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1.	Afutendem, Nkemngu Blake, et al. (författare) Assessing implementation modalities of mhealth intervention on pregnant women in Dschang health district, west region of Cameroon 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. Methods: this was a cross sectional descriptive study in the Dschang health district, west region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. Results: majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced.Out of the 335 women that declared wanting anmHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmedusing telephone services. Conclusion: this study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.
2.	Agyemang, Joyce, et al. (författare) Contraceptive use and associated factors among sexually active female adolescents in Atwima Kwanwoma District, Ashanti region-Ghana 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 32:182 Tidskriftsartikel (refereegranskat)abstract Abstract Introduction: unintended pregnancies and adolescent childbearing are on the increase in Sub-Saharan Africa. In Ghana, 14% of adolescents aged 15-19 are already mothers or pregnant with their first child. Most of these pregnancies are associated with poor outcomes such as miscarriages, stillbirths, unsafe abortions and other complications that might result in infant or mortality. In addition, sexually-active adolescents (16-19 years) are at higher risk of contracting STIs. Evidence suggest that contraceptive use help reduce fertility rate and adolescent reproductive health. This study therefore sought to understand the magnitude and associated factors that influence female adolescents' use of contraceptive in the Atwima Kwanwoma District, Ghana. Methods: a descriptive and analytic cross-sectional study design was used for this study. Using a structured questionnaire, data were collected from randomly sampled 200 sexually active female adolescents; aged 16-19 for a three month period; June to September 2017. The questionnaire elicited data on the socio-demographic characteristics of respondents, their knowledge and perception, use of contraceptives and factors influencing their contraceptive use. Data were analyzed using STATA version 12.1 software. Results: ninety-five percent of the respondents exhibited some knowledge about contraceptives, but this high knowledge did not translate into its use as the prevalence rate was 18%. Condom was the most widely used contraceptive (33%) and perceived side effects of contraceptives was found to be the main reason for not using the contraceptives (53.66%). Marital status and the participants who were staying with both parents were found to be associated with contraceptive use with their p-values of 0.023 and 0.002 respectively. Conclusion: considering the fact that contraceptive knowledge does not necessarily translate into use, further studies (qualitative), are needed to understand why high knowledge levels are not associated with high usage patterns.
3.	Akateh, Derek, et al. (författare) Modern family planning use among people living with HIV/AIDS: a facility based study in Ethiopia 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: despite increasing efforts to address the reproductive health needs of persons living with Human Immuno-Deficiency Virus (HIV), a high unmet need for contraception exists among HIV+ women in sub-Saharan Africa. Currently, Ethiopia promotes integration of family planning (FP) services in to HIV chronic care. Yet the contraceptive prevalence rate among clients remains low. The objective of the study was to assess the role of socio-cultural factors on modern family planning use among HIV+ clients attending Anti-Retroviral Therapy clinics in Addis Ababa sub-cities. Methods: the study involved a facility based cross sectional survey. The ten sub cities were initially categorized/stratified into 5 based on direction (East, West, South, North and Central) and from each category one sub city was randomly selected. The total sample size was proportionally allocated to the selected health facilities according to previous monthly average client load per health center. Participants were selected using simple random sampling technique during their routine visit at the health centers. Data were collected through a semi-structured interviewer administered questionnaire. Both descriptive and inferential statistics were generated and results considered significant at 95% confidence level using STATA version 14.0. Results: six hundred and thirty-six clients participated in the study. Majority of them were age between 30-39 years. Though majority, 607 (95.4%) participants approved the use of modern FP method, current use rate stood at 39%. Condom was the most (14.5%) commonly used single method. The odds of FP use by participants who disclosed their HIV status were almost twice that of their counterparts (AOR= 1.84; 95% CI: 1.14, 2.95). Participants who held discussion with their spouse/partners concerning FP, irrespective of the frequency had an odd of more than four when using FP than their counterparts (AO= 4.35; 95% CI: 2.69, 7.04). Conclusion: this study revealed that 6 out of every 10 HIV+ clients are not currently using FP methods. Disclosure of HIV status as well as open discussion with spouse/partner were positively associated with family planning use. These study findings call for comprehensive and client focus FP education and counseling in line with disclosure of HIV status and dialogue with spouse/partner in order to increase uptake and utilization of FP among clients. Partners have a great influence on the use and choice of FP methods, so their views are paramount.
4.	Anu, Nkengafac Boris, et al. (författare) Prevalence of stillbirth at the Buea Regional Hospital, Fako Division south-west region, Cameroon 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: the study investigated the prevalence of stillbirth at the Buea Regional Hospital, by taking cases of pregnant women who attended antenatal clinic(s) and those who did not attend but had thier deiveries at the Buea regional hospital. The study specifically estimated the prevalence of stillbirths; identified possible risk factors associated with stillbirths, and determined whether the number of antenatal clinic visits is related to the occurrence of stillbirths-because during antenatal clinic visits, pregnant women are educated on risk factors of stillbirths such as: preterm deliveries; sex of the stillbirth; history of stillbirth; history of abortion(s); what age group of mothers are more likely to have a stillbirth. Methods: the study was a hospital based retrospective study at the maternity in which there were 3577 deliveries registered at the Buea Regional Hospital dated May 1st, 2014 to April 30th, 2017. With the aid of a checklist data was collected, analysed and presented with the use of tables, pie-charts and bar charts. Results: the prevalence of stillbirths was 26‰; possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; sex of stilbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendence) had more stillbirths. Conclusion: the study estabished that stillbirths can occur in any woman of child-bearing age. possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; gender of stilbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendence) had more stillbirths.
5.	Atuhaire, C., et al. (författare) Factors associated with postpartum depression among adolescents in Uganda 2018 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 30 Tidskriftsartikel (refereegranskat)abstract Postpartum depression (PPD) is a common and disabling public health complication of the postpartum period in women. It is believed to occur three times more commonly in developing countries than in the developed world and is more prevalent among women in the first six weeks after birth. Research suggests that postpartum depression is more commonly diagnosed among adolescents and may be a risk factor for poor growth and development in children born to these mothers. Therefore, adolescents are a special age group that requires specific health care maternal interventions in order to detect and treat post-partum depression.
6.	Atuhaire, Catherine, et al. (författare) Knowledge and practice of testicular self-examination among secondary students at Ntare School in Mbarara District, South western Uganda 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: Testicular self-examination (TSE) is a screening technique that involves inspection of the appearance and palpation of the testes to detect any changes from the normal. Globally, the incidence of cancer has increased among which is testicular cancer (TC). Data on this topic among male secondary school adolescents in Uganda is limited therefore this study sought to assess the knowledge and practice of testicular self-examination among secondary students at Ntare School, Mbarara District in south western Uganda. The objective of the study is to assess the knowledge and practice of testicular self-examination among secondary students at Ntare School in Mbarara district, south western Uganda. Methods: we conducted a descriptive cross-sectional quantitative study among 165 students. Recruitment was made using simple random sampling technique. Respondents were selected among advanced level (A’ level) male students studying at Ntare School in Mbarara district, south western Uganda. Structured self-administered questionnaires was used for data collection. Results: of the male students, 41.8% reported to have knowledge about TSE and only 23.6% practiced TSE. Most students rated their knowledge of TSE to be below 5 (from 1-10). Of the 39 students who admitted performing TSE, only 16 did so as recommended (monthly). Conclusion: the knowledge and practice of TSE were low among adolescent secondary school boys in Ntare School in Mbarara District, south western Uganda. This suggests that these students are unaware of the value of this personal health promotion tool which is fundamental in early diagnosis of testicular cancer.
7.	Atuhaire, C., et al. (författare) The magnitude of postpartum depression among mothers in Africa: a literature review 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 37 Tidskriftsartikel (refereegranskat)abstract Introduction: postpartum depression (PPD) continues to become one of the major maternal health challenges across the globe but there is a paucity of recent data on its magnitude in Africa. This study was motivated by the need to update the current magnitude of PPD in Africa based on various assessment tools. Methods: a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Results: a total of 21 articles met the study criteria. Fifteen articles used the EPDS and six used other assessment tools. Postpartum depression among studies that used EPDS tool ranged from 6.9% in Morocco to 43% in Uganda and 6.1% in Uganda to 44% in Burkina Faso among studies that used other depression assessment tools. Sensitivity and specificity results of the EPDS ranged from 75%-100% and 87%-98% respectively. Conclusion: despite the limited dearth of literature, the magnitude of PPD in Africa remains high which suggests that PPD is still a neglected illness and calls for immediate interventions. EPDS is an effective tool with high sensitivity and specify in varying study contexts.
8.	Atwine, Fortunate, et al. (författare) Health-care seeking behaviour and the use of traditional medicine among persons with type 2 diabetes in south-western Uganda : a study of focus group interviews 2015 Ingår i: Pan African Medical Journal. - Kampala, Uganda : Pan African Medical Journal. - 1937-8688. ; 20, s. 1-13 Tidskriftsartikel (refereegranskat)abstract Introduction: Health-care seeking behaviour is important as it determines acceptance of health care and outcomes of chronic conditions but it has been investigated to a limited extent among persons with diabetes in developing countries. The aim of the study was to explore health-care seeking behaviour among persons with type 2 diabetes to understand reasons for using therapies offered by traditional healers.Methods: Descriptive study using focus-group interviews. Three purposive focus-groups were conducted in 2011 of 10 women and 7 men aged 39–72 years in Uganda. Data were collected through semi-structured interviews and qualitatively analysed according to a method described for focus-groups.Results: Reasons for seeking help from traditional healers were symptoms related to diabetes such as polydipsia, fatigue and decreased sensitivity in lower limbs. Failure of effect from western medicine was also reported. Treatment was described to be unknown extracts, of locally made products taken as herbs or food, and participants had sought help from different health facilities with the help of relatives and friends.Conclusion: The pattern of seeking care was inconsistent, with a switch between different health care providers under the influence of the popular and folk sectors. Despite beliefs in using different healthcare providers seeking complementary and alternative medicine, participants still experienced many physical health problems related to diabetes complications. Health professionals need to be aware of the risk of switches between different health care providers, and develop strategies to initiate health promotion interventions to include in the care actors of significance to the patient from the popular, folk and professional sectors, to maintain continuity of effective diabetes care. © Katarina Hjelm et al.
9.	Atwine, Fortunate, et al. (författare) Health professionals' knowledge and attitudes to healthcare-seeking practices and complementary alternative medicine usage in Ugandans with diabetes : a cross-sectional survey 2017 Ingår i: Pan African Medical Journal. - : AFRICAN FIELD EPIDEMIOLOGY NETWORK-AFENET. - 1937-8688. ; 28 Tidskriftsartikel (refereegranskat)abstract Introduction: Healthcare-seeking behaviour among persons with diabetes has been investigated to a limited extent, and not from professionals' perspective. The aim of the study was to describe healthcare professionals' knowledge, attitudes and practice concerning healthcare-seeking behaviour and the use of complementary and alternative medicine among persons with diabetes. Methods: A cross-sectional, self-administered questionnaire was conducted in western Uganda. Nurses, midwives or nurse assistants 72.2%, physicians 12% and clinical officers 10% volunteered to participate in the study with a total 108 (93% response rate) response rate. Descriptive statistics were used to analyse data with frequencies, percentages and summarized in tables. Results: Most of the healthcare providers perceived more uneducated people to be at risk of developing complications related to diabetes (66.7%) and that most of the patients with diabetes were not knowledgeable about signs and symptoms of diabetes before being diagnosed (75.9%). The main reasons inducing persons with diabetes to seek care outside the health care sector were reported to be seeking a cure for the condition, influence from the popular sector, the accessibility of the place and signs of complications of diabetes related to poor glycaemic control. Healthcare providers had relatively positive attitudes towards using complementary and alternative medicine. Conclusion: Insufficient knowledge about diabetes, compromised healthcare-seeking practices including drug procurement for diabetes seem to be barriers to diabetes management. Patients were thus reported to be burdened with co-morbidities of complications of diabetes related to poor glycaemic control.
10.	Bashir, Muwada Bashir Awad, et al. (författare) Predictors and correlates of examination anxiety and depression among high school students taking the Sudanese national board examination in Khartoum state, Sudan: a cross-sectional study 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: test anxiety and depression are of the major challenges experienced in students' life, considering the inverse associations they have on their mental wellbeing and academic performance. Evidence from Sudan have reported high figures of adolescent's mental health problems of depression and anxiety. However, studies investigating its association with academic exam stress are lacking. We investigated the prevalence of exam anxiety and depression severity among student setting for Sudan national boarding examination, aiming at identifying possible predictors related to student's socio-demographic and academic status and measuring correlation between exam anxiety and depression severity status among students. Methods: using cross-sectional design, data obtained using standardized west side anxiety scale for measuring test anxiety; and patient's health questionnaire (PHQ9) of nine items for measuring depression was presented in percentages. Association with sociodemographic and academic factors was measured using logisticregression models. Analysis was run at 0.05 level of significance. Results: depression and exam anxiety were found to be highly correlated. The highest fractions of students are those with high levels of test anxiety and moderate to severe depression. Gender, maternal level of education, previous exam experience and academic performance are significant predictor for student's exam anxiety status. Conclusion: high figures of exam anxiety and depression are there among Sudanese students setting for their third years boarding exam. Males, low academic performance and maternal low education are risk factors. school mental health services and programs addressing such group of students are highly demanded in line with more elaborative research efforts in this arena.
11.	Bashir, Muwada Bashir Awad, et al. (författare) Stigma on epileptic patients attending the outpatient clinic of Soba University Hospital and the National Center for Neurological Science (NCNS) Khartoum, Sudan 2019 Ingår i: The Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 32 Tidskriftsartikel (refereegranskat)abstract Introduction: epilepsy is one of the most prevalent neurological conditions for people of different age group, race, gender and socio-economic status in various nations, affecting 50 million people around the world; 80% of them living in developing countries. In Sudan, literature has well documented epilepsy stigma and it related elements of labelling, negative typecasting, isolation, devaluing and discrimination that are significantly affecting patients living standards and social life. This study focuses on understanding the prevailing, different types of stigma among people living with epilepsy (PWE) in Sudan and to determine its frequency in connection with demographic factors and patients coping ability of PWE. Methods: a health facility-based cross-sectional descriptive study was conducted on 270 people between the ages of 16-70years who are affected by epilepsy in an outpatient clinic. Standardized questionnaires were used to interview the patients with assistance gotten from their relative where necessary. The data is analyzed using SPSS version 20. The study was conducted in the outpatient clinic of The National Center for Neurological Sciences (NCNS), Ibrahim-Malik Teaching Hospital Sudan. Results: the study realized that 16.6% of the patient had a positive self-stigma score, half of them having coaching stigma and 25% courtesy stigma. One third of people with epilepsy had poor coping score that was strongly determined by self- stigma and courtesy stigma score. Conclusion: parents and relatives related sigma is a major problem facing people of epilepsy in Sudan; thus, raising such group awareness and education about the disease can markedly improve the quality of life of people with epilepsy in Sudan.
12.	Bashir, Muwada Bashir Awad, et al. (författare) The quality of life and inequalities in health services for epilepsy treatment among patience in the urban cities of Sudan 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Epilepsy in Sudan accounts for 1.6 annual mortality rates and 238.7 disability adjusted life years per 100 000. These figures are higher among females; children and young adults. It is associated with notable stigma and social burdens. Patients of epilepsy are subjected to various forms of social discrimination that affect their quality of life. They are isolated, neglected and deprived of their education and employments rights and not able to achieve normal social and family life. Aiming at highlighting social implications of epilepsy among Sudanese patients, this study found that social encumbrances due to epilepsy in Sudan are more prevalent among highly vulnerable groups like women, children and poor populations living in remote areas. Lack of trained medical personnel in neurology and the medical equipment's required for proper diagnosis and treatment of epilepsy in Sudan are key reasons aggravating social and health burden of epilepsy both among patients and their caregivers.
13.	Bede, F., et al. (författare) Dietary habits and nutritional status of medical school students: the case of three state universities in Cameroon 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 35 Tidskriftsartikel (refereegranskat)abstract Introduction: malnutrition is a major risk factor of cardiovascular and metabolic diseases and therefore the importance of good dietary practices and balanced diet cannot be overemphasized. University students tend to have poor eating practices which is related to nutritional status. The objective of our study was to assess the dietary practices of medical students, determine the prevalence of malnutrition among medical students and factors associated with malnutrition. Methods: we carried out a cross-sectional study from December 2013 to March 2014 involving 203 consenting students in the Faculty of Medicine and Biomedical Sciences of the University of Yaounde I, Faculties of Health Sciences of the Universities of Bamenda and Buea. A three-part questionnaire (socio-demographic profile, eating practices, and anthropometric parameters). Data was analysed using SPSS 18.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean +/- SD) were calculated for continuous variables. Fischer's exact test was used to compare the categorical variables. Statistical significance was set at p <= 0.05. Results: males constituted 44.3% of respondents. The mean age was 20.8 +/- 1.6yrs. Most students had a monthly allowance of less than 20 000frs (34 USD) and 59.1% lived alone. Most students (49.8%) reported taking two meals a day with breakfast being the most skipped meal while supper was the meal most consumed by students. Snacking was common among these students as 40.8% admitted consuming snacks daily. Daily intake of milk, fruits, vegetable and meat were low (6.2%, 4.3%, 20.0% and 21.3% respectively). The BMI status of students was associated with gender (p=0.026). Conclusion: our findings showed a high prevalence of malnutrition of 29.4% based on BMI (underweight 4.9%, overweight 21.6% and obesity 3.0%) among second year medical students of these three state universities. Irregular meals, meal skipping, low fruit, vegetable and milk consumption, high candy, fried foods and alcohol intakes were found to be poor eating practices frequent among these students. Our findings therefore suggest the need for coordinated efforts to promote healthy eating habits among medical students in general and female medical students in particular (and by extension youths in general) as a means of curbing malnutrition among youths.
14.	Benti Geleta, Buli, 1973-, et al. (författare) Misconceptions about Ebola seriously affect the prevention efforts : KAP related to Ebola prevention and treatment in Kouroussa Prefecture, Guinea 2015 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 22:11 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Introduction: Guinea is the third hardest hit country in the region with 2,806 cases and 1,814 deaths as of January 11, 2015 after Sierra Leone and Liberia respectively. This KAP study was conducted in three sub-prefectures of Kouroussa in the Kankan region of Guinea from 15 December 2014 to 15 January 2015. It was conducted with the general objective of examining the knowledge, attitude and practice related to Ebola prevention and care among the public of Kouroussa Prefecture. Methods: a cross-sectional study design was employed to collect quantitative data to examine knowledge, attitude and practice related to Ebola. Structured questionnaire was administered by trained data collectors who were supervised by doctors and epidemiologists from WHO and Africa Union. Data were collected from 358 individuals (93% response rate) and analyzed in STATA 13 while tables and graphs are used to display results. Results: over 96% of the respondents have ever heard about Ebola while only 76.2% believed the disease existed in Kouroussa. Avoiding physical contacts including hand shaking and contacts with body fluids, and early treatment of persons sick from Ebola were the two important prevention methods frequently mentioned (96.8% and 93.9%). Only 35.7% of respondents were found to have comprehensive knowledge about Ebola (composite of correctly accepting three methods of prevention (85%) and rejecting misconceptions (55.7%)). Conclusion: the high level of knowledge about modes of transmission and prevention methods has not positively affected the level of comprehensive knowledge about Ebola. In contrast, the prevailing high level of misconceptions surrounding Ebola was found to be responsible for a low comprehensive knowledge.
15.	Birindwa, Archippe M., et al. (författare) Decreased number of hospitalized children with severe acute lower respiratory infection after introduction of the pneumococcal conjugate vaccine in the Eastern Democratic Republic of the Congo. 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 37 Tidskriftsartikel (refereegranskat)abstract Introduction: acute lower respiratory infections (ALRI) are a leading killer of children under five worldwide including the Democratic Republic of the Congo (DR Congo). We aimed to determine the morbidity and case fatality rate due to ALRI before and after introduction of the 13-valent pneumococcal conjugate vaccine (PVC13) in DR Congo 2013. Methods: data were collected from medical records of children with a diagnosis of ALRI, aged from 2 to 59 months, treated at four hospitals in the eastern DR Congo. Two study periods were defined; from 2010 to 2012 (before introduction of PCV13) and from 2014 to 2015 (after PCV13 introduction). Results: out of 21,478 children admitted to the hospitals during 2010-2015, 2,007 were treated for ALRI. The case fatality rate among these children was 4.9%. Death was significantly and independently associated with malnutrition, severe ALRI, congenital disease and symptoms of fatigue. Among the ALRI hospitalised children severe ALRI decreased from 31% per year to 18% per year after vaccine introduction (p = 0.0002) while the fatality rate remained unchanged between the two study periods. Following introduction of PCV13, 63% of the children diagnosed with ALRI were treated with ampicillin combined with gentamicin while 33% received ceftriaxone and gentamicin. Conclusion: three years after PCV13 introduction in the Eastern part of the DR Congo, we found a reduced risk of severe ALRI among children below five years. Broad-spectrum antibiotics were frequently used for the treatment of ALRI in the absence of any microbiological diagnostic support.
16.	Bisahnyui, P., et al. (författare) Comparative study of clinical methods versus ultrasound methods for accurate gestational age determination in different trimesters of pregnancy, Ndop District Hospital, North West region, Cameroon 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 37 Tidskriftsartikel (refereegranskat)abstract Introduction: gestational age is the estimated age of gestation from a fetus during its development and this is very important for the mother who wants to know when to expect the birth of her baby and for the health care provider so they can chose the time at which to perform various assessment. However, from the information outlined in this research, it can be seen that last menstrual period (LMP) and follicle-stimulating hormone (FSH) are used to assess gestational age. While GSD, CRL, BPD, HC, AC and FL are biometric parameters that can be measured on a fetus in order to estimate gestational age. Many clinicians and ultrasonologists feel that if they are unable to obtain an accurate measurement at the time, they have sometimes failed to do an adequate job. Methods: the study was a comparative study on clinical method versus ultrasound method for accurate gestational age determination and also to determine the significance of fetal biometric parameter in GA determination. The study was an observational, cross sectional and participatory study for a period of 5 weeks from the 22nd of January to the 22nd of February 2018. A total of 72(74.2%) ANC cases were sampled during ultrasonography. Gestational ages from their clinic card were recorded. Twenty five questionnaires were given out to 25(26.8%) health care personnel to assess clinical method. Data was analyzed using SPSS version 16 plus and Microsoft Excel 2010. Results: results showed the best clinical method used was LMP with 9(36%) but when compared to ultrasound, ultrasound presented with greater accuracy of 15(60%) and clinical method 10(40%). Conclusion: based on the findings, it could be concluded that compared to the physical examination and clinical methods, ultrasound examination of the fetus provided the physician and health care professionals with greater accuracy for gestational age.
17.	Broström, Sander, et al. (författare) Transitioning from child to adult-oriented HIV clinical care for adolescents living with HIV in Ethiopia: results from a retrospective cohort study 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 37 Tidskriftsartikel (refereegranskat)abstract Introduction: Ethiopia has one of the largest number of adolescents living with HIV (ALHIV). As these adolescents reach adulthood they need to transfer from pediatric to adult-oriented clinics. Clear implementation guidelines for transition are lacking and factors associated with successful transition are inadequately investigated. Our objective was to describe the rate and age of transition from child- to adult-oriented care and the factors associated with transition success among ALHIV in selected health facilities in Ethiopia. Methods: a retrospective cohort study of adolescents was conducted in eight health facilities in two regions of Ethiopia: Addis Ababa and the Southern Nations, Nationalities and Peoples´ Region (SNNPR). The study was embedded within a broader study originally aimed at studying clinical outcomes of adolescents. The proportion of adolescents who transitioned was calculated and the association between baseline characteristics and transition was assessed by bivariate and multivariate analysis. Results: of 1072 adolescents, 8.7% transitioned to adult care. The most frequent age of transition was 15 (range: 10-22). Multivariate analysis generated two significant findings: adolescents from Addis Ababa were more to likely transitioned than adolescents from SNNPR (aOR: 2.18; 95% CI=1.17-4.06; p<0.01), as well as disclosed adolescents compared to those not disclosed of their HIV-status (aOR: 4.19; 95% CI=1.57-11.98; p<0.01). Conclusion: transition occurred in less than 10% of participants, in a wide range of age, indicating a lack of implementation policies regarding the transition process. Thereto, we found that adolescents from Addis Ababa and those disclosed of their disease, were more likely to transition. Further studies are needed to better understand factors associated with transition success.
18.	Buregyeya, E, et al. (författare) Motivations and concerns about adolescent tuberculosis vaccine trial participation in rural Uganda: a qualitative study 2015 Ingår i: The Pan African medical journal. - : Pan African Medical Journal. - 1937-8688. ; 22, s. 76- Tidskriftsartikel (refereegranskat)
19.	Chtaou, N, et al. (författare) Intravenous thrombolysis with rt-PA in stroke: experience of the moroccan stroke unit 2016 Ingår i: The Pan African medical journal. - : Pan African Medical Journal. - 1937-8688. ; 24, s. 207- Tidskriftsartikel (refereegranskat)
20.	Dakenyo, Rama Djouedjon, et al. (författare) Knowledge, attitudes and practices of women of childbearing age with regards to cervical cancer preventive measures in the MIFI health district, Cameroon : Connaissances, attitudes et pratiques des femmes en âge de procréer du District de Santé de la Mifi sur la prévention du cancer du col de l’utérus, Cameroun. 2018 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 31 Tidskriftsartikel (refereegranskat)abstract English abstract: Introduction: this study aims to describe knowledge, attitudes and practices of women of childbearing age with regards to cervical cancer preventive measures. Methods: we conducted a cross-sectional descriptive study among women of childbearing age. Data were collected using a face to face questionnaire and were analyzed using Epi Info 7.1.3.3 software calculating a confidence interval of 95%. Results: our study highligts that 78.11%(464/594) of women were aware of the existence of cervical cancer. However 58.59% and 60.27% of women were not aware of any risk factor and preventive measure respectively. Only 7% of these women were aware of the existence of vaccine. With regard to their attitude, 31.31% (186/594) of women had already wished for informations on cervical cancer preventive measures, 26.94% (160/594) had taken the initiative to undergo screening test and only 7.41% (44/594) had undergone screening test. Difficulty most commonly mentioned was the lack of information (69.82%) while the most commonly cited awareness-raising tools were the media (75.9%). Conclusion: despite the good knowledge on the existence of cervical cancer, the level of information about risk factors and preventive measures remains weak. Awareness program should be focused on risk factors, preventive measures and on the implementation of screening campaigns. These informations can be used to improve planning approach to prevention. Résumé Introduction: décrire les connaissances, les attitudes et les pratiques des femmes en âge de procréer sur la prévention du cancer du col de l'utérus. Méthodes: il s'est agi d'une étude transversale descriptive menée chez les femmes en âges de procréer. Les données ont été collectées face à face à l'aide d'un questionnaire. L'analyse a été faite par épi info version 7.1.3.3 avec un intervalle de confiance de 95%. Résultats: il ressort de notre étude que 78,11%(464/594) de femmes connaissaient l'existence du cancer du col de l'utérus. Mais 58,59% et 60,27% de femmes ne connaissaient aucun facteur de risque et moyen de prévention respectivement. Seulement 7% connaissent l'existence d'un vaccin. Concernant l'attitude, 31,31% (186/594) avaient déjà désiré les informations sur la prévention du cancer du col de l'utérus, 26,94% (160/594) ont eu l'initiative de faire le test de dépistage et seulement 7,41% (44/594) ont fait le dépistage. Les difficultés évoquées étaient principalement le manque d'information 69,82% et le moyen de sensibilisation le plus fréquemment cité était les medias 75,9%. Conclusion: malgré le bon niveau de connaissance sur l'existence du cancer du col de l'utérus, le niveau d'information sur les facteurs de risque et les moyens de prévention restent faibles. Le programme de sensibilisation devait être axé sur les facteurs de risque, les moyens de prévention et l'organisation des campagnes de dépistage. Ces informations peuvent permettre d'améliorer la planification des interventions de prévention.
21.	Diengou, N. H., et al. (författare) Factors associated with the uptake of intermittent preventive treatment of malaria in pregnancy in the Bamenda health districts, Cameroon 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 35 Tidskriftsartikel (refereegranskat)abstract Introduction: the World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malar ia between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. Methods: to reach our objectives, we carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the Bamenda Health District (BHD) from May to August 2014. All sites within the BHD were included. The participants were selected by simple random sampling. The principal research instrument was a structured and pre-tested questionnaire that was designed to capture socio-demographic data and data related to stage of pregnancy and knowledge about IPTp. Data was entered using Ms Excel and analysed using SPSS v20.0. Descriptive statistics (frequencies and percentages) was used to report findings. We used Chi-Square test to compare the categorical variables (Fischer's exact test was used in cases were conditions for Chi-Square test were not met). Results: uptake for at least one dose of IPTp was 95.3% (381/400) and 54.9% (209/400) had received all three doses, 15.5% (59/400) received only one dose and 4.8% (19/400) did not receive any of the doses of IPTp. Knowledge about IPTp was associated with an increase uptake of IPTp (P<0.001). All health care providers were knowledgeable about the importance and use of IPTp. However, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine) stock out and 84.62% practiced the policy of direct observed therapy. Conclusion: the uptake of the third dose of IPTp is poor in the Bamenda Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp. Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of therapy may improve on IPTp uptake during pregnancy.
22.	Ela, Maurice Ebode, et al. (författare) Association entre le paludisme et le faible poids de naissance à Yaoundé, Cameroun. : Association between malaria and low birth weight in Yaounde, Cameroon 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: Low birth weight (LBW) is an important predictor of newborn survival and development. Given its pathophysiology, malaria is presumed to be one of the risk factors for low birth weight. This study aims to determine the association between malaria in pregnant women (PW)and LBW (weight < 2500 g). Methods: we conducted a case-control analytical study based on the administration of a questionnaire and an observation chart. We calculated the crude odds ratio(OR) and the adjusted odds ratio to determine this association. Logistic regression was applied to recognize the variables which act as determinants of the issue underdiscussion. Results: this study involved 156 women (78 cases and 78 controls). The prevalence of LBW was 12.32% (105/852); 41.02% (64/156) of women had had malaria during pregnancy and 42.14% of parturients had received three doses of IPT (intermittent preventive treatment). A significant association between malaria and LBW emerged. Crude odds ratio= 3.75 [P= 0.0001 (p < 0.05)] and adjusted OR = 2.82 [P = 0.01 (p < 0.05)] were calculated taking into account the various confusion factors. Conclusion: malaria during pregnancy is a factor increasing the risk of LBW. Efforts should be made to improve IPT coverage and the use of long lasting impregnated mosquito nets in order to prevent malaria during pregnancy.
23.	Elhadi, Yasir Ahmed Mohammed, et al. (författare) The formidable task of fighting COVID-19 in Sudan 2020 Ingår i: Pan African Medical Journal. - 1937-8688. ; 35 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract Sudan is facing a formidable task of fighting COVID-19. The country is suddenly challenged by this health issue that will test its path towards peace, stability, and development. The fragile task of handling COVID-19 epidemic in Sudan is brought about by several factors such as the weak healthcare system and political conflicts, that have been intertwined with the recent regime. Even before the COVID-19 pandemic, there was already high unemployment, soaring inflation and lack of social protection and safety nets for its populace. The government has been trying its best to address the pandemic, however, much still needs to be done. Neglecting Sudan by the international community in terms of support towards containment of COVID- 19 has grievous implications for transition out of military dictatorship and efforts to curb the pandemic globally. As no country is safe if all is not safe. It is essential that Sudan should leverage on innovations, country-compatible measures, and other tailor-made strategies for effective responses.
24.	Elimian, KO, et al. (författare) Identifying and quantifying the factors associated with cholera-related death during the 2018 outbreak in Nigeria 2020 Ingår i: The Pan African medical journal. - 1937-8688. ; 37, s. 368- Tidskriftsartikel (refereegranskat)
25.	Elliver, Matilda, et al. (författare) Pregnancy in women diagnosed with hiv on antiretroviral therapy in ethiopia : A retrospective cohort study 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 37:101 Tidskriftsartikel (refereegranskat)abstract Introduction: due to increasing coverage of antiretroviral therapy (ART), more women living with HIV have improved health condition which also increases their chances of getting pregnant. However, the knowledge about pregnancy among women receiving ART in resource-constrained settings, like Ethiopia, is limited. The aim was to assess factors associated with pregnancy among women living with HIV in Ethiopia. Methods: a retrospective cohort study from 2005 through 2013 including a total of 809 women aged 15-49 years on ART was used. The study was conducted in eight hospitals and health centers in two regions of Ethiopia. The data was collected between March and June of 2014 from patients´ pre-ART and ART registers by trained nurses, assisted by data entry clerks and supervised by senior physicians. Kaplan-Meier survival analysis and Cox regression analysis were used to examine the probability of becoming pregnant. Factors associated with pregnancy were presented with hazard ratios with 95% Confidence Interval (CI). Results: a total of 809 women were included in this analysis, their median age was 27 years, 90% were urban residents and 40.6% were married. Four hundred eighty three (60.6%) were in WHO stage III at initiation of ART. The median CD4 count was 162.5 cell/μl at initiation of ART. Eighty-one women became pregnant during 3069 person-years of observation. The overall incidence of pregnancy was 26.4 pregnancies per 1000 person-years of observation. Women under the age of 24, those in less advanced disease stage, women with no education and those with college education had higher rates of pregnancy. Conclusion: the results highlight that younger women, those in less advanced disease stage, either uneducated or highly educated ones have higher probability of becoming pregnant during HIV treatment. This suggests the need for integrating reproductive health services into HIV care services to meet the needs of women on ART.
26.	Ernersson, Åsa, et al. (författare) Audit of essential knowledge of diabetes in patients with diabetes in Zimbabwe 2023 Ingår i: Pan African Medical Journal. - : AFRICAN FIELD EPIDEMIOLOGY NETWORK-AFENET. - 1937-8688. ; 45 Tidskriftsartikel (refereegranskat)abstract Introduction: in Zimbabwe, the organized diabetes education in the governmental health care system is limited, but the Diabetes Association has some educational activities in which persons with diabetes can participate. In this study, the purpose was to measure essential knowledge of diabetes and its management in persons with diabetes living in Zimbabwe.Methods: a cross-sectional descriptive study design was used to audit essential knowledge of diabetes and its management in persons with type 2 diabetes through a survey of 64 persons attending meetings at the Zimbabwe Diabetes Association. Both descriptive and analytic statistical methods were used.Results: in general respondents have acceptable knowledge of diabetes, whereas their knowledge of glycaemic control is low (45%), likewise their knowledge of how to manage medical treatment when ill. Knowledge concerning lifestyle-related issues was generally low. Respondents had limited knowledge about changes in blood glucose during physical activity (18%) and their knowledge about appropriate food for people with diabetes was low (67%). Most respondents were aware of the importance of regular examinations to avoid long-term complications related to diabetes (>87%) but their knowledge of how to prevent foot complications and perform daily preventive foot care was limited (73 %).Conclusion: there is limited knowledge of diabetes in Zimbabwean persons with type 2 diabetes even if they have participated in educational activities at the patient associations. This further supports the need for development of education for patients in health care which requires increased competence in the field among health care staff.
27.	Eyong, Esum Mathias, et al. (författare) The prevalence of HBsAg, knowledge and practice of hepatitis B prevention among pregnant women in the Limbe and Muyuka Health Districts of the South West region of Cameroon: a three-year retrospective study 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 32 Tidskriftsartikel (refereegranskat)abstract Introduction: hepatitis B infection is caused by the Hepatitis B virus (HBV). HBV is transmitted through sexual intercourse, by exchange of saliva during kissing and also to newborns of infected mothers. In the Global Burden of Diseases 2010, 786,000 deaths were attributed to HBV. Studies in Cameroon, reported the prevalence of HBV as high as 10.1% and 12% among blood donors in hospital blood banks. This study therefore, aims at determining the prevalence of HBsAg, knowledge and practices of pregnant women on HBV prevention and transmission in the Limbe Health District (LHD) and Muyuka Health District (MHD). Methods: ANC registers were exploited from the Health Centers for a period of three years (2014-2016) inorder to determine the prevalence of HBV infection. 270 women attending ANC were selected by exhaustive sampling. Knowledge and practices of participants on HBV prevention and transmission was assessed using a structured questionnaire. Results: the prevalence of HBV in the LHD and MHD were 5.7% and 7.5% respectively. Pregnant women in the LHD demonstrated good knowledge but adopted poor practices whereas in the MHD, pregnant women demonstrated poor knowledge and adopted poor practices regarding the mode of transmission and prevention of HBV infection. There was a significant association between the prevalence of HBsAg and marital status (p = 0.000) in the LHD and age (p = 0.022) in the MHD. Conclusion: this study indicated a high prevalence of HBV among pregnant women in the LHD and MHD, knowledge and practices were identified as potential risk factors.
28.	Fomukong, N. H., et al. (författare) A case report of ruptured ectopic pregnancy plus massive hemoperitoneum on a heterotrophic pregnancy in a resource-poor setting, Mbengwi, Cameroon 2021 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 39 Tidskriftsartikel (refereegranskat)abstract Heterotopic pregnancy is a rare obstetrics phenomenon and carries significant maternal morbidity and mortality due to the risk of rupture of the ectopic pregnancy. Physicians tend to feel comfortable and relieved when an intrauterine gestation sac is seen. This results in an inadequate inspection of the adnexae and remaining structures during emergency bedside ultrasound despite a strong initial clinical suspicion of ectopic pregnancy. We present a case report of ruptured ectopic pregnancy and massive hemoperitoneum in a patient with heterotopic pregnancy. The diagnosis was done on bedside ultrasonography in a clinically unstable 32-year-old patient with a history of infertility. She presented with acute abdominal pain, body weakness, and amenorrhea. She underwent emergency laparotomy and salpingectomy. In our context where ultrasound is not readily available, practitioners carrying out salpingectomy for ruptured ectopic pregnancies should bear in mind the plausibleness of heterotopic pregnancy to properly handle the uterus.
29.	Fomukong, Nzozone Henry, et al. (författare) Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon 2019 Ingår i: Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic fascial features usually resolved within 24-48 hours.
30.	Fomukong, Nzozone Henry, et al. (författare) Predictors of mortality of pediatric burn injury in the Douala General Hospital, Cameroon 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: burn injuries are a major cause of hospitalization and are associated with significant morbidity and mortality, particularly in children aged four years or below. In Cameroon, the mortality rate of pediatric severe burns was estimated at 41.2%. There is need to determine the predictors of such mortality in order to guide appropriate management. Methods: this study is aimed at assessing the predictors of mortality of pediatric patients who sustained a burn injury over a period of 11 years (between 1st of January 2006 and 31st of December 2016) in Douala General Hospital (DGH). The data for this study was entered in an electronic questionnaire and analyzed using Epi info version 7. All variables thought to be associated with mortality were entered in a multiple binary logistic regression model. The magnitude or risk was measured by odds ratio, and the 95% confidence interval was estimated. Results: a total of 125 cases of pediatric burns were recorded over the study period. A total of 69 (55.65%) were males, giving a male to female ratio of 1.25:1. The median age was 4 years. Most pediatric burns resulted from accidents. Most patient 78 (69%) came before 8 hours following injury. Scalding was the predominant mechanism of injury in 56 (45.5%) of patients. Most patients had partial thickness burn and most burns involved 1-9.9% body surface areas (BSA). The mean length of hospital stay in this study was 7 days, more than half of the patients had no complications during admission. Among those that developed complications, 19 (35%) developed sepsis. Conclusion: mortality rate of pediatric burns obtained in this study was 29%, mostly due to cardiac arrest. Flame burns (p=0.03) and BSA >25% (p=0.001) were statistically significant predictors of mortality.
31.	Giles, Kagmeni, et al. (författare) Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications. 2016 Ingår i: Pan African Medical Journal. - Kampala : AFRICAN FIELD EPIDEMIOLOGY NETWORK-AFENET. - 1937-8688. ; 24 Tidskriftsartikel (refereegranskat)abstract The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 (range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia. [ABSTRACT FROM AUTHOR]
32.	Gyamfua, Ampofo Ama, et al. (författare) The level of knowledge and associated socio-demographic factors on cervical cancer among women: a cross-sectional study at Kenyase Bosore community, Ghana 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 34:44 Tidskriftsartikel (refereegranskat)abstract Introduction: cervical cancer is a major cause of death amongst women around the world. In Ghana, it accounts for over 2,119 female deaths and about 3,151 new diagnoses of the disease and usually diagnosed at an advance stage, making it difficult to treat. This study aims at assessing the knowledge on risk factors, prevention and treatment of cervical cancer among women in Bosore. Methods: this study was a cross-sectional descriptive study conducted among women in Bosore a town in the Kwabre East District in the Ashanti Region of Ghana. A total of 200 women were selected for the studies using the convenience sampling technique. Structured questionnaires were used to collect data and statistical package for social sciences application was used to analyse the data. Pearson chi-square test was used to find associations between knowledge and awareness level and socio-demographic characteristics of the participants. Results: generally, 9.7% of the respondents had high knowledge on cervical cancer, 20.6% had moderate knowledge and 69.7% had low knowledge on cervical cancer. There was a significant association between educational background (p=0.000) and awareness level of the respondents. There was also a significant association between the occupation (p=0.003), educational background (p=0.000) and knowledge level of the respondents. Conclusion: the knowledge level of the respondents was very low. Specifically, the respondents had inadequate knowledge on risk factors, signs and symptoms, prevention and treatment of cervical cancer. The study revealed that there should be introduction and intense education on cervical cancer education at antenatal and family planning clinics in the community and Ghana as whole.
33.	Hambridge, T, et al. (författare) Hepatitis B mother-to-child transmission in the Eastern Region of Ghana: a cross-sectional pilot study 2019 Ingår i: The Pan African medical journal. - : Pan African Medical Journal. - 1937-8688. ; 33, s. 218- Tidskriftsartikel (refereegranskat)
34.	Heward-Mills, Nii Lante, et al. (författare) The role of faith leaders in influencing health behaviour : a qualitative exploration on the views of Black African Christians in Leeds, United Kingdom 2018 Ingår i: Pan African Medical Journal. - : The Pan African Medical Journal. - 1937-8688. ; 30 Tidskriftsartikel (refereegranskat)abstract Introduction: Black African communities in the U.K suffer from health disparities compared to the general population. This has been attributed to the lack of culturally sensitive interventions that are meaningful to them. Faith leaders are an integral part of the community and are known to have immense influence on health behaviour of congregants and community members. However, their role in health behaviour change (alcohol and tobacco use) has been largely neglected. The aim of this study is to explore the views of Black African Christians on the role of their faith leaders in their health behaviour, with particular focus on the extent of influence and mechanisms that foster this. Methods: Eight (8) semi-structured interviews were conducted with Black African Christians between the ages of 25-44, from two churches in Leeds, UK. Data were analysed using the principles of thematic analysis. Results: Findings revealed that faith leaders could play a very important role in the health behaviour of their congregants. Faith leaders are able to influence health behaviour not only on the individual level but also on a socio-cultural and environmental level. They exert such influence through several mediators including through scriptural influence, social influence and by serving as a role models. However, no single mediator has been found to be exclusively associated to health behaviour change. Conclusion: Congregants view faith leaders as having an immense influence on their health behaviour. As a community resource, faith leaders could be better positioned to organize and foster community participation in health matters. Health promoters should thus consider collaborations with faith leaders to enhance the health of their community.
35.	Ijang, Y. P., et al. (författare) Factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District, Cameroon 2021 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 39 Tidskriftsartikel (refereegranskat)abstract Introduction: birth preparedness and complication readiness (BPCR) intervention should greatly have an impact on the reduction of maternal mortality if implemented properly at all levels. Responsibility for BPCR must be shared among all safe motherhood stakeholders-because a coordinated effort is needed to reduce the delays that contribute to maternal and newborn deaths. This study aimed to assess the factors associated with birth preparedness and complication readiness among pregnant women attending government health facilities in the Bamenda Health District. Methods: this was a cross-sectional analytic study. The study period was 30th October - 30th November, 2016. A total of 345 pregnant women of >= 32 weeks gestational age seen at the antenatal consultation (ANC) units were recruited. The dependent variable was birth preparedness and complication readiness while the independent variables were the socio-demographic and reproductive health characteristics. Frequency distributions were used to determine the awareness and practice and logistic regression at 95% confidence interval (CI) and p<0.05 to identify the factors that favour birth preparedness and complication readiness. Results: the most likely factors that favour birth preparedness and complication readiness were monthly income (Odds Ratio (OR) = 2.94, (1.39, 6.25), p = 0.005) and the -:umber of antenatal care visits (OR = 2.16, (1.13, 3.90), p = 0.013). Conclusion: majority of the women in this study were not prepared for birth/complications. The factors most associated with birth preparedness and complication readiness were monthly income and number of antenatal care visits.
36.	Iken, OF, et al. (författare) Field notes from the Nigeria Centre for Disease Control 2019 pilot internship program for resident doctors 2020 Ingår i: The Pan African medical journal. - 1937-8688. ; 35, s. 88- Tidskriftsartikel (refereegranskat)
37.	Kamala, Benjamin Anathory, et al. (författare) Predictors of low birth weight and 24-hour perinatal outcomes at Muhimbili National Hospital in Dar es Salaam, Tanzania : a five-year retrospective analysis of obstetric records 2018 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 29 Tidskriftsartikel (refereegranskat)abstract Introduction: the global prevalence of low birth weight (LBW) is 16%, representing more than 20 million infants worldwide, of which 96% are born in low-income countries. This study aimed to determine the prevalence, predictors and perinatal outcomes of LBW newborns.Methods: we conducted a retrospective analysis of data obtained from the hospital's obstetric and neonatal database. Descriptive statistics and multivariate logistic regression were performed with 95% confidence intervals (CI).Results: the prevalence of LBW was 21% (n = 8,011) and two-thirds of these were delivered at term. Seven percent of newborns were stillbirths and 2% died within 24hrs after birth. Logistic regression revealed that primigravida and grand multiparity were associated with LBW (OR: 1.25, 95%CI: 1.15-1.37; and OR: 1.21, 95%CI: 1.01-1.25, respectively). Having <4 antenatal care (ANC) visits was associated with increased odds of LBW (OR: 1.74, 95%CI: 1.59-1.87). Regression models revealed an independent association between LBW and increased odds of stillbirths (OR = 7.20, 95%CI 6.71-7.90), low Apgar score (OR = 3.42, 95%CI: 3.12-3.76) and early neonatal deaths (OR = 1.82, 95%CI: 1.51-2.19).Conclusion: the prevalence of LBW was high and was associated with extreme maternal age groups, grand multiparity, low maternal education, low number of ANC visits and obstetrics risks factors and complications. Both LBW and prematurity were independently associated with poor perinatal outcome. Future interventions should focus on improving the quality of ANC and integrating peripartum emergency obstetric and neonatal care.
38.	Kawala, Brenda Allen, et al. (författare) Effect of COVID – 19 response in Uganda on Street Children 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 35:Suppl 2 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract The unprecedented novel Coronavirus disease, COVID-19, which emerged in December 2019 has been labeled “disease X” by the World Health Organization (WHO) based on its rate and extent of spread as well as harsh ramifications. In response, different nations have adopted different management approaches hinging on various considerations, among them the WHO recommendations. Uganda has incorporated lockdowns, a measure that has affected schools, hospitals, businesses, places of worship, markets, public transport, and a rise in abuse of human rights in the form of police brutality, and domestic violence [1]. However, contextual factors such as socioeconomic realities and poverty pose a different set of problems for the mitigation and suppression of efforts for COVID-19, especially for vulnerable populations. Eventually, the effects of these interventions pitch down to individual citizens but invariably disproportionately affect vulnerable populations such as street children. This commentary examines the effects of mitigation efforts of COVID-19 on street children who roam the streets of Ugandan cities and whose plight barely gets on the research as well as policy agenda [2]. This paper also draws parallels with similar stories from street children in a few other African countries.
39.	Kawala, Brenda Allen, et al. (författare) Why policy action should focus on the vulnerable commercial sex workers in Uganda during COVID - 19 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 35:Suppl 2 Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract According to the Ugandan Ministry of Health, as of 24th June 2020, Uganda had registered a total of 797 cases of COVID-19 [1]. Two months prior, a majority of the positive cases in Uganda had been linked to being spread by long-distance truck drivers who drove into Uganda from Kenya and Tanzania. These neighboring countries had registered more COVID-19 infections and mortality. Seeing as the sex workers in Uganda are popularly found at border points where they interact with truck drivers [2,3] they were a key target in reducing community spread. In response, the Ministry of Health employed a self-proclaimed sex worker and Kampala city socialite to cast a commercial break advertisement as a health promotion measure. She warned girls at the Ugandan borders to avoid truck drivers to keep the nation free of COVID-19 [4]. This move went beyond the discrimination that sex workers in Uganda face to show the importance of such a marginalized group in the community spread of infectious diseases like COVID-19. Building from Uganda´s previous experience with HIV/AIDS, unempowered sex workers are at a higher risk for transmission with a 37% infection rate compared to 9% in the general population [5]. Some of these workers are sometimes forced to ignore regulations geared towards infection control as their ‘daily bread’ depend on the trade [6]. During the COVID-19 times, their plight is worsened by the inability to afford safe sex by using condoms and some of their customers preferring not to use protection [7]. Likewise, the majority of sex workers are illiterates as seen by only 53% of them having attained primary education in contrast to 73% in the general population [8]. Consequently, such vulnerable illiterate sex workers fail to fully comprehend the various health measures imposed by policymakers, and their bargaining power for safer sex is subdued.
40.	Kitara, David Lagoro, et al. (författare) The effects of economic stress and urbanization on driving behaviours of boda-boda drivers and accidents in gulu, northern uganda : A qualitative view of drivers 2020 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 36, s. 1-11 Tidskriftsartikel (refereegranskat)abstract Introduction: understanding motorcyclists’ on-the-road behaviour is critical for developing and evaluating interventions specifically targeting them. Risky on-the-road behaviours have historically been subdivided into errors and violations of the rules of road use. Police records could be used to record cyclists’ behaviours, however these documents do not necessarily capture all errors and violations. None use of protective wears have been documented in many studies conducted on Boda-boda drivers in Uganda. The relationship between drivers’ economic stress and road safety have been studied for many years but the effects of global and economic stress, its joint effects on behaviours of drivers in relations to accidents have received very little attention. This study aimed at assessing the relationship between injuries and the Boda-boda drivers’ behaviours in Northern Uganda. Methods: two hundred Boda-boda drivers from Gulu Municipality had face-to-face interviews to assess views and underlying factors on the issue of high prevalence of motorcycle road traffic accidents and injuries. Descriptive statistics were used to describe factors on road accidents including personal information, knowledge, skills and attitudes towards road use and safety. The study was approved by a local Institutional Review Board (IRB). Results: collectively, the results showed that economic stress is an important factor that affects drivers’ behaviour and increases their risks to motorcycle accidents. Conclusion: these authors suggest that more studies should be conducted to determine the relationship between economic stress, anger and dangerous behaviours among Boda-boda drivers and accidents in Gulu Municipality using a Motorcycle Rider Behaviour Questionnaire (MRBQ).
41.	Layu, Donatus, et al. (författare) Assessing the uptake of cervical cancer screening among women aged 25-65 years in Kumbo West Health District, Cameroon 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33 Tidskriftsartikel (refereegranskat)abstract Introduction: cervical cancer remains one of the leading health hazards affecting a majority women across the globe. The situation is even more, preoccupying particularly in areas where screening programmes and services are absent. The World Health Organization (WHO) says "cervical cancer is the fourth most frequent cancer in women, with an estimated 570,000 new cases diagnosed in 2018 which represents 6.6% of all female cancers. Approximately 90% of deaths from cervical cancer occurred in low- and middle-income countries". Despite the high mortality rate from cervical cancer globally, the trend could be reduced through a comprehensive approach that includes prevention, early diagnosis, effective screening and treatment programmes. In Cameroon, the prevalence of cervical cancer is 24% among women of reproductive age. An estimated 1,993 new cases are recorded annually in Cameroon with 1676 deaths. Despite this precarious situation, the uptake in cervical cancer screening service remains poor and stands at 19.6% in Cameroon. It is against this background that this paper evaluates the uptake of cervical cancer among women aged 25-65 years in the Kumbo West Health District (KWHD). Specifically, this study assesses the knowledge of women in this health district on cervical cancer and determines factors that affect the uptake of cervical cancer screening services. Methods: this study is a cross-sectional study in the KWHD involving 253 consented women between the ages 25 to 65 years. The principal research instrument was a three-part questionnaire designed to collect information on socio-demographic profile, cervical cancer knowledge and associated factors for uptake in cervical cancer screening. Data was entered in MS Excel and analysed using Excel. Results were presented in tables and figures. Results: our study reveals that a majority of the participants (74.70%) had heard of cervical cancer and 43.48% had undergone cervical cancer screening. Again, 24.51% and 29.25% of the participants respectively could not identify any risk factor and symptom of cervical cancer. Conclusion: the study revealed that the uptake of cervical cancer screening in KWHD is higher than the national uptake. The level of awareness on the risk factors and symptoms of cervical cancer is low, posing a need to put more emphasis on educating and creating awareness of cervical cancer among communities on risk factors, prevention measures and signs and symptoms in all the health areas of the KWHD.
42.	Layu, Donatus, et al. (författare) Factors associated with adolescent school girl’s pregnancy in Kumbo East Health District North West region Cameroon 2018 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 31 Tidskriftsartikel (refereegranskat)abstract Introduction: teenage pregnancy is a social problem in Cameroon in general and in Kumbo East in particular. This results in physical, psychological and socio-economic consequences on the teenage mother, family and the society as a whole. In spite of studies and interventions that have been and are being implemented, the prevalence of unplanned teenage pregnancy in Kumbo East Health District is still high, suggesting that more efforts are required to achieve effective preventive measures. The aim of this study was to determine factors associated with adolescent school girl's pregnancy in Kumbo East health district. Methods: a cross-sectional descriptive study design was used and a simple random sampling technique was used to select 293 respondents aged 15 to 19year. The district hospital antenatal clinics and the Health Centres were selected. Data was obtained from 292 participants under the age of 20 years who were willing using a questionnaire administered through face-to-face interviews. Results: the study show a high prevalence (60.75%) of teenage pregnancy in the sampled antenatal clinics of Kumbo East Health District attributable to inadequate considerations given to factors associated with school girl's pregnancy. This study has indicated that the age of teenager at first pregnancy, low contraceptive use, socio-economic status and physical violence are factors that are greatly associated with teenage pregnancy. Among the reasons contributing to the low use of contraceptives are: sexually activity, lack of knowledge, fear of side effects, including sterility, condoms disappearing in the womb and inequality of power with sexual partners. This study shows that teenagers obtain information mainly from school (53%) and relatives (20%). Conclusion: the use of contraceptive alone may not reduce teenage pregnancy, however double method is very effective but addressing the impact of poverty on teenagers, empowering them on their rights and information in order to make right choices is very important.
43.	Mahende, C, et al. (författare) Profile of C-reactive protein, white cells and neutrophil populations in febrile children from rural north-eastern Tanzania 2017 Ingår i: The Pan African medical journal. - : Pan African Medical Journal. - 1937-8688. ; 26, s. 51- Tidskriftsartikel (refereegranskat)
44.	Manigoue Tchape, Odette Dorcas, et al. (författare) Physiological and psychosocial stressors among hemodialysis patients in the Buea Regional Hospital, Cameroon 2018 Ingår i: PanAfrican Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 30:May-August Tidskriftsartikel (refereegranskat)abstract Introduction: End Stage Renal Disease (ESRD) is an irreversible kidney condition and hemodialysis is the most frequent treatment option used for this condition. However, hemodialysis also has a detrimental impact on the quality of life and the individuals' physical and psychosocial wellbeing. The main objective of this study was to identify physiological and psychosocial stressors faced by patients undergoing hemodialysis in the Buea Regional Hospital in Cameroon. Methods: a cross-sectional study was carried out (December 2016 - January 2017) among patients undergoing hemodialysis at the Buea regional hospital. Data were collected with the use of a structured questionnaire and analyzed using SPSS version 21.0. Quantitative variables were expressed as frequencies, percentages and means. Results: among the patients undergoing hemodialysis, 28 (70.0%) were below 5-year dialysis while 12 (30.0%) had been on dialysis for five years and more. 21(52.5%) were male and 19(47.5%) female. Half of the patients were married 20(50%), 13(32.5%) were single, 6(15%) were divorced, and one (2.5%) was a widower. Also, 28 (70.0%) were below 5-year dialysis while 12 (30.0%) had been on dialysis for five years and more. All participants experienced at least one or more physiological and psychosocial stressors. Among physiological stressors, the most frequent were feeling tired (97%), followed by arterial and venous stick (88%) while itching (49.5%) was the least noted physiological stressor. Among psycho-social stressors, the most recurrent were transportation to and from the hospital (99.5%), cost of treatment (99.5%) and Limits on time and place of vacation (99%), followed by Limitation in physical activities, frequent hospitalizations, the length of time on dialysis, uncertainty about the future, changes in life style, increased dependence and sleep disturbances. Conclusion: the topic of stressors is of importance among patients receiving dialysis, as these affect their psycho-social and physiological wellbeing. Thus, nephrologists, nurses and family members play an important role in providing patients with effective psycho-social and physiological support.
45.	Masudio, Florence, et al. (författare) Knowledge and practice of birth preparedness and complication readiness among pregnant women attending antenatal clinic in Openzinzi Hciii, Adjumani District, Uganda 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 34 Tidskriftsartikel (refereegranskat)abstract Introduction: every day, approximately 830 women globally die from pregnancy-child birth related complications and all maternal deaths are mainly due to the three phases of delay usually experienced in maternal care which originates from inadequate or lack of birth and emergency preparedness. Despite the benefit of Birth Preparedness and Complications Readiness (BPACR) in the reduction of the three phases of delay and thus reduction of maternal deaths and complications, no study has been conducted in Adjumani district to assess the knowledge and practice of birth preparedness and complication readiness, thus our objective was to assess the knowledge and practice of Birth Preparedness and Complications Readiness (BPACR) among pregnant women attending antenatal clinic at Openzinzi Health Centre (HC) III in Adjumani District. Methods: a descriptive cross sectional study design with a sample of 80 respondents was used for the study. Simple random sampling was used to select the respondents in the study area. A research administered questionnaire was used for data collection. Results: most of the respondents (27.5%) were in the age group of 26-35years. The majority 43.75% ended at primary level of education, 50% were unemployed, and the majority 71.25% and 70% knew identifying skilled birth attendants and health facilities respectively as components of BPACR. 76.25% of the respondents mentioned vaginal bleeding (76.25%) and over vomiting (62.5%) as danger signs in pregnancy while 12.5% did not know any danger sign in pregnancy. 76.25% identified place for skilled birth, 66.25% identified skilled birth attendant, and only 15% identified blood donor Conclusion: the practice of BPACR was poor among the pregnant women attending antenatal care at Openzinzi Health Centre III in Adjumani District. The knowledge about BPACR was higher among the educated respondents involved in the study.
46.	Miller, Hillary, et al. (författare) Long travel times from health center to hospital reduce caesarean section access : a study from Kirehe District, Rwanda 2023 Ingår i: Pan African Medical Journal. - 1937-8688. ; 46 Tidskriftsartikel (refereegranskat)abstract Introduction: timely access to safe cesarean section (c-section) delivery can save the lives of mothers and neonates. This paper explores how distance affects c-section access in rural sub-Saharan Africa, where women in labor present to health centers before being referred to district hospitals for surgical care. Methods: this study included all adult women delivering via c-section between April 2017 and March 2018 in Kirehe District, Rwanda. We assessed the association between travel times and village-level c-section rates. Results: the estimated travel time from home-to-health center was 26 minutes (IQR: 13, 41) and from health center-to-hospital was 43 minutes (IQR: 2, 59). There was no significant association between travel time from home-to-health center and c-section rates (RR=1.01, p=0.42), but the association was significant for health center-to-hospital travel times (RR=0.96, p=0.01); for every 15-minute increase in travel time, there was a 4% decrease in c-sections for a health center catchment area. Conclusion: in the context of decentralized health services, minimizing health center to hospital referral barriers is of utmost importance for improving c-section access in rural sub-Saharan Africa.
47.	Mufunda, Esther, 1958-, et al. (författare) Level and determinants of diabetes knowledge in patients with diabetes in Zimbabwe : a cross-sectional study 2012 Ingår i: Pan African Medical Journal. - 1937-8688. ; 13, s. 78- Tidskriftsartikel (refereegranskat)abstract INTRODUCTION:A previous study of beliefs about health and illness in Zimbabweans with diabetes mellitus indicated limited knowledge about diabetes and the body, affecting self-care and health-care seeking behaviour. The aim of this study was to assess the level of diabetes knowledge in Zimbabwean adults with diabetes mellitus, to determine the main gaps in knowledge and identify the socio-demographic and diabetes-related determinants that predict diabetes awareness and self-care practices.METHODS:A cross-sectional descriptive study was performed using a standardized self-report Diabetes Knowledge Test questionnaire (DKT) of 58 respondents, 32 women and 26 men. Results were analysed with descriptive and analytic statistical methods.RESULTS:The majority of the respondents scored average knowledge on all three sub-scales: general knowledge, insulin use and total knowledge, with an overall score of 63.1 ± 14, 2%. Major knowledge gaps were in areas related to diet, insulin use and glycaemic control. No significant differences in mean scores were detected in the diabetes knowledge sub-scales when comparisons were made of mean knowledge scores in relation to socio-demographic and diabetes-related characteristics. However, diabetes-related complications were significantly associated with lower total and general diabetes knowledge, and female gender was an independent determinant of low general knowledge.CONCLUSION:Knowledge gaps were evident in areas regarding insulin use, diet and glycaemic control. Low diabetes knowledge was associated with female gender and could be a risk factor for development of diabetes-related complications. Knowledge gaps need to be addressed in diabetes education to prevent development of diabetes-related complications.
48.	Mufunda, Esther, et al. (författare) Limited knowledge of diabetes in patients attending an outpatient diabetes clinic at a referral hospital in Zimbabwe: a cross-sectional study 2018 Ingår i: Pan African Medical Journal. - : AFRICAN FIELD EPIDEMIOLOGY NETWORK-AFENET. - 1937-8688. ; 29 Tidskriftsartikel (refereegranskat)abstract Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person?s knowledge of diabetes. The present study aimed to assess patients diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital.
49.	Mugoya, G. J., et al. (författare) Cryptosporidium and giardia species in newly and previously habituated gorillas and nearby water sources in Bwindi Impenetrable National Park, Uganda 2019 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 34 Tidskriftsartikel (refereegranskat)abstract Introduction: cryptosporidium and giardia are of great one health significance and major cause of protozoan diarrhea in humans and primates; they are found in the faecal matter of animals and humans and also in contaminated water and soil as well. Therefore, we aimed at establishing the prevalence and shedding intensity of faecal Cryptosporidium and giardia in the Newly Habituated Mountain Gorillas (NHMG) and Previously Habituated Mountain Gorillas (PHMG) and in selected water sources within the gorilla home ranges in the month of January 2018. Methods: we conducted a cross sectional study in the southern sector of Bwindi Impenetrable National Park where a total of 56 faecal samples from both NHMG (34) and PHMG (22) and 30 water samples were purposively collected. Faecal and water samples were transported in a cooler box at 4 degrees C to Makerere University Parasitology Laboratory for analysis. The samples were analyzed using modified Ziehl-Neelsen technique and Ether concentration method for Cryptosporidium and giardia respectively. Results: the prevalence of cryptosporidium was established as 13 (59.1%), 15 (44.1%) and 7 (23.3%) in PHMG, NHMG and water respectively. The mean concentration of the oocysts per gram was 222 +/- 52.9 in PHMG, 174 +/- 41.5 in NHMG and 31 +/- 13.2 in water. The prevalence of giardia was 3 (13.6%), 4 (11.8%) and 3 (10%) in PHMG, NHMG and water respectively. The mean concentration of the oocysts per gram was 34 +/- 19.9 in PHMG, 25 +/- 12.4 in NHMG and 5 +/- 2.9 in water. There was no significant difference in both the prevalence of cryptosporidium (p>0.05) and giardia (p>0.05) in the PHMG and NHMG. This indicates that there is high risk of cross infection among the gorillas within the forest sharing similar home ranges. Conclusion: the park authorities should ensure that procedures for proper waste disposal while in the forest are properly followed, water drawn for drinking from the forest should be avoided. Further research should be carried out to identify whether the strains of the parasites found in water or other animals in the forest are the same with strains in gorilla dung in order to confirm cross infection.
50.	Muhamadi, Lubega, et al. (författare) Lack of pre-antiretroviral care and competition from traditional healers, crucial risk factors for very late initiation of antiretroviral therapy for HIV : A case-control study from eastern Uganda 2011 Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 8:40 Tidskriftsartikel (refereegranskat)abstract BACKGROUND:Although WHO recommends starting antiretroviral treatment at a CD4 count of 350 cells/[µ]L, many Ugandan districts still struggle with large proportions of clients initiating ART very late at CD4 < 50 cells/[µ]L. This study seeks to establish crucial risk factors for very late ART initiation in eastern Uganda.METHODS:All adult HIV-infected clients on ART in Iganga who enrolled between 2005 and 2009 were eligible for this case-control study. Clients who started ART at CD4 cell count of < 50 cells/[µ]L (very late initiators) were classified as cases and 50-200 cells/[µ]L (late initiators) as control subjects. A total of 152 cases and 202 controls were interviewed. Multivariate analyses were performed to calculate adjusted odds ratios and 95% confidence intervals.RESULTS:Reported health system-related factors associated with very late ART initiation were stock-outs of antiretroviral drugs stock-outs (affecting 70% of the cases and none of the controls), competition from traditional/spiritual healers (AOR 7.8, 95 CI% 3.7-16.4), and lack of pre-ARV care (AOR 4.6, 95% CI: 2.3-9.3). Men were 60% more likely and subsistence farmers six times more likely (AOR 6.3, 95% CI: 3.1-13.0) to initiate ART very late. Lack of family support tripled the risk of initiating ART very late (AOR 3.3, 95% CI: 1.6-6.6).CONCLUSION:Policy makers should prevent ARV stock-outs though effective ARV procurement and supply chain management. New HIV clients should seek pre-ARV care for routine monitoring and determination of ART eligibility. ART services should be more affordable, accessible and user-friendly to make them more attractive than traditional healers.

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