of a total of 77 238 hepatitis B surface antigen test results retrieved countrywide, 9 087 (11.8%) were positive. Of the positive results, 246/9 087 (2.7%) were in children aged 0 - 14 years, with the sexes equally affected. HBV infections increased markedly, particularly among females, in the age group 15 - 39 years, reaching a peak in the age group 30 - 34 years. Routine screening of pregnant women for HBV during ANC visits was found to be systematically conducted in only two regions, Ohangwena and Khomas.Conclusions. This study showed high proportions of positive results in pregnant women, patients with HIV/AIDS and individuals suspected of having HBV infection. The Ministry of Health and Social Services and stakeholders may wish to consider improving the routine and surveillance reporting systems for viral hepatitis and uptake of screening for pregnant women in all regions, and expanding HBV screening to other population groups. Population-based or similar studies are therefore required to determine the HBV prevalence and risk factors. This will assist Namibia in developing appropriate national viral hepatitis strategies as per WHO recommendations

Causes of mortality and associated modifiable health care factors for children (< 5-years) admitted at Onandjokwe Hospital, Namibia

Introduction: Many countries, especially those from sub-Saharan Africa; are unlikely to reach the Millennium Development Goal for under-5 mortality reduction by 2015. This study aimed to identify the causes of mortality and associated modifiable health care factors for under-5year-old children admitted to Onandjokwe Hospital, Namibia. Method: A descriptive retrospective review of the medical records of all children under fiveyears who died in the hospital for the period of 12 months during 2013, using two different structured questionnaires targeting perinatal deaths and post-perinatal deaths respectively. Results: The top five causes of 125 perinatal deaths were prematurity 22 (17.6%), birth asphyxia 19 (15.2%), congenital anomalies 16 (12.8%); unknown 13 (10.4%) and abruptio placenta 11 (8.8%). The top five causes of 60 post-perinatal deaths were bacterial pneumonia 21 (35%), gastroenteritis 12 (20%), severe malnutrition 6 (10%), septicaemia 6 (10%); and tuberculosis 4 (6.7%). Sixty-nine (55%) perinatal deaths and 42 (70%) post-perinatal deaths were potentially avoidable. The modifiable factors were: late presentation to a health care facility, antenatal clinics not screening for danger signs, long distance referral, district hospitals not providing emergency obstetric care, poor monitoring of labour and admitted children in the wards, lack of screening for malnutrition, failure to repeat an HIV test in pregnant women in the third trimesteror during breastfeeding; and a lack of review of the urgent results of critically ill children. Conclusion: A significant number of deaths in children under 5-years of age could be avoided by paying attention to the modifiable factors identified in this study

HIV and/or AIDS-related deaths and modifiable risk factors: a descriptive study of medical admissions at Oshakati Intermediate Hospital in Northern Namibia

Background: High rates of HIV infection have decreased life expectancy in many African countries. Regardless of worldwide efforts to escalate treatment; care and prevention strategies; the number of deaths due to AIDS-related disorders is still high. Local healthcare workers suspect that there are modifiable factors in the care of HIV and/or AIDS patients which can be identified and improved. Aim: To describe the HIV and/or AIDS-related causes of adult mortality and identify modifiable factors amongst patients admitted to Oshakati Intermediate Hospital; northern Namibia. Methods: Data was extracted retrospectively and coded using the modified CoDe protocol for AIDS. Modifiable factors relating to the patient; health system or clinical care were identified using a standardised data collection tool.Results: A total of 177 HIV and/or AIDS patients were identified; 94 (53.1%) were male and 120 (68%) had a CD4 count of less than 200 cells/mL. The common HIV-related causes of death were tuberculosis (25.9%); renal failure (15.8%); Pneumocystis jirovecii pneumonia (11.3%); cryptococcal meningitis (9%); HIV wasting syndrome (7.9%) and AIDS-defining malignancy (7.9%). The analysis revealed 281 modifiable factors; patient-related factors were the most common (153 [54.4%]); followed by health system factors (97 [34.5%]) and healthcare personnel factors (31 [11%]).Conclusion: Our findings have highlighted the challenges in overall HIV and/or AIDS inpatient care and surrounding primary care facilities. The identification of specific modifiable factors can be used to reduce mortality by providing training as well as rational monitoring; planning and resource allocation

Terapia de alta frecuencia en pacientes con afecciones del sistema estomatognático / High-frequency therapy in patients with disorders of the stomatognathic system i: en

Se realizó un estudio descriptivo de 40 pacientes con afecciones del sistema estomatognático, que acudieron al Departamento de Fisiatría del Hospital Estatal Intermedio de Katutura, en Windhoek (Namibia), remitidos de la especialidad de cirugía maxilofacial, desde el 2008 hasta el 2009, con vistas a evaluar los síntomas y signos manifestados, así como el tiempo de mejoría con la aplicación de los agentes físicos. En la serie se consideraron las variables: sexo, edad, diagnóstico, síntomas y signos, sesiones de tratamiento y resultados finales; finalmente, se obtuvo que 87,5 % de los afectados fueron evaluados de bien entre las sesiones 5 y 10 de tratamiento, lo cual indicó que con este método terapéutico se logra una evolución satisfactoria, sin complicaciones ni empeoramiento del cuadro clínico.

A descriptive study was conducted in 40 patients with disorders of the stomagtonathic system who visited the Physical Medicine Department of the Intermediate State Hospital of Katutura, in Windhoek (Namibia) and were referred from the specialty of maxillofacial surgery, from 2008 to 2009, in order to assess the symptoms and signs, as well as the time of improvement with the application of physical agents. Variables such as sex, age, diagnosis, symptoms and signs, sessions of therapy and final results were considered in the series. Finally it was found that in 87.5% of patients good results were obtained between sessions 5 and 10, which indicated that with this therapeutic method a satisfactory course without complications or worsening of clinical pattern is achieved.

Institutionalisation of knowledge transfer on sexual behaviour in the times of AIDS: a case study from a village community in North-Central Namibia

This paper concentrates on the changes in knowledge transfer in northern Namibia with respect to sexual norms; behavioural advice and sexual health information. The research was conducted in a small village community in Ohangwena region; where over 100 semi-structured and structured interviews were held with a sample of 67 community members and 50 professionals dealing with HIV/AIDS issues. The results of the research indicate the change in social roles in family and community dynamics; especially between generations; and thus a change in trust; respect and responsibility attached to information sharing. This further exerts pressure on the classification; choice; adaptation and transmission of information at both the individual and family level. Secondly; and partly as a consequence of this; the levels of indigenous; community level information from elders to youth and the level of institutionalised information sharing leave space for variations in behavioural norms. The research contributes to the discussion on problems in information sharing; knowledge transfer and adaptation of behavioural advice in HIV/ AIDS work

Trocas afetivo-sexuais e econômicas e AIDS na fronteira entre Angola e Namíbia / Sexual-affective and economic exchanges and AIDS on the border of Angola and Namibia

Na África Subsaariana, o engajamento de mulheres jovens em relacionamentos com vários parceiros em busca de benefícios materiais /financeiros, denominado de ‘sexo transacional’ temocupado um lugar de destaque para explicar a dinâmica da epidemia de HIV na região. Porém, os estudos esbarram em dificuldades conceituais e operacionais para delimitar e identificar tais práticas e analisá-las, em sua relação com o HIV/AIDS, desde uma perspectiva que contemple tanto aspectos macro-estruturais do contexto de vida das mulheres quanto aqueles de natureza micro-social observados na formação e manutenção de suas redes afetivo-sexuais. A partir de um estudo epidemiológico associado a um componente qualitativo de investigação, buscou-se com esta tese compreender a dinâmica dos relacionamentos afetivo-sexuais envolvendo trocas econômicas em uma região de fronteira internacional entre Angola e Namíbia e se e como poderiam influenciar a vulnerabilidade de jovens mulheres ao HIV/AIDS. Uma amostra de 500mulheres, com idades entre 15 a 24 anos, foram convidadas a participar por meio da técnica de amostragem com ‘recrutamento’ dirigido pelo participante ou Respondent Driven Sampling (RDS) e a todas foi aplicado um questionário sócio-comportamental por meio de um computador de bolso. Adicionalmente, entrevistas semi-estruturadas com 24 jovens angolanas e14 namibianas e observações participantes foram conduzidas no lado angolano da fronteira. Os resultados evidenciaram que há um conjunto imbricado de fatores estruturais (mudanças econômicas, crescente urbanização, processos de migração e mobilidade relacionados,representações e expectativas normativas de gênero e sexualidade, e processos de estigmatização e discriminação com base em gênero, nacionalidade, etnia e condição e posiçãosocioeconômica) que determinam oportunidades e a busca na formação de redes afetivo-sexuais e econômicas entre mulheres e a população masculina migrante, móvel e/ou autóctone,propiciando às jovens agregarem não apenas capital econômico, mas social e afetivo. Na formação e manutenção dessas redes, há claramente a presença da agência individual das mulheres que buscam acessar homens com maiores chances de lhes proporcionar a realização de seus projetos, desejos, e o acesso a recursos simbólicos e materiais; geralmente homens (vistoscomo namorados e/ou ‘amigos’) mais velhos (diferenças de idade iguais ou maiores que 10 anos) e com melhor condição e posição socioeconômica. O engajamento nesses relacionamentostrazem riscos sociais (perda de reputação, sanções familiares, falta de suporte social, episódios de discriminação e violência) e sua gestão por parte das mulheres ganha precedência à gestão do risco de transmissão do HIV/AIDS por meio, por exemplo, do uso consistente de condom. Este se mostrou reduzido, inferior a 20 por cento, e foi mais utilizado no contexto do relacionamento com os‘amigos’, parcerias ocasionais ou regulares cuja principal motivação das jovens para o relacionamento é a provisão de ajuda material / financeira, do que com os namorados. Com estes, o não uso de condom parece estar menos vinculado à barganha pelo beneficio material e/ou financeiro recebido, como é mais com os amigos, fazendo parte de uma série de obrigações vinculadas às expectativas de reciprocidade baseada na confiança, amor e intimidade estabelecida, e moldadas por assimetrias de poder marcadas por gênero, idade e condiçãosocioeconômica. A permeabilidade e os processos de mobilidade e migração nessa região de fronteira, envolvendo mulheres, jovens e adultas, inseridas em redes afetivo-sexuais e econômicas transfronteiriças reitera a necessidade de esforços conjuntos e bilaterais noenfrentamento da epidemia de HIV na fronteira Angola-Namíbia que levem em consideração as iniquidades sociais e econômicas a que estão sujeitas.