Nearly half of HIV-positive children attending public health facilities are suffering from chronic under-nutrition in conflict-affected zones of Southern Ethiopia.

Background: In combination with HIV infection, malnutrition is a complicated medical condition with high morbidity and mortality rates in affected children due to a variety of socioeconomic and medical etiological variables. To combat this, information from a range of contexts is required, but there is little evidence, particularly about the nutritional status of under 15 living with HIV in impoverished communities such as conflict affected areas. Therefore, in this study the magnitude and related factors of stunting among under 15 children antiretroviral therapy at public health facilities was assessed. Methods: An institution-based cross-sectional study was conducted among under 15 children living with HIV in conflict-affected zones of Southern Ethiopia. After providing written informed consent to study participants, data were collected using an interviewer-administered questionnaire and anthropometric measurements. Bivariable and multivariable logistic regression models were used to identify factors associated with nutritional status, using SPSS Version 25. Results: Of the 401 participants, 197 (49.1%, 95% CI: 0.44, 0.54) had height-for-age z-score ≤ -2. In the multivariable analysis, larger household size (AOR = 1.58, 95% CI: 1.04-2.40), dietary diversity (AOR = 1.78; 95% CI: 1.07-2.96) and having a history of recurrent diarrhea (AOR = 1.96; 95% CI: 1.07-3.59) were significantly associated with chronic under nutrition. Conclusions: The prevalence found in this study was high when compared with the stunting target set in SDG, which states to end all forms of malnutrition In order to mitigate the negative health effects of diarrhea during HIV therapy, extra attention needs to be paid to facilitate timely detection and on-going monitoring. Nutrition programs in conflict-affected areas need to consider households with larger family sizes and/or routinely having fewer food groups.

Factors associated with anaemia among pregnant women in Rwanda: an analysis of the Rwanda demographic and health survey of 2020.

BACKGROUND: Anaemia in pregnancy is associated with several adverse outcomes for mothers and newborns, as well as their families. In this study, we assessed the prevalence of anaemia and the associated factors among pregnant women in Rwanda. METHODS: Secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS) was used. Multistage stratified sampling was used to select 435 pregnant women included in the study. Anaemia among pregnant women was defined as a haemoglobin value < 11 g/dL. Multivariable logistic regression was used to assess the associated factors with anaemia in pregnancy, using SPSS (version 26). RESULTS: Of the 435 pregnant women, 24.6% (95%CI: 21.1-29.3) were anaemic (1 in 4 pregnant women). Not working (AOR = 2.45; 95%CI: 1.14-5.26), being unmarried (AOR = 1.23; 95%CI: 1.24-3.57), low wealth index (AOR = 9.19; 95%CI: 1.64-51.56), having difficulty accessing a nearby health facility (AOR = 5.40; 95%CI: 2.21-13.23), and normal body mass index (AOR = 3.33; 95%CI: 1.46-7.59) were associated with higher odds of being anaemic. However, not taking iron supplements (AOR = 0.16; 95% CI: 0.04-0.67), having no exposure to television (AOR = 0.35; 95%CI: 0.14-0.91), being from the southern region (AOR = 0.14; 95% CI: 0.03-0.66), and low husband/partner's education (AOR = 0.08; 95% CI: 0.01-0.59) were associated with lower odds of being anaemic. CONCLUSIONS: The study findings indicate a high prevalence of anaemia in pregnancy, which was associated with several socio-demographics. There is a need for setting up mobile clinics and health facilities in hard-to-reach areas for easy accessibility to early anaemia screening services. Conducting mass screening for anaemia targeting pregnant women who are not working, the unmarried, and those with a low wealth index would also be beneficial. The intake of locally available iron rich foods and/ or bio-fortified foods is also recommended.

Counseling Supporting HIV Self-Testing and Linkage to Care Among Men Who Have Sex With Men: Systematic Review and Meta-Analysis.

BACKGROUND: Counseling supporting HIV self-testing (HIVST) is helpful in facilitating linkage to care and promoting behavior changes among men who have sex with men (MSM). Different levels of counseling support for MSM HIVST users may lead to variance in the linkage to care. OBJECTIVE: This study aims to synthesize evidence on counseling supporting MSM HIVST users and to conduct a meta-analysis to quantify the proportion of MSM HIVST users who were linked to care. METHODS: A systematic search was conducted using predefined eligibility criteria and relevant keywords to retrieve studies from the MEDLINE, Global Health, Web of Science, Embase, APA PsycINFO, and Scopus databases. This search encompassed papers and preprints published between July 3, 2012, and June 30, 2022. Studies were eligible if they reported counseling supporting HIVST or quantitative outcomes for linkage to care among MSM and were published in English. The screening process and data extraction followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed by the National Institutes of Health quality assessment tool. Data were extracted using random effects models to combine the proportion of HIVST users who were linked to care. Subgroup analyses and metaregression were conducted to assess whether linkage to care varied according to study characteristics. All analyses were performed with R (version 4.2.1; R Foundation for Statistical Computing) using the metafor package. RESULTS: A total of 55 studies published between 2014 and 2021, including 43 observational studies and 12 randomized controlled trials, were identified. Among these studies, 50 (91%) provided active counseling support and 5 (9%) provided passive counseling support. In studies providing active counseling support, most MSM HIVST users were linked to various forms of care, including reporting test results (97.2%, 95% CI 74.3%-99.8%), laboratory confirmation (92.6%, 95% CI 86.1%-96.2%), antiretroviral therapy initiation (90.8%, 95% CI 86.7%-93.7%), and referral to physicians (96.3%, 95% CI 85%-99.2%). In studies providing passive counseling support, fewer MSM HIVST users were linked to laboratory confirmation (78.7%, 95% CI 17.8%-98.4%), antiretroviral therapy initiation (79.1%, 95% CI 48.8%-93.7%), and referral to physicians (79.1%, 95% CI 0%-100%). Multivariate metaregression indicated that a higher number of essential counseling components, a smaller sample size (<300), and the use of mobile health technology to deliver counseling support were associated with better linkage to care. The quality of the studies varied from fair to good with a low to high risk of bias. CONCLUSIONS: Proactively providing counseling support for all users, involving a higher number of essential components in the counseling support, and using mobile health technology could increase the linkage to care among MSM HIVST users. TRIAL REGISTRATION: PROSPERO CRD42022346247; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=346247.

Factors associated with HIV testing among pregnant women in Rwanda: A nationwide cross-sectional survey.

Human immunodeficiency virus (HIV) testing during pregnancy is crucial for the prevention of mother-to-child transmission of HIV, through aiding prompt treatment, care, and support. However, few studies have explored HIV testing among pregnant women in Rwanda. This study, therefore, aimed to determine the prevalence and associated factors of HIV testing among pregnant women in Rwanda. We used secondary data from the 2020 Rwanda Demographic and Health Survey (RDHS), comprising 870 pregnant women. Multistage stratified sampling was used by the RDHS team to select participants. We conducted bivariable and multivariable logistic regression to explore factors associated with HIV testing using SPSS (version 25). Of the 870 pregnant women, 94.0% had tested for HIV during their current pregnancy. Younger age (24-34 years), not working, large household size, multiple sex partners, as well as secondary, primary, and no education were associated with higher odds of HIV testing compared to their respective counterparts. However, being unmarried, belonging to the western region, having not visited a health facility, and not having comprehensive HIV knowledge were associated with lower odds of HIV testing. A high proportion of pregnant women had tested for HIV. The study revealed that individual-level factors had the greatest influence on HIV testing in pregnancy, with a few household-level factors showing significance. There is a need for maternal health stakeholders to design and develop HIV testing programs that are region-sensitive. These programs should target older, more educated, working, and unmarried women with limited HIV knowledge.

Vitamin C, vitamin E, ß-carotene and risk of Parkinson's disease: a systematic review and dose-response meta-analysis of observational studies.

OBJECTIVE: This study aimed to explore the relationship between the intake of vitamin C, vitamin E and ß-carotene, and the risk of Parkinson's disease (PD). METHODS: Web of Science, Embase, PubMed, Cochrane library, CNKI, and WanFang databases were searched from inception to 29 August 2022 for observational studies reporting the odds ratios (ORs) or relative risks (RRs) or hazard ratios (HRs) and 95% confidence intervals (CIs) of PD by Vitamin C/Vitamin E/ß-carotene intake. Random-effects models, publication bias assessment, subgroup, sensitivity and dose-response analyses were performed, using.Stata version 12.0. RESULTS: A total of 13 studies were included. There was no significant association between high-dose vitamin C intake and the risk of PD compared with low-dose vitamin C intake (RR = 0.98, 95%CI:0.89,1.08). Compared with low-dose intake, high-dose intake of vitamin E can prevent the risk of PD (RR = 0.87, 95%CI:0.77,0.99). Compared with lower ß-carotene intake, there was a borderline non-significant correlation between higher intake and PD risk (RR = 0.91, 95%CI:0.82,1.01), and high dose ß-carotene intake was found to be associated with a lower risk of PD in women (RR = 0.78, 95%CI:0.64,0.96). CONCLUSION: This study shows that vitamin E intake can reduce the risk of PD and play a preventive role.

Prevalence of risk factors for human immunodeficiency virus among sexually active women in Rwanda: a nationwide survey.

BACKGROUND: The Human Immunodeficiency Virus (HIV) remains a global health burden, and despite the advancements in antiretroviral therapy and various strategies employed to curb HIV infections, the incidence of HIV remains disproportionately high among women. Therefore, this study aimed to determine the prevalence of the risk factors for the acquisition of HIV among sexually active women in Rwanda. METHODS: Secondary data from the 2020 Rwanda Demographic Health Survey, comprising 10,684 sexually active women, was used. Multistage stratified sampling was employed to select the study participants. Multivariable logistic regression was conducted to determine the associated risk factors using the SPSS (version 25). RESULTS: Of the 10,684 sexually active women, 28.7% (95% confidence interval (CI): 27.5-29.4) had at least one risk factor for HIV acquisition. Having no education (AOR = 3.65, 95%CI: 2.16-6.16), being unmarried (AOR = 4.50, 95%CI: 2.47-8.21), being from female-headed households (AOR = 1.75, 95%CI: 1.42-2.15), not having health insurance (AOR = 1.34, 95%CI: 1.09-1.65), no HIV test history (AOR = 1.44, 95%CI: 1.01-2.08), being from the poorest wealth quintile (AOR = 1.61, 95%CI: 1.14-2.27) and lack of exposure to mass media (AOR = 1.30, 95%CI: 1.07-1.58) were associated with higher odds of exposure to at least one HIV acquisition risk factor. In contrast, age groups of 25-34 (AOR = 0.56, 95%CI: 0.44-0.71) and 35-44 years (AOR = 0.62, 95%CI: 0.48-0.80), rural residence (AOR = 0.63, 95%CI: 0.49-0.81) and being from the western region (AOR = 0.67, 95%CI: 0.48-0.94) were associated with less odds of exposure to at least one HIV acquisition risk factor. CONCLUSION: More than a quarter of sexually active women in Rwanda had exposure to at least one risk factor for HIV acquisition. There is a need to maximize the use of mass media in disseminating HIV prevention and behavioral change messages. Engagement of religious leaders and promotion of HIV testing, especially among the never-testers, may be vital strategies in successful HIV prevention programs.

Differential practice and associated factors of COVID-19 personal preventive measures among the slum and estate communities of Uganda: A community-based cross-sectional survey.

Background: Compliance with personal preventive measures (PPMs) remains essential in the prevention and control of the coronavirus disease 2019 (COVID-19) pandemic and future infectious disease outbreaks. This study aimed at examining and comparing the practice of COVID-19 PPMs and associated factors in selected slum and estate communities of Uganda. Methods: This was a cross-sectional survey conducted among 1025 slum and estate residents in Uganda. The outcome variable was compliance with COVID-19 PPMs, including face mask use, hand washing/hygiene, and social distancing. Logistic regression models were fitted to assess the associated factors, using SPSS (version 26). Results: Of the 1025 participants, 511 and 514 were slum and estate residents, respectively. Compliance with PPMs was as follows; face mask use (slum 45.0% vs. estate 49.6%; P = 0.27), hand washing/hygiene (slum 38.4% vs. estate 44.9%; P = 0.04), and social distancing (slum 19.4% vs. estate 36.0%; P < 0.001). Compared to estate residents, slum residents had more knowledge related to COVID-19, perceived COVID-19 would have a longer timeline and larger impact on their life, had more depression and anxiety symptoms, and faced more difficulties to access information. Illness perceptions, infection risk, and severity perceptions were associated with higher odds of PPMs compliance in both groups, except for perceiving a high chance of contracting COVID-19, which was associated with lower odds of social distancing in the slum community. Depression and anxiety symptoms were associated with higher odds of PPMs compliance in both groups. Frequent exposure to COVID-19 information through health care workers and family members and friends was associated with higher odds of all the PPMs in both communities. Moreover, getting COVID-19 information from local channels was significantly associated with higher odds of mask use and hand hygiene, but only in the estate community. Conclusions: Our findings provided implications to improve PPMs compliance in future infectious disease outbreaks. To improve PPMs compliance rates, redesigning community education to focus on fostering positive perceptions and addressing the water and sanitation needs of slum communities are essential. Moreover, designing programs that provide free or subsidised face masks and soap to the most vulnerable and engaging religious leaders are also vital strategies.

Parental Acceptance, Parental Hesitancy, and Uptake of Seasonal Influenza Vaccination among Children Aged 6-59 Months: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis summarises the literature on parental acceptance, parental hesitancy, uptake, and the associated factors of seasonal influenza vaccination (SIV) among children aged 6-59 months. Studies were sourced from the following platforms: PubMed, Web of Science, MEDLINE, and EMBASE databases. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of parental acceptance, parental hesitancy, and SIV uptake in the last flu season and lifetime among children. A total of 36 studies were included for analysis. The overall prevalence was 64% for parental acceptance (95% CI: 51-75%), 34% for parental hesitancy (95% CI: 22-48%), 41% for SIV uptake in the last flu season (95% CI: 33-50%), and 46% for SIV uptake in a lifetime (95% CI: 20-74%). Associated factors of parental acceptance/hesitancy and uptake included the age of the children or parents, parental education level, household income level, ethnicity, and other modifiable factors, including perceived benefits, perceived barriers, perceived severity, perceived susceptibility, and cues to action related to SIV. Meta-regression analyses revealed regional differences in parental acceptance (Americas: 79% vs. Asia: 60%). The results provided implications informing us of the development of intervention programs targeting parents to improve SIV coverage among young children.

Facilitators and barriers to use rapid antigen test for SARS-CoV-2 among community-dwelling older adults in Hong Kong: A population-based cross-sectional random telephone survey.

Faster diagnosis of Coronavirus disease 2019 (COVID-19) is crucial for surveillance, prompt implementation of infection control measures and adequate patient care among older adults. This study investigated the behavioral intention to use Rapid Antigen Tests (RAT) and associated factors among older adults in Hong Kong for health monitoring and when having COVID-19-like symptoms. This was a population-based cross-sectional random telephone survey of 370 Chinese-speaking adults aged ≥65 years. The behavioral intention to use RAT was the main outcome, and logistic regression models were used to assess the associated factors, using SPSS (version 26.0.). Results indicate that among the participants, 90.3% had used RAT, of which 21.6% obtained positive results. The common challenges faced when using RAT included: difficulty choosing the right RAT kit, uncertainty about how to use RAT, and not knowing what to do after getting a positive result. Additionally, 27.3% intended to use RAT regularly for health status monitoring without any symptoms, while 87.0% if they had COVID-19-like symptoms. After adjustment for significant background characteristics, positive attitudes, perceiving Hong Kong government and their children and/or other family members would support them using RAT, belief that RAT health promotion materials were helpful to understand how to use RAT and thoughtful consideration of the veracity of COVID-19 specific information were associated with higher behavioral intention to use RAT both when having no symptoms and in presence of COVID-19-like symptoms. Having negative attitudes toward RAT was associated with a lower intention of RAT use only when having no symptoms. Addressing difficulties faced when using RAT, strengthening positive attitudes, involving significant others and empowering with adequate information-veracity evaluating skills are potentially vital strategies to increase RAT use among older adults.

Associations between COVID-19 Vaccination and Behavioural Intention to Receive Seasonal Influenza Vaccination among Chinese Older Adults: A Population-Based Random Telephone Survey.

During the Coronavirus Disease 2019 (COVID-19) pandemic, seasonal influenza remained a significant health threat for older adults. Seasonal influenza vaccination (SIV) is highly effective and safe for older adults. This study investigated the associations of COVID-19 vaccination, perceptions related to COVID-19 and SIV, with the behavioural intention to receive SIV among older adults in Hong Kong, China. A random telephone survey was conducted among 440 community-dwelling Hong Kong residents aged 65 years or above, between November 2021 and January 2022. Among the participants, 55.7% intended to receive SIV in the next year. After adjustment for significant background characteristics, concern about whether SIV and COVID-19 vaccination would negatively affect each other was associated with a lower intention to receive SIV, while a perceived higher risk of co-infection with COVID-19 and seasonal influenza was positively associated with the dependent variable. In addition, the perceived severe consequences of seasonal influenza, perceived benefits of SIV, received cues to action from doctors and participants' family members or friends, and the perception that more older people would receive SIV was associated with a higher behavioural intention. Future programmes promoting SIV among older adults should modify perceptions related to COVID-19 vaccination and SIV at the same time.

Comprehensive knowledge about HIV/AIDS and associated factors among adolescent girls in Rwanda: a nationwide cross-sectional study.

BACKGROUND: Limited comprehensive knowledge of HIV/AIDS is highlighted as one of the major factors linked to the high prevalence of HIV among adolescents and young girls. Thus, it is crucial to identify factors that facilitate or hinder adolescent girls from having comprehensive knowledge of HIV/AIDS. We, therefore, assessed the prevalence of comprehensive knowledge about HIV/AIDS and associated factors among adolescent girls in Rwanda. METHODS: We used secondary data from the Rwanda Demographic and Health Survey (RDHS) 2020 comprising 3258 adolescent girls (aged 15 to 19 years). Comprehensive knowledge was considered if an adolescent girl answered correctly all the six indicators; always using condoms during sex can reduce the risk of getting HIV, having one sexual partner only who has no other partners can reduce the risk of getting HIV, a healthy-looking person can have HIV, can get HIV from mosquito bites, can get HIV by sharing food with persons who have AIDS, and can get HIV by witchcraft or supernatural means. We, then, conducted multivariable logistic regression to explore the associated factors, using SPSS (version 25). RESULTS: Of the 3258 adolescent girls, 1746 (53.6%, 95%CI: 52.2-55.6) had comprehensive knowledge about HIV/AIDS. Adolescent girls with secondary education (AOR = 1.40, 95% CI: 1.13-3.20), health insurance (AOR = 1.39, 95% CI: 1.12-1.73), a mobile phone (AOR = 1.26, 95% CI: 1.04-1.52), exposure to television (AOR = 1.23, 95% CI: 1.05-1.44), and a history of an HIV test (AOR = 1.26, 95% CI: 1.07-1.49) had higher odds of comprehensive HIV knowledge, compared to their respective counterparts. However, girls residing in Kigali (AOR = 0.65, 95% CI: 0.49-0.87) and Northern (AOR = 0.75, 95% CI: 0.59-0.95) regions, and those of Anglican religion (AOR = 0.82, 95% CI: 0.68-0.99) had less odds of comprehensive knowledge compared to those in Southern region and of the Catholic religion. CONCLUSIONS: To increase the comprehensive understanding of the disease at a young age, the need for expanded access to HIV preventive education through formal educational curriculum, and mass and social media via mobile phones is highlighted. In addition, the continued involvement of key decision-makers and community actors, such as religious leaders, is vital.

Mosquito bed net use and associated factors among pregnant women in Rwanda: a nationwide survey.

BACKGROUND: In malaria-endemic countries such as Rwanda, the appropriate use of mosquito bed nets is an effective intervention for malaria prevention. Despite being one of the demographics most impacted by malaria, there is a dearth of literature on the usage of mosquito bed nets by pregnant women in Rwanda. The study aimed to assess the prevalence and associated factors for mosquito bed net use among pregnant women in Rwanda. METHODS: We used weighted data from the 2020 Rwanda Demographic and Health Survey of 870 pregnant women, and multistage stratified sampling was used to select participants. Multivariable logistic regression was conducted to determine the factors associated with mosquito bed net use, using SPSS (version 26). RESULTS: Of the 870 pregnant women, 57.9% (95%CI: 54.6-61.1) used mosquito bed nets. However, 16.7% did not use bed nets among those owning bed nets. On one hand, older age (AOR = 1.59, 95%CI: 1.04-2.44), primary education (AOR = 1.18, 95%CI: 1.07-2.23), being married (AOR = 2.17, 95%CI: 1.43-3.20), being from Kigali region (AOR = 1.97, 95%CI: 1.19-3.91), partner's education (AOR = 1.22, 95%CI: 1.13-3.41), having recently visited a health facility (AOR = 2.07, 95%CI: 1.35-3.18), and being in the third pregnancy trimester (AOR = 2.14, 95%CI: 1.44-3.18) were positively associated with mosquito bed net use. On the other hand, low wealth index (AOR = 0.13, 95%CI: 0.07-0.24), and being from Eastern region (AOR = 0.42, 95% CI: 0.26-0.66) had a negative association. CONCLUSIONS: About half of the pregnant women in Rwanda used mosquito bed nets and the usage was associated with various socio-demographics. There is a need for appropriate risk communication and continuous sensitisation to improve mosquito net use among pregnant women. Early antenatal care attendance and partner engagement in malaria prevention and mosquito net use, as well as consideration of household dynamics, are also crucial in improving not only mosquito net coverage but also utilization.

Sexual violence and associated factors among women of reproductive age in Rwanda: a 2020 nationwide cross-sectional survey.

BACKGROUND: Sexual violence against women is a global public health issue with both short- and long-term effects on the physical and mental health of women. This study aimed to determine the prevalence of sexual violence and its associated factors among women of reproductive age in Rwanda. METHODS: We used secondary data from the 2020 Rwanda Demographic and Health Survey of 1,700 participants, who were selected using multistage stratified sampling. Multivariable logistic regression was conducted to explore factors associated with sexual violence using SPSS (version 25). RESULTS: Of the 1,700 women of reproductive age, 12.4% (95%CI: 11.0-14.1) had experienced sexual violence. Justified beating (AOR = 1.34, 95%CI: 1.16-1.65), not having health insurance (AOR = 1.46, 95%CI: 1.26-2.40), not being involved in healthcare decision-making (AOR = 1.64, 95%CI: 1.99-2.70), having a husband/partner with primary (AOR = 1.70, 95%CI: 5.47-6.21) or no education (AOR = 1.84, 95%CI: 1.21-3.37), as well as having a husband/partner who sometimes (AOR = 3.37, 95%CI: 1.56-7.30) or often (AOR = 12.87, 95%CI: 5.64-29.38) gets drunk were positively associated with sexual violence. However, women from male-headed households (AOR = 0.52, 95%CI: 0.29-0.92) were less likely to experience sexual violence. CONCLUSIONS: There is a need to demystify negative culturally-rooted beliefs favouring sexual violence, such as justified beating, as well as increase efforts to promote women's empowerment and healthcare access. Moreover, engaging men in anti-sexual violence strategies is paramount to addressing male-related issues that expose women to sexual violence.

COVID-19 Vaccine Acceptance, Attitude and Perception among Slum and Underserved Communities: A Systematic Review and Meta-Analysis.

This systematic review summarises the literature on Coronavirus Disease 2019 (COVID-19) vaccination, including acceptance, uptake, hesitancy, attitude and perceptions among slum and underserved communities. Relevant studies were searched from PubMed, Scopus, Web of Science and Google Scholar, following a pre-registered protocol in PROSPERO (CRD42022355101) and PRISMA guidelines. We extracted data, used random-effects models to combine the vaccine acceptance, hesitancy and uptake rates categorically, and performed meta-regression by R software (version 4.2.1). Twenty-four studies with 30,323 participants met the inclusion criteria. The overall prevalence was 58% (95% CI: 49-67%) for vaccine acceptance, 23% (95% CI: 13-39%) for uptake and 29% (95% CI: 18-43%) for hesitancy. Acceptance and uptake were positively associated with various sociodemographic factors, including older age, higher education level, male gender, ethnicity/race (e.g., Whites vs African Americans), more knowledge and a higher level of awareness of vaccines, but some studies reported inconsistent results. Safety and efficacy concerns, low-risk perception, long distance to vaccination centres and unfavourable vaccination schedules were prominent reasons for hesitancy. Moreover, varying levels of attitudes and perceptions regarding COVID-19 vaccination were reported with existing misconceptions and negative beliefs, and these were strong predictors of vaccination. Infodemic management and continuous vaccine education are needed to address existing misconceptions and negative beliefs, and this should target young, less-educated women and ethnic minorities. Considering mobile vaccination units to vaccinate people at home or workplaces would be a useful strategy in addressing access barriers and increasing vaccine uptake.

Knowledge and Practice of Personal Protective Measures Against COVID-19 in Africa: Systematic Review.

BACKGROUND: With COVID-19 being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs). OBJECTIVE: This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries as documented in the published literature. METHODS: A systematic search was conducted on the Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed methods studies) conducted in Africa and published in the English language were included. The screening process and data extraction were performed according to a preregistered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool. Thematic analysis was used to systematically summarize the studies into 4 predefined domains: knowledge and perception of PPMs, mask use, social and physical distancing, and handwashing and hand hygiene, including their respective levels and associated factors. RESULTS: A total of 58 studies across 12 African countries were included, published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with the lack of personal protective equipment (mainly face masks) and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing and hand hygiene were particularly noted in several African countries, especially among low-income urban and slum dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), sociodemographic, and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities at the regional level, with East Africa contributing 36% (21/58) of the studies, West Africa contributing 21% (12/58), North Africa contributing 17% (10/58), Southern Africa contributing 7% (4/58), and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good as they satisfied most of the quality assessment criteria. CONCLUSIONS: There is a need to enhance local capacity to produce and supply personal protective equipment. Consideration of various cognitive, demographic, and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42022355101; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022355101.

Hesitancy to Receive the Second COVID-19 Vaccine Booster Dose among Older Adults in Hong Kong: A Random Telephone Survey.

A second COVID-19 vaccine booster dose is effective and safe for older adults. This study investigated hesitancy to take up a second COVID-19 vaccine booster dose and its determinants among older adults in Hong Kong. Participants were Chinese-speaking community-dwelling adults aged 65 years or above. Telephone numbers were randomly selected from up-to-date telephone directories. A total of 370 participants completed the telephone survey. Logistic regression models were fitted for data analysis. Among the participants, half (52.4%) were hesitant to receive the second COVID-19 vaccine booster dose. After adjustment for significant background characteristics, perceived benefits (AOR: 0.50, 95%CI: 0.42, 0.60), cues to action (AOR: 0.39, 95%CI: 0.30, 0.52), and perceived self-efficacy (AOR: 0.37, 95%CI: 0.21, 0.66) of receiving the second booster dose were associated with lower vaccine hesitancy. Perceived barriers (AOR: 1.23, 95%CI: 1.12, 1.34) and vaccine fatigue (tired of receiving repeated COVID-19 vaccination) (AOR: 1.90, 95%CI: 1.52, 2.38) were associated with higher vaccine hesitancy. Level of hesitancy to receive the second booster dose was high among older adults in Hong Kong. Health authorities should address vaccine fatigue and modify perceptions related to the second booster dose.

Differential COVID-19 Vaccination Uptake and Associated Factors among the Slum and Estate Communities in Uganda: A Cross-Sectional Population-Based Survey.

Vaccination against COVID-19 remains one of the ultimate solutions to the ongoing pandemic. This study examined and compared the completion of primary COVID-19 vaccination series and associated factors in the slum and estate communities of Uganda. This was a cross-sectional survey conducted among 1025 slum and estate residents. Logistic regression models were fitted. Of the 1025 participants, 511 were slum residents and 514 were estate residents. Completion of COVID-19 vaccination was 43.8% in the slum community and 39.9% in the estate community (p = 0.03). Having more knowledge about COVID-19 was positively associated with completing COVID-19 vaccination in both communities. Perceived benefits and cues to action also had a positive association, but only among the slum residents. However, perceiving people infected with COVID-19 as having a high death rate, perceived barriers such as serious side effects and long distances, and depressive symptoms had negative associations with vaccine uptake among the slum community, but not in the estate community. Addressing barriers to vaccination, strengthening and utilizing the various cues to action, engagement of religious and cultural leaders, and continued community education and sensitization tailored to the needs of each community are potentially vital strategies in raising vaccination rates. Consideration of socioeconomic impact-alleviation strategies, especially among the urban poor, would also be beneficial.

Changes in COVID-19 Vaccine Acceptability among Parents with Children Aged 6-35 Months in China-Repeated Cross-Sectional Surveys in 2020 and 2021.

China is considering to offer COVID-19 vaccination for children aged 6−35 months. This study investigated the changes in COVID-19 vaccine acceptability and associated factors among parents with children aged 6−35 months in 2020 and 2021. Two rounds of cross-sectional online surveys were conducted among adult factory workers in Shenzhen, China. A subset of 208 (first round) and 229 (second round) parents with at least one child aged 6−35 months was included in the study. Parental acceptability of COVID-19 vaccination increased significantly from 66.8% in the first round to 79.5% in the second round (p = 0.01). Positive attitudes, perceived subjective norm, and perceived behavioral control were associated with higher parental acceptability in both rounds of surveys (p values ranged from <0.001 to 0.003). A negative association of negative attitudes with parental acceptability was observed in the second round (p = 0.02). No significant associations of exposure to information related to COVID-19 vaccination on social media with parental acceptability was found in either round of survey. Expanding the existing COVID-19 vaccination programs to cover children aged 6−35 months is necessary in China. Future programs should focus on modifying perceptions among parents to promote COVID-19 vaccination for children in this age group.

Bibliometric analysis of the African Health Sciences' research indexed in Web of Science and Scopus.

Background: The Journal of African Health Sciences (AHS) is an internationally refereed journal in the field of health sciences with vast research contributions in the world and Africa region. Objective: The study aimed to document the scientific production and explore the AHS research bibliometric characteristics since its first issue. Methods: A comprehensive retrospective bibliometric analysis was performed on AHS published documents indexed in Web of Science (WoS) and Scopus since the journal's first issue. The analysis was done using SPSS v. 22.0, Bibliometrix Package in R, and VOSviewer v.1.6.15. Results: A total of 1649 and 1879 documents indexed in Web of Science (WoS) and Scopus were retrieved. The annual number of publications showed a significant increase in both databases. The most contributing countries (in WoS vs. Scopus) were; Nigeria (n = 393 vs. 276), Uganda (215 vs. 220) and South Africa (143 vs. 101).The most productive authors were "Tumwine JK", "Mayanja-Kizza H", and "Ocama P". Makerere University, The University of Ibadan, and University of Nigeria were the most contributive institutions. International agencies mainly from the USA were the main funders of AHS documents. Analysis of keywords revealed the dominance of research topics with keywords such as HIV/AIDS, Tuberculosis, Malaria, Obesity, Hypertension, risk factors, infection, mortality, amongst others. Conclusions: This analysis has revealed the progress in the development and growth of scientific research from AHS. Moreover, top-cited documents-analysis has reflected its focus on health issues relevant to Africa. This analysis would help in evidence-based descriptions of AHS research output.

Linking Depressive and Anxiety Symptoms with Diet Quality of University Students: A Cross-Sectional Study during the COVID-19 Pandemic in India.

This study examines the association of depressive and anxiety symptoms with diet quality among university students while controlling for different demographic and other health and lifestyle factors. This cross-sectional study was carried out between April 2021 and June 2021 among a total of 440 (unweighted) university students. Diet quality was assessed using a 10-item mini-dietary assessment index tool. The depressive and anxiety symptoms of participants were measured using the validated Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder (GAD-7) scale, respectively. Multivariable logistic regression and mediation analyses were performed. In this study, 61.1% (95% CI: 56.6% to 65.7%) of university students' diet quality was good during the COVID-19 pandemic. Being a post-graduate student, an urban resident, having no depressive (AOR = 2.15, 95% CI: 1.20 to 3.84) and anxiety symptoms (AOR = 1.96, 95% CI: 1.07 to 3.59), no changes or improvement in appetite, and no changes in sleep duration were significantly associated with good diet quality among our study participants. Depressive and anxiety symptoms during COVID-19 had a significant effect on the diet quality of university students. Future public health policies need to be focused on improving the mental health and well-being of students particularly during pandemic situations to enhance their diet quality.