Journal of Public Health in Africa <p>The <strong>Journal of Public Health in Africa</strong>&nbsp;is a peer-reviewed, academic journal that focuses on health issues in the African continent.<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> PAGEPress Publications, Pavia, Italy en-US Journal of Public Health in Africa 2038-9922 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>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.</li> <li>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.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>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.</li> <li>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.</li> <li>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.</li> </ol> Head trauma: A significant public health concern among young men in Botswana. Etiology referral patterns and opportunities for interventions <p>This study aims to present and discuss acute Head Injury (HI) presentations including etiology, referral patterns and disposition in patients presenting to a major referral hospital in Gaborone, Botswana. Cross-sectional, retrospective data collection from July 2015 through September 2015 extracted descriptions of patient demographics, mechanism of injury, comorbidities, diagnosis and disposition from Emergency Centre (EC) records. 360 HI patients presented in three months, averaging four per day and increasing on weekends and end of the month. HI disproportionately impacted young adult males, with motor vehicle accidents accounting for 38%, violence implicated in 39% and 80% recorded as blunt trauma. HIV status was unknown for 84% of patients at the time of presentation and 10% of patients were recorded as HIV positive. Patients referred from external hospitals had a higher admission rate. HI in young males is a significant trauma burden in this hospital, similar to the known regional trauma patterns. More studies regarding trauma, alcohol, and violence related to paydays should be considered to investigate and reduce the burden of HI in Botswana.</p> Megan Cox Timothy Becker Mpapho Motsumi ##submission.copyrightStatement## 2018-10-22 2018-10-22 10.4081/jphia.2018.798 Community awareness of stroke, hypertension and modifiable risk factors for cardiovascular disease in Nkonya-Wurupong, Ghana <p>Hypertension and other non-communicable diseases are growing risk factors for cardiovascular disease and stroke in lowand middle-income countries like Ghana who are experiencing the effects of rapid urbanization and globalization. Awareness and education may help reduce the population’s exposure to modifiable risk-factors. A survey from a central clinic outside the city of Ho, in the Volta region investigates participants’ level of awareness and education surrounding hypertension and stroke. It provides important information about the approach to education and preventing modifiable risk factors. A central clinic in Nkonya-Wurupong, Ghana, evaluated 1671 patients in July 2016, and a group of 302 adults over the age of 18 provided a convenience sampling. The survey examined three main areas: demographics, medical history, and evaluation of knowledge with respect to stroke and cardiovascular risk factors. 18.5% of participants demonstrated hypertension (BP ³ 140/90). 30% of those with hypertension were female. Thirty-five percent believed hypertension was a risk factor for stroke, and only 26% were currently medicated for hypertension. Poor diet, obesity and alcohol were the most frequently identified risk factors for stroke and 86% of participants felt that it was preventable. However, diet, heart disease, smoking, obesity, diabetes, sedentary lifestyle or alcohol were not uniformly identified as stroke risk factors. One-sided weakness was the only symptom the group associated with stroke. Other symptoms included in the survey were headache, slurred speech, visual changes, dizziness, and facial droop. Educational resources included TV, school, internet, radio, medical books and health professionals and 7% responded that they had never been educated about stroke and its risk-factors. Knowledge of hypertensive consequences including cardiovascular disease and stroke varies significantly along with stroke identification and educational sources. However, many indicated that stroke is due to lifestyle and can be prevented. It is unclear what respondents believe these lifestyle choices are. This data suggests there are major areas where healthcare education is needed. Discerning baseline health in developing countries will become increasingly important when evaluating an area for health resource allocation including patient health education programs</p> Melissa Murray Carol King Cecilia Sorenson Elaine Bunick Renee King ##submission.copyrightStatement## 2018-10-11 2018-10-11 10.4081/jphia.2018.783 The Ubuntu concept, sexual behaviours and stigmatisation of persons living with HIV in Africa: A review article <p>Stigma and discrimination and risky sexual behaviours have been major stumbling blocks to the efforts by implementers to mitigate the effects of HIV amongst communities in Africa. A key cultural resource, based on evolving South African cultural traditions, is the notion of Ubuntu, which is grounded in respect, ethics, humanity and the interconnectedness of beings. This concept can be a useful resource in upholding confidentiality, a central requirement in research ethics and the deliverance of health promotion interventions regarding HIV/AIDS. This article explored the applicability of the Ubuntu concept in enhancing safe sexual practices and positive attitudes towards persons living with HIV, with the view of achieving Zero new infections, Zero discrimination against persons living with HIV (PLHIV), and Zero AIDS-related deaths. A review of literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to the tenets of Ubuntu, stigma and discrimination towards PLHIV, and sexual behaviours were used. Only references deemed useful from relevant texts and journal articles were included. Going therefore by the Ubuntu tradition of basic respect and compassion for others, one will expect positive attitudes towards PLHIV. This review therefore advocates positive attitudes towards PLHIV. Also, according to the Ubuntu tradition that prescribes a rule of conduct and social ethics, one would expect the sexual behaviours of youths in Africa to be good. This review article also advocates safe sexual behaviours of adolescents in Africa. With this in mind, from a critical Ubuntu-centric philosophical perspective, this article breaks new ground by advocating the use of the Ubuntu concepts in enhancing safe sexual practices and positive attitudes towards PLHIV in Africa. This could in turn bring about safe sexual practices among youths, and curb the discrimination and stigmatization against PLHIV in Africa.</p> Elvis Enowbeyang Tarkang Lilian Belole Pencille Joyce Komesuor ##submission.copyrightStatement## 2018-10-10 2018-10-10 10.4081/jphia.2018.677 Prevalence of hepatitis C among HIV-1, HIV-2 and dually reactive patients: A multi-country cross-sectional survey in West Africa <p>Little is known on the impact of HIV-2 infection on HCV viral replication. The aim of the study was to compare HCV prevalence and viral replication based on HIV types in West Africa. A cross-sectional survey was conducted within the IeDEA HIV-2 West Africa cohort from March to December 2012. All HIVinfected adult patients who attended participating HIV clinics during the study period were included. Blood samples were collected and re-tested for HIV type discrimination, HCV serology and viral load. A total of 767 patients were enrolled: 186 HIV-1, 431 HIV-2 and 150 HIV-1&amp;2 dually reactive. At time of sampling, 531 (69.2%) were on ART and median CD4+ cell count was 472/mm3. Thirty (3.9%, 95% CI 2.7-5.5) patients were anti-HCV positive (4.3% in HIV-1, 4.0% in HIV-1&amp;2 dually reactive and 3.7% in HIV-2; p=0.91). Detectable HCV RNA was identified in 21 (70.0%) patients (100% in HIV-1 and HIV- 1&amp;2 dually reactive vs. 43.8% in HIV-2; p=0.003). Systematic screening should be promoted and performed in this population, since HCV is now potentially curable in sub- Saharan Africa.</p> Didier K. Ekouevi Patrick A. Coffie Boris K. Tchounga Armel Poda Antoine Jaquet François Dabis Serge P. Eholie ##submission.copyrightStatement## 2018-10-10 2018-10-10 10.4081/jphia.2018.871 Factors associated with early sexual intercourse among teenagers and young adults in rural south of Benin <p>Early initiation to sexual intercourse increases the risk of sexually transmitted infections including HIV/AIDS and early or unwanted pregnancies. This study aimed identifying the factors associated with the early initiation to sexual intercourse among teenagers and young adults aged 10-24, in the south of Benin. A cross-sectional study was conducted in the south of Benin where 360 respondents were selected by random cluster sampling. Multiple logistic regressions was used to find related factors to early sexual intercourse. The significance level for the tests was of 5%. The average reported age of initiation to sexual intercourse was 14.75±2.18. Among the male teenagers and young adults, 41.11% had an early sexual intercourse against 20.24% for the female gender (P&lt;10-3). The lack of communication between parents-teenagers (P=0.003), level of education of the father (P=0.021), exposure to pornographic movies (P=0.025), an adverse opinion on premarital sexual abstinence (P=0.026) were significantly associated with early sexual intercourse. Communication about health promotion for behavioural change may contribute to delay the age of sexual initiation.</p> Yolaine Glèlè Ahanhanzo Charles Sossa-Jérôme Ghislain Sopoh Makilioubè Tchandana Colette Azandjèmè Toyi Tchamdja ##submission.copyrightStatement## 2018-10-01 2018-10-01 10.4081/jphia.2018.681 Gender and socio-demographic distribution of body mass index: The nutrition transition in an adult Angolan community <p>This cross-sectional survey with 2357 subjects aged 15 to 64 years from a ruralurban community in Bengo Province, Angola, aimed to evaluate the gender differences in the prevalence of body mass index categories and how socio-demographic characteristics influence it. Women presented a significantly higher prevalence of obesity (10.5% versus 2.8%) but the underweight frequency was similar to men (10.2% versus 12.4%). Overweight and obesity increased with age, with underweight being more prevalent in the age group 15 to 24 years. Obesity was more prevalent among individuals living with a companion (in a marital relation), decreased with education (in women), but was higher in rural areas, and for those with a higher family monthly income, in both genders. The prevalence of obesity and underweight were similar in women, reflecting a nutrition transition state. Like in other African communities, women present a higher prevalence of overweight and obesity them men, but the values of underweight are similar between genders. This stresses the need of designed health interventions for women, to face the double burden and accumulation of risk factors in women.</p> João M. Pedro Miguel Brito Henrique Barros ##submission.copyrightStatement## 2018-10-01 2018-10-01 10.4081/jphia.2018.865 Impact of universal childhood vaccination against hepatitis B in Ghana: A pilot study <p>Hepatitis B virus (HBV) infection is of public health importance worldwide. Vaccination against the infection, especially in early childhood has significantly reduced the public health impact. This pilot study was undertaken in Cape Coast Metropolitan area to assess the impact of the introduction of HBV vaccination in children. A cross-sectional multi-stage cluster sampling of 501 pupils from 30 public and private primary and junior high schools within the Cape Coast metropolis. A questionnaire covering basic demographic details and immunisation history were administered to the participants after consent and assent had been sought. Hepatitis B serological test for HBsAg, HBcAb, HBsAb, HBeAg and HbeAb was undertaken using Hepatitis B test kit and capillary blood from the participants. The general prevalence of HBcAb, HBsAg and HBsAb was found to be 3.6, 2.6 and 19.8% respectively. The prevalence of HBcAb was 2.6 and 6.1% among pupils delivered after and before the vaccine programme introduction respectively. Introduction of the vaccination programme in Ghana has had a positive impact on the HBV infection in Ghana.</p> Oheneba C.K. Hagan Paul Nsiah Dorcas Obiri-Yeboah Felix Yirdong Isaac Annan Sebastian Eliason Samuel V. Nuvor ##submission.copyrightStatement## 2018-10-01 2018-10-01 10.4081/jphia.2018.721 Effect of health education intervention conducted by Primary Health Care workers on oral health knowledge and practices of nursing mothers in Lagos State <p>Educational interventions on oral health care is traditionally carried out mainly by oral health workers in Nigeria. Despite the introduction of the National Oral Health Policy, oral health services/education is virtually non-existent in PHC centres in Nigeria. This study sought to determine the effect of a health education intervention delivered by Community Health Officers (CHO) on the oral health knowledge and practices of mothers attending a PHC centre in Lagos State. A pre-experimental, Before- After study design was employed. An interviewer- administered questionnaire was administered at baseline to assess the oral health care knowledge and practices of 267 mothers who enrolled in the programme. After enrolling the participants, CHO’s previously trained commenced a health education intervention on oral health. The intervention, which consisted of 2 lecture sessions, a demonstration session and a return demonstration session, utilising flipcharts and health information leaflets spanned a six-month period. Oral health knowledge and practices of participating mothers was evaluated 3 and 6 months after the intervention commenced using a standardised checklist. Data entry and analysis was done using SPSS version 20, P-value of &lt;0.05 was considered significant. The mean oral health knowledge score at baseline was 4.58 (±1.37) while at 3-month and 6-month postintervention the mean scores were 4.68 (±0.97) and 4.96 (±0.49), respectively. There was a statistically significant increase (P=0.000) in the mean knowledge scores at 6 months post-intervention. Mothers who were 36 years or older and those with more than 12 years education displayed significantly better knowledge scores (P&lt;0.05). Most (78.3%) reported using cotton wool or foam with water for their infants’ oral hygiene. By the second post-intervention visit, there was a significant change in the perception of the mothers on correct oral hygiene tool for infants (52.3%; P=0.000). Furthermore the percentage of mothers actually using toothbrush to clean their child’s mouth (98.1%; P=0.000) had increased. The oral health knowledge of the participants increased significantly following the intervention especially at the 6-month evaluation. PHC workers can successfully carry out oral health educational interventions at PHC level. The greatest value will occur with reinforced repetition of the messages.</p> Abiola Adetokunbo Adeniyi Afolabi Oyapero Victor Ajieroh Oyinkansola Sofola Oladapo Asiyanbi ##submission.copyrightStatement## 2018-10-01 2018-10-01 Comparative analysis of dietary pattern, anthropometry and serum ascorbate status of persons living with or without non-Hodgkin’s lymphoma <p>Recent upsurge of cancer cases across the globe is of concern to all and many studies shows the relationship between nutrient and the immune system and consequently cancer. This work aims to compare the dietary pattern, anthropometry and serum ascorbate status of the persons living with and those living without non-Hodgkin’s lymphoma (NHL). A case-control study was conducted using blood samples of eight patients diagnosed for NHL at the University College Hospital (UCH) Ibadan, while eight (8) volunteers were the control group. Socio-economic characteristics, medical history, food preferences, anthropometric indices were retrieved from questionnaires. Ascorbic Serum assay done with ultraviolet absorption spectrophotometry method using Klett-summerson photoelectric. Students’ t-test and Chi-square were used to test the educational levels fruit consumption. 25% of the respondents suffering from NHL skipped lunch and dinner, but none skipped breakfast. 66.67% of the cases and 100% of the control have their weight normally distributed. Cases had 11.11% slightly underweight and 11.11% obese. 25% of the population of the respondents had normal range of 0.4 mg/100 of serum ascorbate, while six had low serum ascorbate levels.</p> Abiodun Adeoso Tola Atinmo ##submission.copyrightStatement## 2018-10-01 2018-10-01 10.4081/jphia.2018.768 The health-related impacts and costs of violence against women and girls on survivors, households and communities in Ghana <p>Past research on violence in Ghana primarily discusses domestic violence and some types of sexual violence, but lacks a comprehensive analysis of violence against women and girls (VAWG) and its wider costs and impacts. Our study on the social costs of VAWG is a unique contribution, which aims to fill that gap. Through indepth interviews (IDIs) and focus group discussions (FGDs) with adult women and men, we explored the health impact of VAWG and the resulting social and economic consequences on survivors, their families and their communities. The research, which took place in the Eastern, Central, and Greater Accra regions of Ghana, points to several physical and mental health outcomes among survivors including physical injuries and disability, as well as impacts on mental health such as anxiety and suicidal ideation. Many VAWG survivors also experience stigma and social isolation. Our findings also reveal that survivors’ families can bear various social and economic costs. Lack of public and private service provision and shelters for survivors heighten these impacts. Without institutional support for survivors, families and communities absorb these costs of VAWG.</p> Gina Alvarado Ama P. Fenny Samuel Dakey Jennifer L. Mueller Lila O'Brien-Milne Aba O. Crentsil Nata Duvvury Stacey Scriver Chloe Schwenke ##submission.copyrightStatement## 2018-10-01 2018-10-01 10.4081/jphia.2018.860