Journal of Public Health in Africa <p>The <strong>Journal of Public Health in Africa</strong> <em>(JPHiA)</em> is a peer-reviewed, electronic journal that focuses on health issues in the African continent.<br><br>The journal editors seek high quality original articles on public health related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.</p> en-US <p>PAGEPress has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener">Creative Commons Attribution NonCommercial 4.0 International License</a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.&nbsp;<br><br>An Open Access Publication is one that meets the following two conditions:<br><br>1. The author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.<br>2. A complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.<br><br>Authors who publish with this journal agree to the following terms: 1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. 3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</p> (Emanuela Fusinato) (Tiziano Taccini) Mon, 21 May 2018 08:34:48 +0200 OJS 60 Isoniazid preventative therapy uptake for child household contacts of TB index cases, Kisumu County, Kenya, 2014-2015 <p><em>Background</em> Isoniazid Preventative Therapy (IPT) is recommended for children aged less than 5 years that have been in contact with an open case of TB and screen negative for TB to prevent the risk of TB progression. We examined IPT uptake among child household contacts of TB index cases within a TB case detection study in a high TB burden region. <br><em>Methods</em> A cross-sectional study involving all IPT eligible children drawn from a TB case detection study was done in Kisumu County, Kenya between 2014 and 2015. By linking a subset study database to the TB program IPT register, we described Child contacts as ‘initiated on IPT’ and TB index cases as ‘having child contacts initiated on IPT’ based on whether their names or their child contacts names respectively, were found in the IPT register. Logistic regression analysis was used to describe index and contact characteristics associated with IPT initiation <br><em>Results</em> Of 555 TB index cases into the study, 243 (44%) had a total of 337 IPT-eligible child household contacts. Forty-seven (19%) index cases that had child contacts initiated on IPT; they were more likely to have been diagnosed with smear positive TB compared to those who were diagnosed with smear negative TB (OR 5.1, 95% CI 1.1-23.2; p=0.03) and to reside in rural Kisumu compared to those in urban Kisumu (OR 3.3, 05% CI 1.6-6.8; p&lt;0.01). The 51 (15%) child contacts that were initiated on IPT were more likely to be were first degree relatives of the index case compared to those who were not (OR 2.6, 95% CI 1.2-5.5; p=0.02) and to reside in rural Kisumu compared to those in urban Kisumu (OR 2.6, 95% CI 1.2-5.1; p&lt;0.01). <br><em>Conclusion</em> IPT initiation, which is influenced by index and contact characteristics, is suboptimal. The TB program should provide health worker training, avail appropriate pediatric TB diagnostic tools and continuous supply of medication, and job aids and monitoring tools to facilitate IPT implementation. Additionally, targeted health education interventions should be formulated to reach those who are unlikely to accept IPT.</p> Barbara Burmen, Kennedy Mutai, Timothy Malika ##submission.copyrightStatement## Mon, 21 May 2018 11:52:20 +0200 Knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government, Lagos State <p>Women of child-bearing age (especially pregnant and lactating women) are in the most nutritionally-vulnerable stages of the life cycle. The aim of this study was to assess the knowledge, attitude and practice of good nutrition among women of childbearing age in Somolu Local Government (LG), Lagos state. This study was a cross-sectional descriptive survey of 244 women of childbearing age (15-49 years). Excellent knowledge and good attitude towards good nutrition was observed among 61.89% and 86.89% respectively. During pregnancy, greater than 80% took folic acid, iron supplements and increased daily consumption of fruits and vegetables while 43.59% avoided eggs, fish, meat and chocolate beverage because of taboos. Seven days prior to interview, over 90% had consumed fast foods, 56.15% and 50.01% of the respondents ate fruits and vegetables every day to ≥ 4 times in a day respectively. A majority of the respondents knew and had a good attitude towards good nutrition supporting studies from Kenya and Northern Nigeria. This, however, did not translate to good practice for about half of the respondents.</p> Ooreoluwa Fasola, Olayinka Abosede, Foluke A. Fasola ##submission.copyrightStatement## Mon, 21 May 2018 11:18:07 +0200 Tuberculosis among individuals with community-acquired pneumonia presenting to emergency in Gaborone, Botswana <p><em>Setting</em>: Delays in diagnosing Tuberculosis (TB) are associated with increased transmission. TB may present as a clinical syndrome that mimics community-acquired pneumonia (CAP). <br><em>Objective</em>: To determine frequency of TB among patients with CAP at a referral hospital in Gaborone, Botswana. <br><em>Design</em>: We performed a retrospective study of adults presenting with CAP from April 2010- October 2011 to the Emergency Department (ED); we matched this cohort to the National Botswana Tuberculosis Registry (NBTR) to identify individuals subsequently diagnosed with TB. We assessed demographics, time to TB diagnosis, clinical outcomes and performed logistic regressions to identify factors associated with TB diagnosis. Results: We identified 1,305 individuals presenting with CAP; TB was subsequently diagnosed in 68 (5.2%). The median time to TB diagnosis was 9.5 days. Forty percent were AFB sputum smear positive. The HIV positive rate was 87%.<br><em>Conclusion</em>: Subsequent diagnosis of TB is common among individuals with CAP at our ED, suggesting that TB may be present at the time of CAP presentation. Given the lack of distinguishing clinical factors between pulmonary TB and CAP, adults presenting with CAP should be evaluated for active TB in Botswana.</p> Jill Gersh, Zachary Feldman, Emily Greenberger, Amit Chandra, Harvey Friedman, Thomas Lere, Ari Ho-Foster, Michelle Haas ##submission.copyrightStatement## Mon, 21 May 2018 10:04:39 +0200 A qualitative exploration of doctors’ and nurses’ experiences on the management of tuberculosis and human immunodeficiency virus co-infection in a tuberculosis-human immunodeficiency virus high burden community in northern KwaZulu-Natal, South Africa <p><em>Background</em>: South Africa is faced with a huge challenge of addressing the high burden of tuberculosis-human immune virus (TB-HIV) co-infection, and this challenge is more pronounced in the province of KwaZulu-Natal which has one of the highest burdens of TBHIV co-infection in the world. <br><em>Aim</em>: The study explored the experiences of doctors and nurses with regard to the management of tuberculosis and HIV co-infection in a TB-HIV high burden community in northern KwaZulu-Natal, South Africa. The particular focus was to provide insight and to inform policy and programme development for effective management of TB-HIV coinfection in the TB-HIV high burden community of northern KwaZulu-Natal. <br><em>Methods</em>: An interpretivist exploratory qualitative approach was employed through individual semi-structured interviews of 16 participants comprising eight doctors and eight nurses, with a total interview time of 8.95 hours. Purposive sampling was used to select the doctors and nurses from the public and private sector of the TB-HIV high burden community of northern KwaZulu-Natal. Thematic analysis was used to analyse the data. <em>Results</em>: Five key themes emerged from this study and these themes were discussed together with the sub-themes based on the various participant responses. The five key themes were practical experience about the management of TB-HIV co-infection; access to information and training on the management of TB-HIV co-infection; challenges and concerns about the management of TB-HIV co-infection; perception about local beliefs; and knowledge of policies and guidelines. <br><em>Conclusion</em>: Overall, this study highlights barriers that hamper the effective management of TB-HIV co-infection in northern KwaZulu-Natal. Recommendations of this study point towards an urgent need to scale up the management of TB-HIV co-infection through effective policies, improved capacity and infrastructure, stronger partnerships of all stakeholders, and further research.</p> Mbuso Mabuza, Constance Shumba ##submission.copyrightStatement## Mon, 21 May 2018 08:51:10 +0200 The effects of nutritional supplementation on body mass index and CD4 count among adult people living with HIV aids on antiretroviral treatment in Conakry, Guinea <p>Whereas the HIV prevalence in Guinea is among the lowest in Africa, many PLHIV in Guinea are malnourished. This study assessed the effect of a nutritional supplementation program on body mass index and CD4 count among adult PLHIV on ART. Study participants were PLHIV who came for consultation in the study sites between May and July 2016. The data came from two sources: retrospectively from participants’ medical records and interviews at the time of recruitment into the study. About six months before they were recruited into the study, some of the PLHIV started to receive a monthly nutritional supplementation consisting of Corn-Soy Blend and oil. Analytic methods included bivariate and multivariable methods. The intervention increased the mean BMI by 7.4% and the average current CD4 count by 4.7% compared to non-intervention (p&lt;. 001). Programs in low resource settings should consider nutrition assistance as part of a comprehensive strategy to ensure optimal metabolic and immunological functions among PLHIV.</p> Sidikiba Sidibé, Alexandre Delamou, Mohamed Lamine Kaba, Aboubacar Sidiki Magassouba, Amara Tabaouo Samake, Yao Serge Arthur Dongo, Jean-Jacques Olivier Kadio, Sandouno Sah Dimio, Lansana Mady Camara, Stella Babalola ##submission.copyrightStatement## Mon, 21 May 2018 00:00:00 +0200 Prevalence of Hepatitis C viral infection among injecting drug users in a Saudi Arabian Hospital: a point cross sectional survey <p><em>Background</em>: Hepatitis C Virus is an important cause of preventable morbidity and mortality among Injecting Drug Users worldwide. The aim of this study is to determine the prevalence and correlations of HCV infection among IDUs in Saudi Arabia. <br><em>Method</em>: A point cross-sectional survey was conducted between May 2012 and Nov 2012 to determine hepatitis C viral antibodies serological status using venous blood among IDUs (N=300) accessing care at Al-Amal Hospital in the Kingdom of Saudi Arabia, as well as to determine clinical correlates of hepatitis C infection among the Injecting Drug Users. <br><em>Results</em>: There was an overall HCV prevalence of 42.7% among IDUs studied. Low level primary education, single marital status, being unemployed and commencing Injecting Drugs beyond the age of 15 years have higher specific prevalence of HCV among IDUs population. There was statistically significant association between clinical assessments of the participants who were abusing drugs generally, dependent on drugs, specifically abusing cocaine, amphetamines, opioids, cannabinoids and alcohol with HCV antibodies seropositivity. There was no statistical significant relationship between drug induced sleep/sexual disorder and psychosis/delusion with HCV seropositivity. <br><em>Conclusion</em>: This study demonstrated a relatively high prevalence of HCV among IDUs in KSA. Targeted public health preventive strategies are necessary to halt the spread of HCV among IDUs in KSA. The resultant benefits of these will include reduction in morbidity and mortality as well as improved socioeconomic wellbeing of the IDU’s population.</p> Osama A. Alibrahim, Yusuf A. Misau, A. Mohammed, Izzeldin S.S. ##submission.copyrightStatement## Mon, 21 May 2018 00:00:00 +0200 Educational intervention on knowledge of cervical cancer and uptake of Pap smear test among market women in Niger State, Nigeria Cervical cancer is the most common female genital tract carcinoma worldwide. It is increasingly becoming the leading carcinoma seen among women in the developing world. The aim of our study was to showcase the effect of educational intervention on the knowledge of cervical cancer and subsequently the uptake of Pap smear test amongst market women in Niger state, Nigeria. The state has a rich network of markets in all the local government areas because of the fishing activities, bountiful agricultural produce yearly and its situation to the North of the national capital, Abuja. This was a quasi-experimental study conducted in two groups with pre and post intervention data collection. Sample size was determined based on a previous similar study done in Nigeria. Multi stage sampling technique was used for recruiting the study participants. SPSS statistical software was used for data entry, editing and analysis. Respondents’ knowledge of cervical cancer were comparable at pre-intervention but were statistically significantly better (P&lt;0.0001) at post-intervention in the intervention group compared to the control group for every variable measured. However, there was only a (Fisher’s exact, P=0.621) compared to the control group. This study showed an increase in knowledge about cervical cancer and Pap smear test however the uptake of Pap smear test remained low even after intervention. This underscores the need for sustained intervention programs to eventually translate knowledge acquired to habitual practice. Godwin Jiya Gana, Mansur O. Oche, Jessica Timane Ango, Aminu Umar Kaoje, Kehinde Joseph Awosan, Ismail A. Raji ##submission.copyrightStatement## Sun, 31 Dec 2017 00:00:00 +0100 Effects of mother related factors on perinatal outcomes-a study of mothers seeking antenatal care at public and non-public health facilities in Kisii County, Kenya The study sought to determine clientlevel and facility-level factors that affect perinatal outcomes among women attending comparable public (government owned) and non-public health facilities (non-government owned) in Kisii County-Kenya in the context of free maternity care. A total of 365 pregnant mothers recruited in 4 health facilities during their ANC visit and followed up to 2 weeks post-delivery but only 287 attended all follow-up visits. Study subjects were recruited proportionate to number of deliveries each of the facilities had conducted in the preceding 6 months. The dependent variable was perinatal outcome; independent variables were demographic and clinical factors. Analysis was done using χ2, logistic regression, paired t and McNemar’s tests. Maternal BMI and a mother’s parity were statistically correlated with perinatal outcome (χ2= 8.900, d.f =3, P=0.031 and (χ2= 13.232, d.f =4, P=0.039) respectively. Mothers with 1 parity were 4.5 times more likely to have normal perinatal outcomes (OR =4.5, 95% CI 2.25-14.29, P=0.012). There was a significant relationship between a mother’s knowledge of pregnancy-related issues and the baby’s weight (t=-67.8 d.f. 213 P&lt;0.001). Mothers’ knowledge on pregnancy issues and spousal involvement influences perinatal outcomes. Dietary Diversity Score (DDS) of a mother does not have a direct influence on the outcome of a pregnancy. There is need to focus on maternal factors that affect perinatal outcomes besides free maternity care. Micah Matiang’i, Simon Karanja, Peter Wanzala, Kenneth Ngure, Albino Luciani ##submission.copyrightStatement## Sun, 31 Dec 2017 00:00:00 +0100 Caesarean section in a primary health facility in Ghana: Clinical indications and feto-maternal outcomes There is great concern about the increasing rise in the rate of caesarean section in both developed and developing countries. This study was to ascertain the prevalence and compare outcomes of elective and emergency caesarean sections among women who deliver at the University of Cape Coast Hospital, Ghana. This retrospective study reviewed records of 645 women who delivered through caesarean sections during the period of January 2014 and December 2015. The prevalence of caesarean section was 26.9%. There was a significantly higher rate of adverse fetal outcomes (P=0.016) among babies born through emergency caesarean section. There were 12 (1.9%) women who had caesarean section done based on maternal request. The caesarean section rate found in this study was high. The lack of availability of technology for diagnosing fetal distress found in this study could possibly lead to over diagnosis of fetal distress. Thus availability of such diagnostic technology could reduce the high caesarean section rate. The high numbers of women requesting caesarean section without medical indication should be investigated and the motivation factors identified so as to curb the practice. James Prah, Andreas Kudom, Alex Afrifa, Mohammed Abdulai, Ignatius Sirikyi, Emmanuel Abu ##submission.copyrightStatement## Sun, 31 Dec 2017 00:00:00 +0100 Perceptions and practice of health care workers regarding hepatitis B vaccination, Bouaké, Côte d’Ivoire, 2016 Barriers to immunization are seen in both the general population and the health care workforce. We conducted this study to determine the perception of health workers on vaccination and the immunization of their patients. This cross-sectional descriptive analytical study was carried out among the medical staff in Bouaké, from 10 January to 07 March 2016. The data collected from the interviews were analyzed using Epi info 2000 software and SPSS 17.0. The Chi-2 test and logistic regression were performed and the significance threshold of the tests was 5%. The vaccination status of the 291 health care workers (HCWs) for the hepatitis B virus (HBV) was statistically related to their participation in the course in vaccination during their training (ORa = 1.69, 95% CI: 1.04-2.75 P&lt;0.05) and the systematic verification of the vaccination status of the patient was statistically related to the vaccination status of the HCW (ORa = 4.33, 95% CI: 2.97-8.18, P&lt;0.05). Promoting the vaccination among the population should be dependent on the promotion among HCWs. Damus Kouassi, Odile Angbo-Effi, Lepri Aka, M’Bégnan Coulibaly, Sory Soumahoro, Gnissan Yao, Nagho Soro ##submission.copyrightStatement## Sun, 31 Dec 2017 00:00:00 +0100