ABSTRACT
OBJECTIVE: We conducted a systematic review to assess the scope and effectiveness of interventions to improve human papilloma virus (HPV) vaccination in Africa from 2006 to 2021. STUDY DESIGN: Systematic review. METHODS: Four databases (Medline, Embase, CINAHL and PsycINFO) were searched for articles published between 2006 and 2021. Articles were screened and included based on eligibility criteria using DistillerSR (Version 2.35). Data were extracted and reported using a narrative synthesis. A quality assessment was also conducted for each study using validated quality appraisal tools. RESULTS: Out of 7603 articles identified by a systematic search, 18 articles met the inclusion criteria. Included studies comprised impact evaluation and cross-sectional studies published between 2012 and 2021 and conducted in eight African countries namely: Nigeria, Cameroon, South Africa, Kenya, Tanzania, Zambia, Mali, and Malawi. Study quality ranged from high to low quality. Interventions comprised fifteen educational and three multicomponent interventions. Out of thirteen impact evaluation studies (all educational interventions), twelve studies were effective in increasing HPV vaccine uptake and/or improving participants' knowledge, attitudes, and perceptions about the vaccine. Across five cross-sectional studies (two educational and three multicomponent interventions), HPV vaccine uptake rates ranged from 34% to 93.3%, with a consensus on safety and effectiveness in 67.9%-90.3% of participants post-intervention. CONCLUSION: Educational and multicomponent interventions have been implemented to improve HPV vaccination in Africa. While educational interventions have proven effective at improving HPV vaccine uptake, a more diverse range of interventions with robust impact evaluation study designs are needed to strengthen the available evidence and improve vaccine uptake.
ABSTRACT
OBJECTIVE: To assess the microbiological quality of sachet-packaged drinking water in Western Nigeria and its impact on public health. STUDY DESIGN: Cross-sectional microbiological testing. METHODS: Ninety-two sachet-packaged water samples were analysed for microbiological and metal qualities. Total bacterial and coliform counts were determined, and the presence of Escherichia coli, an important water quality indicator, was tested. The level of conformity of the water processors with the guidelines of Nigeria's quality regulatory agency was also determined. RESULTS: Varying levels of microbial contamination were recorded in samples from the different sampling locations. The total bacteria count ranged between 2.86 and 3.45log colony-forming units (cfu)/ml. The highest coliform count recorded was 1.62log cfu/ml. Faecal coliform E. coli was detected in one sample from Oke-Iho and one sample from Okaka, representing 2.2% of total samples. Lead and manganese were not found in any of the samples. However, iron was detected and the highest iron concentration (0.10mg/l) was detected in samples from Ikorodu. The bacteria that were identified from the water samples included E. coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Klebsiella sp., Proteus vulgaris, Alcaligenes faecalis, Bacillus cereus, Staphylococcus aureus, Streptococcus lactis, Aeromonas sp. and Micrococcus luteum. Many of the water processors did not comply with the guidelines of the quality regulatory agency. CONCLUSIONS: Some of the sachet-packaged samples of drinking water were of poor quality. The results indicate a need for Nigeria's quality regulatory agency to take appropriate measures in safeguarding public health.
