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1.
Occupational Health Southern Africa ; 26(1), p3-7, fig., tab., 2020
Article in English | AIM (Africa) | ID: afr-201768

ABSTRACT

Background: Physical inactivity is one of the major risk factors of non-communicable diseases (NCDs), such as type 2 diabetes, cardiovascular diseases, obesity, certain cancers, and all-cause mortality. Office employees are particularly exposed to such diseases, due to the nature of their work, which mainly involves passive activities that require less energy expenditure. Objectives: The objective of the study was to assess the leisure-time physical activity participation (LTPAP) among government employees in Kigali, Rwanda, as well as to highlight the factors that motivate, or hinder their participation. Methods: A cross-sectional, descriptive quantitative study was conducted with 600 participants. A stratified sampling technique was used to determine the study sample from the Government of Rwanda’s Sports Policy stakeholder institutions. Then, a convenience sample of participants was selected from each stratum to form the final study sample. Data were collected using a three-part customised, self-administered questionnaire to capture demographic data, leisure-time physical activity levels (LTPA) using the Godin-Shephard questionnaire, and the factors that influenced participation. Analysis was done using the Statistical Package for the Social Sciences (SPSS). Descriptive and inferential statistics were employed to summarise and draw meaningful associations between different variables. Results: More than half (61.1%) of the participants were not sufficiently active. Physical activity levels declined significantly with advancing age (p = 0.004) and increasing working experience (p = 0.002); female participants were less active than males. The prevention of diseases and maintenance of good health were the most frequently reported contributors (48.8%) to physical activity participation, while time and tight work schedules were the most frequently reported hindrances (62.2%). Conclusion: The majority of government office employees in Kigali did not engage in sufficient leisure-time physical activity, hence they may be at high risk of developing NCDs. Strategies to increase LTPA among employees should be implemented.


Subject(s)
Disease/epidemiology , Disease/prevention & control , Leisure Activities , Exercise , Rwanda
2.
Occupational Health Southern Africa ; 26(1), p.15-20, tab., 2020
Article in English | AIM (Africa) | ID: afr-201769

ABSTRACT

Background:Globally, approximately three million healthcare workers experience a percutaneous injury each year. Medical students are at a particularly high risk of exposure to blood-borne pathogens. Despite this, the rate of non-reporting is still high. Objectives: The objectives of this study were to describe and improve the knowledge and practice of the post-exposure prophylaxis (PEP) protocol among medical students, through the implementation of quality-improvement interventions, with a view to improving the protocol. Methods: This was an intervention study conducted among third- to fifth-year students, in 2015 and 2016. The quality-improvement interventions took place over 11 months and included the issuing of laminated protocols, posters and lectures. Data from survey questionnaires were used to quantify the impact of these interventions. Student practice was measured by the number of correct steps of the protocol completed. McNemar and Wilcoxon signed-rank tests were used to test differences in the paired categorical data. Results: Of approximately 750 students who participated in the study intervention, 407 returned the initial questionnaire and 148 returned the post-intervention survey questionnaire. Eighty-six students (21.1%) completed both questionnaires. The blood-borne pathogen exposure rate prior to the intervention period was 28.0%. In the paired group, reporting of exposures increased from 12.2% in 2015 to 31.3% in 2016. Knowledge of the PEP protocol increased significantly in the paired group, from 17.4% to 40.2% (p < 0.001). Prior to the intervention, 91.7% completed fewer than half of the steps of the PEP protocol. This decreased significantly to 69.4% in the paired group, post-intervention (p = 0.03). Conclusion: Practice of the PEP protocol significantly improved after the intervention was implemented. In addition, there was a significant improvement in the knowledge of students about postexposure management. However, many exposures were still unreported post-intervention, indicating that more work is needed to improve reporting behaviour


Subject(s)
Needlestick Injuries , Wounds and Injuries , Blood , Health , Knowledge , Attitude , Students , Occupational Groups , Africa
3.
Occupational Health Southern Africa ; 26(1), p.12-14, fig., tab., 2020
Article in English | AIM (Africa) | ID: afr-201770

ABSTRACT

Background: Occupational noise-induced hearing loss (ONIHL) is one of the most common occupational health diseases affecting miners in South Africa. Accurate and appropriate medical data are essential for making valid diagnoses. Objectives: The purpose of this study was to describe the electronic records of a South African platinum mine’s audiometry medical surveillance system and their role in early diagnosis of ONIHL. Ear-related conditions of affected miners, occupations, and noise levels were concurrently reviewed, and the characteristics of miners with and without ONIHL were described. Methods: This was an analysis of secondary data from the electronic audiometry and employee occupational records of 305 platinum mine workers for the period 2014 to 2017. Data were analysed using descriptive statistics. Results: Although the audiometry records contained appropriate and relevant data, including annual hearing screening percentage loss of hearing (PLH) shifts, there was evidence of inaccurate and insufficient recording of risk factors for hearing loss in the medical surveillance records. The records indicated that the miners in some occupations were exposed to dangerously high noise levels, exceeding 85 dB(A). Miners as young as 21 years of age were diagnosed with ONIHL. Conclusion: The insufficient and inaccurate data captured in the miners’ records has important implications for the mine’s efficient implementation of hearing conservation programme (HCP) elements aimed at mitigating ONIHL. The hazardous noise levels recorded call for increased attempts to meet noise level regulations, while the presence of conditions such as pseudohypacusis highlights the need for exploration of more reliable assessment measures.


Subject(s)
Hearing , Noise , Platinum , Health/complications , Miners , Africa
4.
Article in French | AIM (Africa) | ID: afr-201778

ABSTRACT

Introduction: l'hypertension artérielle est un problème majeur de santé publique en Afrique subsaharienne par sa fréquence élevée et le risque cardiovasculaire qu'elle entraine. L'objectif de cette étude était d'évaluer la prévalence des facteurs de risques cliniques et biologiques de l'hypertension artérielle à Bamako (Mali).Méthodes: il s'agit d'une étude cas-témoin, stratifiée en fonction du sexe, portant sur 72 participants dont 36 hypertendus et 36 contrôles. Vingt-deux paramètres biochimiques plasmatiques ont été mesurés et analysés par des tests univariés et multivariés.Résultats: une hyperhomocystéinémie a été retrouvée chez 55,6% des femmes (p = 0,03) et 100% des hommes (p = 0,007) hypertendus. Le N-terminal pro B-type natriuretic peptide (NT-ProBNP) était également augmenté chez 16,7% des femmes (VIP > 1 dans le modèle multivarié) et des hommes hypertendus (p = 0,00006). Un bon modèle multivarié prédictif (OPLS-DA) a uniquement été obtenu chez les femmes hypertendues, avec un Q2cum = 0,73, attestant ainsi d'un important dimorphisme sexuel associé à l'hypertension artérielle. Ce modèle impliquait huit paramètres dont la concentration plasmatique était modifiée (homocystéine, NT-ProBNP, potassium, urée, glycémie, sodium, chlore et protéines totales).Conclusion: nous avons noté une association significative entre l'hyperhomocystéinémie et l'hypertension artérielle. Par conséquent, le dosage de l'homocystéine associé à une bonne prise en charge diminuerait le risque cardiovasculaire tout en améliorant la qualité de vie des patients hypertendus.


Subject(s)
Mali
5.
Article in French | AIM (Africa) | ID: afr-201779

ABSTRACT

Introduction: la qualité des soins est essentielle pour sauver des vies humaines de différentes maladies. Cependant, un diagnostic inapproprié ne peut en aucun cas aboutir à une prise en charge correcte des patients ainsi qu'à des soins de qualité. Nous avons effectué une analyse descriptive transversale dans trois laboratoires des hôpitaux généraux en République Démocratique du Congo.Méthodes: une équipe d'experts nationaux dans le domaine des laboratoires avait conduit l'enquête au niveau de trois laboratoires cliniques des hôpitaux généraux de la République Démocratique du Congo. Des observations, visites et entretiens structurés à l´aide d'un questionnaire ont été utilisées pour évaluer la performance de ces laboratoires cliniques. Nous avons également utilisé un guide d'évaluation développé au niveau national pour l'évaluation des laboratoires.Résultats: les laboratoires cliniques des hôpitaux généraux visités ont présenté de nombreux déficits notamment en ce qui concerne les infrastructures, la formation de base et continue des personnels, les équipements, la supervision et le contrôle de qualité. Le plateau technique de ces laboratoires n'était pas adapté pour répondre aux besoins de la population en ce qui concerne les maladies fréquemment rencontrées dans ces zones. Nous avons également noté que, ces laboratoires sont peu ou presque pas accompagnés et qu'il n'y avait aucune équipe de coordination dédiée à la supervision et évaluation des laboratoires au niveau de l'hôpital, voire même au niveau de la zone de santé. En plus, les techniciens de ses différents laboratoires n'ont pas été supervisés pendant de nombreuses années.Conclusion: les laboratoires cliniques doivent être améliorés pour permettre un diagnostic adéquat de différentes maladies. Cette amélioration doit s'appuyer sur les maladies locales. Au sein du système, il est important de consacrer plus d'attention aux laboratoires cliniques. Un plaidoyer pour cette composante négligée du système de santé est nécessaire, car cette situation pourrait être la même dans de nombreux pays en voie de développement.


Subject(s)
Congo
6.
Article in French | AIM (Africa) | ID: afr-201780

ABSTRACT

Introduction: les algies pelviennes aiguës sont responsables d'une morbi-mortalité importante. L'objectif de ce travail était de décrire leurs aspects épidémiologiques, cliniques et thérapeutiques à Yaoundé.Méthodes: nous avons mené une étude transversale descriptive avec collecte prospective des données au Service de Gynécologie-Obstétrique de l'Hôpital Gynéco-Obstétrique et Pédiatrique de Yaoundé du 1er avril au 31 juillet 2015. Nous avons inclus toutes les femmes admises pour douleur pelvienne dont l'évolution était inférieure à un mois et ayant accepté de participer à l'étude. Nous avons exclu les femmes qui étaient au troisième trimestre de grossesse ou en post-partum. Le logiciel Epi info version 3.5.4 a servi à l'analyse des données. Ces données ont été présentées sous forme de fréquence et de pourcentage.Résultats: au total 5915 femmes ont consulté pendant la période de l'étude dont 125(2,11%) étaient des algies pelviennes aiguës. La moyenne d'âge était de 29,5 ± 6,9 ans. Les étiologies des douleurs étaient les infections génitales hautes (36,8%) et la grossesse extra-utérine (18,4%). Le traitement surtout médical (92,8%), associait antibiotiques (65,5%), anti-inflammatoires (56,9%) et antalgiques (39,7%). La chirurgie a été réalisée chez 25(20%) patientes par laparotomie (80%) et cœlioscopie (20%)L'indication chirurgicale était la grossesse extra-utérine dans 76% des cas. La régression de la douleur était obtenue chez 99% des cas. Conclusion: les d'algies pelviennes aigues survenaient chez les femmes jeunes, dues aux infections génitales hautes et à la grossesse extra-utérine étaient principalement. En cas de grossesse extra-utérine le traitement chirurgical était surtout la laparotomie.


Subject(s)
/diagnosis
7.
Article in French | AIM (Africa) | ID: afr-201781

ABSTRACT

Introduction: l'obésité représente un sérieux problème de santé publique qui a un impact direct sur la santé physique et psychologique des individus. L'objectif du présent travail est de déterminer la prévalence de l'obésité et du surpoids en milieu scolaire urbain et rural, chez une population infantile oasienne.Méthodes: nous avons entrepris une étude transversale descriptive au sein des établissements scolaires publics urbains et ruraux de l'oasis de Tafilalet. Nous avons recruté un échantillon représentatif de 3684 enfants scolarisés appartenant à 39 écoles publiques primaires. Résultats: la moyenne d'âge était de 9,81 ± 2,13 ans. L'échantillon total s'est réparti en 1794 garçons (48,70) et 1890 filles (51,30). 2309 appartenant à l'urbain (62,70%) et 1375 au rural (37,30%). Selon les références de l'organisation mondiale de la santé, notre étude a révélé un taux d'obésité de 1,9% et 10,8 pour le surpoids. L'obésité et le surpoids n'étaient pas significativement associés avec le sexe des enfants.Conclusion: la prévalence de l'obésité dans l'oasis de Tafilalet est inférieure aux données nationales et internationales, le mode de vie et les habitudes alimentaires de cette population semblent être un facteur protecteur contre l'obésité et le surpoids.

8.
Article in English | AIM (Africa) | ID: afr-201782

ABSTRACT

Introduction: several studies have shown that older people have a higher risk of exposure to viral hepatitis B and C than younger people. This study aimed to determine the seroprevalence of hepatitis B and C and their associated factors in people aged 45+ years old in Burera, a rural district of Rwanda.Methods: a cross sectional study was conducted from July to December 2017 during a mass campaign of hepititis B (HBV) and hepititis C (HCV) screening and vaccination of eligible populations against HBV in Burera District. Blood samples were collected and hepatitis B surface antigen (HBsAg) and an antibody against hepatitis C (Anti-HCV) were detected using an Enzyme-Linked Immuno-Sorbent Assay (ELISA). The associated factors were identified using a structured questionnaire and the data was analyzed using SPSS software.Results: of the 374 people included in this study, 53.2% were females. The median age was 56 years old with an Interquartile range (IQR) of 50 - 63 years old. The prevalence of HBV and HCV infection was 6.4% and 9.4%, respectively, with 0.3% co-infection rate. Age, social economic level, history of blood transfusion, history of never using a condom, as well as a history of injury with a used sharp material were significantly associated with HCV infection.Conclusion: the study showed a high seroprevalence of both HBV and HCV in Burera's elderly population aged 45+ years. Several factors associated with HBV and HCV in this study could be prevented through education and improved hygiene.


Subject(s)
Hepatitis , Risk , Population , Rwanda
9.
Article in English | AIM (Africa) | ID: afr-201783

ABSTRACT

Introduction: the World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malaria between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. Methods: to reach our objectives, we carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the Bamenda Health District (BHD) from May to August 2014. All sites within the BHD were included. The participants were selected by simple random sampling. The principal research instrument was a structured and pre-tested questionnaire that was designed to capture socio-demographic data and data related to stage of pregnancy and knowledge about IPTp. Data was entered using Ms Excel and analysed using SPSS v20.0. Descriptive statistics (frequencies and percentages) was used to report findings. We used Chi-Square test to compare the categorical variables (Fischer’s exact test was used in cases were conditions for Chi-Square test were not met). Results: uptake for at least one dose of IPTp was 95.3% (381/400) and 54.9% (209/400) had received all three doses, 15.5% (59/400) received only one dose and 4.8% (19/400) did not receive any of the doses of IPTp. Knowledge about IPTp was associated with an increase uptake of IPTp (P<0.001). All health care providers were knowledgeable about the importance and use of IPTp. However, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine) stock out and 84.62% practiced the policy of direct observed therapy. Conclusion: the uptake of the third dose of IPTp is poor in the Bamenda Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp. Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of therapy may improve on IPTp uptake during pregnancy.


Subject(s)
Malaria/prevention & control , Malaria/diagnosis , Malaria/therapy , Pregnancy , Therapeutics , Cameroon
10.
Article in English | AIM (Africa) | ID: afr-201784

ABSTRACT

Introduction: heart failure (HF) is a major complication following ischemic heart disease (IHD) and it adversely affects the outcome. The objective of this study was to identify predictors of HF in patients with IHD. Methods: this is a 24-month longitudinal retrospective study of all consecutive patients diagnosed with IHD. Endpoints were incident HF and time to incident HF. Patients with a previous history of HF were excluded. Results: a total of 306 patients with IHD were included in the analysis. The 6-month, 12-month and 18-month cumulative risk of developing incident HF were 18.8%, 28.4%, and 53.5% respectively. Increasing age, female gender, diabetes mellitus (DM), lower hemoglobin, and dilated left atrium were strong predictors of incident HF. Predictors of shorter time to incident HF were coexisting DM and hypertension, and the presence of dilated left atrium in patients with left ventricular ejection fraction < 40%. The strongest predictor of incident HF in patients with DM was a higher level of LDL cholesterol.Conclusion: patients with IHD have a higher risk of incident HF. Strong predictors of incident HF in these patients were increasing age, female gender, DM, lower hemoglobin and dilated left atrium. Such patients need close follow-up and more intensive treatment.


Subject(s)
Heart , Disease , Ischemia , Ethiopia
11.
Article in English | AIM (Africa) | ID: afr-201785

ABSTRACT

Introduction: this study aimed to analyze the spatial distribution and capacities of public health facilities and assess utilization of the facilities in Biu area of Borno State, Nigeria. Methods: a descriptive survey of health facilities and households were conducted by stratifying the area into 11 electoral wards. Data collection instruments include a hand-held GPS (Garmin 76CSx) and 2 sets of structured questionnaires (facility and household). The hand-held GPS was used in taking the coordinates of each health facility in the area. Twenty-five facility-based and 400 household-based questionnaires were administered. Results: it was identified that 138 public health personnel serve the area's population of 240,838. Medical professionals (doctors/nurses/midwives) to patient ratio is 1:2973, about 7 times less than the minimum WHO recommendation of 2.5 medical personal per 1000 population. Uneven distribution of facilities exists, which impact on utilisation. For instance, a ward (Mandaragrau) with a population of 18,732 have 5 facilities (4 dispensaries and 1 primary health care) in comparison to a ward (Miringa) with a population of 21,343 with only one Dispensary. Income level and distance were significant socio-economic factors affecting service utilisation (p < 0.001). Area's households Gini index was 26.7, most of which (49.7%) survive on less than USD2/day and majority (33.6%) spend an average cost of treatment of ₦2,750 (approx. $8) per clinic visit. Conclusion: it was concluded that insufficiency and inequity in distribution of healthcare services exist in Borno state. It is thus recommended that future policies be directed toward improving healthcare in under-served areas.

12.
Article in French | AIM (Africa) | ID: afr-201787

ABSTRACT

Introduction: l'allo-immunisation du système ABO est impliquée dans les ictères néonataux avec une prévalence globale considérable. Le rôle de l'incompatibilité dans le système ABO est relativement peu connu. L'objectif de cette étude était d'investiguer les ictères néonataux attribuable aux incompatibilités fœto-maternelles dans le système ABO et de déterminer le lien entre le titre d'hémolysines retrouvé chez la mère et le degré d'ictère observé chez l'enfant Méthodes: nous avons mené une étude transversale de juin à novembre 2015 et la population d'étude était exclusivement constituée des mamans de groupe sanguin « O » ayant des enfants de groupe sanguin différents reçus en service de néonatalogie des centres hospitalier de référence dans la ville de Yaoundé. Les analyses statistiques ont été réalisées à l'aide du logiciel GraphPadPrism 6 à un intervalle de confiance de 95%. Résultats: la fréquence d'hémolysines retrouvées dans cette étude était de 20,58% (7/34) et l'hémolysine anti-A était le plus fréquent avec 85,7% (6/7). Les nouveau-nés de groupe sanguin B ont présenté une plus grande concentration en bilirubine comparer à ceux du groupe AB (p = 0,01). La multiparité n'était pas associée à la présence d'hémolysine (p = 0,8) tout comme le groupe sanguin de l'enfant n'a été associé à la survenue des hémolysines chez la mère (p = 0,5). Conclusion: les ictères néonataux précoces ou prolongés sont également causés par des hémolysines anti-A et anti-B dérivées de l'allo-immunisation ABO. Une étude sur un échantillonnage plus grand est recommandée pour une meilleure évaluation.


Subject(s)
/abnormalities
13.
Article in French | AIM (Africa) | ID: afr-201789

ABSTRACT

Objectif : Identifier les facteurs associés aux érosions osseuses dans la polyarthrite rhumatoïde observée à Abidjan. Matériels et méthode : Etude rétrospective et descriptive menée au service de rhumatologie du CHU de Cocody de Janvier 2005 à Avril 2017. Ont été inclus les patients souffrant d’une polyarthrite rhumatoïde répondant aux critères de l’ACR 1987 et de l’ACR-EULAR 2010, avec des érosions osseuses. Résultats : La fréquence des érosions osseuses étaient de 51,72% soit 58 sur 112 patients recrutés pendant la période d’étude. Notre effectif comportait 41 femmes et 17 hommes âgés de 46,62+/-13,02 ans. La majorité des patients étaient de niveau socioéconomique précaire (68,96%) et scolarisés (65,51%). Le délai diagnostique moyen était 28,9+/-9,7 mois. Tous les patients présentaient une polyarthrite proximale et distale. Une raideur matinale supérieure à 1 heure (44,8%), une atteinte cervicale (51,72%), des déformations (51,72%), une atteinte viscérale (48,27%), une fièvre (41,37%) et un amaigrissement (58,62%) ont été notés. On notait une vitesse de sédimentation moyenne à 22,9mm et une CRP moyenne à 47,7mg/l. Les facteurs rhumatoïdes et les anti-CCP étaient positifs respectivement chez 37,93% et 34,4% des patients. Les facteurs associés significativement aux érosions osseuses étaient la durée de la raideur matinale (P=0,04), l’atteinte des grosses articulations (P=0,025), l’atteinte du rachis cervical (0,038), la présence de déformations (0,025), l’élévation de la CRP (P=0,004) et la positivité des antiCCP (P=0,01). Conclusion : La durée de la raideur matinale, l’atteinte des grosses articulations, l’atteinte du rachis cervical (0,038), la présence de déformations, l’élévation de la CRP et la positivité des anti-CCP (P=0,01) sont associés aux érosions osseuses dans la polyarthrite rhumatoïde à Abidjan.


Subject(s)
/diagnosis
14.
Article in French | AIM (Africa) | ID: afr-201790

ABSTRACT

Introduction: les pays à ressources limitées présentent un haut risque de retard dans les 4 domaines du développement et le taux d'un handicap dans un de ces domaines est très élevé. L'objectif de cette étude est de déterminer l'âge de développement psychomoteur de l'enfant congolais en utilisant l'échelle de Bayley 2ème édition (BSID II).Méthodes: étude descriptive, observationnelle réalisé auprès les nourrissons en bonne santé apparente de Kinshasa (Centre de Santé BOMOI, CH de Kingasani II) et de la cité d'Idiofa dans la province du Kwilu durant la période allant de Janvier 2010 à janvier 2012. Les variables d'intérêts étaient les caractéristiques sociodémographiques (âge, sexe, milieu d'habitation), l'Index de développement psychomoteur (PDI) et Index de développement mental (MDI) et l'échelle comportementale (BRS) évalués à l'aide de l'échelle de Bayley 2nde édition (BSID-II). Résultats: sur 366 nourrissons retenus, 51,9% étaient du sexe féminin (sex ratio 1H/1F). L'âge chronologique et développemental médian était de 16,8 et 17 mois respectivement. Les valeurs moyennes de PDI et MDI étaient de 104,0±17,4 et 100,5±15,0 respectivement. Le retard mental et moteur sévère noté chez ces nourrissons était respectivement de 4,9% et 4,1%. Dans toutes les composantes du développement psychomoteur, les nourrissons du milieu rural avaient significativement une médiane d´âge élevée (p<0,05).Conclusion: les enfants en milieu urbain sont en avance en ce qui concerne la motricité, le cognitif et ont aussi un comportement meilleur par rapport à ceux du milieu rural.


Subject(s)
Congo
15.
Article in French | AIM (Africa) | ID: afr-201791

ABSTRACT

Introduction: en 2014, moins de 3 enfants sur dix (823 000 enfants environ) vivant avec le VIH avaient accès à un traitement antirétroviral (TAR), contre plus de quatre adultes sur dix. En conséquence, les enfants survivants qui ont une chance d´accéder au TAR sont traités souvent tardivement, à un stade avancé de la maladie. À Lubumbashi (RDC), les études sur l´évaluation du TAR chez l´enfant sont quasi nulles. Cette étude avait comme objectif décrire les caractéristiques sociodémographiques, cliniques, immunologiques et thérapeutiques des enfants infectés par le VIH et sous TAR et identifier les facteurs associés à un échec thérapeutique. Méthodes: il s'agit d'une étude transversale, réalisée du 1er janvier au 31 mars 2015 et portant sur une cohorte d'enfants de moins de 15 ans infectés par le VIH, suivis dans le service de Pédiatrie de l´hôpital Jason Sendwe. Résultats: 62 enfants âgés de moins de 15 ans infectés par le VIH ont été mis sous TAR. Les filles étaient prédominants (54,8%). 83,9% étaient à un stade clinique avancé (3 ou 4) lors de l´initiation au TAR. Notre étude montre que l´échec thérapeutique était significativement associé à l´âge ≥10 ans lors de l´évaluation de la prise en charge. Conclusion: l´étude a permis de montrer le retard avec lequel la prise en charge de l´enfant infecté VIH à Lubumbashi s´effectue; suggérant ainsi un renforcement du programme de la PTME et un dépistage précoce en vue d´une prise en charge précoce et la mise en place d´un mécanisme de rétention des enfants suivis.


Subject(s)
HIV/diagnosis , Congo
17.
Article | AIM (Africa) | ID: afr-201794

ABSTRACT

Introduction: unsafe blood remains a major threat to the global spread of transfusion transmissible infections (TTIs). Blood is usually tested for four TTIs: Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and Syphilis before transfusion. This study determined the trends of transfusion-transmissible infections among blood donors in the Hohoe Municipal Hospital, Ghana from 2015 to 2016. Methods: a total of 3,173 blood donor records were reviewed for the presence of anti-HIV 1/2 IgG/IgM, HBV, anti-HCV IgG/IgM, and anti-Treponema pallidum IgG/IgM/IgA, using commercial ELISA kits following standard protocols. Statistical analysis was performed using Stata version 14.0 at the level 0.05 Results: seroprevalence of HIV, HBV, HCV and Syphilis were 3.9% 5.0%, 4.2% and 5.2% respectively. Females were 30% less likely to be infected with Syphilis (OR=0.3; 95% CI: (0.15-0.69); p=0.004); donors aged 20-29 years were 60% less likely to be infected with HIV than those less than 20 years (OR=0.6; 95% CI: (0.04-0.99); p=0.049), while those aged 30-39 years were 90% more likely to be infected with Syphilis than those less than 20 years (OR=1.9; 95% CI: (1.23-3.20) p=0.005) and those aged 40-49 years were 2 times more likely to get infected with HBV than those less than 20 years (OR=2.2; 95% CI: (1.17-4.04)); p=0.013). Conclusion: males presented higher prevalence of Syphilis and all TTIs were recorded highest among young adults. It is important to continue screening donated blood with highly sensitive tests and to sensitize young adults, especially females on the importance of blood donation.


Subject(s)
Blood , /adverse effects , Tissue Donors , Disease , Ghana
18.
Article in English | AIM (Africa) | ID: afr-201795

ABSTRACT

Introduction: aural foreign bodies (FB) are frequent in pediatric otorhinolaryngology and in pediatric emergencies. The objective of this study was to describe the socio-demographic, clinical and therapeutic aspects of aural FB in children in a pediatric hospital in Senegal. Methods: this was a four-year hospital-based descriptive study performed in the Otorhinolaryngology department of the Children's Hospital of Diamniadio, from 1st January 2013 to 31 December 2016 including all children under 15 years of age received for aural FB. The variables studied were age, gender, provenance, presenting symptom, time to consultation, the type of FB and morbidity. Results: sixty three FB were extracted. Mean age was 6 years 4 months. 52.4% of patients were under 5 years old. There was a slight female predominance (32/63). Location was in the right ear canal in 55.6%. Seventy three percent of patients presented in our office were asymptomatic. The median time to consultation was 4 days. Within the first 24 hours after insertion, 22.2% of children presented to our office. Beads were the first FB (29.68%), followed by seeds and cotton (12.5% respectively). Foreign bodies' extraction were performed in consultation for 79.4% of patients. The morbidity was 20.6%. It was primarily otitis externa (8%). Myringoplasty was performed in one patient who had sequelae of tympanic membrane perforation. Conclusion: aural FB is a common accident in under-5 year-olds. In our context there is a delayed consultation. Morbidity is similar to that of the literature.


Subject(s)
Ear , Otolaryngology , Child , Hospitals , Senegal
19.
Article in English | AIM (Africa) | ID: afr-201796

ABSTRACT

Introduction: regular use of Antiretroviral Therapy (ART) in pregnancy and breastfeeding reduces the odds of Mother-to-Child HIV Transmission (MTCT). However, adherence to ART is critical for MTCT to be successful. The present study investigated factors that influence adherence to ART among HIV infected pregnant women in Zambia. Methods: a cross-sectional study design was conducted involving 71 HIV infected pregnant women who were advised to join the Prevention of Mother-to-Child HIV Transmission (PMTCT) program during their routine Antenatal clinic (ANC) visit and were on ART for more than six months. We used the Medication Possession Ratio (MPR) to quantify adherence levels. We used logistic regression to establish factors that influence adherence to ART. Results: a total of 71 HIV infected pregnant women with a median age of 27years (IQR, 25-30) were enrolled in the study. There was evidence of a difference in adherence levels between pregnant women above 30 years and ones between 15 years and 30 years (P<0.001). Median adherence levels in this group were found to be at 96%(IQR 89-97). The main predictor of adherence in this population was marital status (being on separation) and age. The women who were on separation were 0.14 times less likely to adhere to option B+ compared to married women. Conclusion: adherence to option B+ among pregnant women is low. Adherence was significantly influenced by marital status (being on separation) and age. Efforts to improve adherence should be directed towards women on separation and young adults (< 30 years of age).


Subject(s)
HIV , Infections/diagnosis , Infections/therapy , Therapeutics , Therapeutics , Compliance , Health , Zambia
20.
Article in French | AIM (Africa) | ID: afr-201797

ABSTRACT

Introduction: Nigeria is among the countries with high Tuberculosis (TB) burden by global rating signifying the relevance of TB surveillance system evaluation in improving performance and capacity of the existing system. Hence, this evaluation was conducted in order to determine the gaps and proffer solution to enhance the TB surveillance system performance. Methods: eight questionnaires were administered to key informants using face-to-face interview method; data obtained was analyzed. Total number of TB cases and estimated number of cases for year 2018 was obtained. Percentage of positive cases using the GeneXpert test for 6 months (January to June 2019) was obtained. Available documents and publications on the National Tuberculosis, Leprosy and Buruli Ulcer Control Programme (NTBLCP) were also sought for information. Results: the NTBLCP has over 5,300 TB service points and 1,602 microscopy Centre's distributed across the country. Acceptance for the standard TB case definition was 100%, forms used are easy to fill and diagnosis is laboratory-based requiring specialized trainings for laboratory personnel. The system had 25% sensitivity, high data quality with 100% timeliness. The TB surveillance system is representative of all ages. The system was first designed as TB and leprosy control programme but later Buruli Ulcer was incorporated into the programme. First quarter supervisory visits are skipped due to late funding and delayed budget approval. Major share of the funding comes from donor partners.Conclusion: the system is useful, representative, acceptable, has good data quality, timely, and sensitive. The system is stable but needs to be funded more by the government. There is need for early funding and budget approval to avoid skipping the first quarter supervisory visits. The system is not simple due the various test that need to be conducted before, during and after treatment to detect and verify that the patient is cured. We recommend continuous training of health workers, routine monitoring and evaluation, integration of TB care and prevention into other health services programmes like HIV/AIDS and active case search at all levels to increase the sensitivity of the system. Speed up the process of integration of NTBLCP surveillance system with IDSR for data harmonization in the country.


Subject(s)
Tuberculosis/epidemiology , Tuberculosis/diagnosis , Leprosy , Ulcer , Nigeria
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