Subjects -> HEALTH AND SAFETY (Total: 1541 journals)
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HEALTH AND SAFETY (722 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 4)
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 3)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 12)
Advances in Public Health     Open Access   (Followers: 28)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 3)
African Health Sciences     Open Access   (Followers: 5)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 47)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 7)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 3)
Akademika     Open Access   (Followers: 1)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 21)
American Journal of Health Education     Hybrid Journal   (Followers: 36)
American Journal of Health Promotion     Hybrid Journal   (Followers: 34)
American Journal of Health Sciences     Open Access   (Followers: 12)
American Journal of Health Studies     Full-text available via subscription   (Followers: 16)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 32)
American Journal of Public Health     Full-text available via subscription   (Followers: 280)
American Journal of Public Health Research     Open Access   (Followers: 28)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 6)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 8)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 14)
Annals of Health Law     Open Access   (Followers: 6)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal   (Followers: 1)
Applied Research In Health And Social Sciences: Interface And Interaction     Open Access   (Followers: 5)
Apuntes Universitarios     Open Access   (Followers: 1)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 2)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 10)
Archivos de Prevención de Riesgos Laborales     Open Access   (Followers: 1)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 11)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 5)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 12)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 6)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Autism & Developmental Language Impairments     Open Access   (Followers: 16)
Behavioral Healthcare     Full-text available via subscription   (Followers: 8)
Bijzijn     Hybrid Journal   (Followers: 1)
Bijzijn XL     Hybrid Journal  
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
Biosafety and Health     Open Access   (Followers: 5)
Biosalud     Open Access   (Followers: 1)
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 7)
BMC Pregnancy and Childbirth     Open Access   (Followers: 24)
BMJ Simulation & Technology Enhanced Learning     Hybrid Journal   (Followers: 12)
Boletin Médico de Postgrado     Open Access  
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 50)
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 23)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos de Saúde     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 13)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 14)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 3)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 27)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 2)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
Case Studies in Fire Safety     Open Access   (Followers: 25)
CASUS : Revista de Investigación y Casos en Salud     Open Access   (Followers: 1)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access   (Followers: 1)
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 11)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access   (Followers: 2)
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia & Salud     Open Access   (Followers: 2)
Ciencia & Trabajo     Open Access   (Followers: 1)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 4)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access   (Followers: 2)
Cities & Health     Hybrid Journal   (Followers: 2)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
Clocks & Sleep     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 2)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 6)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 2)
Cuaderno de investigaciones: semilleros andina     Open Access   (Followers: 3)
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Digital Health     Open Access   (Followers: 9)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 14)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 3)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 26)
East African Journal of Public Health     Full-text available via subscription   (Followers: 4)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 24)
EcoHealth     Hybrid Journal   (Followers: 5)
Education for Health     Open Access   (Followers: 9)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 4)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 5)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 6)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 22)
EsSEX : Revista Científica     Open Access   (Followers: 1)
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access   (Followers: 1)
Ethics & Human Research     Hybrid Journal   (Followers: 3)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 7)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 8)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access   (Followers: 2)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 9)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 9)
Family & Community Health     Hybrid Journal   (Followers: 14)
Family Medicine and Community Health     Open Access   (Followers: 10)
Family Relations     Partially Free   (Followers: 15)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 19)
Food Quality and Safety     Open Access   (Followers: 1)
Frontiers in Digital Health     Open Access   (Followers: 2)
Frontiers in Public Health     Open Access   (Followers: 9)
Frontiers of Health Services Management     Partially Free   (Followers: 4)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access   (Followers: 1)
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Advances in Health and Medicine     Open Access  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 8)
Global Health Annual Review     Open Access   (Followers: 5)
Global Health Journal     Open Access   (Followers: 2)
Global Health Promotion     Hybrid Journal   (Followers: 17)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 14)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access   (Followers: 1)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Global Transitions     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 9)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 5)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 6)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 15)
Health and Human Rights     Open Access   (Followers: 10)
Health and Research Journal     Open Access   (Followers: 4)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 11)
Health and Social Work     Hybrid Journal   (Followers: 71)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 6)

        1 2 3 4 | Last

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African Health Sciences
Journal Prestige (SJR): 0.446
Citation Impact (citeScore): 1
Number of Followers: 5  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1680-6905
Published by African Journals Online Homepage  [265 journals]
  • Annus horribilis: pandemic, infodemic and our response

    • Authors: James K Tumwine
      Abstract: Nil.
      PubDate: 2020-12-16
      Issue No: Vol. 20, No. 4 (2020)
  • Editor’s choice: this December 2020

    • Authors: James K Tumwine
      Abstract: Nil
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.2
      Issue No: Vol. 20, No. 4 (2020)
  • A systematic review and meta-analysis of the prevalence and predictors of
           anemia among children in Ethiopia

    • Authors: Alemu Gebrie, Animut Alebel
      Pages: 21
      Abstract: Background: Anemia is a wide-spread public health problem characterized by a decrease in hemoglobin concentration and/ or red blood cell volume below an established cut-off value. In developing countries including Ethiopia, about half of children are estimated to be anemic. Therefore, the purpose of this study was to determine the pooled prevalence of anemia and its predictor factors among children in Ethiopia. Method: The studies were identified through explicit and exhaustive search of reputable databases (PubMed, Google schol- ar, Science Direct, EMBASE, Cochrane library, and the hand search of reference lists of previous prevalence studies to retrieve more related articles. Thirty-nine studies were selected based on a comprehensive list of inclusion and exclusion criteria. Data were extracted using a standardized and pre-tested data extraction checklist, and the analysis was done using STATA 14 statistical software. To assess heterogeneity, the Cochrane Q test statistic and I2 tests were used. In our analysis, considerable heterogeneity was observed. Therefore, a random effect meta-analysis model was used to estimate the pooled prevalence of anemia. Moreover, the predictor factors of anemia were examined. Results: The forest plot of 39 included studies revealed that the overall pooled prevalence of anemia among children in Ethiopia was 34.4% (95% CI: 29.1, 39.7%). Sub-group analysis showed that the highest anemia prevalence was observed in Somali Region with a prevalence of 49.4 % (95% CI: 20.9, 77.8). Also, anemia in children was found to be highest in the age group of less than five years (45.2, 95% CI: 39.6,50.8). Low literacy of families: 1.3 (95% CI: 1.1, 1.7), low family socioeco- nomic status: 1.9 (95% CI: 1.1,3.01.3), having housewife mothers or with no job: 1.5 (95% CI: 1.4, 1.9) and rural residence: 3.3 (95% CI: 1.7,6.1) were found to be predictors of anemia among children. Conclusion: In this study, one in three children were anemic in Ethiopia. It is a moderate public health problem in children in this study. Low literacy, low socioeconomic status as well as rural residence of the families and helminthic infection of the children were found to be predictors of anemia in the children. Community and school-based interventions should be strengthened to improve the problem. Keywords: Anemia; prevalence; predictors; children,; Ethiopia; systematic review; meta-analysis.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.59
      Issue No: Vol. 20, No. 4 (2020)
  • Invited Editorial. COVID-19 Vaccine: Hope and reality

    • Authors: Mohamud Sheek-Hussein, Fikri M Abu-Zidan
      Pages: 1507 - 9
      Abstract: Nil
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.3
      Issue No: Vol. 20, No. 4 (2020)
  • My covid-19 experience: picking up the pieces

    • Authors: Oliver Ombeva Malande
      Pages: 1510 - 3
      Abstract: Nil
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.4
      Issue No: Vol. 20, No. 4 (2020)
  • The epidemiology of seasonal influenza after the 2009 influenza pandemic
           in Africa: a systematic review

    • Authors: Adamou Lagare , Soatiana Rajatonirina , Jean Testa , Saidou Mamadou
      Pages: 1514 - 36
      Abstract: Background: Influenza infection is a serious public health problem that causes an estimated 3 to 5 million cases and 250,000 deaths worldwide every year. The epidemiology of influenza is well-documented in high- and middle-income countries, however minimal effort had been made to understand the epidemiology, burden and seasonality of influenza in Africa. This study aims to assess the state of knowledge of seasonal influenza epidemiology in Africa and identify potential data gaps for policy formulation following the 2009 pandemic. Method: We reviewed articles from Africa published into four databases namely: MEDLINE (PubMed), Google Scholar, Cochrane Library and Scientific Research Publishing from 2010 to 2019. Results: We screened titles and abstracts of 2070 studies of which 311 were selected for full content evaluation and 199 studies were considered. Selected articles varied substantially on the basis of the topics they addressed covering the field of influenza surveillance (n=80); influenza risk factors and co-morbidities (n=15); influenza burden (n=37); influenza vaccina- tion (n=40); influenza and other respiratory pathogens (n=22) and influenza diagnosis (n=5). Conclusion: Significant progress has been made since the last pandemic in understanding the influenza epidemiology in Africa. However, efforts still remain for most countries to have sufficient data to allow countries to prioritize strategies for influenza prevention and control. Keywords: Influenza; epidemiology; review; Africa; post pandemic.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.5
      Issue No: Vol. 20, No. 4 (2020)
  • Characteristics and treatment outcomes of HIV infected elderly patients
           enrolled in Kisii Teaching and Referral Hospital, Kenya

    • Authors: Benuel Nyagaka, Stanslaus Kiilu Musyoki, Lucy Karani, Anthony Kebira Nyamache
      Pages: 1537 - 45
      Abstract: Background: A better understanding of the baseline characteristics of elderly people living with HIV/AIDS (PLWHA) is relevant because the world’s HIV population is ageing. Objectives: This study aimed to evaluate the baseline characteristics of PLWHA aged ≥ 50years at recruitment to HIV/ AIDS clinic compared against the viral load (VL) and CD4 count among patients attending Kisii Teaching and Referral Hospital (KTRH), Kenya. Methods: We retrospectively evaluated temporal inclinations of CD4 levels, viral load change and baseline demographic characteristics in the electronic records at the hospital using a mixed error-component model for 1329 PLWHA attending clinic between January 2008 and December 2019. Results: Findings showed a significant difference in the comparison between baseline VL and WHO AIDS staging (p=0.026). Overall VL levels decreased over the period significantly by WHO AIDS staging (p<0.0001). Significant difference was ob- served by gender (p<0.0001), across age groups (p<0.0001) and baseline CD4 counts (p=0.003). There were significant differences in WHO staging by CD4 count >200cell/mm3 (p=0.048) and residence (p=0.001). Conclusion: Age, WHO AIDS staging, gender and residence are relevant parameters associated with viral load decline and CD4 count in elderly PLWHA. A noticeable VL suppression was attained confirming possible attainment of VL suppression among PLWHA under clinical care. Keywords: HIV infected elderly patients; Kisii Teaching and Referral Hospital, Kenya.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.6
      Issue No: Vol. 20, No. 4 (2020)
  • Modelling CD4 counts before and after HAART for HIV infected patients in
           KwaZulu-Natal South Africa

    • Authors: Ashenfai A Yirga, Sileshi F Melesse, Henry G Mwambi, Dawit G Ayele
      Pages: 1546 - 61
      Abstract: Background: This study aims to make use of a longitudinal data modelling approach to analyze data on the number of CD4+cell counts measured repeatedly in HIV-1 Subtype C infected women enrolled in the Acute Infection Study of the Centre for the AIDS Programme of Research in South Africa. Methodology: This study uses data from the CAPRISA 002 Acute Infection Study, which was conducted in South Africa. This cohort study observed N=235 incident HIV-1 positive women whose disease biomarkers were measured repeatedly at least four times on each participant. Results: From the findings of this study, post-HAART initiation, baseline viral load, and the prevalence of obese nutrition status were found to be major significant factors on the prognosis CD4+ count of HIV-infected patients. Conclusion: Effective HAART initiation immediately after HIV exposure is necessary to suppress the increase of viral loads to induce potential ART benefits that accrue over time. The data showed evidence of strong individual-specific effects on the evolution of CD4+ counts. Effective monitoring and modelling of disease biomarkers are essential to help inform methods that can be put in place to suppress viral loads for maximum ART benefits that can be accrued over time at an individual level. Keywords: Random-effects model; spatial covariance structure; CD4+ count; HAART; CAPRISA.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.7
      Issue No: Vol. 20, No. 4 (2020)
  • VMMC clients’ perception of increased risk of HIV infection,
           circumcision preferred choice of method, providers’ socio-demographics
           and mode of service delivery

    • Authors: Barbara M Nanteza, Ronald H Gray, David Serwadda, C Kennedy, Fredrick Makumbi
      Pages: 1562 - 72
      Abstract: Introduction: Voluntary medical male circumcision (VMMC) is a scientifically proven HIV prevention intervention. Uganda, like many countries has been implementing VMMC for over 10 years but uptake is still low especially in northern Uganda. To attain 80% needed for public health impact, scale-up was recommended with many innovations implemented with sub-optimal results. This study therefore wanted to find out some of the correlates of VMMC uptake in Gulu district, northern Uganda. Methods: Two studies were conducted separately but data was analyzed for this study. For the quantitative study, propor- tions and frequencies were used to measure perception of increased risk of HIV infection using age, gender, occupation, marital and circumcision status. Qualitative study provided data from FGDs, IDIs and KIIs were first transcribed in Acholi and then translated in English. Transcripts were uploaded in MAXDQA software for data management. A code book for emerging themes was developed. Results: A total of 548 respondents were interviewed for the quantitative study, where two thirds (66%) of the participants perceived themselves to be at increased risk of HIV infection. For the qualitative study, 149 participants from 19 FGDs, 11 KIIs and 9 IDIs were interviewed. Data were analyzed thematically using both inductive and deductive approaches. Devices were preferred to conventional surgery while mobile services were preferred to static services. However, there were diver- gent views regarding circumcision service providers’ socio-demographics and these were influenced mainly by age, level of education and location. Conclusion: People in Northern Uganda perceived themselves to be at an increased risk of HIV infection. They preferred devices to conventional surgery, mobile services to static services but had varying views about the socio-demographics of the service providers. Keywords: Male circumcision; challenges; HIV prevention.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.8
      Issue No: Vol. 20, No. 4 (2020)
  • Opportunistic fungal infections in persons living with advanced HIV
           disease in Lagos, Nigeria; a 12-year retrospective study

    • Authors: Rita Oladele, Folasade Ogunsola, Alani Akanmu, Katie Stocking, David W Denning, Nelesh Govender
      Pages: 1573 - 81
      Abstract: Introduction: Nigeria has a large estimated burden of AIDS-related mycoses. We aimed to determine the proportion of pa- tients with AIDS-related opportunistic fungal infections (OFIs) at an urban antiretroviral treatment (ART) centre in Nigeria. Methods: A retrospective analysis of a cohort of ART-naïve, HIV-infected patients, assessed for ART eligibility and ART- experience at the PEPFAR outpatient clinic at Lagos University Teaching Hospital over a 12-year period (April 2004-Feb- ruary 2016) was conducted. Results: During this period, 7,034 patients visited the clinic: 4,797 (68.2%) were female; 6161 patients had a recorded base- line CD4 count, and the median CD4 count was 184 cells/µl (IQR, 84-328). A baseline HIV-1 viral load (VL) was recorded for 5,908 patients; the median VL was 51,194 RNA copies/ml (IQR, 2,316-283,508) and 6,179/7046(88%) had initiated ART. Some 2,456 (34.9%) had a documented opportunistic infections, of whom 1,306 (18.6%) had an opportunistic fungal infection. The total number of OFI episodes was 1,632: oral candidiasis (n=1,473, 90.3%), oesophageal candidiasis (n=118; 8%), superficial mycoses (n=23; 1.6%), Pneumocystis pneumonia (PJP) (n=13; 0.8%), and cryptococcal meningitis(CM) (n=5; 0.4%). 113 (1.6%) were known to have died in the cohort. Conclusion: Approximately 1 in 5 HIV-infected patients in this retrospective cohort, most of whom had initiated ART, were clinically diagnosed with an OFI. Improved access to simple accurate diagnostic tests for CM and PJP should be pri- oritised for this setting. Keywords: Opportunistic fungal infections; ART Adherence; Advanced HIV disease.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.9
      Issue No: Vol. 20, No. 4 (2020)
  • Effects of health education on HIV/AIDS related knowledge among first year
           university students in China

    • Authors: Yan Liu, Li Lu, Yuan Yuan Wang, Meredith R Wilkinson, Yan-Ming Ren, Chao-Cai Wang, Fa-Bin Zhang, Jie Gao, Shou Liu
      Pages: 1582 - 90
      Abstract: Background: The number of new HIV infections has increased and implementation of school-based health education programs on AIDS have been advocated for a long time. Objective: This study aimed to explore the effectiveness of an intervention of HIV/AIDS on the knowledge of HIV/ AIDS prevention and control among first year university students. Methods: An awareness questionnaire was adopted to assess awareness and knowledge of HIV/AIDS pre- and post-health education among first year university students in Qinghai, China. Independent sample t-test, chi-square test, and multiple logistic regression analyses were used. Results: A total of 2,165 and 2,062 first year university students were respectively recruited pre- and post- HIV/AIDS health education. The awareness rate increased significantly after the health education intervention (from 48.59%, 95%CI: 46.47%-50.72% to 76.24%, 95%CI: 74.35%-78.06%). Students from Hui and Tibetan ethnicities, and those holding prej- udices against AIDS patients were less knowledgeable than their counterparts regarding HIV/AIDS related knowledge, whereas urban-dwellers and those with higher paternal education were positively associated with awareness of HIV/AIDS related knowledge (p <0.05). Conclusion: HIV/AIDS awareness among first year university students improved greatly after receiving an education inter- vention, which underscores its utility as part of the approaches of HIV/AIDS control and prevention. Keywords: HIV/AIDS knowledge; awareness; health education; university students; China.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.10
      Issue No: Vol. 20, No. 4 (2020)
  • HIV/AIDS knowledge and attitude towards people living with HIV/AIDS
           (PLWHA): a cross-sectional study of primary school teachers

    • Authors: Ignatius O Nwimo, Nwamaka A Elom, Cajetan I Ilo, Rita N Ojide, Uchechukwu A Ezugwu, Vitalis U Eke, Lazaus E Ezugwu
      Pages: 1591 - 600
      Abstract: Background: Teachers are in advantage position to propagate correct information with regard to HIV/AIDS thereby influencing attitude towards PLWHA. With correct information stigmatization leading to spread of the scourge might be prevented. Aims & Objectives: The study was conducted to determine knowledge and attitude of primary school teachers towards PLWHA. Methods & Materials: The cross-sectional survey was used to study a sample of 400 primary school teachers in Ebonyi State, Nigeria. The instrument used for data collection was researchers’ designed questionnaire. Out of 400 copies of ques- tionnaire administered; 394 representing 98.5% return rate, were used for analysis of data. Results: Results showed respondents had moderate (57.4%) knowledge concerning HIV/AIDS and positive attitude (3.09 ± 0.98) to PLWHA. Female teachers’ dispositions to PLWHA were better than the males based on their attitude scores and the difference was not significant in general knowledge of HIV/AIDS and attitude to PLWHA. Conclusion: Our findings underscore the need for a universal health education programme, focusing on HIV/AIDS educa- tion, in education institutions that train teachers in Nigeria so as to possibly mitigate the discrepancy in knowledge regarding curability of AIDS and any undesirable attitude towards PLWHA that may arise among teachers. Keywords: HIV/AIDS; knowledge; attitude; PLWHA; primary school; teachers.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.11
      Issue No: Vol. 20, No. 4 (2020)
  • Knowledge, attitude and practices about dengue fever among adults living
           in Pwani Region, Tanzania in 2019

    • Authors: Method Kazaura
      Pages: 1601 - 9
      Abstract: Background: Dengue fever (DF) is currently widespread in tropical and sub-tropical countries. Among the triggers of ep- idemic include urbanization and internal migrations. Within the past few years, there have been DF outbreaks in Tanzania. Although Pwani region is among the predicted risk areas for the DF, there is insufficient data about people’s knowledge, attitude and practices towards prevention of DF in their settings. Therefore, the aim of this study was to assess knowledge, attitude and practices about DF among adults in Pwani region in Tanzania. Methods: The cross-sectional study conducted in Mkuranga District, Pwani region in Tanzania. We used face-to-face inter- views to collect data. The main analytical procedure was descriptive using frequencies. Results: The majority, 97.7%, were aware of DF. Nevertheless, almost 80% had a low knowledge on symptoms, transmis- sion and vector control measures. Furthermore, less than 20% had positive attitude towards dengue fever prevention, sever- ity of the illness and health seeking behavior. Conclusion: Lack of enough knowledge and positive attitude about disease transmission, symptoms and preventive meas- ures put the population at high risk of contracting the disease. There is need to create and improve friendly, correct and simple information, education and education messages for the rural populations. Keywords: Attitude; Dengue; knowledge; practice; rural.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.12
      Issue No: Vol. 20, No. 4 (2020)
  • Association between osteoporosis and hepatitis B cirrhosis: a case-control

    • Authors: Yijin Zhang, Xuesong Gao, Ting Liu, Ping Gao, Hongjie Li, Nan Liu, Lili Gao, Gang Wan, Yaonan Zhang, Xuefei Duan
      Pages: 1610 - 6
      Abstract: Background and aims: Hepatitis B virus (HBV)-related cirrhosis is associated with decreased bone mineral density (BMD); however, the mechanism is yet unknown. To assess the incidence of osteoporosis in patients with HBV-associated cirrhosis and relevant mechanisms. Methods: A total of 80 hospitalized patients with HBV-associated cirrhosis and 80 healthy controls were enrolled. The levels of serum osteocalcin, total procollagen type 1 amino-terminal propeptide, β-C-terminal telopeptide of type I collagen (β-CTX), and 25-hydroxy vitamin D3 (25(OH)D3) was evaluated in the cirrhosis group. Results: The BMDs of the lumbar spine (P<0.001) and hip joints (P=0.015) in the cirrhosis group were significantly lower than those in the controls. The incidence of osteoporosis in the cirrhosis group was significantly higher than that in the con- trol group (P<0.001). Compared to the patients of the Child-Pugh grade A and B, the BMD of lumbar spine and 25(OH)D3 was significantly decreased in patients of grade C, while β-CTX was elevated. Patients in the cirrhosis group faced a higher risk of osteoporosis as compared to the controls(P<0.001). Conclusion: Enhanced bone resorption accounted for increased risk of osteoporosis in severe cirrhosis. Thus, HBV-asso- ciated cirrhosis was a risk factor for osteoporosis. Keywords: Liver cirrhosis; bone density; osteoporosis; osteopenia; hepatitis B, chronic.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.13
      Issue No: Vol. 20, No. 4 (2020)
  • Molecular detection of Mycobacterium tuberculosis in pulmonary and
           extrapulmonary samples in a hospital-based study

    • Authors: Kalal Iravathy Goud, Matam Kavitha, Adi Mahalakshmi, Ravi Vempati, Abdulaziz A Alodhayani, Arif A Mohammed, Imran Ali Khan
      Pages: 1617 - 23
      Abstract: Objective: Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), remains a deadly infectious disease. India contributes to one-third of the global TB burden. However, no studies have been carried out in the Telangana (Hyderabad) population using real-time polymerase chain reaction (RT-PCR). Therefore, the current study evaluated the role of RT-PCR as a rapid and non-invasive test to diagnose TB by testing for pulmonary tuberculosis (PTB) and extrapulmonary tubercu- losis (EPTB). Materials and methods: This hospital-based study examined 1670 samples (900 EPTB; 770 PTB) comprising tissue (n = 537), peritoneal fluid (n = 420), sputum (n = 166), bronchial fluid (n = 126), cerebrospinal fluid (n = 145), ascetic fluid (n = 76), sputum pus (n = 78), urine (n = 79), and bronchoalveolar fluid (n = 43) samples. DNA from samples was separated using specific isolation kits and subjected to RT-PCR. Results: In this study, we enrolled 1670 subjects and categorized 54.4% as females and 45.6% as males. The collected sam- ples were categorized as 48.5% of fluid samples, followed by tissue (32.2%), sputum (9.9%), urine (4.7%), and pus-swab (4.6%). RT-PCR analysis revealed that 4.7% patients were positive for Mtb. Our results revealed that 61% of the affected patients were male and 39% were female. Among the specimen types, tissue samples gave the highest proportion of positive results (36.3%). Conclusion: The results showed that RT-PCR should be implemented and given top priority in TB diagnosis to save time and facilitate a definitive diagnosis. Tissue samples are highly recommended to screen the Mtb through the technique RT- PCR. Future studies should extend the technique to the global population and exome sequencing analysis should be per- formed to identify TB risk markers. Keywords: Tuberculosis (TB); EPTB; PTB; Mycobacterium tuberculosis (Mtb).
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.14
      Issue No: Vol. 20, No. 4 (2020)
  • Prevalence of Helicobacter pylori infection among children with primary
           nephrotic syndrome: a cross-sectional study

    • Authors: Ahmed Mahmoud, Ashraf Bakr, Afaf Elsaid, Yahya Wahba
      Pages: 1624 - 31
      Abstract: Background: Limited data are available about the prevalence of helicobacter pylori (H.pylori) infection among primary NS children. Objectives: To assess the frequency and risk factors of H.pylori infection among children with primary NS. Methods: A cross-sectional study was carried out in Mansoura University Children’s Hospital, Egypt during the period from 2017 to 2019 including 100 NS children (NS group) and 100 healthy controls. NS group included 88 steroid sensitive (SSNS) and 12 steroid resistant (SRNS) cases. All patients were assessed for H.pylori infection using H.pylori stool antigen (HpSA) test. Statistical analysis was done using chi-square, fisher exact and Mann-Whitney tests. Results: With regard to HpSA test results, no significant differences were detected between control and NS groups (p = 0.193) and between SSNS and SRNS groups (p = 0.286). Concerning total biopsied cases and MCD (proven plus presumed) cases, no significant differences were found between those with positive and negative HpSA test (p = 0.648 and 0.126, re- spectively). The high dose of steroid therapy was associated with a higher risk of H.pylori infection among NS group (Odds ratio = 3.8; 95% confidence interval = 1.3-11.3). Conclusion: The current study negates the increased risk of H.pylori infection in children with primary NS. Keywords: Children; H.pylori; primary nephrotic syndrome.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.15
      Issue No: Vol. 20, No. 4 (2020)
  • Sensitizing multi drug resistant Staphylococcus aureus isolated from
           surgical site infections to antimicrobials by efflux pump inhibitors

    • Authors: Baiomy Amr A, Shaker Ghada H, Abbas Hisham A
      Pages: 1632 - 45
      Abstract: Background: Staphylococcus aureus is a common hospital acquired infections pathogen. Multidrug-resistant Methicillin-resist- ant Staphylococcus aureus represents a major problem in Egyptian hospitals. The over-expression of efflux pumps is a main cause of multidrug resistance. The discovery of efflux pump inhibitors may help fight multidrug resistance by sensitizing bacteria to antibiotics. This study aimed to investigate the role of efflux pumps in multidrug resistance. Methods: Twenty multidrug resistant S. aureus isolates were selected. Efflux pumps were screened by ethidium bromide agar cartwheel method and polymerase chain reaction. The efflux pump inhibition by seven agents was tested by ethidium bromide agar cartwheel method and the effect on sensitivity to selected antimicrobials was investigated by broth microdilu- tion method. Results: Seventy percent of isolates showed strong efflux activity, while 30% showed intermediate activity. The efflux genes mdeA, norB, norC, norA and sepA were found to play the major role in efflux, while genes mepA, smr and qacA/B had a minor role. Verapamil and metformin showed significant efflux inhibition and increased the sensitivity to tested antimicrobials, while vildagliptin, atorvastatin, domperidone, mebeverine and nifuroxazide showed no effect. Conclusion: Efflux pumps are involved in multidrug resistance in Staphylococcus aureus. Efflux pump inhibitors could increase the sensitivity to antimicrobials. Keywords: Staphylococcus aureus; multidrug resistance; efflux pump inhibitors.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.16
      Issue No: Vol. 20, No. 4 (2020)
  • Antibiotic prescribing practices in three neonatology units in Kigali,
           Rwanda. – an observational study

    • Authors: Peter Thomas Cartledge, Fidel Shofel Ruzibuka, Florent Rutagarama, Samuel Rutare, Tanya Rogo
      Pages: 1646 - 54
      Abstract: Introduction: There is limited published data on antibiotic use in neonatal units in resource-poor settings. Objectives: This study sought to describe antibiotic prescribing practices in three neonatology units in Kigali, Rwanda. Methods: A multi-center, cross-sectional study conducted in two tertiary and one urban district hospital in Kigali, Rwan- da. Participants were neonates admitted in neonatology who received a course of antibiotics during their admission. Data collected included risk factors for neonatal sepsis, clinical signs, symptoms, investigations for neonatal sepsis, antibiotics prescribed, and the number of deaths in the included cohort. Results: 126 neonates were enrolled with 42 from each site. Prematurity (38%) followed by membrane rupture more than 18 hours (25%) were the main risk factors for neonatal sepsis. Ampicillin and Gentamicin (85%) were the most commonly used first-line antibiotics for suspected neonatal sepsis. Most neonates (87%) did not receive a second-line antibiotic. Cefotaxime (11%), was the most commonly used second-line antibiotic. The median duration of antibiotic use was four days in all sur- viving neonates (m=113). In neonates with negative blood culture and normal C-reactive protein (CRP), the median duration of antibiotics was 3.5 days; and for neonates, with positive blood cultures, the median duration was 11 days. Thirteen infants died (10%) at all three sites, with no significant difference between the sites. Conclusion: The median antibiotic duration for neonates with normal lab results exceeded the recommended duration mandated by the national neonatal protocol. We recommend the development of antibiotic stewardship programs in neo- natal units in Rwanda to prevent the adverse effects which may be caused by inappropriate or excessive use of antibiotics. Keywords: (MeSH): Antimicrobial stewardship; anti-bacterial agents; neonatal sepsis; sepsis; infant mortality; neonatal intensive care units; Africa; Rwanda.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.17
      Issue No: Vol. 20, No. 4 (2020)
  • Clinical and microbiological profile of adult inpatients with community
           acquired pneumonia in Ilorin, North Central, Nigeria

    • Authors: Olutobi Babatope Ojuawo, Olufemi Olumuyiwa Desalu, Ademola Emmanuel Fawibe, Ayotade Boluwatife Ojuawo, Adeniyi Olatunji Aladesanmi, Christopher Muyiwa Opeyemi, Mosunmoluwa Obafemi Adio, Abdulraheem Olayemi Jimoh, Dele Ohinoyi Amadu, Abayomi Fadeyi, Kazeem Alakija Salami
      Pages: 1655 - 68
      Abstract: Background: The optimal management of community acquired pneumonia (CAP) depends on the clinical and microbio- logical profile in the locality. Objectives: To determine the clinical and microbiological profile of patients admitted with CAP in Ilorin, Nigeria. Methods: One hundred and two consenting consecutively selected patients with clinical and radiologic confirmation of CAP were recruited in 12 months. The socio-demographic, physical examination and laboratory/radiologic parameters were documented in a questionnaire. Microbiological evaluation of their sputum was done and blood samples were taken for complete blood count, culture, serum urea and serological evaluation for atypical bacteria and some viral pathogens. Results: CAP constituted 5.9% of the total medical admissions during the one-year study period. The mean age of the pa- tients was 49 ± 22 years with the largest frequency in those aged 65 years and above. The commonest symptoms were short- ness of breath (96.1%) and cough (94.1%), with a median duration of 3 days from symptom onset to admission. Systemic hypertension was the commonest comorbid illness (25/102; 24.5%). Klebsiella pneumoniae was the predominant pathogen iso- lated (20/102; 28.1%). The susceptible antibiotics were Imipenem, Ceftazidime and Ceftriaxone. Intra-hospital mortality was 17.6%. CURB – 65 score of ≥ 2 and the presence of complications of CAP were the independent predictors of mortality. Conclusion: CAP constitutes a significant disease burden in Ilorin, Nigeria. Typical bacteria accounted for over half of the pathogens isolated from the patients with gram negative agents predominating. This highlights a possible shift in the micro- biological profile which could guide empirical treatment. Keywords: Community acquired pneumonia; microbiological profile; Nigeria.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.18
      Issue No: Vol. 20, No. 4 (2020)
  • Cryptosporidium spp., Giardia duodenalis and Toxoplasma gondii detection
           in fresh vegetables consumed in Marrakech, Morocco

    • Authors: Salma Berrouch, Sandie Escotte-Binet, Yassine Amraouza, Pierre Flori, Dominique Aubert, Isabelle Villena, Jamaleddine Hafid
      Pages: 1669 - 78
      Abstract: Background: Protozoan parasites such as Toxoplasma gondii, Giardia duodenalis, and Cryptosporidium spp., can be transmitted to humans via accidental consumption of contaminated water, fresh produce and foodstuffs. There is a lack of epidemiological data about these pathogens in Morocco. Hence the aim of this study, which is the determination of their prevalence in some leafy greens and root vegetables sold in Marrakech. Methods: A total of 132 vegetable samples including carrot, coriander, lettuce, parsley and radish were purchased monthly from three different markets in Marrakech from March 2017 to January 2018, pre-treated and subjected to microscopic and molecular analyses. Results: Of the 132 samples of vegetables analyzed by qPCR, the overall rate of protozoan was 21.21% (28/132); 22 samples were found to be contaminated with T. gondii, 6 with G. duodenalis, and none was positive for C. parvum/hominis. Whereas, modified Ziehl-Neelsen staining allowed the detection of Cryptosporidium spp. in 3% (4/132) of examined samples. Conclusion: This survey on the presence of protozoan parasites in fresh vegetables revealed that vegetables sold in Marrakech are contaminated by these protozoan parasites, as it showed that leafy green vegetables were more susceptible for parasitic contamination than root ones. Keywords: Fresh vegetables; protozoan parasites; Marrakech; qPCR.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.19
      Issue No: Vol. 20, No. 4 (2020)
  • Improved antimalarial activity of caprol-based nanostructured lipid
           carriers encapsulating artemether-lumefantrine for oral administration

    • Authors: Paul Achile Akpa, Joseph Abuchi Ugwuoke, Anthony Amaechi Attama, Chinenye Nnenna Ugwu, Ezinwanne Nneoma Ezeibe, Mumuni Audu Momoh, Adaeze Chidiebere Echezona, Franklin Chimaobi Kenechukwu
      Pages: 1679 - 97
      Abstract: Background: Artemether and lumefantrine display low aqueous solubility leading to poor release profile; hence the need for the use of lipid-based systems to improve their oral bioavailability so as to improve their therapeutic efficacy. Aim and objective: The objective of this work was to utilize potentials of nanostructured lipid carriers (NLCs) for im- provement of the oral bioavailability of artemether and lumefantrine combination and to evaluate its efficacy in the treat- ment of malaria. This study reports a method of formulation, characterization and evaluation of the therapeutic efficacies of caprol-based NLC delivery systems with artemether and lumefantrine. Method: The artemether-lumefantrine co-loaded NLCs were prepared using the lipid matrix (5% w/w) (containing beeswax and Phospholipon® 90H and Caprol-PGE 860), artemether (0.1%w/w) and lumefantrine (0.6%w/w), sorbitol (4%w/w), Tween® 80( 2%w/was surfactant) and distilled water (q.s to 100%) by high shear homogenization and evaluated for phys- icochemical performance. The in vivo antimalarial activities of the NLC were tested in chloroquine-sensitive strains of Plasmodium berghei (NK-65) using Peter´s 4-day suppressive protocol in mice and compared with controls. Histopathological studies were also carried out on major organs implicated in malaria. Results: The NLC showed fairly polydispersed nano-sized formulation (z-average:188.6 nm; polydispersity index, PDI=0.462) with no major interaction occurring between the components while the in vivo study showed a gradual but sus- tained drug release from the NLC compared with that seen with chloroquine sulphate and Coartem®. Results of histopatho- logical investigations also revealed more organ damage with the untreated groups than groups treated with the formulations. Conclusion: This study has shown the potential of caprol-based NLCs for significant improvement in oral bioavailability and hence antimalarial activity of poorly soluble artemether and lumefantrine. Importantly, this would improve patient com- pliance due to decrease in dosing frequency as a sustained release formulation. Keywords: Nanostructured lipid carriers; artemether-lumefantrine; malaria; Caprol.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.20
      Issue No: Vol. 20, No. 4 (2020)
  • In vivo studies on the biochemical indices of Plasmodium berghei infected
           mice treated with Alstonia boonei leaf and root extracts

    • Authors: Grace C Onyishi, Godwin C Nwosu, Joseph E Eyo
      Pages: 1698 - 709
      Abstract: Background: A study on the biochemical indices of albino mice infected with Plasmodium berghei and treated with Alstonia boonei aqueous and ethanolic extracts was undertaken. Methods: 216 males mice were randomly assigned to six treatment groups each containing six mice for both aqueous and ethanolic extracts experiments. P. berghei NK-65 was inoculated into the mice intraperitoneally and establishment of infection confirmed. Administration of extracts of was done after phytochemical and acute toxicity tests at varying concentrations, for both suppressive and curative tests. Blood samples collected by ocular puncturing were examined for the biochemical indices; ALT, AST, ALP, creatinine and total protein using the standard procedures. Results: A. boonei extracts suppression of P. berghei in mice was comparable to the standard drug. Significantly higher (p<0.05) recovery of mice treated with A. boonei extracts was observed. The biochemical indices examined all had signif- icantly (p<0.05) increased concentration after 7 days post-infection, except for total protein concentration which had no significant increase or decrease due to A. boonei extracts administration. Conclusion: The antiplasmodial potentials of A. boonei leaf and root extracts were dosage and duration-dependent, and have demonstrated satisfactory normalization of altered biochemical indices due to malaria. Keywords: In vivo; anti-malaria; Alstonia boonei; biochemical; Plasmodium berghei; mice.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.21
      Issue No: Vol. 20, No. 4 (2020)
  • Investigation of high-resolution computed tomographic (HRCT) outcomes
           associated with chronic pulmonary microaspiration (CPM) in Tehran and
           Zahedan, Iran

    • Authors: Bahareh Heshmat Ghahderijani, Fatemeh Hosseinabadi, Shahram Kahkouee, Mohamad Kazem Momeni, Samira Salajeghe, Hussein Soleimantabar
      Pages: 1710 - 5
      Abstract: Background: In patients with chronic pulmonary microaspiration (CPM) the recognition of high-resolution computed tomographic (HRCT) findings and their pattern is important. Objective: To investigate the HRCT detections in patients with CPM. Materials and Methods: This descriptive study enrolled 100 consecutive patients with CPM underwent HRCT of the lungs between 2017 and 2018 in Tehran and Zahedan Hospitals and private centers. The required variables were recorded for each patient with a questionnaire. Subsequently, HRCT was performed and abnormalities were then reported by two radiologists. Results: Most of patients exhibited bronchial thickening in 33.6% of cases, followed by ground-glass opacity (12.4%), em- physema (11.1%), and bronchiectasis (8.5%). In addition, the most common HRCT findings were found in left lower lobe (LLL) (37.1%), followed by right lower lobe (RLL) (35.9 %), right upper lobe (RUL ) (6,2%), and left upper lobe (LUL) (6%). Conclusion: Our data showed the most common findings in HRCT were bronchial thickening ground-glass opacity, em- physema, and bronchiectasis, where these findings was dominantly found in LLL, RLL, RUL, and LUL, indicating its high tendency to dependent areas. Keywords: Imaging; high-resolution computed tomographic; chronic lung microaspiration.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.22
      Issue No: Vol. 20, No. 4 (2020)
  • Comparing the association of cardiovascular nursing care with blood
           pressure and length of stay of in-patients with coronary artery disease in
           Wuhan, China

    • Authors: Fatina B Ramadhani, Yilan Liu, Xue Jing, Ye Qing, Han Xiong, Fengjian Zhang, Pian Wei
      Pages: 1716 - 24
      Abstract: Background: Coronary artery disease is a leading cause of morbidity and mortality worldwide. Comorbidity-like hyperten- sion has been among the major risks of coronary artery disease. Recent evidence identified multiple benefits of cardiovas- cular nursing care to coronary patients. However, little has been appraised on benefits regarding patients’ blood pressure control and length of hospitalisation. Objective: To compare the association of cardiovascular nursing care delivered to coronary artery patients with patients’ blood pressure and length of stay. Methods: Records based retrospective design was applied at a large teaching hospital in Wuhan, China. SPSS 21 version was used for data entry and analysis with univariate and multivariate logistic regression models for comparing study variables. Results: Of 300 patients, 224 (74.7%) were known to be hypertensive and admitted with subnormal blood pressure. Cardiovascular nursing care like “assess to grade pain severity on 1-10 scale” and “counsel patient to cope with stress” were six and three times more likely to contribute improved patients’ blood pressure (AOR=5.8; 95%CI: 2.8-12.2, p=0.001) and (AOR=3.1; 95%CI: 1.2-7.8, p=0.015) respectively. No significant difference with length of stay (p>0.05). Conclusion: There is a possibility of coronary artery patients to recover with normal blood pressure following reception of evidence-based cardiovascular nursing care. Keywords: Cardiovascular nursing care; blood pressure; in-patients; coronary artery; Wuhan; China.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.23
      Issue No: Vol. 20, No. 4 (2020)
  • The prevalence of hypertension and influencing factors among the employees
           of a university hospital

    • Authors: Seher Kurtul, Funda Kaya Ak, Meral Türk
      Pages: 1725 - 33
      Abstract: Background: Hypertension is a serious disease with increasing worldwide prevalence, leading to life-threatening complica- tions. Methods: This cross-sectional study was carried out in a university hospital. The Occupational Health and Safety Unit data concerning the health examinations of employees were used to determine the prevalence of hypertension in a university hospital and to define the relationship between hypertension and sociodemographic and occupational parameters. Logistic regression analyses were performed for the variables having a significant association with high blood pressure. Results: The data generated during the periodic examination of 3,480 (92%) of all employees (3,780) were analyzed. The prevalence of hypertension was 14.8%. The prevalence of hypertension was found to be 13.5%, 13.9%, and 23.7% among physicians, non-physician healthcare personnel and officers respectively. The logistic regression model revealed a statistically significant correlation between hypertension and male gender, age and BMI. Conclusion: The prevalence of hypertension was highest among staff members. Special programs would facilitate the diagnosis, control, and prevention of high blood pressure among the high-risk groups, especially men, the elderly and the obese hospital employees. Keywords: Hypertension; hospital; health care worker.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.24
      Issue No: Vol. 20, No. 4 (2020)
  • Developmental outcomes of HIV-exposed infants in a low-income South
           African context

    • Authors: Carmen Cornelia de Beer, Esedra Krüger, Jeannie van der Linde, Renata Eccles, Marien Alet Graham
      Pages: 1734 - 41
      Abstract: Background: Effective HIV transmission prevention strategies have led to a growing population of vulnerable HIV- and antiretroviral-exposed infants in sub-Saharan Africa, however uncertainty exists regarding their development. Objective: To determine the developmental outcomes of HIV-exposed (HE) infants in a low-income South African con- text, when compared to HIV-unexposed (HU) counterparts. Methods: In this prospective cross-sectional, group comparison study, the development of 41 HE and 40 HU infants (mean age=8.4 months, SD=2.1 months) from a low-income context was assessed. Caregivers were interviewed using the Vineland Adaptive Behavior Scales, Third Edition (Vineland-3) to evaluate infants’ development. Results: Most HE participants had age-appropriate overall development (90.2%;n=37). Some HE participants, however, presented with delays in domains of communication (9.8%;n=4), daily living skills (2.4%;n=1), socialisation (19.5%;n=8), and motor development (7.3%;n=3). HU participants also demonstrated some domain-specific delays, thus delays were present in both groups. No statistically significant between-group differences regarding development were found. Conclusion: Findings were reassuring and suggested that HE and HU participants had similar development. Developmen- tal differences may, however, only emerge with age, therefore large-scale longitudinal research is recommended. It is suggest- ed that the entire sample was vulnerable, highlighting the importance of developmental surveillance in low-income contexts, irrespective of HIV and antiretroviral exposure status. Keywords: Developmental outcomes; HIV-exposed infants; low-income context.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.25
      Issue No: Vol. 20, No. 4 (2020)
  • ECG abnormalities among HIV infected children placed on ART at Enugu,
           South East of Nigeria

    • Authors: Emeka Spiff Eleazar, Clara Idara Eleazar, Daniel Chukwu Nwachukwu, Uchenna Ifeanyi Nwagha
      Pages: 1742 - 8
      Abstract: Background: Cardiovascular abnormalities are not much reported among human immunodeficiency virus (HIV) infected children especially in Africa where there is high HIV disease. In addition, the use of highly active antiretroviral therapy (HAART) in such children may have a protective effect on the cardiovascular system. Methods: Cross-sectional study of randomly selected eighty HIV infected and 80 aged matched non- HIV-infected chil- dren were used. HIV-infected children were on HAART for more than 5years and had steadily received the treatment for 6 months prior to the time of the tests. Heights and weights were measured and body mass index calculated. Cardiac indi- ces evaluated were heart rate (HR), PR interval, QRS duration, QT/QTC Interval, P/QRS/T Axis, RV5/SV1 voltage and RV5+SV1 voltage. Results: The average heart rate was significantly higher among HIV infected children on HAART than their non-infected counterparts (P= 0.019). At 0.05 significance level, their PR interval was significantly higher than those in the control group (P=0.050). The average QRS duration result also showed a significant difference between that of test and control subjects (P = 0.022) Conclusion: The HAART usage possibly improved the cardiovascular functioning in the infected children but the protective effects diminish with increase age and longer exposure. Keywords: HIV; cardiovascular; children; HAART.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.26
      Issue No: Vol. 20, No. 4 (2020)
  • Relationship of left ventricular and atrial dimensions with moderate to
           severe left ventricular diastolic dysfunction (grade II and above)

    • Authors: Muhammad Hamza, Mishal Fatima, Muhammad Masood, Hafiz Umar Masood, Ghazal Tasleem, Hassaan Ahmed, Maha Nadir, Zubair Satti
      Pages: 1749 - 53
      Abstract: Introduction: Left ventricular diastolic dysfunction (DD) is an entity in which the ventricle fails to fill up properly due to impaired ventricular relaxation and/or decreased compliance. The diagnosis of diastolic dysfunction is based on a variety of parameters in doppler echocardiograpy. However, some parameters like interventricular septal thickness in diastole (IVSd), posterior wall thickness in diastole (PWd), left ventricular internal end diastolic and systolic diameters (LVIDD and LVISD) along with left atrial diameters (LAD) have yet to be evaluated for the diagnostic workup of DD. Methods: A case control study was done in the cardiology department from patient records from 2016 to 2018. Patients were diagnosed as diastolic dysfunction grade II and above by doppler echocardiography. IVSd, PWd, LVIDD, LAD, LVISD were obtained through 2-D echocardiography. Results: Patients with DD had greater LAD, IVSd and PWd and decreased LVIDD and LVISD as compared to control group. Overall, IVSD was the most significant predictor (OR 1.52 95%CI 1.35-1.71) of DD followed by PWd and LAD. Similarly, LAD, IVSd and PWd had higher sensitivity and specificity than LVIDD and LVIDS. Conclusion: IVSd, LAD and PWd showed significant performance in the diagnosis of diastolic dysfunction and hence can be used as a screening and diagnostic tool in diastolic dysfunction of grade ll and above. Keywords: Heart failure; diastolic; echocardiography; left ventricle.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.27
      Issue No: Vol. 20, No. 4 (2020)
  • The relationship between epicardial fat thickness and high-grade

    • Authors: Isa Sincer, Emrah Erdal, Adnan Gucuk, Emre Bostancı, Yilmaz Gunes
      Pages: 1754 - 60
      Abstract: Background: Varicocele is abnormal dilation of testis veins. The precise mechanism of varicocele is not fully understood despite some hypothesis were suggested in the literature. Disequilibrium between constrictor and dilatator mechanism of the veins have been shown to cause varicocele. High-grade varicoceles have been also linked to endothelial dysfunction and increased vasoconstriction. Objectives: We hypothesized that epicardial fat thickness (EFT), flow-mediated dilatation (FMD) and aortic stiffness (AS) could be associated with varicocele. In the present study, we aimed to compare vascular parameters such as FMD, EFT and AS in healthy subjects and high-grade varicocele patients. Methods: The study population consisted of 35 men with high-grade varicocele and 32 age- and sex-matched control subjects younger than 45 years old. This is a cross-sectional study conducted at Bolu Abant Izzet Baysal University Hospital between May to October 2018. Results: EFT, aortic diastolic diameters (AoDD) and EFT/BMI ratio were significantly higher in control group than in pa- tients with high-grade (p=0.012, p=0.044, p=0.026, respectively). EFT and EFT /BMI ratio were significantly and inversely correlated with presence of varicocele (r=-0.422, p=0.009; r=-0.38, p=0.026, respectively). Conclusion: The present study suggests that high-grade varicocele may be associated with decreased echocardiographic EFT but not with aortic stiffness and FMD. Keywords: High-grade varicocele; epicardial fat thickness, flow-mediated dilatation, aortic stiffness.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.28
      Issue No: Vol. 20, No. 4 (2020)
  • Aerobic exercise affects sleep, psychological wellbeing and immune system
           parameters among subjects with chronic primary insomnia

    • Authors: Shehab M Abd El-Kader, Osama H Al-Jiffri
      Pages: 1761 - 9
      Abstract: Background: Chronic primary insomnia is characterized by long-term difficulties in maintaining and initiating sleep, too early waking up, poor mood, fatigue, impaired concentration and poor quality of life. Exercise training is recommended to prevent and alleviate sleep disorders. Objective: The aim of the study was to investigate the influence of aerobic exercise training on quality of sleep, psycho- logical wellbeing and immune system among subjects with chronic primary insomnia. Material and methods: Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 35-56 years. All participants were randomly assigned to supervised aerobic exercise intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, Beck Depression Inventory (BDI), Profile of Mood States(POMS), Rosenberg Self-Esteem Scale (RSES), number of CD3+,CD4+,CD8+ T cells count and CD4/CD8 ratio were measured before and at the end of the study after six months. Results: There was a significant increase in the total sleep duration, sleep efficiency and sleep onset latency in group(A) after six months of aerobic exercise training, while, wake time after sleep onset and rapid eye movement (REM) latency significantly reduced after six months of aerobic training compared with values obtained prior to aerobic exercise training. Also, the mean values of BDI, POMS, CD3 count, CD4 count and CD8 count decreased significantly and the mean value of RSES significantly increased in group (A) after the aerobic exercise training, while the results of the control group were not significant. Moreover, there were significant differences between both groups at the end of the study. Conclusion: Exercise training can be considered as a non-pharmacological modalty for modifying sleep quality, psycholog- ical wellbeing and immune system among subjects with chronic primary insomnia. Keywords: Aerobic exercise; chronic primary insomnia; immune function; sleep quality; psychological wellbeing.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.29
      Issue No: Vol. 20, No. 4 (2020)
  • Association of FADS2 rs174575 gene polymorphism and insulin resistance in
           type 2 diabetes mellitus

    • Authors: Shilpa S Shetty, Suchetha Kumari N, Harshini Devi, Sharmila KP, Srinidhi Rai
      Pages: 1770 - 6
      Abstract: Background: Many risk factors contribute to the pathogenesis of diabetes. Gene and lifestyle factors are considered to be the major contributors. A dietary pattern is attributed to be one of the lifestyle risk factors favoring diabetes. The present study aims to find an association between fatty acid desaturase (FADS) gene polymorphism and glycemic profile in type 2 diabetes mellitus (T2DM). Methodology: A total of 429 subjects were included in the study on the basis of inclusion and exclusion criteria, of which 213 and 216 subjects were diabetic and control, respectively. Body mass index was calculated. Fasting plasma glucose, gly- cated hemoglobin (HbA1c) and insulin were measured using commercially available kits. rs174575 of FADS2 was selected based on previous publications and identified using the dbSNP database. To compare the biochemical parameters with the genotype, the following three models were used: additive model (CC vs CG vs GG), dominant model (CC + CG vs GG), and recessive model (CC vs CG + GG). Results and Discussion: FBS, HbA1c, insulin, HOMA-IR, and HOMA-B exhibited a high and statistically significant difference between subjects and controls. The three models exhibited a statistically significant difference between FBS, HO- MA-IR, and HOMA- B (p<0.05). Conclusion: The distribution of rs174575 genotype differed significantly between the subjects and controls in the present study. The study revealed that genetic variation in FADS2 is an additional facet to consider while studying the risk factors of T2DM. Keywords: Fatty acid desaturase; gene polymorphism; type 2 diabetes mellitus.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.30
      Issue No: Vol. 20, No. 4 (2020)
  • Effects of body weight and posture on pulmonary functions in asthmatic

    • Authors: Ghobrial Emad Emil, El Baz Mohamed Saad, Abdel Fattah Mohammed, Haroun Manar Mohamed
      Pages: 1777 - 84
      Abstract: Background: Asthma is one of the most common chronic illnesses in the world. Pulmonary function tests are important tools in monitoring of asthmatic patients. There is need for investigating if spirometric indices were affected by body weight or posture or not. Objectives: The aim of this study was to evaluate the spirometric measurements in standing and sitting positions in a group of Egyptian asthmatic children with different body weights. Methods: Sixty patients were included. They were stable asthmatics and were following up in the allergy clinic. Spirometry was conducted at pulmonary functions laboratory of Pediatric Allergy and Chest Unit of New Children’s University Hospi- tal, Cairo. The one-way analysis of variance was used to test the differences between groups. The Duncan multiple compar- ison test was used to test the significant differences between each pair of groups. Results: The study found that sitting FEV1/FVC is significantly lower in overweight/obese asthmatic children compared to normal weight asthmatic children (p value=0.046). Conclusion: There was no effect of weight on standing spirometric data. Weight showed significant negative correlation with asthma control level. We concluded that in overweight/obese asthmatic children, spirometric position might affect the results. Keywords: Body weight; posture; asthmatic children.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.31
      Issue No: Vol. 20, No. 4 (2020)
  • The relationship between sleep quality and dyspnoea severity in patients
           with COPD

    • Authors: Emine Kaplan Serin, Emine Derya Ister, Ahmet Ozdemir
      Pages: 1785 - 92
      Abstract: Objectives: This study aimed to determine sleep quality, frequency and severity of dyspnoea in COPD patients and to eval- uate the relationship between dyspnoea severity and sleep quality. Method: The sample of the study consisted of 110 patients admitted to the Chest Diseases polyclinic of a private hospital and diagnosed as COPD for at least one year. The data of the study were collected using the "Individual Information Form", "COPD and Asthma Sleep Scale (CASIS)" and "Medical Research Council (MRC) Dyspnoea Scale”. Results: It was found that 6.4% of the patients did not experience dyspnoea, 34.5% had mild, 40.9% had moderate, and 18.2% had severe dyspnoea. The mean CASIS score of the patients without dyspnoea was 29.08±7.83, with mild dyspnoea was 40.22±9.30, with moderate dyspnoea was 50.31±8.97 and with severe dyspnoea was 56.96±13.13. There was a statisti- cally significant difference between dyspnoea severity and mean CASIS score (p=0.001). Correlation analysis between MRC dyspnoea scale and CASIS score showed a significant positive correlation (r=0.61 p=0.001). Conclusion: It was concluded that the majority of COPD patients had moderate or poor sleep quality and dyspnoea. As dyspnoea severity increases, sleep quality decreases. Keywords: Dyspnoea; COPD; Sleep.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.32
      Issue No: Vol. 20, No. 4 (2020)
  • Acute effects of electronic cigarette smoking on ventricular
           repolarization in adults

    • Authors: Vahit Demir, Siho Hidayet, Yaşar Turan, Hüseyin Ede
      Pages: 1793 - 9
      Abstract: Background: Electronic cigarette (e-cigarette) use is constantly increasing. However, the association between e-cigarette use and ventricular arrhythmia is unknown. Thus, in this study, we aimed to evaluate the markers of ventricular repolarization such as QT interval, corrected QT (QTc), QT dispersion (QTd), peak-to-end interval of the T wave (Tp-e), corrected Tp-e and Tp-e/QT ratios in e-cigarette users. Methods: The study population consisted 36 e-cigarette users and 40 healthy subjects. Ventricular repolarization parameters were obtained from 12-lead resting electrocardiogram. Ventricular repolarization parameters of the groups were compared. Results: Basal demographic and laboratory data were similar in both groups. According to the electrocardiographic parameters, the Tp-e interval, corrected Tp-e, and Tp-e/QT ratio were significantly higher in individuals using e-ciga- rettes than in control subjects [74.9±6.4 milliseconds (ms) vs. 80.1±4.1ms, <0.001; 82.9±7.5 ms vs. 87.8±6.3 ms, p=0.003; 0.20±0.01 vs. 0.21±0.01, p=0.002; respectively]. Conclusion: This is the first study to show the disruption of ventricular repolarization properties in e-cigarette users. E-cig- arette use in terms of public health leads to augmentation of transmural dispersion of repolarization, which may be potential indicator of ventricular arrhythmogenesis. Keywords: Electronic cigarette; ventricular repolarization; Tp-e interval; Tp-e/QT ratio.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.33
      Issue No: Vol. 20, No. 4 (2020)
  • Association between APOC3 polymorphisms and non-alcoholic fatty liver
           disease risk: a meta-analysis

    • Authors: Jun Wang, Chuncui Ye, Sujuan Fei
      Pages: 1800 - 8
      Abstract: Background and Aim: The apolipoprotein C3 (APOC3) polymorphism has been reported to predispose to non-alcoholic fatty liver disease (NAFLD). However, the results remain inconclusive. This meta-analysis aimed to provide insights into the association between APOC3 polymorphisms and NAFLD risk. Methods: Studies with terms “NALFD” and “APOC3” were retrieved from PubMed, Web of Science, CNKI and Wan- fang databases up to August 1, 2019. Pooled odds ratio (OR) and 95% confidence interval (95% CI) for the association of APOC3 polymorphisms and NAFLD risk were calculated using fixed and random-effects models. Results: A total of twelve studies from eleven articles were included. Of them, eight studies (1750 cases and 2181 controls) reported the strong association of variant rs2854116 with NAFLD and six studies (1523 cases and 1568 controls) found the association of rs2854117 polymorphism with NAFLD. Overall, a statistically significant association between rs2854116 pol- ymorphism of APOC3 gene and NAFLD risk was found only under dominant model. However, association of rs2854117 polymorphism with NAFLD risk was not detected under all four genetic models. In sub-group analysis of NAFLD subjects based on country, no association among them in China was detected. Besides, four studies analyze the association between the two polymorphisms and clinical characteristics in all subjects or NAFLD patients, and we also failed detect any associa- tion between the wild carriers and variant carriers. Conclusion: The meta-analyses suggests that the rs2854116 polymorphism but not rs2854117 polymorphism in APOC3 gene might be a risk factor for NAFLD among Asians. That is, individuals with CT+CC genotype have higher risk of devel- oping NAFLD. However, studies with sufficient sample size are needed for the further validation. Keywords: Apolipoprotein C3; polymorphism; non-alcoholic fatty liver disease; meta-analysis.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.34
      Issue No: Vol. 20, No. 4 (2020)
  • The effect of home care based on the Neuman systems model on symptomatic
           relief and quality of life in patients undergoing hemodialysis

    • Authors: Kevser Işik, Behice Erci
      Pages: 1809 - 16
      Abstract: Background: Chronic renal failure (CRF) is an important common health problem with high morbidity and mortality rate in the world and in Turkey. Objectives: This study was conducted to determine the effect of home care based on the Neuman Systems Model on relief of physical and psychological symptoms and quality of life in patients undergoing hemodialysis. Methods: This study was conducted as a pretest-posttest randomized controlled trial. The sample of the study was com- posed of 160 hemodialysis patients. The patients were randomly and sequentially assigned to experimental and control groups as 80 hemodialysis patients. Results: After the intervention, it was determined that the symptoms levels of the patients in the experimental group re- duced and their quality of life increased. Conclusion: The care provided based on the Neuman Systems Model reduced the symptoms of the patients having hemo- dialysis treatment and enhanced their quality of life. Care given using a model is important in improving the quality of life of hemodialysis patients. Keywords: Hemodialysis; dialysis symptom; quality of life.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.35
      Issue No: Vol. 20, No. 4 (2020)
  • Bilateral paediatric cataract surgery - outcomes of 298 children from
           Kinshasa, the Democratic Republic of the Congo

    • Authors: Janvier Kilangalanga Ngoy, Thomas Stahnke, Serge Dinkulu, Emile Makwanga, Astrid Moanda, Georgette Ngweme, Edith Mukwanseke, Günther Kundt, Frank Thiesen, Adrian Hopkins, Rudolf F Guthoff
      Pages: 1817 - 27
      Abstract: Introduction: The leading cause of childhood blindness globally is paediatric cataract. Bilateral cataract surgery can help to improve visual performance and to diminish the burden of childhood blindness. Objective: To report in a retrospective observational cohort study the long-term outcomes of 298 children who had bilat- eral cataract surgery with IOL implantation from 2001-2016 in Kinshasa. Methods: A standardized surgical treatment of paediatric cataract was practiced on 298 children. Patient’s follow-up, com- plications, and visual outcomes were recorded and analysed. Results: The mean age was 5.7 ± 4.3 years and males were predominant (64.9%). Most of children were living mainly in urban poorest areas (96.3%). Strabismus, nystagmus and microcornea were encountered in 20.1%, 25.1% and 8.7% of children, respectively. Using WHO criteria most of patients were classified as blind preoperatively and 81.9% of them had improved visual outcomes after surgery. Main reasons for reduced vision during follow-up were secondary cataract (5.7%), IOL decentration (1.2%), retinal detachment (1.2%), and secondary glaucoma (1.5%). Conclusion: In spite of the post conflict challenges, elimination of cataract blindness in children remains a priority. Children present at a late age for surgery and long term follow-up is poor. There is need for program strengthening in these areas. Keywords: Paediatric cataract surgery; bilateral cataract; outcomes.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.36
      Issue No: Vol. 20, No. 4 (2020)
  • Bilateral oedipism: a case of extreme self-harm in an African society
           averse to self-mutilation

    • Authors: Ugochukwu Uzodimma Nnadozie, Okwudili Nicodemus Obayi, Edak Ezeanosike, Christian Eze, Charles Chidiebele Maduba, Fortune Udoka Nnadozie, Kene Joe-Akunne, Christian Chidebe Anikwe
      Pages: 1828 - 30
      Abstract: Nil
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.37
      Issue No: Vol. 20, No. 4 (2020)
  • Evaluation of MRI Artifact in some selected centers in Kano Metropolis,

    • Authors: Sidi Mohammed, Muhammad Abubakar
      Pages: 1831 - 9
      Abstract: Background: Magnetic Resonance Imaging (MRI) artifacts can occur due to hardware or software related problems, human physiologic phenomenon or physical restrictions. Careful study design and scanning protocols can prevent certain artifacts from occurring, but some are unavoidable. Study aims: The study aimed at evaluating MRI artifact in some selected centers in Kano metropolis, Nigeria. Methodology: A descriptive cross-sectional study was conducted involving both prospective and retrospective phases across three centres in the Kano metropolis from March 2019 to August 2019. Using the purposive sampling method, 3 centers were selected. A data capture sheet was designed for data collection. Results: Thirty five (50%) of the artifacts encountered were from the centreA, 28(40%) from the centre B, and 7(10%) from the centre C. Motion-induced artifact was the most frequently encountered artifact 26(37.1%), followed by wrap-around artifact 15(21.4%), and then frequency-induced artifact 13(18.6%). Thoracic spine MRI had the highest number of artifacts 28(40%), followed by brain 20(28.6%), and then lumbar spine 19(27.1%). Conclusion: In Kano metropolis the most encountered MRI artifact was the motion-induced artifact and thoracic spine MRI had the highest number of artifacts. The artifacts had a negative effect on image quality. Keywords: MRI artifacts; image quality; Kano metropolis.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.38
      Issue No: Vol. 20, No. 4 (2020)
  • Association of ERCC gene polymorphism with osteosarcoma risk

    • Authors: Guanliang Wang, Jianping Li, Xiling Xu, Ramit Kumar Gupta, Xiaoqiang Gao
      Pages: 1840 - 8
      Abstract: Background: The relationship between ERCC gene polymorphism and osteosarcoma risk / overall survival of osteosarco- ma is still conflicting, and this meta-analysis was performed to assess these associations. Material and methods: The association studies were identified from PubMed, and eligible reports were included and cal- culated using meta-analysis method. Results: Four studies were included for the association of ERCC gene polymorphism with osteosarcoma risk, and nine studies were recruited into this meta-analysis for the relationship between ERCC gene polymorphism and overall survival of osteosarcoma. The meta-analysis indicated that ERCC1 rs3212986 (8092 C>A) gene polymorphism, ERCC1 rs11615 (19007 T>C) gene polymorphism, ERCC2 rs1799793 (A>G) gene polymorphism, ERCC2 rs13181 (Lys751Gln) gene pol- ymorphism were not associated with osteosarcoma risk. ERCC1 rs2298881 (C>A) gene polymorphism, ERCC1 rs3212986 (8092 C>A) gene polymorphism, ERCC1 rs11615 (19007 T>C) gene polymorphism, ERCC2 rs1799793 (Asp312Asn) gene polymorphism were not associated with overall survival of osteosarcoma. Interestingly, ERCC2 rs13181 A allele and GG genotype were associated with overall survival of osteosarcoma, but AA genotype not (A allele: OR = 0.78, 95% CI: 0.65- 0.93, P = 0.007; GG genotype: OR = 1.32, 95% CI: 1.05-1.65, P = 0.02; AA genotype: OR = 0.69, 95% CI: 0.45-1.04, P = 0.08). Conclusion: ERCC2 rs13181 A allele and GG genotype were associated with overall survival of osteosarcoma. Keywords: Osteosarcoma; overall survival of osteosarcoma; ERCC; gene polymorphism; meta-analysis.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.39
      Issue No: Vol. 20, No. 4 (2020)
  • BRAFV600E hot spot mutation in thyroid carcinomas: first Moroccan
           experience from a single-institution retrospective study

    • Authors: Meryem Kaabouch, Hafsa Chahdi, Naima Azouzi, Mohammed Oukabli, Issam Rharrassi, Adil Boudhas, Hassan Jaddi, Mouna Ababou, Nadia Dakka, Amélie Boichard, Youssef Bakri, Corinne Dupuy, Abderrahmane Al Bouzidi, Rabii Ameziane El Hassani
      Pages: 1849 - 56
      Abstract: Background: The incidence of thyroid cancer is increasing worldwide at an alarming rate. BRAFV600E mutation is described to be associated with a worse prognostic of thyroid carcinomas, as well as extrathyroidal invasion and increased mortality. Objective: To our knowledge, there are no reported studies neither from Morocco nor from other Maghreb countries re- garding the prevalence of BRAFV600E mutation in thyroid carcinomas. Here we aim to evaluate the frequency of BRAFV600E oncogene in Moroccan thyroid carcinomas. Methods: In this Single-Institution retrospective study realized in the Anatomic Pathology and Histology Service in the Mil- itary Hospital of Instruction Mohammed V ‘HMIMV’ in Rabat, we report, using direct genomic sequencing, the assessment of BRAFV600E in 37 thyroid tumors. Results: We detected BRAFV600E mutation exclusively in Papillary Thyroid Carcinomas ‘PTC’ with a prevalence of 28% (8 PTC out 29 PTC). Like international trends, Papillary Thyroid Carcinomas ’PTC’ is more frequent than Follicular Thyroid Carcinomas ‘FTC’ and Anaplastic Thyroid Carcinomas ‘ATC’ (29 PTC, 7 FTC and 1 ATC). Conclusion: Our finding gives to the international community the first estimated incidence of this oncogene in Morocco showing that this prevalence falls within the range of international trends (30% to 90%) reported in distinct worldwide ge- ographic regions. Keywords: Biomarker; BRAFV600E; Thyroid cancer; Morocco. 
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.40
      Issue No: Vol. 20, No. 4 (2020)
  • Human epidermal growth factor receptor 2 overexpression in gastric and
           gastroesophageal junction adenocarcinoma in patients seen at the
           University Teaching Hospital, Lusaka, Zambia

    • Authors: Chimwasu Kasochi, Peter Julius, Isaac Mweemba, Violet Kayamba
      Pages: 1857 - 64
      Abstract: Background: There are scanty data on the occurrence of gastric tumours overexpressing human epidermal growth factor receptor 2 (HER2) in Africa. Objective: To assess HER2 protein overexpression in gastric and gastroesophageal junction adenocarcinoma (GGEAC) samples from a single centre in Zambia. Methodology: This was a cross-sectional study of formalin-fixed paraffin-embedded blocks with GGEAC. Prepared slides were first stained with Haematoxylin and Eosin and then evaluated for HER2 protein overexpression by immunohistochem- istry. Results: A total of 57 gastric tissues were stained and evaluated for HER2 overexpression. Thirteen (23%) showed overex- pression, 41/57 (72%) had negative and 3/57 (5%) had equivocal staining. The equivocal cases were excluded from the final analysis. Of the remaining 54 tissues, 28 (52%) were from females, and 26 (48%) were from males. The mean age was 59 years (SD 15 years). HER2 overexpression was highest in moderately differentiated tumours (p=0.0005). Intestinal type tu- mours had a higher occurrenc of HER2 overexpression than diffuse or mixed sub-types (p=0.0087). HER2 overexpression was not associated with age (p=0.27), sex (p=1.00) or anatomical location (p=1.00). Conclusion: The occurrence of GGEAC HER2 overexpression in Zambian patients is similar to proportions reported elsewhere, and it is associated with moderately differentiated tumours of the intestinal type. Keywords: Gastric and Gastroesophageal junction adenocarcinoma; Human Epidermal growth factor Receptor 2 over- expression; immunohistochemistry.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.41
      Issue No: Vol. 20, No. 4 (2020)
  • Congenital infantile digital fibromatosis: a case report and review of the

    • Authors: Omolade O Adegoke, Akinlabi E Ajao, Gbemi H Ano-Edward
      Pages: 1865 - 9
      Abstract: Infantile digital fibromatosis (IDF), also called inclusion body fibromatosis is an uncommon benign tumour occurring in the digits of young children. In about a third of cases, it is congenital and the diagnosis is based on the presence of peculiar intracytoplasmic inclusions on histology. Recurrence rate post-surgery is high. However, spontaneous regression has been reported. We present a case of a 5-month-old infant who had excision of a right second toe mass, which has been present from birth. Histological examination revealed this to be infantile digital fibromatosis. To the best of our knowledge, no report of this has been made in Nigeria. It is important that this diagnosis be entertained in young children with masses on the digits as this will influence the management instituted. Keywords: Fibromatosis; digits; inclusion body.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.42
      Issue No: Vol. 20, No. 4 (2020)
  • Does shared decision making increase prostate screening uptake in
           countries with a low prevalence of prostate cancer'

    • Authors: Hussein Saad Amin, Mostafafa Ahmed Arafa, Karim Hamda Farhat, Danny Munther Rabah, Abdulaziz Abdullah Altaweel , Abdulaziz Hamed Alhammad
      Pages: 1870 - 4
      Abstract: Background: Men over 50 should discuss the benefits and harms of prostate-specific antigen (PSA) testing with their doctors. Objectives: To investigate whether shared decision making (SDM) increases the uptake of prostate cancer screening prac- tices among Saudi men. Methods: This community-based study recruited men aged ≥ 50 years between January and April 2019. Sociodemographic characteristics, history, and current medical condition information were collected. SDM information with regards to prostate cancer screening was discussed. Results: In total, 2034 Saudi men, aged between 50 and 88 years, agreed to participate in the current study. Prostate exam- ination for early detection of cancer was recommended for 35.4% (720) of subjects. Of the subjects, 23.3% (473) reported that the physicians discussed the advantages and benefits of PSA testing, whereas only 5.6% (114) stated that the physicians explained the disadvantages and drawbacks of PSA testing. Conclusion: Our findings suggest that less than one fourth discussed the advantages and disadvantages of PSA testing with their physicians; of these, less than one third underwent PSA blood tests. Improvements are needed in SDM for and against PSA screening. SDM does not affect the intensity of PSA testing. Primary health care physicians should be actively involved in the SDM process. Keywords: Decision making; prostate cancer screening; low prevalence countries.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.43
      Issue No: Vol. 20, No. 4 (2020)
  • Non- pancreatic neuroendocrine tumour presenting with hypoglycemia in an
           elderly patient

    • Authors: Merve Eren, Feyzi Bostan
      Pages: 1875 - 9
      Abstract: Background: Hypoglycemia is a common, symptom seen in individuals. Hypoglycemia in the elderly is both under-recog- nized and misdiagnosed due to nonspesific hypoglycemic symptoms and accompanying comorbidities in this population. In diabetic individuals, hypoglycemia is most commonly caused by administering insulin or sulphonylureas and insulin secretagogues. Other drugs, such as antibiotics or beta-blockers, have been reported to reduce blood glucose to abnormally low levels. Hypoglycemia in non-diabetic patients is considered a rare event, and the possible reasons may be reactive hypo- glycemia, insulin-secreting tumours and other malignancies, hypopituitarism, hypocortisolism, alcohol abuse, inappropriate insulin self-administration, malnutrition, renal failure and sepsis. Case: An 86- year- old male was admitted to the emergency department with hypoglycemia diagnosed with non-pancreatic neuroendocrine tumour (NET) on lung secreting insulin. No surgical intervention or chemotherapy was planned due to patients age and comorbidities so best supportive care was planned. We used prednisone for symptomatic treatment of hy- poglycemia and the patient has been followed up periodically. In this period he had no hypoglycemic attack. Conclusion: For patients with hypoglycemia who are unable/decline to receive any further treatment, low dose glucocorti- coid is a good choice to achieve normoglycemia. It seems to be more cost effective compared to other treatment options. Furthermore hospitalisation rates may decrease due to decreased hypogylcemic attacks. Keywords: Neuroendocrine tumour; hypoglycaemia; prednisone; non-islet cell tumour.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.44
      Issue No: Vol. 20, No. 4 (2020)
  • The relationship between Vitamin D deficiency and polycystic ovary

    • Authors: Feyzi Gokosmanoglu, Attila Onmez, Hasan Ergenç
      Pages: 1880 - 6
      Abstract: Background: Vitamin D deficiency is frequently seen in patients with polycystic ovary syndrome (PCOS) and has been shown to exhibit multiple effects on the disease process. The purpose of this study was to investigate the role of vitamin D deficiency in complex PCOS pathophysiological pathways. Methods: Two hundred sixty-seven patients with PCOS were divided into two groups Group 1 with 25(OH)D3 deficiency, and Group 2 with normal 25(OH)D3. Biochemical and hormonal parameters (androgen hormones, gonadotropins, and thyroid function tests) were compared between the two groups. Results: Eighty-six percent of the patients (n=231) were in Group 1 and 14% (n=36) in Group 2. Statistically signifi- cantly higher concentrations of serum testosterone, dehydroepiandrosterone-sulfate and LH were determined in Group 1 (p<0.05). 25(OH)D3 concentrations were negatively correlated with body mass index (r=−0.459), serum testosterone (r =−0.374) and dehydroepiandrosterone-sulfate levels (r=−0.418); (all; p< 0.05). Conclusion: The study findings show that low 25(OH)D3 levels are associated with high androgen levels in women with PCOS. Vitamin D deficiency should be considered as an additional risk factor in the development of PCOS. We think that providing vitamin D supplementation for women from identified deficiency areas can reduce the risk of PCOS development. Keywords: Polycystic ovarian syndrome; vitamin D deficiency; androgen hormones; testosterone.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.45
      Issue No: Vol. 20, No. 4 (2020)
  • Micro RNAs and the biological clock: a target for diseases associated with
           a loss of circadian regulation

    • Authors: Qianwen Ma, Genlin Mo, Yong Tan
      Pages: 1887 - 94
      Abstract: Background: Circadian clocks are self-sustaining oscillators that coordinate behavior and physiology over a 24 hour peri- od, achieving time-dependent homeostasis with the external environment. The molecular clocks driving circadian rhythmic changes are based on intertwined transcriptional/translational feedback loops that combine with a range of environmental and metabolic stimuli to generate daily internal programing. Understanding how biological rhythms are generated through- out the body and the reasons for their dysregulation can provide avenues for temporally directed therapeutics. Summary: In recent years, microRNAs have been shown to play important roles in the regulation of the circadian clock, particularly in Drosophila, but also in some small animal and human studies. This review will summarize our current un- derstanding of the role of miRNAs during clock regulation, with a particular focus on the control of clock regulated gene expression. Keywords: MicroRNAs; biological clock; circadian rhythm.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.46
      Issue No: Vol. 20, No. 4 (2020)
  • Ectopic pregnancy in the ampulla of the fallopian tube at 16 gestational
           weeks: lessons from a case report

    • Authors: Nnabuike Chibuoke Ngene, Ongombe Lunda
      Pages: 1895 - 7
      Abstract: Background: It is uncommon to find ampullary tubal pregnancy in the second trimester. Methods: A 35-year-old G4P3 at 16 gestational weeks presented with a day history of sudden severe lower abdominal pain and no vaginal bleeding. The patient had a normal pulse of 82/minutes, haemoglobin concentration of 6.3 g/dl and ultrasonography showed an empty uterus with an alive fetus in the right adnexa. She was provisionally diagnosed to have an abdominal pregnancy. Results: The patient had an emergency laparotomy where 2.2 L of haemoperitoneum and a slow-leaking right ampullary tubal pregnancy were found. Right total salpingectomy was performed and she had an uncomplicated post-operative fol- low-up. Histology of the lesion confirmed tubal pregnancy. Conclusion: The growth of a pregnancy in the ampulla beyond the first trimester is possibly due to increased thickness and or distensibility of the fallopian tube. A tubal pregnancy may present with a normal pulse despite significant haemorrhage. Keywords: Abdominal pain; ampullary tubal ectopic pregnancy; Bezold–Jarish-like reflex.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.47
      Issue No: Vol. 20, No. 4 (2020)
  • Geographic variation and risk factors for teenage pregnancy in Uganda

    • Authors: Joseph Byonanebye, Ruta Brazauskas, Nazarius Tumwesigye, Staci Young, Thomas May, Laura Cassidy
      Pages: 1898 - 907
      Abstract: Background: Teenage pregnancy is a global health issue with high rates in sub-Saharan Africa. In Uganda, teenage pregnan- cy is a public and community health issue. Objectives: This study hypothesized that there would be regional variations in rates, risk factors and trends of teenage pregnancy in Uganda. Methods: Data were analyzed from the Uganda Demographic and Health Surveys (UDHS) in 2006 and 2011. The outcome of interest was current pregnancy for females 15 to 19 years of age at the time of the survey. Bivariate analysis was per- formed for each year to examine the rate and trends of pregnancy by various demographic characteristics. Logistic regres- sion was conducted to assess the association between teenage pregnancy and sociodemographic variables. Results: Uganda’s rate of teenage pregnancy increased from 7.3/1000 in 2006 to 8.1/1000 in 2011. The East Central region consistently had the highest rates than other regions. In 2006, teenage pregnancy was significantly associated with being mar- ried, living with a partner or separated, as compared to those who were single. Marital and wealth status were also significant predictors of teenage pregnancy based on the 2011 survey. Conclusion: The rate of teenage pregnancy in Uganda is high and the trend demonstrated regional variation. Future inter- ventions could focus on regions with high poverty and low education. Keywords: Teenage pregnancy; risk factors; Uganda demographic; health survey.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.48
      Issue No: Vol. 20, No. 4 (2020)
  • Knowledge and barriers on correct use of modified guidelines for active
           management of third stage of labour: a cross sectional survey of
           nurse-midwives at three referral hospitals in Dar es Salaam, Tanzania

    • Authors: Fatina B Ramadhani, Yilan Liu, Melania Menrad Lembuka
      Pages: 1908 - 17
      Abstract: Background: Despite the fact that it is possibly preventable, postpartum haemorrhage (PPH) is the global most deadly form of obstetric bleeding, mainly sub-Saharan Africa with at least one-fourth of maternal deaths in East African regions. Active management of third stage of labour (AMTSL) is recommended to prevent PPH. However, AMTSL guidelines have been revised since 2006. Objectives: To examine the current status of nurse-midwives’ knowledge on modified AMTSL guidelines and highlight barriers to AMTSL correct use. Method: Descriptive cross sectional survey was conducted to 160 nurse-midwives at three referral hospitals in Dar es Sa- laam, Tanzania. One-way, interactive modes ANOVA and Chi square (χ2) test were run in SPSS 21 version to compare the association of independent and dependent variables. Results: Virtually all nurse-midwives knew the first recommended uterotonic (99.4%) and delayed cord clamping (98.8%) protocols as modified. Knowledge was significantly contributed by multiple factors; p=0.001. Reported correct AMTSL use was 46.8% which was significantly affected by AMTSL training (χ2 = 6.732, p = 0.009) and prioritizing atteding an asphyx- iated baby (χ2 = 5.647, p = 0.017). Conclusion: Regardless of high nurse-midwives’ AMTSL knowledge; it is imperative that responsible authorities plan ap- propriate strategies to solve reported barriers affecting correct AMTSL use. Keywords: Nurse-midwives’ knowledge, maternal bleeding, maternal mortality, third stage of labour, AMTSL, atonic uterus
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.49
      Issue No: Vol. 20, No. 4 (2020)
  • Management of spinal-induced hypotension for elective caesarean section: A
           survey of practices among anesthesiologists from a developing country

    • Authors: Samina Ismail, Muhammad Sohaib, Fatima Farrukh
      Pages: 1918 - 26
      Abstract: Background: In developing countries, more than half of the anesthesia-related maternal deaths are related to spinal hypo- tension. Objective: To explore the practices of management of spinal induced hypotension with respect to fluid and vasopressor administration among anesthesiologists from a developing country. Methods: After approval from institutional ethics committee, an online questionnaire was sent to anesthesiologists reg- istered with Pakistan Society of Anesthesiologists between July and August 2018 to determine management strategies for prevention and treatment of spinal-induced hypotension. Results: The response rate was 36% (156/433), majority from academic institution (62.8%) with equal representation from attending and trainee anesthesiologist. For prophylaxis 39.1% respondents did not use vasopressors, 32.7% used fluid preloading with crystalloids (54.7%) as fluid of choice followed by combination of co-loading and vasopressor(22.4%). Phenylephrine was the vasopressor of choice for both prophylaxis (33.1%) and treatment (57%). Attending anesthesiologist used a combination of fluid co-loading and vasopressors for prophylaxis as compared to trainee anesthesiologists (37.2% vs. 17.9%; P=0.035) and selected vasopressors according to patient’s heart rate (33.3% vs. 19.5%; p=0.05). Prophylactic phenylephrine was used more by respondents from the academic institution (p=0.023). Fluid co-loading was used more by respondents with <30 % compared to those with > 30% of clinical responsibility to obstetric anesthesia (P<0.05). Conclusion: Phenylephrine as the vasopressor of choice indicates growing awareness of management strategies among anesthesiologists from developing countries but there is a need to increase its use for prophylaxis. Some variation in practice according to the level of anesthesiologist, practice type and responsibilities to obstetric anesthesia are evident. Keywords: Spinal anesthesia; Hypotension; Cesarean delivery; Vasopressors.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.50
      Issue No: Vol. 20, No. 4 (2020)
  • Transverse cerebellar diameter: a reliable predictor of gestational age

    • Authors: Sanjay Mishra, Surajit Ghatak, Pratibha Singh, Dushyant Agrawal, Pawan Garg
      Pages: 1927 - 32
      Abstract: Objectives: To determine accuracy of transverse cerebellar diameter (TCD) measurement in the prediction of gestational age (GA) in normal fetuses; to develop reference chart for TCD according to GA in Indian population. Design: A retrospective cross-sectional study. Method: Ultrasonographic measurements in 300 singleton pregnant women included biparietal diameter (cm), head circum- ference (cm), abdominal circumference (cm), femur length (cm) and transverse cerebellar diameter (cm). Reference chart with mean TCD for corresponding gestational age (GA) in weeks was developed. Results: Statistically significant relationship found between TCD and gestational age (R2=0.92, p=0.0006). Regression for- mulae based on TCD with other parameter can be used to predict gestational age of foetus. When TCD is compared with findings in other studies in different ethnic population, it is found that there is significant difference exists. Conclusion: In normally developing fetuses the TCD has linear correlation with advancing gestational age. A separate refer- ence chart is required for every different population because ethnicity, nutrition and environmental factors can have impact on normal TCD values. This will help to avoid misinterpretation of data to determine gestational age. Keywords: Transverse cerebellar diameter; ultrasonography; gestational age.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.51
      Issue No: Vol. 20, No. 4 (2020)
  • Prevalence, predictors and reasons for home delivery amongst women of
           childbearing age in Dodoma Municipality in central Tanzania

    • Authors: Situ Muhunzi, James Samwel Ngocho, Amasha Mwanamsangu, Leah Sanga, Hellen Hiza, Sia E Msuya, Michael J Mahande
      Pages: 1933 - 42
      Abstract: Introduction: The objective was to determine the prevalence, predictors and reasons for home delivery amongst women of childbearing age in Dodoma, Tanzania. Methods: A cross-sectional study was conducted amongst women living in Dodoma Municipality. Data were collected using adapted questionnaires and analysed using SPPS version 23. A multivariable logistic regression model was used to assess the independent predictors of home delivery. Results: A total of 425 women of childbearing age were enrolled in this study. The mean (± SD) age of the participants was 28.7 (±7.1) years. The prevalence of home delivery was 35.5% (n=150, 95% CI 30.9 – 40.2). Women with secondary school and above had 93% less odds of home delivery than women who had no education (AOR=0.0795% CI: 0.03-0.18). Women who lived in rural areas (AOR=3.49, 95% CI: 2.12-5.75), and women living more than 5km from health facilities (AOR=2.67, 95% CI: 1.65-4.37) had higher odds of home delivery. The main reasons for home delivery were transportation cost, and long distance to the nearest health facilities. Conclusion: In this population, the prevalence of home delivery remained to be high. To address this more collaborative mul- tisectoral effort like strengthening health education and strengthening maternity waiting homes are needed. Keywords: Women, home delivery, prevalence, factors, Tanzania.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.52
      Issue No: Vol. 20, No. 4 (2020)
  • Prevalence and predictors of postpartum depression among postnatal women
           in Lagos, Nigeria

    • Authors: Adeyemo EO, Oluwole EO, Kanma-Okafor OJ, Izuka OM, Odeyemi KA
      Pages: 1943 - 54
      Abstract: Background: Globally, postpartum depression is one of the most common but often unrecognized complications of childbirth, yearly affecting about 10–15% of postnatal women. This study aimed to determine the prevalence of postpartum depression and its predictors among postnatal women in Lagos. Methods: A descriptive cross-sectional study was conducted among 250 mothers in Eti-Osa Local Government Area of Lagos State, Nigeria, attending six Primary Health Care centers for infant immunization at six weeks post-delivery. Data was collected using a pretested semi-structured interviewer administered questionnaire which included the Edinburgh Postnatal Depression Scale. Analysis was carried out using SPSS version 23TM. Chi-square and logistic regression analyses were used to determine associations and predictive relationships between various factors and the presence of postpartum depression. The level of significance was set at <0.05. Results: The prevalence of postpartum depression was 35.6%. Multiparity, delivery by cesarean section, mother being unwell after delivery, and not exclusively breastfeeding the baby were the factors linked with postpartum depression. Following multiple logistic regression, having postpartum blues (p=0.000; OR=32.77; 95%CI=7.23-148.58)., not getting help with caring for the baby (p=0.008; OR=2.64; 95%CI=1.29-5.42), experiencing intimate partner violence (p=0.000; OR=5.2; 95%CI=2.23-11.91) and having an unsupportive partner (p=0.018; OR=2.6; 95%CI=1.17-5.78) were identified as predic- tors of postpartum depression. Conclusion: This study revealed a high prevalence of postpartum depression, identifying both the obstetric and psycho- social predictors. Social support for women both in the pre- and postnatal periods and routine screening of women for postpartum depression should be encouraged for early detection and immediate intervention. Keywords: Postpartum depression; PPD; Eti-Osa; postnatal women; Lagos.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.53
      Issue No: Vol. 20, No. 4 (2020)
  • Combating female genital mutilation in Northeast (Horn) Africa and its

    • Authors: Amirbahram Arabahmadi
      Pages: 1955 - 67
      Abstract: Background: This article investigates the practice of female genital mutilation as a long-held custom in the countries of North- east Africa, known as Horn of Africa, where many women in rural and urban areas are faced with different physical and psychic consequences in their future lives. Objective: To investigate the prevalence of FGM in the Horn of Africa and the traditional thinking of People about it. Methods: This study was based on descriptive analysis method. The questions of the study are (a) Why female circumcision is widely practiced in Horn of Africa; (b) What are the mental and physical consequences of female genital mutilation for the wom- en; and (c) How regional and international entities, whether governmental or NGOs, are combating this tradition. Results: This article has found out that female genital mutilation in Northeast African countries has resulted in many lifelong diseases and sexual degradation in many women and the best way to combat this tradition is to inform people by gradual (not abrupt) trainings without any insult to the beliefs of the people. Conclusion: This study reveals the Health education based on behavioral change. In doing so, the unity of policies between regional and international actors along with attracting the support of tribal elites is also needed. Keywords: Female genital mutilation; Northeast Africa; international organizations; nongovernmental organizations; gender discrimination.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.54
      Issue No: Vol. 20, No. 4 (2020)
  • Towards characterization of Female Genital Mutilation (FGM) in rural

    • Authors: Amelia Ngozi Odo, Samuel Ifeanyi Christian Dibia, Evelyn Nwanebe Nwagu, MaryJoy Umoke, Prince Christian Ifeanachor Umoke
      Pages: 1968 - 78
      Abstract: Background: Female genital mutilation (FGM) is a public health challenge and seems to be secretly practiced in some rural communities, despite the ban in Nigeria. Objectives: The study aimed to identify the activities that are involved in FGM, type(s) of FGM practiced and the knowl- edge of health implications of FGM among rural community members in Ebonyi State, Nigeria. Methods: We employed exploratory design using qualitative technique. In-depth interviews were conducted with 44 adult (18 years and older) volunteers in four rural communities in Ebonyi State, Nigeria. After thematic analysis using NVivo 11 Pro software, eight sub-themes emerged, among which are: types of FGM practiced, seasons for FGM, FGM by health workers and community leaders, punishment for refusing FGM and knowledge of health implications of FGM. Results: Findings show that FGM is more like a process than just an act, and type most practiced in the study area is Type 1. Circumcisers are health workers and women leaders. Knowledge of health implications of FGM was found to be low among those interviewed. Conclusion: Based on the findings, we concluded that FGM is still practiced in some rural communities in Nigeria, maybe because of poor knowledge of health implications of FGM. Keywords: Female genital mutilation; qualitative study; practice; health implications; Nigeria.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.55
      Issue No: Vol. 20, No. 4 (2020)
  • The impact of menopause on sexual function in women and their spouses

    • Authors: Zahra Bostani Khalesi, Fatemeh Jafarzadeh-Kenarsari, Yalda Donyaei Mobarrez , Mahmood Abedinzade
      Pages: 1979 - 84
      Abstract: Background: The purpose of this study is to evaluate the impact of menopause on sexual function in women and their spouses. Methods: This is a cross-sectional study that was conducted from January 2018 to May 2019 in Rasht (North of Iran). The participants included 215 menopausal women and their spouses. Data were collected using the demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and the International Index of Erectile Function (IIEF) question- naire. Results: On the basis of the FSFI and IIEF scores, 36.28% (78/215) women reported female sexual dysfunction (FSD) and 17.2% (37/215) men reported erectile dysfunction (ED) with 8.37% (N = 18) being mild, 5.58% (N = 12) mild to moderate, and 3.25% (N = 7) moderate ED. After adjusting differences in the female age distribution, the total score and scores of the IIEF subscales were also not significantly lower in the spouses of women with FSD than women without FSD. Conclusion: Although, significant correlations between male erectile function and menopausal female sexual function have not identified; but, low scores of the subscales of FSFI in female participants mostly impaired sexual satisfaction and overall satisfaction in their spouses. Keywords: Erectile function; female sexual function; couple; menopause.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.56
      Issue No: Vol. 20, No. 4 (2020)
  • Infertility and associated factors in three hospitals in Douala, Cameroon:
           a cross-sectional study

    • Authors: Thomas Obinchemti Egbe, Charmaine Ngo Mbaki, Nicholas Tendongfor, Elvis Temfack, Eugene Belley-Priso
      Pages: 1985 - 95
      Abstract: Aim: We determined the prevalence and factors associated with couple infertility in three hospitals in Douala, Cameroon. Methods: We conducted a cross-sectional study from December 18th 2015 to March 18th 2016 in three public hospitals in Douala. Three hundred and sixty participants were studied prospectively for associated fac- tors using a multivariate logistic regression model and 4732 files were studied retrospectively for the prevalence of infertility. Statistical significance was set at p < 0.05. Results: The prevalence of couple infertility was 19.2%. In logistic models, the factors which independently increased the risk of couple infertility were a history of reproductive tract infection/STI, a history of uterine fibroids, a history of dys- menorrhea and abortion for the females while for males it was a history of mumps, erectile dysfunction and exposure to chemicals/toxic substances/pesticides. Conclusion: One in every five couples in this study was infertile. Several factors affect the risks associated with couple in- fertility. The identification of these factors could help detect subgroups of couples at high risk of infertility. Reproductive health education, screening programmes for STI’s that may lead to infertility should be offered to couples. Keywords: Couple infertility; prevalence; associated factors; Douala; Cameroon.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.57
      Issue No: Vol. 20, No. 4 (2020)
  • A multilevel analysis of the determinants of handwashing behavior among
           households in Eswatini: a secondary analysis of the 2014 multiple
           indicator cluster survey

    • Authors: Maswati S Simelane
      Pages: 1996 - 2006
      Abstract: Introduction: Handwashing with soap has received considerable attention due to its importance in the prevention and inter- ruption of the transmission of diseases. Regardless of the positive effects of handwashing with soap, developing countries still have a low rate of handwashing. Objective: The study aimed to determine the individual, household and community-level factors associated with handwash- ing behavior among households in Eswatini. Methods: Using the Eswatini Multiple Indicator Cluster Survey conducted in 2014, a secondary analysis was done of the households surveyed. A total of 1,520 households nested in communities with complete data on handwashing practices were included in the analysis. Univariate, bivariate analysis and multivariate multilevel logistic regression were used to estab- lish the factors that were associated with handwashing behavior. Results: The prevalence of handwashing among households was 56% in 2014. Households whose heads were aged 35-54 and 55 years and older were more likely to practice handwashing (AOR=1.88, 95% CI:1.39, 2.54); and (AOR=1.77, 95% CI: 1.205, 2.62) compared to those aged 15-34 years. Households with a pit latrine or no toilet facility at all, were less likely to practice handwashing (AOR=0.24, 95% CI: 0.17, 0.35); (AOR=0.28, 95% CI: 0.11, 0.71) respectively compared to those with a flush toilet. Region of residence was a community-level variable associated with lower odds of handwashing, with those from the Hhohho (AOR=0.22, 95% CI: 0.14, 0.35) and Manzini region (AOR=0.42, 95% CI: 0.27, 0.67) compared to Lubombo region. Households from communities where access to mass media was high were more likely to practice handwashing (AOR =1.47, 95% CI: 1.05, 2.03) compared to those from communities where access to mass media was low. Conclusion: Households headed by young adults, with pit latrine or no toilet facility at all and lived in the Hhohho and Manzini regions and with low access to mass media, should be targeted for interventions aimed at improving handwashing practices. Keywords: Handwashing; factors; Eswatini; households; multilevel logistic regression.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.58
      Issue No: Vol. 20, No. 4 (2020)
  • Comparison of breastfeeding self-efficacy and breastfeeding success of
           obese and normal-weight mothers in the early period

    • Authors: Sinem Ceylan, Sevil Şahin
      Pages: 2022 - 31
      Abstract: Background: Body mass index (BMI) of overweight and obese women is a risk factor for breast milk secretion. Aim: This study was conducted in a descriptive and comparative way in order to identify the relation between the breastfeed- ing success and self-efficacy of obese and non-obese mothers during postnatal period and to make a comparison between the obese and non-obese group. Methods: The study sample consisted of 113 obese and 111 non-obese mothers that met the study criteria who were hos- pitalized at the postnatal service of Health Education and Research Hospital in Ankara, September 2014-February 2015. Result: The mean BMI of obese women prior to the pregnancy was 31.41±2.4 while it was 22.25±2.8 for the non-obese women. As the BSS scores increase among both the obese and non-obese mothers, the LATCH breastfeeding success score averages increase as well (p<0.05, r:0.613). Conclusion: In the light of the data of, to increase the breastfeeding success among obese mothers, it is suggested that the perception of self-efficacy is enhanced, and additional consultation is provided on breastfeeding starting from the antena- tal period. The trainings given to mothers by the midwife and nurse are supported with home visits especially in the obese women in the postnatal period in order for them to breastfeeding. Keywords: Breastfeeding success; self-efficacy; maternal obesity.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.60
      Issue No: Vol. 20, No. 4 (2020)
  • Pediatric self-medication use in Rwanda – a cross sectional study

    • Authors: Joyeuse Ukwishaka, Christian Umuhoza, Peter Cartledge, Natalie McCall
      Pages: 2032 - 43
      Abstract: Background: Self-medication, a worldwide practice, has both benefits and risks. Many countries have regulated non-pre- scription medications available for use in self-medication. However, in countries such as Rwanda, where prescriptions are not required to purchase medications, prescription, non-prescription and traditional medications have been used for self-medi- cation. Objectives: To determine the reported self-medication use in Rwanda and to determine attitudes and reasons associated with parental decisions to self-medicate their children. Methods: A cross-sectional multi-center questionnaire based quantitative study of 154 parents/caregivers of children under ten years undertaken in private and public health facilities. Results: The use of self-medication was reported to be 77.9%. Among these parents/caregivers, 50.8% used modern self-medication only, 15.8% used traditional self-medication only and 33.3% used both types of self-medication. Paraceta- mol was the most commonly used drug in modern self-medication; the traditional drugs used were Rwandan local herbs. Parents/caregivers who used modern medicines had slightly more confidence in self-medication than self-medication users of traditional medicines (p=0.005). Parents/caregivers who used modern self-medication reported barriers to consultation as a reason to self-medicate more frequently than those who used traditional drugs. Having more than one child below 10 years of-age was the only socio-demographic factor associated with having used self-medication (AOR=4.74, CI: 1.94- 11.58, p=0.001). Being above 30 years (AOR= 5.78, CI: 1.25-26.68, p=0.025) and living in Kigali (AOR=8.2, CI: 1.58-43.12, p=.0.012) were factors associated with preference of modern self- medication compared to traditional self-medication. Conclusion: Self-medication is common in Rwanda. Parents/caregivers are involved in this practice regardless of their socio-demographic background. Keywords: Self-medication; medicines; parents; caregivers; children; Nonprescription Drugs; Rwanda.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.61
      Issue No: Vol. 20, No. 4 (2020)
  • Self-reported halitosis and oral health related quality of life in
           adolescent students from a suburban community in Nigeria

    • Authors: Omolola Alade, Ebenezer Ajoloko, Aderonke Dedeke, Omolara Uti, Oyinkansola Sofola
      Pages: 2044 - 9
      Abstract: Background: Halitosis is an important cause of impaired quality of life in adolescents. Little is known about the prevalence of self-reported halitosis in adolescents in Nigeria and the extent to which self-reported halitosis impairs their oral health related quality of life. Objectives: To determine the prevalence and impact of self-reported halitosis on the oral health related quality of life of adolescent students in a suburban community in Nigeria. Methods: An analytical cross-sectional study. Pre-tested self-administered pro-forma was used to obtain the adolescents’ demographic data and their self-perception of halitosis. The Oral Health Impact Profile (OHIP-14) was used to assess the adolescents’ OHRQoL. The Mann-Whitney U test was used to compare the median OHIP-14 scores between adolescents who reported halitosis and those who did not. The level of significance was set at p < 0.05. Ethics approval for this study was obtained from the Health Research and Ethics Committee of the Lagos University Teaching Hospital. Results: A total of 361 adolescents aged 10 – 19 years (mean age 14.1 ± 1.79 years) took part in the study. Of these, 32.7% (n=118) had self-reported halitosis. The median OHIP-14 score among adolescents with self-reported halitosis was 3 (0-9) while those who did not report halitosis had a median OHIP-14 score of 0 (0 – 5). This difference was statistically significant (p < 0.0001). Conclusion: Self-reported halitosis significantly impaired the oral health related quality of life of the adolescents. Keywords: Halitosis; oral health; quality of life; adolescent.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.62
      Issue No: Vol. 20, No. 4 (2020)
  • Trace metal toxicity in some food items in three major markets in
           Ado-Odo/Ota LGA, Ogun State, Nigeria and associated health implications

    • Authors: Opeyemi Isaac Ayanda, Oluwakemi Adetutu Bello, Oluwatosin Ifeanyichukwu Nwabuisi
      Pages: 2050 - 61
      Abstract: Background: Many of the markets in Nigeria are open, where foodstuffs are laid bare on flat trays and open baskets, direct- ly exposing them to environmental contaminants. This study aimed at determining whether some food items on sale around an industrialized area of Ogun State are contaminated with trace metals. Methods: Seven different food items – Clarias gariepinus (roasted, fresh and smoked) Bos taurus (dried and fresh beef), zobo leaf (Hibiscus sabdariffa) and crayfish (Astacus leptodactylus) were sampled from three major markets, namely: Lusada, Atan and Ota in Ado-Odo/Ota LGA of Ogun State. They were analyzed for Lead, Cadmium, Nickel, Manganese and Zinc using Atomic Absorption Spectroscopy. Results: Cd was not detected in most of the food items across the markets. Pb, Ni and Mn were detected in very high con- centrations above the maximum allowable limits by international regulatory agencies. Zn was the only metal that was gen- erally below regulatory limits in food items across the three markets. The Estimated Daily Intake (EDI) and Target Hazard Quotient (THQ) values were generally higher than values acceptable in food. Conclusion: Some of the food items consumed in this area are not entirely safe from metal toxicity and this may have se- rious health consequences. Keywords: Cadmium; food items; lead; Manganese; nickel; zinc.
      PubDate: 2020-12-16
      DOI: 10.4314/ahs.v20i4.63
      Issue No: Vol. 20, No. 4 (2020)
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