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100 articles

The Impact of Public Financing, Economic Growth, and Corruption on Immunization Performance: Evidence from 37 Sub-Saharan African Countries

Oct 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5729

Background In sub-Saharan Africa, where many countries continue to experience high burdens of vaccine-preventable diseases, increasing immunization access have been a priority for the governments and international organizations such as Gavi, the Vaccine Alliance. Over 40 Gavi-supported African countries have been impacted, with 364 million children reached and over US$5.7 billion disbursed, averting over 8.9 million child deaths. Despite this progress, the African region has struggled with immunization coverage due to various factors. Nevertheless, some African countries are transitioning out of Gavi support due to economic growth. However, many require strong political will to increase their expenditure on immunization. This study therefore aims to understand the factors influencing immunization performance and its relationship to public expenditure. Methods Data on 37 Gavi-eligible sub-Saharan African countries between 2006 and 2019 was obtained from the World Bank’s World Development Indicators, the WHO and UNICEF Joint Reporting Form and the Transparency International’s Corruption Perception Index. Descriptive immunization and health expenditure were analyzed using a panel regression of variables. DPT3 was used as an indicator of immunization uptake. The indicator for public expenditure on immunization per child was based on government spending on immunization divided by the number of children in the birth cohort. Results The average gross national income increased from US$639 to US$1,192 per capita, while government spending on immunization increased from US$1.7 to about US$4.5 per child. The findings show that there is a correlation between improved immunization financing, increased gross national income, reduced corruption, and improved immunization coverage. However, performance declines beyond a certain threshold when gross national income per capita increases. In addition, an English-speaking country effect was observed. Conclusions While improved immunization financing increases immunization coverage and constitutes an advocacy talking point, there is a need to understand why an increase in gross national income per capita does not translate into an improved immunization coverage. Key highlights Increasing national spending on immunization drives up the uptake of childhood vaccines. There is a threshold beyond which immunization coverage falls despite increased GNI. Controlling corruption increases immunization coverage tendency. French- and English-speaking countries’ immunization coverage differs. Immunization and health system financing have separate outcomes.

Hodgkin's Lymphoma In Low-Income Countries: Experience Of Togo

Mar 2024 DOI 10.14302/issn.2372-6601.jhor-24-4962

While highly curable in developed countries, Hodgkin's lymphoma (HL), remains a significant challenge for resource-limited ones. This study aimed to describe the profile of HL in Togo. This was a retrospective, descriptive study conducted at the Clinical Hematology Department of the Campus University Hospital Center in Lomé, Togo. It focused on patient records diagnosed with HL between January 1, 2006, and December 31, 2022. Various variables such as age, gender, histological type of HL, Ann Arbor stage, prognostic classification, therapeutic protocol used, and patient outcomes were examined. The annual incidence of HL was 1.5 with a mean age of 38.7 years (range 12-63). Lymph node enlargement was the primary clinical sign (100%). Histologically, classical HL was found in 21 patients (87.5%). Staging was conducted for 16 (66.7%) patients, among whom 11 (66.7%) were at an advanced stage, and 6 (37.5%) had an unfavorable prognosis. The ABVD protocol was used in 13 patients (54.2%), receiving between 1 and 6 cycles. One patient achieved complete remission (4.1%), three deceased (12.5%), and 17 (71%) were lost to follow-up. Hodgkin's lymphoma prognosis remains unfavorable with low remission rates in Togo. Improving the technical facilities will ensure better management of this lymphoma.

Agronomy Research Open Access

A Long-Term Polydromic Function to Disentangle Personal Remittance, Migration and Employment in Agriculture in Order to Raise the GDP of the Donor aid Ratio in Five African Countries

Nov 2021 DOI 10.14302/issn.2639-3166.jar-21-4004

Economic statistics concerning the quinquennial features of Agriculture employment (A), net Migration (M), Donor aid (D) and Personal remittances (P), available for over forty years from five West African countries have here been related to the GDP (G). The overall results of a multilinear regression (R2 0.84) have confirmed that the GD ratio, which is an index of aid efficiency, is significantly and positively driven by the PD ratio (high P and low D - favorable) and the PA ratio (high P and low A - favorable), but negatively driven by the PG ratio ( a higher D efficiency is obtained for constant G and lower P). A higher migration flux corresponds to a non-significant rise in the GD ratio. The five countries are clustered, by means of a principal component analysis, into three types. Partial least square regressions fitted to the GD ratio within each cluster provide a long-term polydromic function that highlights certain particular cluster features: reactive to forcing factors, such as Donor diminutions (SEN), active, as driven by Personal remittance (MLI), and mostly entropic for GMB, GNB and MRT. The learnt from the database is that Donor variations may follow different evolutions of the GD ratio in the three clusters.

Health Systems of Underdeveloped and Developing Countries

Jul 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3489

The right to health and access to health care are basic human rights, yet the relationship between poverty, marginalization and access to services is often misunderstood or overlooked in health policies and in development actions. To build equitable health systems a rights-based approach to reform and planning is needed. This involves a wide range of interventions, all of which should ensure that investments in the health system will bring benefits to all members of society, especially the poorest and most marginalized

Family Medicine Open Access

Post Abortion Contraception Model: A Comprehensive Package for Improving Safe Abortion Care in Developing Countries

May 2018 DOI 10.14302/issn.2640-690X.jfm-18-2088

Background: Despite liberal abortion laws and wide availability of contraceptives in Ghana, declining Post Abortion Contraception remains a public health challenge due to early unplanned pregnancies and recurrent abortions. The development of this model was therefore to address challenges of low contraception following induced abortion in health facilities within the capital city of Ghana. Method: The development of this model was an outcome of a nested study title: ‘decision making for induced abortion in Accra metropolis, Ghana’ in 2014. This model was piloted for four years using Marie Stopes, Ipas and Ghana Health Service trained abortion providers with family planning skills in one hundred purposively selected health facilities comprising 90 private and 10 Non-Governmental Organization mandated by law to provide safe abortion care services in the capital city of Ghana. The model mainly focused on contraceptive products, pricing, placement, promotion and people. Results: There was an increase (90% average) in Post Abortion Contraception across the selected facilities following the intervention using the model. Conclusion: The study concludes that an integration of products, pricing, placement, promotion and people with options counselling prior to an induced abortion are key considerations for an improved post abortion contraception uptake in developing countries.

The Risk Factors, Complications, Management Strategies and Predictors of Morbidity & Mortality Among Pediatric Patients Presenting with Severe Diarrhea at Muhimbili National Hospital’s Emergency Medicine Department

Jun 2026 DOI 10.14302/issn.2766-8681.jcsr-26-6296

Background Acute diarrhea is the major cause of health public problem among paediatric patients in Tanzania. And in Low income countries (LICs), studies have shown, Acute watery Diarrhea (AWD) is the cause of morbidity and mortality which can be prevented by immediate identification and treatment of complications. Methods A prospective cohort study was done between December 2021 and April 2022 to determine the risks, complications, management strategies and predictors of mortality among paediatric patients ≤12 years of age with severe diarrhea. We excluded those who arrived in cardiac arrest at the Emergency Medicine Department (EMD) of Muhimbili National Hospital (MNH). Proportion was used to summarize the counts and frequency of participants who were at risk of complications and management strategies given and for predictors of outcomes. A Modified Poisson log linear model with a robust estimation test was used to test for significant associations between predictors and outcomes. Multivariate logistic regression was used to adjust for confounders. Results A total 6,570 paediatric patients presented to EMD during study period, and we recruited 144 (2.2%). The median age was 1 (IQR 0.7-2.0) years and most were male 86 (59.7%). Among the study participants with diarrhea, 120 (83.3%) had dehydration, acidosis 60 (42.3%), hypoglycemia 8 (5.6%), hypokalemia 76 (53.1%), and Acute renal failure 11 (7.6%). Those patients with complications received appropriate management, including IV crystalloid solution given to 131 (90.97%), and correction of acidosis 60 (42.3%), hypoglycemia correction with IV dextrose 10% 6 (4.2%), and hypokalemia and infections were corrected with IV potassium chloride 52 (36.1%) and IV antibiotic treatment 84 (58.3%) respectively. Conclusion Pediatric patients under 2 years of age are at high risk of severe diarrhea with dehydration as compared to other ages. Early referral and availability of point care tests are essential in early recognition of accompanied complications.

Toxicology and Drug Safety Issues: A Review Article

Dec 2025

Background Research and drug development industries have multiphase drug screening procedures, which can be debated. As a result, harmful products may still reach for public health service delivery due to vulnerabilities in the process. Main body A wide range of test compounds have delayed manifestation of undesired effect on the study subject, with the time to undesired effects after acute exposure being weeks and months. Acute toxicology in a preclinical trial also has limited clinical value as its lethal dose is the endpoint for a conclusion, and death sometimes occurs after a scheduled period of acute toxicology. Countless resources are wasted, and numerous new drugs are introduced into the pharmaceutical market with assumed safety analysis every year due to vulnerable multi-procedures in preclinical trials. The principal use of collected data from a preclinical trial is to support regulatory categorization and harmful labelling decisions. However, the data can also be used to derive safe use threshold levels, which may lead to the use of unsafe material. The criteria for classification and labelling also differ among countries, sometimes among authorities within the same country. The fundamental concept of toxicology states that ‘all chemical substances are potential poisons depending on the amount and duration of exposure. However, the toxic property of a test compound cannot be created or eliminated by simply the amount administered to study animals. Conclusion All xenobiotics are poisons at any amount with different severity that can be calculated using biological parameters.

Correlation of Fast Food Consumption and Overweight/Obesity among Undergraduate Students at the University of Hargeisa in Hargeisa, Somaliland

Dec 2025

Background Fast food consumption is the major cause of obesity and overweight in worldwide affecting more than 2 billion people, especially developing countries and low income countries. It can lead to hyperinsulinemia and development of insulin resistance, high energy density, high glycemic index, and fatty acid composition of fast foods may increase the prevalence of obesity and cardiovascular risk factors Objectives The main aim of this study was, to assess fast food consumption and its association with overweight /obesity among undergraduate students of University Hargeisa, Somaliland, 2023. Methods The study was carried out from May 01 to July 20, 2023 at University of Hargeisa using an institutional based cross-sectional study design to among 260 students. The study participants were selected using a simple random sampling technique. A structured questionnaire was prepared based on review literatures and dig out from related studies. The anthropometric data was taken by data collectors to measure weight and height using a stadiometer. Data was entered and checked for errors using EPI-info version 7.1.5.0 and then, data were exported to statistical package for social sciences (SPSS) software version 21 and STATA software version 14 for data processing and analysis. Descriptive statistics such as; frequencies, means and proportion was used for present the findings. A variable with P-values of less than 0.25 in the binary logistic regression analysis was entered into a multivariable logistic regression analysis to identify the independent predictors of stunting. Finally, variable at P-value less than 0.05 in multivariable logistic regression analysis was considered as a statistically significant variable. Results In this study, the majority 235 (90.4%, CI: 86.5- 93.8) of the study participants were fast food consumers. The study revealed that, from the total study participants 46(17.7%),127(48.8%),84(32.3%), 3(1.2%) were underweight, normal, overweight and obese respectively. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. On multi-variable logistic regression model educational level of the students (AOR = 12.45 (95% CI: 1.7, 14.6)) and frequency of fruit (AOR = 0.76, 95% CI (0.7, 0.8)) and vegetable consumptions (AOR = 0.51, 95% CI (0.47, 0.575)) were found to be significantly associated with fast food consumptions (p < 0.05). Conclusion In this study, of the total 90.4% number of fast food consumers. A chi-square test revealed that there was a significant (p-value=0.058) associations between BMI and fast food consumption among students of University of Hargeisa. Educational level of the students and frequency of fruit and vegetable consumptions were found to be significantly associated with fast food consumptions. Effort should be made to increase access to fast food-related information and counseling.

Insect-Based Foods: A Comprehensive Review on Nutritional Benefits and Environmental Sustainability

Dec 2025 DOI 10.14302/issn.2768-5209.ijen-25-5732

The growing population demands and environmental concerns associated with traditional protein sources have prompted the exploration of alternative and sustainable food sources. The purpose of this comprehensive review is to highlight the nutritional benefits and sustainability of insect-based foods as a promising solution. Global population growth necessitates innovative approaches to meet the demand for nutritious and sustainable protein sources. There are numerous challenges associated with traditional livestock farming, including land use inefficiency, high water usage, and greenhouse gas emissions. As a result, edible insects have emerged as a viable alternative, providing proteins (35-77% of dry matter), healthy fats (10-50%), essential amino acids, and micronutrients such as iron (up to 31mg/100g) and zinc (up to 20mg/100g), vitamins, and minerals. In contrast to livestock, which requires 22,000-43,000 liters of water to produce 1 kg of beef, insect farming consumes significantly less water and land resources. Insects have the potential to address nutritional deficiencies and strengthen food security as they are recognized for sustainable production. The study thoroughly investigates the literature addressing environmental and sustainability concerns associated with edible insect farming, using a rigorous bibliometric and scientometric analysis via Vos viewer. With the help of Vos Viewer, it was possible to identify the geographical distribution of countries that contributed to the field of edible insects and their acceptance, as well as the top ten documents in this field with the most citations and mostly used keywords in this field of research. Future research and implementation strategies will be able to benefit global food security and environmental conservation through these alternative protein sources.

Cervical Cancer Open Access

Uptake of Cervical Cancer Screening and Its Determinants among Refugee Women in Uganda: Insights from the Uganda Refugee Population-based HIV Impact Assessment

Dec 2025 DOI 10.14302/issn.2997-2108.jcc-25-5518

Cervical cancer is the fourth most common cancer in women globally, with 660,000 new cases and 350,000 deaths in 2022. The burden is disproportionately high in low- and middle-income countries (LMICs), particularly sub-Saharan Africa. Despite proven interventions like HPV vaccination and screening, uptake remains low. While cervical cancer screening has been studied in the general population, little is known about uptake among refugee women in Uganda, which hosts approximately 1.7 million refugees. This study examines cervical cancer screening uptake and associated factors among refugee women in Uganda. Methods We conducted a cross-sectional secondary analysis of the 2021 Uganda Refugee Population-based HIV Impact Assessment (RUPHIA) survey, focusing on women aged 21–49 in refugee settlements in the West Nile and South-Western regions, which host 90% of Uganda’s refugee population. The primary outcome was self-reported cervical cancer screening status. We used descriptive statistics and logistic regression to identify factors associated with screening uptake. Results Among 731 women, only 72 (9.8%) reported undergoing cervical cancer screening. The mean age of screened women was 37 years (±7), compared to 32 years (±8) for unscreened women. Screening uptake was significantly higher among women aged 31–39 years (AOR = 2.67, 95% CI: 1.32–5.52, p = 0.007), married women (AOR = 12.0, 95% CI: 1.76–163, p = 0.03), and those in polygamous relationships (AOR = 4.76, 95% CI: 1.96–11.1, p < 0.001) Conclusion Cervical cancer screening uptake among refugee women in Uganda is critically low. Integrating culturally sensitive screening programs into refugee health services and addressing socio-economic barriers could improve access and utilization.

Applying Cultural Humility During an International Collaboration Seeking to Optimize A Peaceful Coexistence Intervention in The Kingdom of Bahrain: Lessons Learned

Oct 2025 DOI 10.14302/issn.2641-4538.jphi-25-5661

The World Health Organization emphasizes the importance of international collaboration to save lives and improve health at national and global levels. However, significant challenges face those engaged in international collaborations such as language barriers, cultural differences, different rules and regulations, and limited resources. This paper discusses the use of cultural humility theory to support an international collaboration between stakeholders from different countries with diverse cultural backgrounds working together to optimize a novel middle and high school curriculum intended to promote peaceful coexistence in the Kingdom of Bahrain. We use the attributes of cultural humility as a framework to reflect on lessons learned while navigating cultural differences, conclude by recommending the use of this framework during international collaborations, and provide practical examples about how to operationalize the attributes of cultural humility to inform international collaborations attempting to promote global public health.

Model Based Research Open Access

A New Model of Body Composition Detects Association Between Severe Obesity and Increase in Skeletal Muscle Mass

Sep 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5688

Obesity is associated with functional limitations in muscle performance. The true effect of obesity on skeletal muscle mass, including any interactions with aging effects, remains to be elucidated. The present study investigated the impact of obesity on the stimulation of muscle growth, based on a new model of body composition. A dataset of 44 men and 64 women was analysed. Body weight (Wt), body height (Ht), hand circumference (HdC) and waist circumference (WC) were measured. Processed by the Dahlmann-Body-Analysis (DBA) system, a new model of body composition, the increase of skeletal muscle mass (ΔSMM) compared to the individual reference weight was calculated. Muscle mass data derived by the DBA model are compared with DXA-derived predictive equations of studies representing different countries and ethnicities estimating the appendicular skeletal muscle mass. Means of these groups are tested by ANOVA. Age ranged from 18 to 72 years. All subjects had a BMI ≥ 29.7 (kg/m²). The mean values of ΔSMM as an estimate of muscle mass gain calculated by the DBA-system were 11.8 ±3.6 kg for men and 8.9 ±2.6 kg for women, respectively, demonstrating a linear, significantly rising relationship with BMI (ß > 0, p<0.001). The study population did not show a decrease in muscle mass with age in either men or women up to an age of 65 years. The results suggest that the present model has satisfactory prediction qualities to detect an increase in skeletal muscle mass associated with a growing burden of body fat.

Bridging Gaps in Blood Transfusion Services through Collaborative Healthcare Systems in Cameroon: The Cornerstone University Blood Management System version 1.0

Aug 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5540

The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.

Immunization Open Access

Predictors of COVID-19 Vaccine Uptake Among Healthcare Workers in Kiambu County, Kenya

Jul 2025 DOI 10.14302/issn.2577-137X.ji-25-5581

Coronavirus Disease 2019 (COVID-19) placed significant pressure on global health systems, necessitating rapid and widespread immunization, especially among healthcare workers (HCWs). Despite being prioritized in immunization programs, variations in vaccine uptake among HCWs have been reported across different settings. This study aimed to investigate the predictors of COVID-19 vaccine uptake among HCWs in Kiambu County, Kenya. An analytical cross-sectional study design was employed, involving 112 HCWs sampled using stratified random sampling from Level 2 to Level 5 healthcare facilities. Data were collected through a pre-tested and validated 18-item questionnaire and analyzed using SPSS version 29.0. Statistical methods included descriptive analysis, chi-square tests, logistic regression, and ANOVA. The overall COVID-19 vaccine uptake was 88.9%. Significant predictors of uptake included age (p = 0.048), cadre (p = 0.015), and facility level (p = 0.031). Knowledge of COVID-19 vaccines emerged as the strongest predictor, with HCWs demonstrating good-to-excellent knowledge being 14.97 times more likely to be vaccinated (p < 0.001). Confidence in vaccine safety and effectiveness was also significantly associated with uptake (p < 0.001). Uptake was highest in Level 5 hospitals and lowest in dispensaries. The study reveals high vaccine uptake among HCWs in Kiambu County, but disparities persist due to individual and systemic factors. Strengthening vaccine education, institutional support, and deploying mobile vaccine education units in lower-level facilities could help close these gaps, offering practical strategies for improving HCW vaccine coverage in Kenya and other low- and middle-income countries.

Malaria: A Driving Force to the Emergence and the Global Spread of Antibiotics Resistance

Mar 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5429

Malaria and bacteraemia are significant public health concerns and economic threats. In Africa, the intensity for simultaneous transmission and co-infection of Plasmodium spp and other bacteria pathogens are extremely high. It is believed that malaria suppress the immune system and enable the translocation of bacteria in the gastrointestinal tract to other cellular compartments in the body. Some of the factors that contributed to the co-emergence of these pathogens are poor access to clean water, sanitation and hygiene (WASH), poor infection control measures, inefficient health care systems. In addition, the similarities in the clinical signs and symptoms of these febrile diseases and the fact that the etiologic diagnostic testing can be complex, costly, and limited are the reasons why clinicians in resource-constrained setting often prescribe antibiotics empirically prior to or without laboratory testing to prevent severe outcomes in any patient hospitalized with malaria. However, this indiscriminate use of antibiotics has been identified as the driving force for antibiotic resistance, which is already at alarming rate in malaria endemic nations. In developed countries where malaria had been previously eradicated, there are increasing reports of imported malaria with concurrent bacteraemia. In this review, we emphasized the role of malaria in the indiscriminate use of antibiotics and the fact that eliminating malaria in Africa is one of the best strategies to address the emergence and the global spread of multi-drug resistance organisms.

Primary Healthcare Services and Health-Related Quality of Life of Older Persons with Non-Communicable Diseases: A Narrative Literature Review

Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5233

In response to the rising burden of non-communicable disease (NDC), the World Health Organization (WHO) developed tools to enable early detection and management of NCDs in Primary Healthcare centers (PHC). Globally, the prevalence of NCDs remains alarmingly high with 41 million deaths annually. Of these, 17 million people die before the age of 70, and 86% of these premature deaths occur in low-and middle-income countries. This narrative review aimed to assess the effect of PHC services on health-related quality of life (HRQoL) of older persons with NCDs, to critically analyze the potential of the existing literature in informing improvements in PHC services. We searched various databases (PubMed, Springer, Scopus, and ScienceDirect) for relevant literature. Peer-reviewed articles on the influence of PHC services on HRQoL among older persons with NCDs written and published in English between January 2013 and May 2024 were considered. The review indicates that effective PHC services are linked to good HRQoL. However, PHC services are sub-optimal and poor in low- and middle-income countries, hence more health interventions are essential to improve PHC services to enhance HRQoL of older persons.

Family Medicine Open Access

Antibiotic Prescribing Practices for Upper Respiratory Tract Infection Among Clinical Officers at Kiambu County

Mar 2024 DOI 10.14302/issn.2640-690X.jfm-24-5016

Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.

Energy Conservation Open Access

Potential of Energy Efficiency and Conservation Measures in Residential Buildings in Ghana (Case Study of Student Hostel)

Mar 2024 DOI 10.14302/issn.2642-3146.jec-24-4935

Promoting responsible energy usage in student hostels and residential buildings plays a crucial role in ensuring sustainable development. By implementing cost-efficient strategies for managing and conserving energy, both students and homeowners can not only reap economic and social benefits but also mitigate the adverse environmental effects associated with energy consumption. Unfortunately, student hostels and residential buildings in developing countries like Ghana are falling behind in the adoption of energy efficiency and management practices, thereby missing out on valuable implementation opportunities. This study investigates the potential for energy efficiency and conservation measures in student hostels, specifically the GETFUND hostel of the University of Energy and Natural Resources in Ghana. The hostel's monthly energy consumption is approximately 64,929.458kWh, which translates to $5,667.20. The objectives of the study include analysing the current electricity consumption pattern, identifying energy misuse, and recommending measures to save energy, as well as calculating the financial benefits of implementing energy management practices. The methodology employed is an energy audit approach. The results of this study can contribute to overall energy conservation efforts in Ghana and may be applied to other university residence halls in sub-Saharan African countries with similar climatic and energy-use characteristics. In a broader sense, the primary objective of this study is to enhance the energy efficiency of the GETFUND hostel and minimize energy wastage, resulting in substantial financial savings.

Determinants of Exclusive Breastfeeding Among Mothers of Infants Less Than Six Months of Age in Mogadishu: A Facility-Based Cross-Sectional Study

Jan 2024 DOI 10.14302/issn.2691-5014.jphn-23-4865

Background Breastfeeding is a vital practice for infant health and well-being, with exclusive breastfeeding (EBF) during the first six months being particularly crucial. Despite its benefits, EBF is sub-optimally practiced in many low-to-middle income countries. This study focuses on Somalia, a country with historical political instability and poor health indicators, aiming to identify the prevalence and determinants of exclusive breastfeeding among women with infants under six months attending SOS Mother and Child Hospital in Mogadishu. Methods A hospital-based cross-sectional design was used, and data were collected through a structured questionnaire. The study sample consisted of 345 mothers, selected using a systematic sampling technique. Descriptive, bivariate, and multivariate analyses were conducted to assess breastfeeding practices and determine factors influencing exclusive breastfeeding prevalence. Result The study found that the prevalence of exclusive breastfeeding among the study population in Somalia was 44%, influenced by factors such as maternal education, employment, and utilization of antenatal and postnatal care services. Male infants and younger infants had higher odds of being exclusively breastfed. Conclusion and recommendations The study emphasizes the importance of promoting exclusive breastfeeding as the optimal feeding practice for infants in Somalia, highlighting the need for comprehensive health education during antenatal care visits and postnatal counseling. It recommends the development of supportive policies, such as maternity leave and workplace accommodations, along with community-based initiatives and support groups to facilitate and encourage exclusive breastfeeding practices.

Barriers to Managing Childhood Obesity in the General Practice Amidst of the Double Burden of Malnutrition: A Sri Lankan Perspective

Jan 2024 DOI 10.14302/issn.2692-5257.ijgp-23-4772

Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries.  Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community.  In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach.  While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems. Childhood obesity is on the rise, mostly in the low-income regions in South Asia including Sri Lanka. Simultaneously, undernutrition also continues to be an ongoing public health issue. The coexistence of childhood obesity with undernutrition has resulted in a double burden of malnutrition in these countries. Management of obesity in a community already affected by undernutrition is a challenging situation. At present, management of childhood obesity occurs as a hospital-based lifestyle modification intervention which cannot address all tiers in the community alike. Although national level multifaceted strategies are in place, implementation is limited due to financial constraints. In this context, the general practitioners can be considered as an important group of medical professionals who can reach families in the community. In many households in Sri Lanka, an overweight child is considered as normal and well-nourished in comparison to an underweight child. Unhealthy eating habits and force feeding have become norms in the society. Changing mindsets of people need significant time and commitment. General practitioners, in the community would be able to achieve this target through effective communication based on a nutrition sensitive approach. While uplifting the infrastructure facilities, steps have to be taken to update the knowledge and communication skills of the general practitioners on managing childhood obesity in a community affected with double burden of malnutrition. The well-equipped GP is an asset to modify the attitudes and thinking patterns of parents with regard to child nutritional problems.

A Roadmap to Developing a Population-Based Colorectal Cancer Screening Program in Oman

Jan 2024 DOI 10.14302/issn.2641-4538.jphi-23-4856

Colorectal cancer (CRC) is a major public health problem worldwide, as it is the third most common disease and the second leading cause of cancer-related fatalities. In recent years, Oman, like many other countries, has seen an epidemiological shift from communicable diseases to noncommunicable diseases, including colorectal cancer, necessitating comprehensive planning to address the root cause of the problem as well as a comprehensive screening program to detect diseases at an early stage and thus improve health outcomes. Colorectal cancer is the second most frequent cancer in Oman, with the highest mortality rate, inflicting considerable public health and economic consequences; nevertheless, there is no population-based CRC screening programme in place to minimise the disease's incidence, mortality, and severe health outcomes. This review highlights the epidemiology of colorectal cancer in Oman, the Wilson and Junger criteria, operational readiness, and recommendations for implementing a population-based colorectal cancer screening program.

Human Immunodeficiency Virus Drug Resistance (HIVDR) and Baseline Characteristics among Antiretroviral Therapy (ART) experienced Children and Adolescents under the care of Chidamoyo Christian Hospital in Hurungwe, Zimbabwe

Dec 2023 DOI 10.14302/issn.2324-7339.jcrhap-23-4634

Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.

A Review on Monkey Pox: Role of One Health Approach Against Monkey Pox

Oct 2023 DOI 10.14302/issn.2641-4538.jphi-23-4622

The Ortho-poxvirus virus, which causes monkey pox, is a member of the Poxviridae genus. It was initially found in primates. In 1970, the Democratic Republic of the Congo reported the first instance of monkey pox. From there, it spread to a number of countries both inside and outside of Africa. There are two genetic varieties of monkey pox, which have been spread to people through respiratory droplets, and touch with objects contaminated by an affected person and consequently is often encountered in work situations. Among the countries with the worst effects are Nigeria and the Democratic Republic of the Congo. Non-human primates, rats, squirrel, and or mice are just a few of the creatures that can become infected by monkey pox. Although the origins of monkey pox infections are unknown, rodents from Africa and non-human primates like monkeys may contain the viruses and infect humans. Monkey pox is more likely to naturally infect rodents. Monkey pox has symptoms and lesions that are difficult to distinguish from smallpox in its clinical manifestations. Fever, chills, migraines, tiredness, tonia, swollen lymph nodes, back pain, and myalgia are some of the clinical symptoms of monkey-pox. A few examples of diagnostic tests include immune-fluorescent antibody assays, enzyme-linked immune-sorbent assays, and real-time polymerase chain reactions. A specialized vaccine that offers complete protection against by them on key-pox virus exists, yet there is no specific therapy for human monkey infection and interaction with the vaccinia virus. Smallpox vaccination can give cross-immunity with partial protection against infection and a reduction in symptom severity. Unfortunately, community health effects in the view of one health approach has not been addressed in vast. Therefore, the objectives of this review paper are to discuss the community health effects of monkey pox and to emphasize the role of one health approach against monkey pox.

Veterinary Healthcare Open Access

Camel Brucellosis in Ethiopia: Seroprevalence and Associated Risk Factor

Oct 2023 DOI 10.14302/issn.2575-1212.jvhc-23-4532

Camels are a significant source of income for nomadic populations in many developing countries, including Ethiopia. Camels are well adapted to dry and semi-dry regions, providing income, food security, and transportation. However, camel production and productivity are constrained by infectious diseases, such as brucellosis, which is a highly infectious bacterial disease that affects camels and humans worldwide. Brucellosis causes significant economic losses due to abortion, low herd fertility, and decreased milk production. In Ethiopia, the prevalence of camel brucellosis varies depending on factors related to the host, agent, climate, and management system, with a reported prevalence ranging from 0.5% to 11.9%. Accurate diagnosis of camel Brucellosis is essential for herd-based screening of animals. Although culturing the pathogen is the preferred method for diagnosis, serological tests such as Rose-Bengal plate test (RBPT), Enzyme-linked immunosorbent assay (ELISA), and Complement fixation test (CFT) and polymerase chain reaction (PCR) assays have been developed. Implementing effective diagnosis and surveillance systems to control the spread of brucellosis in animals and humans is very important, on top of awareness campaigns, vaccination programs, and suitable laboratory establishment recommended. Continued research is essential to maintain the health and productivity of camel populations, particularly in pastoral areas where camels play a significant role in the livelihood of communities. Therefore, the present paper views the seropositive prevalence and potential risk factors associated with camel brucellosis in Ethiopia.

Hybrid Limited Shoulder Surgical Management (HLSSM) Sayed Issa's Hybrid Shoulder Arthroscopic-Open Surgical Management

Aug 2023 DOI 10.14302/issn.2641-5518.jcci-23-4646

Introduction The idea of HLSSM2 is to get the least easy surgical intervention, as arthroscopic surgery begins with examining the shoulder joint, and the location and size of the lesion are determined, then open over the lesion with an open surgical approach that is very limited for surgical repair; not using arthroscopic instruments but conventional surgical instruments in the second step. Figure 1 Figure 1.   Methods Clinical experience with this technique consists of 44 cases over a period of thirty-one months, this study was from September 2020 to May 2023. All cases were done as outpatients and under general anesthesia. Results The mean duration of the operation was 35 minutes, and the minimum duration was 25 minutes. There was no major nerve or vascular injury in all cases. This technique is simple, safe, and good cosmetically satisfactory for all patients after full recovery about three months after the procedure, and it is cost-effective. One 43-year-old female patient suffered pain and stiffness during the first six months after surgery and was not very satisfied, she did not stop visiting us till now, she was not happy because of shoulder pain and tenderness. Conclusion It can be used by experienced hand surgeons in shoulder arthroscopy and in Mini Lateral Shoulder Approach (MLSA)3, especially in countries where shoulder arthroscopic release and repair with suture anchors are expensive4 or not available. This technique is not very simple but is available, safe, cosmetically satisfactory, and cost-effective.

Diseases Open Access

Epidemio-Clinical Profile of Acute Diarrhea in Children From 0 To 5 Years and Prevalence of Rotavirus Before and After the Introduction of the Rotasiil Vaccine in the Democratic Republic of Congo.

Jul 2023 DOI 10.14302/issn.2997-1977.jd-23-4588

Introduction Acute diarrhea remains one of the major health problems in developing countries. According to the WHO, rotavirus contributes to approximately 40% hospitalizations and is the leading cause of severe diarrhea in children 0-5 years old. The objective was to determine the prevalence of rotavirus and the sociodemographic and clinical profile among children with diarrhea in 4 hospitals in the DRC. Methods This study is documentary, retrospective and analytical taking two periods, before and after introduction of the vaccine, i.e. January 2017 to December 2018 and January 2020 to December 2021 in 4 hospitals, i.e. 2 in Kinshasa and 2 in Lubumbashi. Results Total 1872 children, 924 (49.4%) of whom were enrolled before the introduction of the vaccine and 948 (50.6%) after. Only 1737 had performed serology, of which 875 (50.4%) were rotavirus positive and 862 (49.6%) were negative. Positive results, a reduction of 30.6% is noted since the introduction of the vaccine. The predominant age range was 6 to 11 months. The male gender was predominant at 56.7%. Diarrhea was found in 88.5%, vomiting in 73.7% and fever in 73.9%. Before vaccination, the risk was more: 11 times to have diarrhea, 9-10 times the frequency between 3-10 times a day, 9 times vomiting, 2 times fever and 2 times to have a positive result. Conclusion From this study, we note a reduction frequency due to diarrhea unlike previous years, probably attributable to the vaccine.

A Data Mining Methodology for Detecting Conspiracy Theories from Scientific Articles: The Covid-19 Case

Jun 2023 DOI 10.14302/issn.2692-1537.ijcv-23-4586

The goal is to do a text mining analysis of all scientific publications and find out what journal and what aspects are studying about the conspiracy theories of Covid-19. For this purpose, all publications available in the National Center for Biotechnology Information (NCBI) database were consulted as they were peer-reviewed papers. Of all these papers, only the abstracts of each one were studied using artificial intelligence techniques to determine, for example, whether the subject is of importance depending on the journals where it has been published, and above all, what possible relationships could be extracted from the information published in them. In addition, the "Net Prevalence per Covid19" index was definedin those countries with a high value, greater campaigns should be sponsored to avoid the misinformation generated by Covid-19, although this comment should be verified in future publications. The main challenge was to unify the abstracts and for this purpose, a text summarizer was used under artificial intelligence schemes. The results obtained indicate the tendency of certain topics by the frequency of the words obtained where the focus on the conspiration are the Covid-19 vaccines, but further work is still needed to continue working on this methodology to unify the results.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

May 2023 DOI 10.14302/issn.2691-5014.jphn-23-4555

Severe ascorbic acid (Vitamin C) deficiency, commonly known as “scurvy,” continues to be a problem in malnourished populations across the world but is relatively rare in the United States. Early features of this condition include general weakness, fatigue, and aching limbs. An extremely rare and late feature of this condition is subgaleal hemorrhage. Scurvy has such a low prevalence in First World countries that it is often misdiagnosed or not diagnosed at all. The subject in this case report presented acutely and is one of few to involve a subgaleal hemorrhage to be documented in medical literature to date. Laboratory studies and clinical improvement through treatment established the diagnosis. Ascorbic acid deficiency should be considered when evaluating children with poor nutrition despite socioeconomic status, living conditions, or access to health care. This case also reminds us that neurodivergent children are a vulnerable population and more research will need to be conducted to determine just how detrimental the pandemic has been to patients with ongoing problems who were lost to follow up.

Outcome of traumatic brain injury and its associated factors among pediatrics patients treated in Amhara national regional state comprehensive specialized hospitals, Ethiopia 2022.

Apr 2023 DOI 10.14302/issn.2694-1201.jsn-23-4385

Background Traumatic brain injury in pediatrics is one of the commonest causes of morbidity, disability and mortality worldwide. In low- and middle-income countries Study showed that death of pediatrics from traumatic brain injury was 7.3%. However, there is limited data towards the outcome of traumatic brain injury and its associated factors in Ethiopia. Objective To assess the outcome of traumatic brain injury and associated factors among pediatrics patients in Amhara National Regional State Comprehensive Specialized Hospitals, Ethiopia. Methods An institution based retrospective cross-sectional study was conducted among 423 pediatrics patients from January 1, 2019 to December 30, 2021, and data extraction period was from May 16 to June15, 2022. Systematic random sampling technique was employed to select the study participants. Data were collected from patient charts and registry books by using a data extraction tool. Data were entered into the Epi-info version 7 and analysis was done by SPSS Version 25. Both Bi-variable and multi-variable analyses were employed to identify factors associated with outcome of traumatic brain injury. Result From 423 sampled study participant charts 404 of them had complete information with response rate of 95.5% and included in the final analysis. The overall unfavorable outcome of traumatic brain injury at discharge was found that 12.13% (95% CI: 9.1% - 15.7 %). Sever traumatic brain injury (AOR: 5.11(CI :1.8-14.48), moderate traumatic brain injury (AOR:2.44(CI:1.07-5.58), Hyperglycemia (AOR: 3.01 (CI:1.1-8.04), sign of increased intracranial pressure (AOR:7.4(CI:3.5-15.26), and medical comorbidity (AOR: 2.65(CI:1.19-5.91) were predicted of unfavorable outcome of traumatic brain injury pediatrics patient. Conclusion and recommendations twelve present of traumatic brain injury results unfavorable outcome. Sever and moderate form of traumatic brain injury, hyperglycemia, signs of increased intracranial pressure, and medical comorbidity were factors associated with unfavorable outcome of traumatic brain injury in children. Therefore, it is preferable to improve accesses to acute and post-acute care services to lower the unfavorable outcome of traumatic brain injury in children.

Human Health Research Open Access

Assessment of the Factors that Contribute for the Cause of Asthma Disease in Ambo Town

Apr 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4259

Asthma is a chronic disease of airways; that is widely characterized by an increased responsiveness to a large variety of stimuli, airway inflammation and obstruction. It is the most common respiratory disorder disease in developed and developing countries. The study was aimed to assess the factors that contribute for the cause of asthma disease in Ambo town and cross-sectional survey was conducted to gather information from March to April 2022. 30 respondents were selected using purposive sampling technique for interview and data collections. According to the study the more affected age group were 22-32(53%) and the major risk factor for the disease was air pollution (53%). The pollution is due to domestic wastes that are discharged to the environment. Therefore, the government and extension health workers should aware the community about the risk factors of asthma and proper waste disposal mechanisms.

Context Specific Complementary Feeding Recommendations for Children in Pakistan Based on Secondary Analysis of National Complementary Feeding Assessment and Pakistan Demographic Health Survey 2018

Mar 2023 DOI 10.14302/issn.2379-7835.ijn-22-4116

Background In Low Middle-Income Countries (LIMCs), malnutrition, especially undernutrition is one of the leading causes of childhood mortality and morbidity. Poor complementary feeding practices are among the most notable contributors to poor nutritional indicators in children under five. This article provides an output of secondary data analysis of the Cost of Diet (CoD) and Optifood component of National Complementary Feeding Assessment conducted by UNICEF Pakistan along with Pakistan Demographic Health Survey (PDHS) 2018. Methods For correlation of Optifood data and CoD data with PDHS data of CF, GraphPad software, MS Excel was used along with manual quantifications. The analysis of DHS-2018 data was conducted using STATA software. Univariate analysis included comparison of categorical variables i.e. various individual, household and community level parameters with that of outcome variables of minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum dietary diversity (MAD) using chi-square test. Findings The overall rate of MMF was 56.6% among children of 6-23 months of age with MDD in 18.6% and MAD in 13.8% of children. Percentage of annual cost spent on nutritious diet for MDD, MMF and MAD varies from 27.86% to 43.08% across all the provinces. Children aged 6–8 months and 9–11 months often consumed infant milk and cereals, while children aged 12–23 months often consumed eggs and grain products. Consumption of dairy products was highest in Punjab, Sindh, AJK, and Islamabad, that of grains roots and tubers was highest in KPK, FATA and GB. Conclusion Considering CF practices in Pakistan are inadequate as indicated by poor MDD, MMF, and MAD, therefore it is imperative that a holistic approach using both communication and non-communication based interventions is to be employed through active stakeholder engagement.

Prevention and Safety Training to Improve Community Health

Mar 2023 DOI 10.14302/issn.2690-0904.ijoe-21-3884

Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.

Diseases Open Access

Prevalence of Typhoid and Paratyphoid fever in a tertiary care hospital of Kathmandu valley

Feb 2023 DOI 10.14302/issn.2997-1977.jd-22-4378

Typhoid or enteric fever is caused by Salmonella serotype typhi and paratyphi. It is one of the major public health problem in developing countries including Nepal. In recent years, increased urbanization and growing population within Kathmandu valley, attributed mainly to improper sanitary condition and fecal contamination of drinking water. These all factors contributes to a very high prevalence of typhoid fever through out the country. Methods This study was laboratory based study carried out six month period from march 2017 to August 2017 at microbiology lab in Nepal Medical college. Results and conclusion In the present study, the prevalence of enteric fever is mainly caused by Salmonella. Typhi than Salmonella Paratyphi A was observed.

Wildlife Open Access

Distribution of protected area and large-sized mammals order in Ethiopia

Feb 2023 DOI 10.14302/issn.2997-2248.jwl-23-4439

Ethiopia is one of the countries found in the eastern horn of Africa, which is endowed with beautiful landscape and topography from which diverse habitats and fauna composition. The objective of this paper is to review relevant documents on distribution of protected area and large-sized mammals order in Ethiopia. The Method of the data were by compiling related information from different sources like published articles grey literature and other office reports from concerned institutions. Altitudinal and geographical variations made the Ethiopia to be among the biodiversity-rich nations in the world. Mammal fauna in Ethiopia consists of 326 species, among 144 genera, 43 families and 14 orders; out of which 32 mammals of the country categories under critically threated group. Among the mammals in Ethiopia eight of them are endemic. Among mammals’ antelopes are flagships (charismatic). The large mammals are mainly concentrated in the south and southwest border.

Quality of Maternal & Newborns Health indicators in Western Province of Rwanda

Oct 2022 DOI 10.14302/issn.2641-4538.jphi-22-4313

Data quality is defined as a measure of data status that fulfills the following elements: accuracy, completeness, consistency, reliability, and if the data is current. The World Health Organization (WHO) reported that only 40% of all countries have an adequate system to collect information on birth and deaths. Even though the system is there, vital registration systems are inaccurate and incomplete in developing countries. In Rwanda, maternal health related data was over-reported more than other indicators. These are the main reasons for conducting the study to investigate the data quality of four maternal and newborn health indicators reported by Rwandan Western Province health centers. This concurrent-mixed method study included 61 data managers and 12 key informants. Routine data quality assessment tool and structured interview guide were used to collect data. Descriptive statistics were used to get proportion of respondents’ socio-demographic characteristics. The analysis was done for assessing median of data quality index. The results show that 55.7% of data managers were male while 58.3% of responsible of maternity were female. Majority (58.9%) of participants was in age’s category from 33-42, 61.6% have A1 education level and 53.4% have experience less than five years. Data quality index of one out of four (25%) MNH indicators was found below 95% accepted by WHO. The main reasons for insufiscient quality of data are lack of data validation meetings (57.5%) and incompleteness of reporting tools (36.4%). Monthly data validation meetings chaired by HC leaders are important to contribute to high-quality data in healthcare settings. Supportive supervisions done in data quality and management have to be organized in a supportive, and educative way.

Outcome of Percutaneous Coronary Intervention Among Very Elderly Patients with Ischemic Heart Disease

Sep 2022

Background Cardiovascular disease, and ischemic heart disease (IHD), is a major cause of morbidity and mortality in the very elderly patients worldwide. In the developing countries like Bangladesh it has been increasing with time. Due to life style, food habits and urbanisation. These patients represent a rapidly growing cohort presenting for percutaneous coronary intervention (PCI), now constituting more than one in five patients treated with PCI in real-world practice. Materials and Methods From July 2020 we included 152 patients with IHD purposively in Cardiology department of Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh undergone PCI who were divided into 2 groups according to age: e” 75 years (n = 51) and <75 years (n = 101). Baseline clinical characteristics, indications for coronary intervention, in hospital outcomes were obtained. Study endpoint was Renal impairment, MI, LVF, emergency revascularization and death. Results Very elderly patients were more frequently male (86.2%) and nonsmoker at present (41.1% vs. 63.3%, p=0.003), had higher prevalence of hypertension (60.7% vs. 50.4%, p<0.13), and more often presented with NSTEMI (54.9% vs. 23.7%, p<0.001). Elderly group had higher incidence of TVD and LM disease (37.2% vs. 26.7% and 9.8% vs. 2.9%, p=0.07) and more incidence of ostial (17.6% vs.5.9%,p=0.007) and calcified lesions (31.3% vs. 14.8%, p=0.004). Procedural success (TIMI III) were high in both groups, but still lower in the elderly as compared to younger group (96% vs. 97%, p=0.65). Very elderly patients had higher incidence of post PCI bleeding, CIN, MI, LVF and death (9.8% vs.5.9%, 7.8% vs.3.9%, 5.8% vs.5.9%, 9.8% vs. 4.9% and 5.8%vs.3.9%,p=0.07), whereas emergency revascularization were higher in younger group (5.8% vs. 6.9%, p=0.07). Conclusion Very elderly patients aged ≥80 years face more vascular site complications during PCI, usually have more LM and TVD with more ostial and calcified lesions in comparison with younger group. Though procedural success is similar with younger group, they face more post PCI CIN, LVF and MI. Repeat revascularization was higher in younger group.

Weather Changes Open Access

Biotechnology: A Panacea to Climate Change Disasters- Brief Review

Aug 2022 DOI 10.14302/issn.3070-3379.jwc-22-4233

Man’s activity and/ or inactivity continually impedes the environment in many ways. Sometimes, these impediments could be negative with catastrophic consequences. Emission of greenhouse gases, desert encroachment, deforestation, global warming, and general environmental degradation by different human practices poses a lot of threat to this planet. It has therefore become imperative to explore novel ways or technologies in checkmating hazards emanating from these disasters. Biotechnology which simply refers to the use of living organisms or their parts particularly microorganisms to produce materials for human and animal consumption comes in handy. The aim of this paper is to do a brief review on the merits of applying this technology in mitigating hazards arising from climate change. Focus will be centered on agricultural and industrial biotechnology more as a result of their involvement in land and environmental related matters. Manipulation of crops via genetic engineering for varieties with stress resistance, phytoremediation, tissue culture of orphan crops, and so many other biotechnological practices will be examined so as to highlight their role in stemming disasters caused by climate change. In conclusion, the paper will attempt to explain the reason why developing countries like Nigeria should also join the global race in curtailing this menace via her indigenous biotechnology.

What Could Represent the Mantissa of the Registered Covid-19 Cases?

Mar 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4108

In this work we present how it is possible to visualize the different coronavirus outbreaks from the calculation of the mantissa from the daily record of cases by Covid-19.This curve can also indicate the speed of propagation of the disease from the calculated infection rate. These conclusions are derived from the respective calculations in four different countries: Australia, Brazil, Italy, and Venezuela.

Features of the Emergence and Re-Emergence of Infectious Diseases, Geopolitics and Gain-of-Function Research

Jan 2022 DOI 10.14302/issn.2692-1537.ijcv-21-4044

This paper attempts to present the dissemination and transmission dynamics of emerging and reemerging infectious diseases and the underlying features of gain-of-function research and geopolitics in the ambient within and across borders. Research and publication are relevant from perspectives in the management of local and global health because disease is perspicuously a geopolitical issue ostensibly linked to gain-of-function research where health diplomacy undergirds present and future global functionalities regarding the emergence and reemergence of infectious diseases. These have generated vehement reactions with propensity for extreme geopolitics and gain-of-function natural and anthropogenic activities. Geopolitical parameters and gain-of-function issues impact on the social determinants of health and vice versa. The convening and convergence of countries for unprecented epidemic or pandemic treaty settings or other formulations to confront emerging and reemerging infectious diseases will afford considerable opportunities concerning challenges in action, preparedness and response. Provisions are pertinent for legal instruments, effective and efficient systems to curb future threats and outbreaks of infectious diseases.

Characterizing the Dynamics of Covid-19 Based on Data

Nov 2021 DOI 10.14302/issn.2691-8862.jvat-21-3991

The objective of this paper is to apply datadriven discovery of dynamics modeling to obtain a system of differential equations that allows us to describe the transmission dynamics of Covid-19, based on the number of confirmed cases and deaths reported daily. This methodology was applied in four different countries: Brazil, Colombia, Venezuela, and the United States. The main advantage is that only one differential equation is needed to characterize the dynamic of Covid-19 without any mathematical assumption.

Sexual Risk Behaviors of Sex Workers for HIV / AIDS and STIs in the City of Bamako, Mali

Nov 2021 DOI 10.14302/issn.2324-7339.jcrhap-21-4010

Background: HIV / AIDS affects all social strata and including female sex workers who are a particularly vulnerable group at risk of HIV infection. Objective To assess the risky sexual behavior of female sex workers in Bamako, Mali. Methods This is a quantitative cross-sectional analytical study conducted among 288 female sex workers in the city of Bamako, Mali. This study used a questionnaire to collect information from January to April 2021. Results Out of 288 sex workers, 41% came from neighboring countries (Burkina Faso, Cote d'Ivoire, Mauritania). More than half of the participants had started working as sex workers before the age of 20. More than half of sex workers do not always use a condom. About 32% of female sex workers had previously had anal sex, 20% had experienced group sex, and less than a quarter smoked or drank alcohol before sex. A significant relationship was found between the behavior or practice of sex workers with the following variables: ethnicity (P = 0.04); marital status (P = 0.01); monthly income (P = 0.001), age at first sexual intercourse (P = 0.03); the presence of STDs in the past (P = 0.02), knowledge of HIV status (P = 0.04) and nationality (P = 0.03). Conclusions This study highlights negative risk behaviors of sex workers such as not using condoms consistently, anal sex, alcohol, and smoking. It is therefore important to develop education actions to improve the knowledge, attitude, and practice of sex workers related to HIV/ AIDS in Mali.

Cervical Cancer Open Access

One Out of Five Women Practiced Cervical Cancer Screening in Felege Hiwot Referral Hospital, Amhara, North West Ethiopia

Nov 2021 DOI 10.14302/issn.2997-2108.jcc-21-3975

Background Eighty five percent of cervical cancer occurrence in resource-poor countries. Contributing factors for these are inadequate knowledge about the disease, early initiation of sexual intercourse and multiple sexual partners. Early screening is an intervention in reduction of maternal deaths due to cervical cancer. Consequently this study was conducted aiming to find out about the practice of cervical cancer screening and its associated factors. Methods A facility based cross sectional study was conducted using a pretested structured questionnaire among women attended Maternal and Child Health (MCH) department of Felege Hiwot Referral Hospital (FHRH) from March15 to April 15, 2019. The study participants were selected systematically. The collected data were entered and analyzed using SPSS version 20. Logistic regression analysis was employed to examine factors association with cervical cancer screening that was confirmed using AOR with its 95% CI. Results A total of 400 study participants were included with a response rate of 99.5%. Of the total study participants only 78 (19.5%; 95% CI: 15.6, 23.4) practiced screening for cervical cancer. The cervical cancer screening practice was affected by age (AOR=2.025; 95% CI: 1.118, 3.668). Of those women who had ever heard of about cervical cancer were seven fold more likely to practice cervical screening (AOR=6.924; 95% CI: 1.602, 29.928) compared to those who did not have any information before. Moreover, knowing genital tract discharge as a problem of female organ implement fourfold more likely compared to that of knowing nothing about problem of genital tract (AOR=3.766; 95% CI: 1.761,8.055). Conclusion and Recommendation The study depicted there was low utilization of cervical cancer screening. Awareness creation about cervical cancer and knowledge of genital tract problems had positive influence for screening practice.

Stroke Survivors’ Preference of Herbal Center to Hospital

Nov 2021 DOI 10.14302/issn.3070-3360.ijco-21-3995

Proceeding to hospital immediately stroke occurs is important for early intervention that would minimize the consequences of stroke. But most stroke patients in developing countries prefer herbal centers than hospital. Reasons for this attitude have not been established. Two well-trained assistants were used to interview 117 stroke survivors who attended Bebe Herbal Center (BHC) in Nigeria for at least two visits. The survivors self-reported their experiences in hospitals visited and at BHC. Data obtained were analyzed using Independent t-test, Pearson’s chi-squared test, on SPSS package version 23. Significant value was set at p<0.05. Results showed the survivors comprised 48.7% males and 51.3% females, with mean age 63.98±10.41 years (range: 40-84 years). Following onset of stroke, 61.5% went firstly to hospital, 21.4% to traditional healing places, and 17.1% to BHC. Eventually all survivors went to BHC and 99.1% said they were satisfied with treatment received at BHC. Seventy-nine (68.1%) said they experienced substantial recovery under one month, 25.9% between 1-6 months. All the survivors who went firstly to hospitals said they received inadequate care in them. None of the hospitals they visited had CT or MRI equipment. Pearson’s chi-squared test showed that the impact of stroke had a significant difference between males and females regarding checking of blood pressure after stroke (χ2=7.62; df=3; P<0.05). The inadequate care received in hospitals and the early satisfactory recovery in BHC influence stroke patients in Nigeria to reject going to hospital.

Position Paper: Overview of Workplace Bullying in Higher Educational Organizations

Oct 2021 DOI 10.14302/issn.2324-7339.jcrhap-21-3961

Coronavirus disease (COVID-19) outbreak has severely affected the whole world. It has overshadowed all the developmental activities across different countries. The COVID-19 pandemic has negatively affected global economy and has threatened health security of people worldwide. This pandemic have affected environment dynamically. Decrease in economic activities, travelling, transport and traffic restrictions all over the world have led to decreased emissions of greenhouse gases and drop in air and water pollution observed universally. Also more than 40 % of downfall is observed in NO2 concentration in Asia and Europe as compared to 2019. Reduced pollution had a good effect on freshwater aquatic life. The reduction in worldwide aircraft flight directly impact on forecast and decreases 65% of weather prediction. Snow fall was observed even in a summer in India. This pandemic has had a long-term impact, affecting all aspects of human life and halting all developmental processes. Combating the COVID-19 pandemic is currently at the top of the global agenda. Quarantine measures opted for safety of the public have positively affected the environment. Although it has downturned the economic growth drastically, it has also contributed in lowering the pollution. If there is a silver lining to this horrible situation, it may be that it has given us a whiff of the air we will breathe in a low-carbon future.

Colorectal Cancer in Africa: Causes, Dietary Intervention, and Lifestyle Change

Oct 2021 DOI 10.14302/issn.2379-7835.ijn-21-3908

Colorectal cancer (CRC) is a menace in the global public health system. According to GLOBOCAN reports, colorectal cancer is the second most diagnosed cancer in the world with more than 1.9 million cases and 935,000 deaths in 2020 alone. Diet plays a key role in exposing humans to environmental carcinogens and anti-carcinogens, consequently mitigating or aiding in the development of various cancers. CRC is most prevalent in western countries with a high intake of saturated fats, refined carbohydrates, and processed meat. CRC was an extremely rare disease in Africa some decades ago, but the situation is fast changing. The traditional African diet consists of leafy, roots and cruciferous vegetables, fruits, roots, tubers and plantains, legumes, whole grains, and spices, all of which have been shown to possess protective effects against CRC. However, the effect of urbanization has contributed to the shift of dietary choices among the African population to consuming more ultra-processed foods with high levels of unhealthy components that have originated from colorectal cancer prevalent regions. This review evaluates the current nutritional challenges of the African diet to colorectal cancer and the potential roles of the traditional African diets and lifestyle modification in the prevention and management of colorectal cancer.

RETRACTED: Profile of Children with Covid 19 Infection in our Set Up

Oct 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3951

This article has been retracted on July 20, 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2692-1537.ijcv-25-5866) In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. In humans, COVIDs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. in our study , we consider the symptomatology , complications and mortality patterns of this disease in children.

Nutritional Status of Inmates in the Central Prison of Mbuji-Mayi, Democratic Republic of Congo

Sep 2021 DOI 10.14302/issn.2379-7835.ijn-21-3926

Background The nutritional situation in prisons of developing countries and the health status of inmates remain a major human rights concern. The objective of the study was to assess the nutritional status of inmates jailed in a prison of the Democratic Republic of Congo (DRC). Methods This cross-sectional study was conducted over a 4-month period in the Central Prison of Mbuji-Mayi, DRC. Three hundred inmates were selected according to the Malnutrition Universal Screening Tool (MUST). Severe malnutrition was defined according to Buzby index and Nutritional Risk Index (NRI). Data were analyzed by Stata™ (version12.0). Results The inmates were aged between 18 and 70 years and primarily males (88.7%). Of them, 24% were suffering from severe malnutrition and 62% of moderate malnutrition as based on the NRI. At the time of study, 88% of inmates were incarcerated for more than 6 months. Multivariate logistic regression analysis showed that factors independently associated with severe malnutrition were incarceration of more than 6 months (OR=5.1; 95% CI (1.5-17.4)), origin of food (prison vs. family or NGO) (OR=4.7; 95% CI (1.6-13.8)) presence of tuberculosis, human immunodeficiency virus and/or intestinal infections (OR=2.6; 95% CI (1.4-4.7)). Conclusions The nutritional situation in the Central Prison of Mbuji-Mayi is precarious. There is urgent need to supply enough nutrient-rich food to improve health of inmates.

Liver Disease: A Retrospective Hospital Based Study in Addis Ababa-Ethiopia

Aug 2021 DOI 10.14302/issn.2578-2371.jslr-21-3912

Background Liver disease has caused significant morbidity and mortality worldwide. Its epidemiologic and clinical pattern, however, is not well characterized in sub-Saharan countries. Objective This study aimed to describe demographic, clinical characteristics, and patterns of liver disease in a community hospital in Addis Ababa, Ethiopia. Method A retrospective hospital-based study was conducted on patients with liver disease admitted at Ras Desta Damtew memorial hospital, in Addis Ababa-Ethiopia, from February 2015 to April 2020. Result Of the total 212 patients majority, 78.8% were male, 49.1% of patients were in the age range of 31-50 with a median age of 42. The most common initial clinical presentation was ascites (87.7 %), and more than half of patients (56.6%) had a history of alcohol misuse documented on their medical charts. Chronic liver disease (cirrhosis) was found in 177 (83.5%), and Hepatocellular Cancer accounted for 7.5% of the patients. Alcohol misuse caused 45% of chronic Liver Disease, followed by Hepatitis B virus infection. Conclusion Chronic liver disease is the most common form of liver disease, and the most affected were middle-aged men. The common cause of chronic liver disease was alcohol followed by hepatitis B virus infection.

A Missing Data on Covid-19 Forecasts

Aug 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3918

Mathematical and computational studies of Covid-19 have underestimated the influence that other countries have on their daily records. To visualize this, a Granger causality analysis was implemented in Python to determine if the cases registered in Brazil, Chile, Colombia, Ecuador, Panama, Paraguay, Peru and the USA have any effect on Venezuela, and between all of them. Finally, this paper highlights the need to incorporate causality analysis employing only the cases of Covid-19 to improve mid and long term forecasts.

Proportion of WaterBorne Diseases in Children Aged 0 To 5 Years in the Health Area of the Urban Dispensary in Ebolowa - Cameroon

Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897

Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.

Characterization of Ground Water Quality in Southern and Northern Region of Zanzibar Island

Jun 2021 DOI 10.14302/issn.2377-2549.jndc-21-3740

Millions of people from different countries depend on groundwater, which might contain elevated levels of unhygienic constituents. Poor quality of drinking water in many countries has been forcing people to use bottled water. In the present study, groundwater samples were collected in November 2014 leading to twenty-nine analysis of groundwater samples. The primary objective of this paper is to study the selected groundwater quality parameters as an establishment of preliminary baselines on groundwater constituents. A total of twenty nine water samples were collected (fourteen and fifteen samples from North and South regions of Zanzibar Island respectively. Physical parameters (Turbidity, oxidation-reduction potential ORP, Eh, pH, total dissolved soild TDS, salinity, and Electrical conductivity (EC) were determined in situ using Horiba multiparameters digital meters. Analysis of anions (NO3-, Br- , SO42-, F-, NO2-) was carried out using Ion chromatography (IC). Nitrite and nitrate for some water were below detection limit (BDL) The order of relative abundance for anions in samples collected at Northern region of Zanzibar Island, was NO3- > Br- > SO42- > F- > NO2- , while for the Southern region the order was NO3- >Br- > NO2- > SO42- > F- . In both regions, the orders for other parameters were; Turbidity > pH > salinity; and EC >TDS > ORP > Eh. Almost all the measured parameters were within the WHO guidelines for drinking water. However, for nitrate and bromide, the percentage that exceeded the WHO limit was 7%, and 10.3% respectively. Based on toxicological perspective, although few samples had concentrations above groundwater quality criterion it is fundamental to estimate the intake by humans through the drinking water pathways.

Antimicrobial Resistance: A Situational Analysis in the Deido Health District, Douala, Cameroon

Jun 2021 DOI 10.14302/issn.2474-3585.jpmc-21-3851

Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.  

Impact of COVID-19 on Supply Chains in Zimbabwe

May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3824

Zimbabwe like many other sub-Saharan African states has been struggling to provide a quality health service delivery system. Nations with rampant corruption and ineffective bureaucracy made worse, the response towards the fight against COVID-19, Coronavirus Disease 2019. Despite the Zimbabwean government setting out protocols with international agencies such as WHO, World Health Organization to mount an effective response against COVID-19, the health system has been overstretched with lack of personal protective equipment, shortage of drugs and essential equipment and wanton corruption practices coupled with shortage of staff. Timely delivery of orders is still a challenge due to strict bureaucratic measures when transporting goods and the existing competition between countries. Manufacturers and donors are shifting their focus to their countries leaving the Zimbabwean health service underfunded and under-resourced. However, among the challenges experienced the country has been given a chance to revisit its priorities and strategize how best the government and organizations can move essential medical goods, utilize current trade agreements such as ACFTA, African Continental Free Trade Area and local drug manufacturers to produce essential medicines. Launching an efficient mechanism to end corrupt practices in procurement and supply as well as improve interagency cooperation and communication may help improve efforts to end COVID-19 in Zimbabwe.  

Chirps Amidst Coronavirus Disease-2019 (COVID-19) Transmission and Prevention in Ethiopia in 2020

Apr 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3741

Background Ethiopia confirmed its 1st case of COVID-19 on Friday 13th February 2020. The burden increased dramatically by August/2020. The conditions that led to this rise were not reviewed. Objective To exploreCOVID-19 related phenomena in Ethiopia during 2019-2020. Materials and Methods Review of journals, books, and letters to editors, e-sources, news, personal experiences, observations, and communications. Results The zoonotic source of SARS- CoV-2 (Severe Acute Respiratory Distress Syndrome- Coronavirus-2) is not confirmed. The precedent events; and exact mechanism of COVID-19 is not clear. Dynamic models were required on the time line of dynamics of COVID-19; dynamics of infectiousness of COVID-19, and mechanism of transmission of COVID-19. Incubatory carriers might have been missed. Screening based on temperature had been problematic. The time spent in the development of diagnostic test for COVID-19 might have contributed to the early spread. Uninterrupted flights to China during the epidemic by Ethiopian Airlines as well as uninterrupted domestic flights; IDP (Internally Displaced People); and others put Ethiopia (and other countries) at great risk. Demographic adjustment may not be applicable for Ethiopia due to lack of census which had to be conducted every 10 year, was conducted only in 2007. This adds to the problem of error projection. The impact of HIV (Human Immuno-Deficiency Virus Disease) and war in Ethiopia before 2000 might have had affected people who would be now old age and who would be at the most risk of death. This made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. There were also hesitations inconsistencies in case definitions; implementations of quarantine; and burial regulations. Conclusion Even though uninhibited foreign flight to China as well as domestic flights; inconsistencies in the implementation of regulations pertaining to COVID-19 have contributed to COVID- 19 emergence in Ethiopia, the absence of census; the demographic impact of HIV and war before 2000 might have made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. Recommendation Accurate and current evaluation of the impact of COVID-19 in Ethiopia may require the absence of census; demographic consequences of HIV; and war before 2000 into consideration.

Mathematical Modeling of Covid-19

Jan 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3701

Background The novel coronavirus (COVID-19) suddenly appeared in Wuhan, Hubei since December 2019, and quickly swept across China, then the whole world. Today, after more than 100 days of fighting against the virus, China's epidemic has been effectively controlled, but when we looking at the entire world, the novel coronavirus has rampaged globally, especially in the United States and many European countries. This paper mainly studies the impact of COVID-19 outbreaks at Hubei Province and the United States, fits the given data and predicts future trends. Methods Based on the theoretical basis of traditional differential equations and SIR infectious disease model1, and combined with the actual situation to improve the model. Hubei Province is modeled in different time periods, and the effects of birth rate and natural mortality on the model are analyzed. Since the birth rate and natural mortality in the United States in recent years cannot be found, the epidemic situation in the United States can only be analyzed based on the absence of births and natural deaths. Finally, we used Netlogo2 to establish a closed environment (Small World), and combined with known data to conduct simulation experiments on COVID-19 infection. Findings Through the analysis of given data through the SIR model, it is found that before the Chinese government has taken comprehensive measures to cure patients (before 10 February), the number of patients in Hubei Province will reach the peak at the end of February, and will gradually decline thereafter, and on 20 March, the epidemic will be effectively controlled in the future, which coincides with the fact that Wuhan closed the last mobile cabin hospital on 10 March. On the other hand, after the Chinese government tried its best to cure the patients (after 21 February), the number of patients continued to decline over time and will reach 0 in mid-April, which is also consistent with the actual data. According to the factors of birth and natural death, the sensitivity analysis of the above model found that when the epidemic situation is at its peak, it has little effect on the curve, but when the epidemic situation gradually flattens, it still has a certain effect on the trend of the curve. Finally, looking at the situation in the United States, due to the high transmission rate, the number of patients in the United States continues to rise and is expected to reach its maximum in mid-June. We also use Netlogo to simulate the environment in which the virus spread, and find that the general trend of the curves is also consistent with the actual curves. Interpretation The Chinese government has taken various measures to deal with the novel coronavirus pneumonia, including the establishment of two temporary hospitals and dozens of sheltered hospitals, the temporary transformation of university dormitories into isolation rooms345, the closure of Wuhan, the ban on the movement of people and so on. These measures have helped to reduce the spread of the virus and greatly increased the patient's cure rate. But the US government ’s actions are not as effective as China’s, not only because the government ’s actions are inappropriate and untimely, and the people’s opposition to isolation has not subsided. As a result, the virus has spread widely in the United States. More than one million people have been infected with the virus, and tens of thousands of people have died from COVID-196.

Models and data Analysis of the Outbreak Risk of COVID-19

Jan 2021 DOI 10.14302/issn.2692-1537.ijcv-20-3383

With the spread of the new coronavirus around the world, governments of various countries have begun to use the mathematical modeling method to construct some virus transmission models assessing the risks of spatial spread of the new coronavirus COVID-19, while carrying out epidemic prevention work, and then calculate the inflection point for better prevention and control of epidemic transmission. This work analyzes the spread of the new coronavirus in China, Italy, Germany, Spain, and France, and explores the quantitative relationship between the growth rate of the number of new coronavirus infections and time. In investigating the dynamics of a disease such as COVID-19, its mathematical representation can be constructed at many levels of details, guided by the questions the model tries to help answer. Mathematical sophistication may have to yield to a more pragmatic approach closer to the ability to make predictions that inform public health policies. Background In December 2019 , the first Chinese patients with pneumonia of unknown cause is China admitted to hospital in Wuhan, Hubei Jinyintan , since then, COVID-19 in the rapid expansion of China Wuhan, Hubei, in a few months time, COVID-19 is Soon it spread to a total of 34 provincial-level administrative regions in China and neighboring countries, and Hubei Province immediately became the hardest hit by the new coronavirus. In an emergency situation, we strive to establish an accurate infectious disease retardation growth model to predict the development and propagation of COVID-19, and on this basis, make some short-term effective predictions. The construction of this model has Relevant departments are helpful for the prevention and monitoring of the new coronavirus, and also strive for more time for the clinical trials of Chinese researchers and the research on vaccines against the virus to eliminate the new corona virus as soon as possible. Methods According to the original data change law, Establish a Logistic growth model, we collect and compare and integrate the spread of COVID-19 in China, Italy, France, Spain and Germany, record the virus transmission trend among people in each country and the protest measures of relevant government departments. Findings Based on the analysis results of the Logistic model model, the Logistic model has a good fitting effect on the actual cumulative number of confirmed cases, which can bring a better effect to the prediction of the epidemic situation and the prevention and control of the epidemic situation. Interpretation In the early stage of the epidemic, due to inadequate anti-epidemic measures in various countries, the epidemic situation in various countries spread rapidly. However, with the gradual understanding of COVI D -19, the epidemic situation began to be gradually controlled, thereby retarding growth

Post Covid-19 Doctor-Patient Relationship Model. Creation of Social Connection Contexts With Physical Distancing

Dec 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3649

The coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 has produced a significant change in the way general medicine is conducted. This shift has been remarkably quick towards telecare. The form of the clinical interview has changed, and with it communication and the doctor-patient relationship; Before COVID-19, all communication techniques and doctor-patient relationship, which were considered tried and true to establish a good relationship with patients, involved physical proximity 2. Now in many European countries and in the United States face-to-face consultations have been reduced to 10-20%, with most contacts now being provided remotely using symptom checkers, electronic messaging, and phone or video consultations 3.

Survival among Breast Cancer Patients in a Tertiary Cancer Center in Brunei Darussalam

Dec 2020

Background In Brunei Darussalam, cancer has been the leading cause of death, and breast cancer as the leading cause of death among women. With a nationally-funded cancer treatment, it is essential to determine the survival rates among breast cancer patients which can serve as a basis for comparison across timelines with the end view of improving healthcare delivery, hence, survival among the patient population. Methods This study was conducted from January – May 2019. Medical records data were abstracted for breast cancer patients treated between years 2011-2016 in a tertiary specialist cancer center. Kaplan-Meier Product Limit estimation was used for the over-all observed survival rates within 5 years after diagnosis. STATA Version 15 was used for statistical analysis. Ethical approval was obtained. Results Over-all, five-year breast cancer survival rates was favorable at 88.89%. . Survival rates according to TNM staging showed lowest at stage IV at 59% five-year survival. Survival rates according to age at the time of diagnosis showed favorable survival across age groups except for age groups 30-39 years and 80 years old and above. Survival rates according to treatment combinations were highest in surgery (mastectomy) and hormonal therapy. Conclusions The Center’s 5-year breast cancer survival rates were relatively high and comparable to survival figures of developed countries. The Center’s high survival rates could have been related to the ‘treatment factors’ due to the following: prompt treatment of early stage breast cancer stages, responsive coordination, government-funded cancer treatment which allowed patients uninterrupted, free access to standard treatment.

What is the Level of Empathy in Medical Students of University of Ghana Medical School in Accra Ghana?

Dec 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3613

Empathy has been described as a multi-dimensional construct with cognitive and emotional components, both of which are concerned about responsivity to others. It has been touted as a skill essential for medical practice and thus useful to all healthcare professionals. It has been assessed in several countries and among several healthcare cadres however, there is a yawning gap in Ghana about its level in medical students. This study utilised a cross-sectional design to assess empathy using the Multi-Dimensional Emotional Empathy Scale in medical students of the University in Ghana. The scale has an alpha reliability of 0.88. One hundred and eleven students, aged 24 years ±1.5 years completed the study. Overall, there were more males than females. The mean empathy score for the cohort was 101SD 13 and this was adjudged to be low. There was no statistical difference between age, gender and clinical year and empathy in this cohort. The authors recommend that empathy, especially its cognitive aspects, should be taught in medical school curriculum of the University of Ghana Medical School, Accra.

Process Evaluation of Auditable Pharmaceutical Transaction Service in Seka primary Hospital, Jimma Zone, South West Ethiopia

Nov 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3501

Background A well-functioning drug supply management is the corner stone for any meaningful health service. However, Pharmaceutical supply systems in many developing countries have severe problems, including inefficient selection, procurement and use of drugs. The magnitude and extent of the problem is huge and chronic in the Ethiopian health care system for a long time. Objective To evaluate auditable pharmaceutical transaction service process in Seka primary hospital, Jimma zone south west Ethiopia. Evaluation Methodology Case study design involving both quantitative and qualitative methods was conducted in Seka primary hospital. The focus of this evaluation was on the process of Auditable pharmaceutical transaction service. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 326. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 23 software. Results In Seka primary hospital, percentage availability of the 32 selected Key medicinewas 10.7(82.0%) and there were no expired drugs found on their shelves. The availability of 17 of the required 20(85%) professionals was adequate according the Auditable pharmaceutical transaction service. The average lead time was found to be less than five days. The average counselling and dispensing time were 5:43 minutes and 1:17 minutes, respectively. The average number of drugs per prescription was 2.0. The 1154(97.9%) of drugs prescribed by generic name and 1175(99.7%) of prescribed drugs on Essential Drug List indicates prescribers ‘adherence to facility specific List. Conclusion This evaluation revealed that (based on the pre-set judgment criteria) the achievement of the Auditable pharmaceutical transaction service in Seka primary Hospital was GOOD 82.6 % (achieved 355.2 of 430 weight given), i.e. even though it is Good achievement ,there are areas that needs improvement. Areas for improvement identified were: Pre- and in-service training for all health workers involved in store room and dispensary to improve on the medium counselling time, poor record keeping and the extremely poor labelingof drugs which this all improve the overall client satisfaction.

The Feasibility of Enzyme Immunoassay Tests in the Absence of a Conventional Source of Electricity

Oct 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3517

Background of the Study African  countries are facing frequent blackout. Thus in sub Saharan region, due to frequent power cut, the laboratory professionals find sometimes difficulty to carry out earlier diverse diagnostic tests. Objective The  aim of this work is to evaluate the feasibility of enzyme immunoassay tests in the absence of a conventional source of electricity. Methods We  developed a battery-powered experimental device, which was then applied to diagnose measles. The samples included 45 sera randomly selected from non-haemolysed serum samples received and stored at the National Public Health Laboratory of Benin. The experimental device is composed of two devices (Devices 1 and 2). The Device 1 provided an average temperature of 34.47 °C, 20 min after starting. With Device 2 an average temperature of 20.32 °C is obtained 15 min after starting. Results With  the experimental device the same rate of measles antibody-positive sera (44.68%) was obtained as recorded from the test using the standard equipment of laboratory. The experimental device detected 18 negative and 8 intermediate results against respectively 19 and 7 by the standard equipment. The analysis of the results of both equipments shows a concordance rate of 93.33% with a kappa reproducibility coefficient of 0.89. Conclusion The  device conceived in our study is a simply equipment allowing the realization of the enzyme immunoassay tests, in this case the ELISA anti-measles test. The rate of concordance obtained shows that this device can be used with commercial kits and at temperatures close to those recommended by the manufacturer without altering the results.

Dynamics of Infections and Number of Vaccines Needed to Avoid Covid-19 in Europe

Oct 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3587

The work analyzes the dynamics of transmission of infections by the new coronavirus in twelve European countries, including France, Germany, Italy, Spain, UK, Austria, Croatia, Denmark, Greece, Romania, Czech Republic, and Portugal, whose data from contagion were obtained by Johns Hopkins University until September 24, 2020. The study confirmed that this new coronavirus (SARS-CoV-2) surprised all the countries of the world that had to improve their public health policies to confront this disease according to the results obtained from the calculation of the mantissa. Although the countries were able to improve their policies after the first wave of contagion, Spain and France have the highest proportion of cases that stand out significantly with the rest of the countries in the second wave of infections that the world faces again. Likewise, the beginning of the epidemic outbreak was determined, which could help to track the spread of the disease through European countries (not the first case registered in each country), from which it can be inferred that the outbreak begins in Italy and later the rebound begins in Germany, France, and Spain. Within days, it significantly affects Greece and Austria, reaching Denmark, the Czech Republic, Romania, and Croatia. Finally, the number of people who must be vaccinated to counteract the advance of Covid-19 in these European countries was determined based on the calculation of the Effective Reproductive Number, Rt. The number of people that would have to be vaccinated in all these countries to counteract this disease sums up to 206.830.361.

Risk Factors Associated with Breast Cancer

Sep 2020 DOI 10.14302/issn.2372-6601.jhor-20-3544

In Mexico, breast cancer is the second most common site of cancer in women and in most developed and emerging countries. Incidence rates have increased in many countries, although in some, mortality has remained stable with a slight reduction. There are geographical differences with high rates of breast cancer in North America, Northern Europe and Oceania, and lower rates in Central and South America, South and East Europe; in addition to emerging countries in Africa and Asia. Genetic and hereditary factors constitute less than 5% of breast cancer cases and other risk factors for breast cancer are related to the reproductive life of the woman. This work was carried out in order to determine if the risk factors considered classic are really associated with breast cancer in our sample of Mexican women studied.

Assessment of Self Medication Practice and Drugs Storage Among South Sudanese Community in Addis Ababa, Ethiopia

Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526

Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.

Physical Exercise as a Means of Managing Covid-19; an Insight Review

Sep 2020 DOI 10.14302/issn.2694-2283.jsem-20-3539

The following document provides important information that everybody know about physical exercise as a means of managing COVID-19. It addresses the health benefits of physical exercise on our body’s immune system, and stress reduction. Already today in the entire world, coronavirus is now the leading causes of morbidity and mortality. It kills thousands of peoples per day worldwide and continues its impact on the governments and the society. Nowadays it is the greatest public health problem in most countries in the world. Since its identification on Jan, 7 by the chines scientists named the pathogen as a novel coronavirus. In the current situation COVID-19 is rapidly spreading worldwide and the number of cases and deaths are rising up speedily. The spread of the virus is a headache to the government in general and the society in particular. The nature of the virus disallowed contacting with one another, working together, meeting, and other activities the majority of government and private business organizations are enforced to discontinue their work. The growing burden of the virus would place millions of jobs at risk an additional 8.8 million people in working poverty around the world. The danger of the disease and loss of employment leads the majority at stress. A chronically stressed person impairs the organism’s ability to mount a strong immune response with a resultant increase in morbidity and mortality.

Factors Affecting Traumatic Brain Injury Outcome Among Patients Treated for Head Injury at Surgical Side, in Nekemte Referral Hospital, Oromia, Ethiopia.

Sep 2020 DOI 10.14302/issn.2694-1201.jsn-20-3554

Background Traumatic brain injury is an expanding major public health problem and the leading cause of death of the young and productive part of the world’s population. Research is mainly done in high-income countries where only a small proportion of the worldwide fatalities occur. Only few studies have examined prognostic factors of traumatic brain injury outcome in developing countries including Ethiopia. This study was aimed at defining the peculiar demographic and other associated factors of traumatic brain injury (TBI) outcome among patients treated for head injury at Nekemte Referral Hospital. Objective The main purpose of this study was to describe the magnitude of TBI outcome and assess factors associated with unfavourable outcome of TBI among patients treated for head injury at the surgical side in Nekemte Referral Hospital from July 8, 2016 to July 7, 2018. Methods A retrospective cross-sectional document review was conducted among TBI patients treated for head injury from July 8, 2016 to July 7, 2018 at Nekemte Referral Hospital. Data were collected using a pre-tested data collection format. Data analysis was done using SPSS version 20. Descriptive statistics were computed and association between the dependent and independent variables were assessed by using logistic regression. Odds ratios with 95% confidence interval were computed. Significant association was declared when the p value was <0.05. Results In this study, out of 378 cases 95 (25.1%) were discharged with unfavourable outcome of which 37(9.8%) were neurologic deficits and 58 were deaths giving overall mortality rate of 15.3%. Patient age>60years (AOR: 15.13; 95%CI: 3.575-64.028), time interval from injury to treatment (AOR: 16.054; 95%CI: 5.832-44.194), low GCS (AOR: 18.224; 95%CI: 4.167, 79.695), conservative management (AOR: 20.774; 95%CI: 6.106-70.681), pupils abnormality (AOR: 9.078; 95%CI: AOR: 2.996-27.509) were associated with unfavourable outcome. Conclusions A quarter of patients treated for TBI at Nekemte Referral Hospital are discharged with unfavourable outcomes. Old age, delayed presentation to the hospital, low GCS, conservative management, and pupillary abnormality increase the odds of unfavourable outcome. Timely management of TBI before patients develop secondary brain injury and use of surgical intervention based on CT scan diagnosis will reduce the occurrence of unfavourable outcome.

Model Based Research Open Access

Experimental Analysis PVP Coated Silver Nanofluid Properties for Application in Photovoltaic/Thermal (PVT) Collectors

Aug 2020 DOI 10.14302/issn.2643-2811.jmbr-20-3476

Nowadays, supplying energy for the global population has turned into a prominent issue for countries engendering the consumption of huge amounts of fossil fuels which leads to some serious environmental problems. Among the renewable energy technologies, solar collectors can play major role to improve the efficiency, in air conditioning utility systems by minimum pollution. In photovoltaic/thermal (PVT) solar collectors, which are currently considered as the most advanced type to produce electricity and heat simultaneously, working fluid absorbs Energy from photovoltaic (PV) module engendering to decrease temperature of PV module and increase the electricity efficiency and also provide permissible amount of heat for other residential applications. Meanwhile, utilizing nanofluid as the working fluid in collector, regarding that the nanofluid has enhanced thermal properties relative to the base fluid, leads to a higher collector efficiency. In this research, PVP coated silver nanofluid was prepared in three volume concentration being 250, 500 and 1000 ppm by two-step method. To assess the stability of nanofluid the zeta potential is calculated which is obtained -41.6 V. Also, the prominent thermal properties of the nanofluid were analyzed regarding PVT solar collector applications. According to the results, thermal conductivity of the PVP coated silver nanofluid, improves the properties of base fluid, to the extent that thermal conductivity coefficient grows up 50% in some temperatures and increased from 0.594 for base fluid to 1.098 W/mK by escalation of concentration to 1000 ppm. Thus, PVP coated silver nanofluid can be deemed as the vital working fluid to improve the performance of PVT solar collectors.

Factors Influencing Recovery among Children with Moderate Acute Malnutrition Treated at Kirehe District Health Centers

Aug 2020 DOI 10.14302/issn.2641-4538.jphi-20-3437

Acute malnutrition affects nearly 52 million of under five years children globally, 75% of them live in low to middle income countries. The treatment of acute malnutrition using supplement foods could help children recovering and could reduce the risk of sickness. The present study investigated the factors associated with recovery among children with moderate acute malnutrition (MAM) under a follow-up program at health facilities. A prospective study was conducted in 16 health centers of Kirehe District of Rwanda and included 200 children from 6 to 59 months. A semi-structured questionnaire was used for data collection. All children enrolled in the study spent three months in nutrition program at health centers. The results show that after 3 months in the program 77.5% recovered from MAM. Children aged above 36 to 59 months were recovered at 90% whereas children aged from 24-35 months were recovered at 73.5%. Micronutrients and deworming provided at health facility were contributed to the recovery as children who received them were recovered at 89.1% and for those who didn’t were recovery at 72.1%. The findings demonstrated that boys were 16 times more likely to recover from MAM in three months of intervention than girls (AOR=16.19, p<0.001, 95% CI: 5.39- 48.63). Children from moderate income families were 3 more likely to recover than those from very low income families (AOR=2.8, p=0.029, 95% CI: 1.11-7.51). Male gender, receiving micronutrients and deworming from health facilities and family income status were factors associated with MAM recovery status

A New Graph to Display the Epidemic Outbreaks of Covid-19 in the World

Aug 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3498

The paper proposes a new visualization scheme for the registry of Covid-19 cases by calculating the mantissa of the registered ones, so there is no need of performing complicated mathematical calculations. As an example, six countries are randomly selected: Australia, Brazil, China, Colombia, Portugal and Venezuela. The results show that China is the only country that keeps the epidemic under control, while Australia begins a new outbreak after having previously controlled the epidemic. Colombia and Portugal show a very similar behavior of registered cases and, finally, we can see that Venezuela, Brazil, Portugal, and Colombia present a growth of cases that may trigger new outbreaks in the future. Results are obtained from data registered at Johns Hopkins University until July 18th, 2020.

Coronavirus: A Practicing Veterinarian Prospective

Jul 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3473

COVID19 is posing threat cosmopolitically encompassing more than 200 countries and making threat to entire population globally as pandemic. The cats, dogs and bovine are at threat which are close partner to human population. The veterinarians specially practicing are at risk when they encounter the sick animals. This study focus to the Pakistani veterinarian where animal population is under estimated or sometimes census is not performed. As Current population of domestic animals in Pakistan consist of 23.34 million buffaloes, 22.42 million cattle, 24.24 million sheep, 49.14 million goats, and with a huge population of dogs and cats without official census which may pose a threat to innocent population and even more a practicing veterinarian and veterinary paramedics are more at threat, if god forbids. There is need for further investigation its role and zoonotic perspective. Regarding practicing field veterinarians fighting without weapons against mass destructing pathogen and making vulnerability on wide.

A quick Look at the Registered Cases of Covid-19 Throughout the World

Jul 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3453

The present work analyzes the registered cases of Covid-19 throughout the world according the data registered at Johns Hopkins University. We selected 15 countries to analyze their data. In alphabetical order the countries are: Argentina, Australia, Brazil, Chile, China, Colombia, Germany, India, Italy, Mexico, Peru, Portugal, Spain, United States and Venezuela. With this information, three different studies were carried out. First, the data was validated using Benford's Law which is based on forensic techniques that allow us to guarantee the integrity of the information. Later, we calculated the value of the basic reproduction number (R0), ie., the number of secondary host infections caused by one primary host infection that helps us to determine if a country has an outbreak of Covid-19. Finally, we show that the best representation for the change in the number of cases in the time is to calculate the mantissa value, ie., the floating number obtained from the logarithm of the data.

How Valid are the Reported Cases of People Infected with Covid-19 in the World?

May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3376

The goal of this paper is to analyze the registered cases of people who have been infected with Covid-19 registered from throughout the world, using a digital forensic analysis technique that is based on Benford's Law. Twenty-three countries were randomly chosen for this analysis: China, India, Germany, Brazil, Venezuela, Netherlands, Italy, Colombia, Russia, Norway, South Africa, Portugal, Singapore, United Kingdom, Chile, Ecuador, Egypt, Denmark, Ireland, France, Belgium, Australia and Croatia.. We calculate on the p-values based on Pearson χ2 and Mantissa Arc Test according to the results obtained with the first digit. If any country fails these two tests, a third proof will be carried out based on the Freedman-Watson test. The results indicated that results from Italy, Portugal, Netherlands, United Kingdom, Denmark, Belgium and Chile are suspicions of data manipulation because the numbers fail the Benford’s Law according to the results obtained until April 30, 2020. However, it is necessary to carry out further studies in these countries in order to ensure that they countries manipulate or altered the information. 

Tele-Pharmacists’ Prospects in Pandemic Situations: A Bangladesh Scenario

May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3355

Telemedicine and telehealth technologies are especially effective during epidemic outbreaks, when health authorities recommend implementing social distance systems. Currently, coronavirus COVID-19 has affected 210 countries around the world, killed more than 200,000 and infected more than 3 million, according to worldometer, April 26, 2020. Home-care is especially important in these situations because hospitals are not seemingly safe during pandemic outbreaks. Also, the chance to get out of the home during the lockdown period is limited. Telephone-based measures improve efficiency by linking appropriate information and feedback. It can also help provide education at distance on various health issues and topics. In addition to increasing access to healthcare, telemedicine is a fruitful and proactive way to provide a variety of benefits to patients seeking healthcare; diagnose and monitor critical and chronic health conditions; improve healthcare quality and reduce costs. The article reveals scope of pharmacy professionals in telemedicine sector during epidemic outbreaks.  

Mental Health in The Context of The COVID 19 Pandemic

May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3367

We explore the global evidence of major health crisis potential impacts and the factors influencing the mental health outcomes among the population during the outbreak of COVID-19. Preparation measures for a COVID-19 focus on rapid quarantine of social isolation and economic concerns have risen metal health considerations that become an integrated part of the pandemic outbreak. This outbreak of novel Coronavirus disease (COVID-19) pandemic is swayed an overall 213 countries, areas or territories, with over 2,921,439 confirmed cases and 203,289 confirmed deaths reported till 26 April 2020. This created a lot of strain and fear; fear of falling ill and dying of being infected leading to heightened levels of insurmountable psychological pressure. This scrutiny attempt to assess the widespread outbreaks of COVID-19 on mental health professionals, healthcare workers and general population in association with adverse mental health sequelae like generalized anxiety disorder (GAD), depressive symptoms, insomnia, panic attacks, post-traumatic stress disorder, OCD, suicidal behavior, delirium, psychosis, harmful alcohol consumption, and drug use. There is a need for more evocative exploration to intensify awareness to address the potential psychological and behavioral risks that will remain elevated as long as the COVID-19 pandemic continues in the community. In conclusion, incessant surveillance of the subsyndromal mental health problems for outbreaks should be part of galvanized global action during the quarantine.  

Using Human Development Indices to Identify Indicators to Monitor the Corona Virus Pandemic

Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3306

Introduction The Corona virus (CoVID-19) pandemic has hit the most developed countries and has thence spread to inflict other countries around the world. It is the first pandemic that appears in countries not linked to poverty and poor hygiene. Aim To study the relationship between human development and the pattern of the pandemic caused by the CoVID-19 and to identify development indicators that can be useful in monitoring the pandemic. Methods Data collected included confirmed cases of CoVID-19 by country, number of cases that recovered and cases that died and population density per million in this particular country. The data for this information was obtained from the online data on the daily reports on CoVID-19 from the different countries. Data for the Human Development index (HDI) and the ranking for each country were obtained from the most recent United Nations Development of Populations (UNDP) report for 2019. We analyzed data for 166 countries for which the HDI was available for the date of cases reported online on 27th March, 2020 at midnight. Findings There were significant differences by ANOVA for the confirmed cases of CoVID19 cases and total cases per one million population between the countries in the 4 tier group of Human Development. HDI was significantly correlated with confirmed cases, case density and cases that died from CoVID-19 (P<0.01) for all countries but the significance decreased by tier group. Country ranking was inversely correlated with confirmed cases of CoVID-19 (r-0.25 at P=0.001), CoVID-19 cases per million (r-0.4 at P=0.000) and cases that died from CoVID-19 (r-0.2 at P=0.03). Recovery was not inked to HDI or country ranking. The upper HDI tier groups (very high, high and medium) showed significant correlations with total cases per one million population P<0.05, but no correlation was found with confirmed cases or cases that died or recovered from CoVID-19 P>0.05. Conclusions Total cases of CoVID-19 per one million population seems to be a better indicator of the pandemic. The pattern of spread is closely linked to industry.

Pharmacodynamic Modeling of Sunscreens: New Efficacy Evaluation, Risks of Sunburn and Melanoma and Very Low to Very High Sun Protection Factor

Mar 2020 DOI 10.14302/issn.2471-2175.jdrt-20-3274

Pharmacodynamic modeling of sunscreens was performed using a new concept of Skin UV Index (SUI) on the exposed skin as a parameter to evaluate the potential effectiveness of sunscreens against sun damage. The SUI predicts the UV heat intensity on the skin surface in terms of the solar UV Index at the time of the study and is calculated by solar UV Index/sunscreen’s SPF. SUI numbers for sunscreen with SPF ranging from 2 to 100 under a solar UV Index of 10 was used for illustration. Based on guidelines from WHO, Australia and New Zealand, sunscreens yielding SUI < 3 are assumed to be effective against sun damage such as sunburn and melanoma. Based on the above assumption, sunscreens with SPF > 4 were found to be effective when sunscreens were evenly applied at 2 mg/cm2. Review of numerous studies suggests that missing applications may represent a major, seemingly unavoidable, SPF-independent factor causing unintended sunburns for sunbathers in the US and other countries with a temperate climate. This might in turn become a major factor for causing exponential increase in melanoma incidence rates observed in the last few decades. For example, in an SPF 30 sunscreen study all 25 participants suffered unintended sunburns after one week of sunbathing. Also, a mean missing application of 20% of the total exposed area and a mean missing of about 50% of the time were reported in two separate studies. Simulations were also performed with under-applications of 50% and 75%. The present simulations may provide a rationale of why routine use of a low SPF 8 sunscreen was reported to be effective against melanoma in a 2018 Australian study. Based on model simulations it is proposed that in the US, SPF 8 sunscreen and SPF 2 to 6 sunscreen may be adequate for routine, unintentional use for sun-sensitive populations and non-sun-sensitive populations, respectively.

Mathematical Modeling and Epidemic Prediction of COVID-19 and its Significance to Epidemic Prevention and Control Measures

Mar 2020 DOI 10.14302/issn.2766-8681.jcsr-21-3719

Background Since receiving unexplained pneumonia patients at the Jinyintan Hospital in Wuhan, China in December 2019, the new coronavirus (COVID-19) has rapidly spread in Wuhan, China and spread to the entire China and some neighboring countries. We establish the dynamics model of infectious diseases and time series model to predict the trend and short-term prediction of the transmission of COVID-19, which will be conducive to the intervention and prevention of COVID-19 by departments at all levels in mainland China and buy more time for clinical trials. Methods Based on the transmission mechanism of COVID-19 in the population and the implemented prevention and control measures, we establish the dynamic models of the six chambers, and establish the time series models based on different mathematical formulas according to the variation law of the original data. Findings The results based on time series analysis and kinetic model analysis show that the cumulative diagnosis of pneumonia of COVID-19 in mainland China can reach 36,343 after one week (February 8, 2020), and the number of basic regenerations can reach 4.01. The cumulative number of confirmed diagnoses will reach a peak of 87,701 on March 15, 2020; the number of basic regenerations in Wuhan will reach 4.3, and the cumulative number of confirmed cases in Wuhan will reach peak at 76,982 on March 20. Whether in Mainland China or Wuhan, both the infection rate and the basic regeneration number of COVID-19 continue to decline, and the results of the sensitivity analysis show that the time it takes for a suspected population to be diagnosed as a confirmed population can have a significant impact on the peak size and duration of the cumulative number of diagnoses. Increased mortality leads to additional cases of pneumonia, while increased cure rates are not sensitive to the cumulative number of confirmed cases. Interpretation Chinese governments at various levels have intervened in many ways to control the epidemic. According to the results of the model analysis, we believe that the emergency intervention measures adopted in the early stage of the epidemic, such as blocking Wuhan, restricting the flow of people in Hubei province, and increasing the support to Wuhan, had a crucial restraining effect on the original spread of the epidemic. It is a very effective prevention and treatment method to continue to increase investment in various medical resources to ensure that suspected patients can be diagnosed and treated in a timely manner. Based on the results of the sensitivity analysis, we believe that enhanced treatment of the bodies of deceased patients can be effective in ensuring that the bodies themselves and the process do not result in additional viral infections, and once the pneumonia patients with the COVID-19 are cured, the antibodies left in their bodies may prevent them from reinfection COVID-19 for a longer period of time.

Analysis and Forecast Based on the Kinetic Equation for Changing the Numerical Composition of Living Systems

Mar 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3212

The possibility of applying the kinetic theory of aging of biological species published earlier by the authors of this work to assess and predict changes in the number of specific populations is evaluated. The populations of the USA, China and Russia, as well as the population of mice observed in the experiment "mouse paradise" of the American scientist John Calhoun are considered. To this end, a historically consistent analysis of the main previously proposed multi-scenario mathematical models describing demographic data and predicting the dynamics of the population was performed. The results of these models show a decrease in the population growth rate, a tendency toward a limit with an increase in historical time, the achievement of such a limit in some developed countries with a relatively high level of social security, a subsequent decrease in the number and further uncertainty of the final population outlook in the distant future. In addition, these models made it possible to establish that the observed population growth in developed countries is unambiguously accompanied by its aging - a relative predominant increase in the number of elderly people compared to the number of the younger generation (people are aging, the population of countries is aging). In this work, the assumption was made and confirmed that the dynamics of the aging of the population of the countries of the World corresponds to the dynamics of aging of a person of one generation and is mathematically described by the differential equation of the kinetic theory of aging of living systems of the same type with close values of the parameters. The biophysical meaning of the parameters of the kinetic equation reflects G. Selye's concept of the determining role of stress in human life and populations. An analysis of the changes in the numbers of the considered populations of humans and mice at various stages of their development is qualitatively commented on from the standpoint of comparative tension according to G. Selye. To assess the degree of aging of a biological object of one population in kinetic theory, the probability of death during life is selected as an indicator of aging. In this work, the probability of reaching the maximum population size was chosen as an indicator of the aging of a biological object of various populations. The published literature predicts various options for changing the population after reaching a maximum - maintaining the reached maximum level and decreasing to a certain limit, less than the maximum achieved. In this paper, based on an analysis of its results and an analogy with the complete degeneration of mice in the “mouse paradise” experiment, a conclusion is drawn about a hypothetically possible third variant of the limiting decrease in the population - its complete degeneration.

The Effect of Aqueous Extract of Ocimum gratissium (Linn) on 1, 2 - Dimethyl Hydrazine induced Colon Cancer in Male Wistar Rats

Feb 2020 DOI 10.14302/issn.2577-2279.ijha-20-3180

Background Colon cancer is one of the leading causes of cancer death world-wide. There is a steady increase in incidence over the past four decades in developing countries. This has been partly attributed to increasingly low intake of vegetables among other causes. Aims Therefore this study aims to evaluate the protective effect of aqueous extract of Ocimumgratissimum (OG) leaves (a staple vegetable) on experimental model of colon carcinogenesis induced with 1, 2 Dimethylhydrazine (DMH). This is compared with celecoxib (a cyclooxygenase-2 inhibitor) which is used in the chemoprevention of colon cancer. Methods Sixty adult male Wistar rats were randomly divided into six groups: A to F, n=10. Group A was the normal control, Group B was given only DMH weekly for 16 weeks,Groups C, D and E were given graded doses of OG for two weeks prior to cancer induction by DMH. After which both OG and DMH were given for 16weeks. Group F received celecoxib daily for two weeks prior to cancer induction. Colonic wall was analysed grossly, histologically and biochemically. The induced lesions were staged investigated and staged using Duke’s Staging method. Results The result showed tumour incidence in groups B and C while no evidence of primary colonic tumour was observed in groups A, D, E and F. There was a dose dependent increase in the goblet cell count in the groups treated with OG with group E being statistically higher than group F. There was a significant reduction in collagen staining intensity (F = 129.74, p < 0.0001) for the colonic wall in group B when compared to other groups. There was a decreased nucleo-cytoplasmic ratio in groups C, D, E and F when compared to group B. There was a significant increase in the concentration of nitric oxide and prostaglandin E2in group B when compared to other groups D, E and F. Conclusion In conclusion, this research showed a protective effect of Ocimumgratissimum leaves on 1, 2-dimethylhydrazine-induced colon cancer which further corroborated its ethno-medicinal use. 

Term Paper on The Nature of Cyber Crime and Cyber Threats: A Criminological Review

Feb 2020 DOI 10.14302/issn.2692-5915.jafs-20-3204

Cybercrime is one of the fastest-growing criminal activities in contemporary age. The first recorded cybercrime happened in France in the year 1820. It was not as sophisticated as cybercrime we know in our world today, but, still, that was a crime. Cybercrime has evolved globally as the online platform is progressing. While progress is made in the battle against cybercrime there still remains a wide gap in the consistency of laws across international borders. The main objectives of this study are to explore the nature of cybercrime in developing countries, find out the cyber threats for terrorist activities and explain cybercrime and threats from criminological aspects. This is a descriptive study which is based on secondary data. This study is based on previous researches & studies. this paper discusses the nature of cybercrime in developing countries. It could allow developed countries to understand better the national and international effects of that cyber threats, to determine the conditions of current regional and international agreements, and to help countries create a sound legal framework. And then we notice the impact of cyber threats all over the world. At last, we discuss cybercrime from criminological point of view. Cybercrime is not limited to two neighboring countries and cross-border conflicts; an attempt could be conducted from another world. It is fearful to see cyber wars as the easiest way to carry out sabotaging rather than wars such as cold war, chemical and biological wars, terrorist wars or jihadist attacks. The international legal framework aims by the International Criminal Court to keep offenders accountable for their actions. The government has by far the biggest burden and obstacle in raising knowledge of cybercrime among the people.

Measuring Availability and Prices of Locally Produced and Imported Medicines in Sudan

Jan 2020 DOI 10.14302/issn.2641-5526.jmid-19-3119

Introduction The objective of this study was to compare the availability and prices of locally produced and imported medicines, in particular after one year from medicines importation restriction and to answer the key questions, did local manufacturers able to coverage national needs of medicines and what is the patient prices for locally produced compared to imported medicines in different sectors and regions of Sudan. Methodology The WHO/HAI methodology survey tool was adapted to measure the availability and price of locally produced and imported medicines. Patient price and availability were collected from capital cities of 6 states as per WHO/HAI methodology. Data were collected and analyzed for 50 medicines from the 104 medicines restricted to local manufacturer. Availability was based on whether the medicine was in stock on the day of data collection at the surveyed facility. Prices were expressed as median price ratio (MPR). Results Availability of locally manufactured medicines (LMM) was much better than imported medicines (IM), in the public, (47.2% vs. 14%, respectively) and private (63.9% vs. 23.5%, respectively) sectors. Based on median price ratio (MPR), public sector patient prices for locally manufactured medicines were lowered priced and had a median MPR of 2.4 (n=42) than imported medicines which had a median MPR of 4.99 (n=20). In private sector patient prices for locally manufactured medicines were also lowered priced and had a median MPR of 2.76 (n=45) than imported medicines which had a median MPR of 5.53 (n=27). Thus; patients were paying about 52% less for locally produced than for imported medicines in both sectors Conclusion The survey showed low availability of the basket of medicines surveyed in the public and private sectors for imported medicines (I.M), while not achieving WHO’s target of 80 % for locally manufactured medicines (LMM). In developing countries a lot of barriers are well known to business and industrial need to be resolved in order to maintain availability and self-reliance in drug production as a mean of increasing access to medicines.

Parasite Research Open Access

Malaria and Typhoid Fever Coinfection in the Hospital University of Bobo-Dioulasso, Burkina Faso

Dec 2019 DOI 10.14302/issn.2690-6759.jpar-19-3081

Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.

D Allele and DD Genotype of I /D Polymorphism in The ACE Gene in Patients with Hypertension, Stroke And Cancer Prostate In Libreville: A Concern Given The High Frequencies of these Signatures in Gabonese Population

Dec 2019 DOI 10.14302/issn.2326-0793.jpgr-19-3114

Background During the last two decades, the polymorphism of Angiotensin-Converting Enzyme (ACE) gene has been extensively studied among different human populations. In humans, several studies have shown the relationship between this polymorphism and the risk of many serious diseases with a heavy burden of health in developing countries. After analyzing the polymorphism in the population, the present study was also concerned with the investigation of an eventual association between hypertension, stroke, cancer prostate and I/D polymorphism of the ACE gene. Materials and Methods Our study population included 163 Baka (pygmy) and 158 Fang (Bantu) from Gabon to evaluate the polymorphism in the country. Concerning the diseases, we included 105 patients and 120 controls for hypertension, 37 patients stroke matched with 50 controls and 97 patients with prostate cancer were recruited. All participants in the study were genotyped for the ACE I/D polymorphism obtained by polymerase chain reaction amplification on genomic DNA. Results Our analysis showed that the ACE D allele DD genotype frequencies were highest of all the data so far in human populations. We obtained a frequency of 0.138 for I allele and 0.862 for D allele among pygmy and the frequencies of 0.313 and 0.687 respectively for the I and D alleles. This difference was significant (p<0.05). In patients, we revealed the predominance of D allele and DD genotype for hypertension (0.27 for I allele and 0.73 for D allele), for stroke (0.15 for I allele and 0.85 for D allele) and 83% of individuals with cancer prostate carry the D allele. D allele and DD genotype are associated with risk to hypertension whereas allele I seem protective at the occurrence of stroke (p<0.05 between healthy and controls). Conclusion We show that the D allele and DD genotype were higher in this population. Also theses two signatures may be associated at genetic risk of hypertension, stroke and prostate cancer in this country deprived of human resources for quality care of many patients.

Risk Factors of Persistent Diarrhoea in Children below Five Years of Age

Oct 2019 DOI 10.14302/issn.2691-5014.jphn-19-3038

Background Persistent diarrhoea is a commonly observed phenomenon both in Bangladesh and all over the developing countries. It is the single most important cause of diarrhoea related deaths in the community, accounting for over half of them. If associated factors are properly identified & treated, it is possible to prevent most cases of persistent diarrhoea. Objective This study was undertaken to find out the possible risk factors associated with persistent diarrhoea in children below 5 years of age. Methods This was a prospective analytical case control study carried out in a tertiary care hospital, Dhaka. A total of 30 consecutive cases of persistent diarrhoea and 60 consecutive acute diarrhoea controls (matched for age and sex) under 5 comprised the study subjects in this study. Children beyond the age and whose parents didn’t give written consent were excluded from the study. Data were collected using a structured questionnaire and a standered case definition of acute & persistent diarrhoeawere adopted. Data were later processed and analyzed using SPSS (Statistical Package for Social Science version 12) in the year 2012. Results were considered statistically significant when p value was <0.05. Results According to the study, 56.6% of cases and 63.3% of controls were in the ‘6 to 12 months’ age group and about two-third of the participants in both cases 20 (66.7%) and controls 39 (65.0%) were males.Strong association was found with ‘bottle feeding’ RR=2.2556; 95% CI: 1.259, ‘presence of blood/mucus’ RR=2.5038; 95% CI: 1.4129, ‘WAZ≤ 2)’ RR=2.8867; 95% CI: 1.7202 and ‘early complementary feeding [RR=4.67; 95% CI: 2.5017-8.7175 and OR=7.8858; 95% CI: 3.6791-16.9 Conclusion In the present studyfour factors showed some association with persistent diarrhoea, namely: ‘use of animal milk’; ‘antibiotic use during acute diarrhoea’; ‘history of diarrhoea in previous 3 months’ and ‘pre-lacteal feed’. Strong association was found with ‘bottle feeding practices’ ‘presence of blood &/or mucus in stool’, WAZ <-2 and ‘early complementary feeding

Long Non-Coding RNAs Emerging as Potential Epigenetic Biomarkers for Tobacco and/or Alcohol-Induced Head and Neck Cancer

Aug 2019 DOI 10.14302/issn.2572-3030.jcgb-19-2973

Head and Neck cancer (HNC) is one of the most prevalent and lethal cancer globally. The incidence of tobacco-induced HNC is gradually increasing in low and middle income countries. Among the various causative factors associated with HNCs, tobacco and alcohol play synergistic effect and are frequently associated with the risk of HNC. Tobacco-induced HNCs show distinct genetic and epigenetic alterations leading to different clinical outcomes in comparison to HPV-infected HNCs. Tobacco-induced HNCs are often associated with tumor aggressiveness, poor prognosis and low or nil prevalence of HPV infection. Apart from carcinogenic effects of these causative factors (use of tobacco products, alcohol intake and HPV or EBV infections), recent studies show that exposure to these factors alter/disrupt the regulation of non-coding RNAs including the long non-coding RNAs (lncRNAs). Altered lncRNA regulation is brought about by signalling networks that regulate cellular differentiation, apoptosis, angiogenesis and inflammatory pathways which play key functions in the genesis of different cancers including HNCs. There are numbers of studies supporting the emerging role of lncRNAs in development of HNC; however, reports connecting lncRNAs expression and addiction habits in HNC are still preliminary and sparse. Therefore, identification and characterization of lncRNAs that are differentially expressed upon exposure to risk-factors can serve as unique therapeutic targets and potential biomarker(s) for effective treatment of HNC subtypes. In this short review, we briefly reviewed the emerging role of lncRNAs in tobacco and alcohol induced HNCs.

Assessment of Anticancer Effect of Alendronate in Breast Cancer: An In vitro Study

Aug 2019 DOI 10.14302/issn.2576-6694.jbbs-19-2953

Breast cancer has high incidence in women from both developed and developing countries. Approximately 2 million women are diagnosed with breast cancer in 2018. In Asia, unfortunately Pakistan leads the highest number of breast cancer patients. Various treatment strategies are present but they are not well developed. There is a great need to develop effective methods for early detection and treatment of the disease. For cancer treatment chemotherapeutic interventions have always been a method of choice. One of the mechanisms involved in cancerous cell proliferation is Mevalonate (MVA) pathway. It is hypothesized that arresting MVA pathway leads to cell death hence cancer cell growth is suppressed. Various inhibitors of MVA pathway have been studied that can suppress cell proliferation. Nitrogen containing bisphosphonates are MVA pathway inhibitor and clinically used for treatment of bone diseases. Their anticancer efficacy is also reported. Current study focuses on alendronate, a nitrogen containing bisphosphonate to examine their anticancer effect on breast cancer cell line. Results of this study may help in addition of new anticancer drug for breast cancer.

Characterization of rpoB Gene Mutations Associated with Rifampicin Resistance in Multidrug Resistant Tuberculosis Patients Co-infected with HIV from Southern India.

Jul 2019

Co-infection of HIV with Mycobacterium tuberculosis is a common event, particularly in developing countries. The emergence and spread of multidrug resistant tuberculosis (MDR-TB) is an increasing public problem in India. The drug-resistant M. tuberculosis strains are posing a significant challenge to TB control. This study used PCR to characterize mutations inside the rifampicin resistance-determining region (RRDR) of the rpoB gene in the rifampicin-resistant M. tuberculosis co-infected with HIV. All the rifampicin-resistant strains had missense mutations. Sequence analysis detected a single or multiple hotspot mutations in the RRDR region of the rpoB gene at codons 516, 512 and 531, in most strains. Furthermore, mutations also occur at codons 512, 514, 517 and 526. The results suggest that hotspot mutations in the rpoB gene are not the sole contributors to MDR-TB co-infected with HIV.

Outcome Assessment of Open Foot Injuries in A Teaching Hospital in Ghana

Jun 2019 DOI 10.14302/issn.2474-3585.jpmc-19-2750

Purpose Foot injuries are common in low- and middle-income countries and continue to increase in incidence due to the surge in the use of motorcycles as means of transport.Yet, there is scanty data on the incidence and outcomes of treatment of open injuries to the foot in the developing world.We aimed to determine the incidence and functional outcomes of open foot injuries that are treated in a teaching hospital in Ghana. Methods We used a structured questionnaire to record the type of open foot injury, the mechanism of injury, any concomitant injuries, the time interval between injury and arrival at the hospital for treatment as well as the type of treatment instituted. Recruited patients were followed up for six months, complications resulting from the injury or its treatment were recorded for each patient. The function of the foot after healing of the injury was measured using a questionnaire-based visual analogue outcome scale of the American Foot and Ankle Society. Regression and chi-square analysis were used to evaluate potential associations. Results Over a four-month period, a total of 81 cases of open injuries to the foot were recorded. Out of this figure, 55 patients (67.9%) were males and 26 (32.1%) were females. It was found, that 66.7% aged between 19 and 49 years, 76.5% of the injuries occurred on the road and 29.7% was motor cycle related. Pedestrians are the most afflicted (61.7%). The treatment outcomes of traumatic amputations, open phalangeal fractures, dorsal skin degloving and lacerations were good. Gustillo-Anderson grade IIIB open fractures with associated plantar skin degloving had the worst outcomes with residual pain on weight bearing, bigger foot, inability to wear previous shoes and inability to tiptoe on the affected foot. Conclusions Open injuries to the foot are common in Ghana and exert a significant health burden, particularly on active young males. Long term disability may occur, even after adequate treatment of open fractures involving the foot.

Docking Studies of HIV-1 Reverse Transcriptase and HIV-1 Protease with Phytocompounds of Carissa Carandas L.

May 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2847

Background Carissa carandas L. is a well-known wild fruit plant distributed through-out the India and also present in other countries. The fruits are rich in nutrients and minerals. A number of medicinally important phytochemicals such as carrisone, carindone, carandinol, lupeol, scopoletin, stigmasterol, β-sitosterol, myo-inositol, β-amyrin, Des-n-methylnoracronycine etc. have been reported from the extract of this plant. Being safe and cost effective molecules, the activity of phytochemicals against HIV-1 enzymes needs to be screened. Objective The aim of this study was to screen the potent phytocompound of C. carandas against human immunodeficiency virus-1 using docking method. Methods Total nine compounds viz. carandinol, caridone, carrisone, lupeol, p-coumaric acid, gallic acid, rutin, scopoletin and ursolic acid were used for in-silico study towards drug development against human immunodeficiency virus-1 reverse transcriptase (HIV-1RT; PDB ID: 1REV) and human immunodeficiency virus-1 protease (PDB ID:1EBY) using Autodock software. Results The qualitative characterization of the extracts showed the presence of a number of phytochemicals such as phenolics, flavonoids, alkaloids, terepnoids, terpenes, steroids, glycosides etc. Carandinol was observed as most effective anti-HIV-1 molecule having lowest binding energy and small inhibition coefficient. Another compound, p-coumaric acid, showed least effectiveness against human immunodeficiency virus- 1 reverse transcriptase or human immunodeficiency virus-1 protease showing highest binding energy and inhibition coefficients among all the evaluated phytocompounds. Conclusion The in-silico study demonstrated that some phytoconstituents of C. carandas exhibit potential anti-human immunodeficiency virus -1 activity and hence can be optimized to develop as a drug candidate in future.

Surgical Site Infection in Cesarean Section Operation: Risk and Management

May 2019 DOI 10.14302/issn.2690-4837.ijip-19-2842

Cesarean sections (CS) are one of the most commonly performed surgical procedures worldwide. There is great variability in the percentage of cesarean sections between countries, varying from 3% to 42.9%5. In the US, approximately 32% of deliveries occur through a cesarean section. Overall, a drastic increase in cesarean section rate has been reported reaching its highest level at the present time. In Brazil, considering the types of births by live births from 2006 to 2016, the national percentage of cesarean section was 52.37%. The variability in this percentage can still be perceived within Brazilian territory. The highest cesarean rate occurred in the Southern region, representing 58.33% of births, while the lowest rate occurred in the Northern region, with 41.79%. It is possible to see the steady increase in the percentage of CS over time, from 45.01% in 2006 to 55.39% in 2016.

International Comparison of Children’s Knowledge, Barriers and Reported Fluid Intake Across the School Day.

Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-904

Background To date, no research has explicitly examined children’s knowledge and consumption of fluids at school, particularly during times of exercise (physical education (PE)). Methods Between May and July, 2018, 322 (213 females, 104 males; mean age = 8 years 5 months, SD ± 2 years 1 month) elementary school children from Ireland (n=237) and England (n=85) completed a questionnaire on their understanding of fluid intake and how much they perceived they drank on days when they did/did not participate in PE. Results Younger (<9 years) English children were most thirsty at the end of the school (68%), compared to younger and older (≥9 years) Irish children who were most thirsty after (38% <9 years; 39% ≥9 years) or during (21% < 9 years; 21% ≥9 years) PE. In both countries for <9 year olds, similar amounts were consumed on days when they did, and did not, partake in PE with 41% of all participants reporting intakes below daily guidelines. No child, of any age, was correct at predicting what their fluid intake should be on days when they took part in PE. Conclusion Young children in England and Ireland do not understand fluid recommendations, especially the increased need for fluid on days when they partake in PE. Further objective research is needed to ascertain whether actual fluid intake in children matches perceived intakes and whether the structure of the school day, and intensity levels of PE lessons, influence these intakes. Additional research needs to gauge the importance of the teacher and how they are a key influencer in supporting children in their learning of how, why and when to drink.  

The Agronomy of Mauka (Mirabilis expansa (Ruíz & Pav.) Standl.) - A Review

Feb 2019 DOI 10.14302/issn.2641-9467.jgrc-19-2619

The Andean region is the centre of origin and domestication of at least 9 species of native root and tuber crops in addition to several species of native potatoes. Within this group, Mauka – also known as Miso or Taso ‒ (Mirabilis expansa Ruíz & Pav.) Standl. ‒ Nyctaginaceae) is one of the least well known, despite having much potential. It is cultivated at high altitudes (2300 to 3500 m a.s.l.) in Ecuador, Peru and Bolivia and is thought to be of pre-Inca origin. Mauka is characterized by its high nutritional value due to substantial levels of protein, calcium and phosphorus, as well as secondary metabolites with nutraceutical properties of varied application. It also has good potential as a forage plant. Based on ethnobotanical knowledge and scientific investigations, this review presents advances in the agronomic understanding of Mauka since its discovery five decades ago in several isolated rural Bolivian communities. The information presented covers both Andean and non-Andean countries. It includes results from journals on natural resources, botany, agronomy, and the congress minutes from botanical, agronomic and phytogenetic resources conferences. Theses on Mauka specifically and on phytogenetic resources in general were also reviewed. Books and manuals were reviewed in the libraries of the International Potato Center, INIAP-Ecuador, INIA-Peru and universities. The plant is described with emphasis on its agronomic traits and according to its propagation forms (seed or vegetative); in terms of its agroecology, phenology, growth dynamics and their indices, crop management, harvest and post-harvest processes. It is concluded that important advances in the understanding of the agronomy of Mauka have been accomplished. Furthermore, the review highlights aspects requiring further research, in order to develop improved production technologies to ensure its future use and conservation.

Ophthalmic Science Open Access

Accessibility and Barriers to Uptake of Ophthalmic Services among Rural Communities in the Upper Denkyira West District, Ghana

Jan 2019 DOI 10.14302/issn.2470-0436.jos-19-2602

Vision impairment and blindness remain a challenge in developing countries, especially in rural communities. Notwithstanding, VISION 2020 global initiative seeks to eliminate avoidable blindness by 2020. This community-based cross-sectional study aimed at determining the accessibility of ophthalmic services and barriers to its utilization in rural communities in the Upper Denkyira West District, Ghana. One-hundred and seventy participants from 5 randomly chosen rural communities in the district were included. Participants were interviewed using a structured questionnaire. Socio-demographic information, information regarding accessibility, utilization, and barriers to eye care services were obtained. Descriptive statistics were carried out using SPSS version 23. The Chi-squared test was employed to determine associations. P-values less than 0.05 at a confidence interval of 95% were considered significant. Only 21.8% of participants had had eye examination within the past 3 years, with over half of the examinations undertaken at screening grounds and health centres. Significant associations were found between ophthalmic services utilization and increasing age (p = 0.004), female gender (p = 0.027) and those who had a past history of eye problem(s) (p = 0.0010. The study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Public health education and eye care interventions should prioritize and target rural populations. Key Messages This study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Rural dwellers were thus compelled to resort to harmful eye care practices. Public health education and eye care interventions should prioritize and target rural populations

Evaluation of Serum Vitamin D Levels in Foster's Children Care Center

Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456

Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.

Knowledge, Attitude and Practice of Healthcare Workers Towards Availability of Antiretroviral Pre-Exposure Prohylaxis in Nigeria

Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333

Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral

Prevalence of Diarrhea and Associated Factors among Under Five Years Children in Harena Buluk Woreda Oromia Region, South East Ethiopia, 2018

Dec 2018 DOI 10.14302/issn.2641-4538.jphi-18-2470

Background: Acute diarrheal diseases are the leading cause of preventable childhood death, especially in developing countries. It is the second leading cause of death in under-five year children nest to pneumonia. Objectives: The aim of this study was to determine the magnitude and associated factors of diarrhea in under-five in Harena Buluk district. Methods: A community based Cross sectional study was conducted in February, 2018. A two stage stratified sampling method was done to select the eligible households. Data was collected by trained data collectors using pretested questionnaire list which was prepared based on EDHS and WHO core questionnaires related to diarrhea. Data was entered in to a computer using Epi data 3.1 and exported to SPSS V.20 for further analysis. Logistic regression was used to determine level of association with 95% CI. A p-value <0.05 in the final model were considered as significant. Result: The two weeks period magnitude of diarrhea among under-five children was 28.4% with 95% CI (14.5-20.8) which was associated with households with one under five children (AOR: 0.268, 95% CI(.08,0.90)), living in the home with single room ((AOR = 6.01, 95% CI(1.01,36.01)), clean latrine/faces not seen around the pit or on the floor of latrine(AOR: 0.298, 95% CI(0.097,0.92)), long time take to fetch water from source (AOR: 0.046,95%CI(0.01,0.22)), home based water treatment ((AOR = 0.15, 95% CI: (0.04, 0.62)), living with animal in the same house(AOR: 8.31, 95% CI(2.46,28.06)), children who took gruel type of food(AOR: 0.24, 95% CI(0.07,0.81)), hand washing practice before cooking food (AOR: 0.195(0.066, 0.574)). Conclusion: The two weeks period magnitude of acute under-five diarrhea was relatively high and number of under five children in the household, cleanness latrine, time taking from the source of water, home based water treatment, number of rooms in the home, live with animal in the same house, type of food child take, hand washing before food preparation had significant association with the occurrence of under-five diarrhea. Improve community about home and environmental sanitation and hand practices were recommended.

Clinical Evaluation of Significance of 25(Oh)D Levels in Patients with Organophosphorus Poisoning

Oct 2018 DOI 10.14302/issn.2379-7835.ijn-18-2228

Introduction: Organophosphate (OP) pesticide poisoning is a major challenging public-health problem in developing countries. Vitamin D deficiency is pandemic, yet it is the most under-diagnosed and under-treated nutritional deficiency in the world and it has been reported to be clinically correlated with psychiatric illness and manifestation of severe systemic inflammatory response syndrome like ARDS. Thus vitamin D deficiency may affect clinical course and outcome in cases of OPP. Aim: To evaluate status of 25 hydroxyvitamin D (25(OH)D) level in OP poisoning and its correlation with outcome of such patients. Materials and Methods: Serum 25(OH)D levels were measured at the time of hospitalization by electro-chemiluminescent Assay in 96 patients (76 male and 20 female) suffering from OP poisoning. Diagnosis of OP poisoning was made by history of poisoning including container of the poison brought by patient’s relative, clinical examination and measurement of serum butyrylcholinesterase activity. All patients were evaluated as per Performa and follow up till discharge. Results: Mean level of 25(OH)D in our cases was 24.57±9.91ng/ml and 66.7% had low levels of 25(OH)D. Our study shows linear relationship between 25(OH)D level and duration of hospital stay. All cases of OP poisoning who developed severe manifestations like ARDS, Intermediate syndrome (IMS) were having significant 25(OH)D deficiency. Our study also shows lower levels of 25(OH)D were associated with poor outcome (11.27±3.21vs 27.02±8.54, p<0.001). Conclusion: Vitamin D deficiency in OP poisoning is associated with longer hospital stay, more requirement of ventilator support and high prevalence of complication (ARDS and IMS) and poor outcome. Awareness of 25(OH)D level in patients with OP poisoning may be important to improve outcome.

HIV Status in Sero-Discordant Couples: Prevalence and Pattern among Pregnant Women in Plateau State, Nigeria

Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2263

Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.  

HIV Status in Sero-Discordant Couples: Prevalence and Pattern among Pregnant Women in Plateau State, Nigeria

Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2236

Nigeria is one of the high-burden countries in sub-Saharan Africa for HIV/AIDS and contributes to reproductive health morbidities and mortalities. This study was aimed at determining the prevalence of HIV-discordant rate among pregnant women in Plateau state Nigeria. The study sought to determine the prevalence and trend of HIV sero-discordance among pregnant women in Plateau state, Nigeria. The study was a 5-year descriptive analysis of HIV sero-discordance among pregnant women accessing prenatal care and their partners in Plateau state, Nigeria based on data generated between January 2012 and December 2016. The data was disaggregated by year, HIV concordant negative, HIV concordant positive, and HIV sero-discordant prevalence in the software and analysis were done using excel to obtained the proportions and trend of HIV sero-discordant prevalence among the antenatal population. Out of a total of 7,851 partners of pregnant women studied, 969 (16.3%) were HIV sero-discordant, 5,795 (73.8%) were HIV concordant negative, and 773 (9.9%) were HIV concordant positive. HIV sero-discordant positive males accounted for 12.3% while females were 4.0%. The prevalence of HIV sero-discordance was low with a high proportion of HIV positive male partners in Plateau state with grave public health implications for new HIV infections among partners and eroding the gains made in the Prevention of mother-to-child transmission of HIV.  

Psychosocial Determinants of Marijuana Utilization among Selected Junior High School Students in the Central Region of Ghana

Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2223

Marijuana utilization among school aged adolescents is major public and mental health concern in Ghana and other developing countries, with the rate of usage soaring high among school going adolescents. The objective of this study was to investigate the prevalence of marijuana utilization among selected Junior High School (JHS) students in the Central Region of Ghana and explore the relative impact of psychosocial factors accounting for its usage. Using a descriptive cross-sectional survey design with the Global School Based Survey GSHS questionnaire, a sample of 1400 school going adolescents students were drawn using multistage sampling procedure. Frequencies, percentages and binary logistic regression results indicated marijuana utilization prevalence of 9% (n = 122). Statistically, gender (OR = 0.52, 95% CI= 0.35 - .765, p = 0.001), religious affiliation (OR = 1.76, 95% CI = 1.0 - 2.95, p = 0.034), socioeconomic background (OR = 0.52, 95% CI = 0.33 - 1.23, p = 0.004) and geographical location (OR = 0.53, 95% CI = 0.31 - .886, p = 0.016) significantly predicted marijuana utilization among school aged adolescents. No statistically significant variations were found in the odds of students’ marijuana usage for age (OR = 1.15, 95% CI = 0.69 - 1.88, p = 0.590), parental communication (OR = 0.83, 95% CI = 0.56 - 1.23, p = 0.348) and academic performance (OR = 1.09, 95% CI = 0.66 -1.80, p = 0.744). Findings suggest that school based research should reflect and perhaps replicate existing prevalence, patterns of marijuana and other drug use through multiple school surveys nationwide. This pathway may provide useful information towards the design, evaluation and implementation of drug prevention cognitive-behavioural interventions and the development of stringent drug regulative standards.  

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