Journal of Public Health in Africa https://publichealthinafrica.org/index.php/jphia <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> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="http://creativecommons.org/licenses/by-nc/4.0/" 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> emanuela.fusinato@pagepress.org (Emanuela Fusinato) tiziano.taccini@pagepress.org (Tiziano Taccini) Fri, 03 May 2019 11:34:23 +0200 OJS 3.1.1.4 http://blogs.law.harvard.edu/tech/rss 60 Providing mothers with mobile phone message reminders increases childhood immunisation and vitamin A supplementation coverage in Côte d’Ivoire: a randomised controlled trial https://publichealthinafrica.org/index.php/jphia/article/view/1032 <p>We conducted a randomised controlled trial to assess the effect of providing mothers with mobile voice or text (SMS) reminder messages on health facility attendance at five infant immunisation and vitamin A supplementation (VAS) visits. The study was conducted at 29 health facilities in Korhogo district. Mothers were randomised to receive a voice or text reminder message two days prior to each scheduled visit and two additional reminders for missed doses (n = 798; intervention group), or no phone reminder messages (n = 798; control group). Infants in the intervention group were 2.85 (95% CI: 1.85-4.37), 2.80 (95% CI: 1.88-4.17), 2.68 (95% CI: 1.84- 3.91), and 4.52 (95% CI: 2.84-7.20) times more likely to receive pentavalent 1-3 and MMR/yellow fever doses, respectively, and 5.67 (95% CI: 3.48-9.23) times more likely to receive VAS, as compared to the control group. In the reminder group, 58.3% of infants completed all five visits, compared to 35.7% in the control group (P &lt; 0.001). Providing mothers mobile phone message reminders is a potentially effective strategy for improving immunisation and VAS coverage in Côte d’Ivoire.</p> Romance Dissieka, Marissa Soohoo, Amynah Janmohamed, David Doledec ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/1032 Wed, 19 Jun 2019 12:32:14 +0200 Hunger in the midst of plenty: A survey of household food security among urban families in Lagos State, Nigeria https://publichealthinafrica.org/index.php/jphia/article/view/885 <p>Research has documented that food security at national level does not translate to food security at household level. The study assessed the level of food security among urban households in Shomolu LGA, Lagos State. Using the 9-item Household Food Insecurity Access Scale (HFIAS) information was collected from 306 heads of households on adequacy of food availability and consumption. Data were analyzed using Epi info and presented as frequencies and percentages. Associations between variables were tested using Chisquare at a significance level of 0.05. Households were classified as food secure, food insecure without hunger and food insecure with hunger. Only 33.8% of households were food secure, 45.1% were food insecure without hunger and 21.1% were food insecure with hunger. Food secure households were statistically significantly associated with households where heads had secondary or higher education, women were married, spending &lt;40% of household monthly income on food and living in their own homes (P=0.001). Household food insecurity is found in urban communities and is positively associated with indicators of poverty.</p> Alero Ann Roberts, James Olufemi Osadare, Victor Akpan Inem ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/885 Wed, 19 Jun 2019 12:22:41 +0200 Assessment of the relationship between water insecurity, hygiene practices, and incidence of diarrhea among children from rural households of the Menoua Division, West Cameroon https://publichealthinafrica.org/index.php/jphia/article/view/951 <p>The objectives of a cross-sectional, semi-quantitative study were to: i) assess the prevalence of water insecurity and its association with water access-related behaviors such as time, distance, and sources of water; ii) identify major themes of concern raised in reference to anxiety, water quality/quantity, and perceived health risk domains of water insecurity, and; iii) examine the relationship between water insecurity, hygiene practices, and diarrhea lincidence among children in rural areas of the Menoua Division in the Western Region of Cameroon In-person interviews were conducted with 18 years or older women living with at least one child between 2 and 5 years old (n=134). Participants spent on average 17±12 minutes walking to a drinking water source. Prevalence of water insecurity was 58%, and it was associated with a lower hygiene score among caretakers, <em>i.e.</em>, hygiene score of water secure: 9.2±1.2 <em>vs.</em> insecure: 8.2±2.2, F<sub>(1, 132)</sub>=8.096, P&lt;0.01). Overall, the incidence of diarrhea among children was 18%, and it was significantly higher among water insecure house-holds (79%) compared with secure house-holds (21%, P=0.02). In conclusion, access to improved sources of water is an issue in rural areas. Addressing water insecurity is critical in promoting optimal health and development of children due to its association with poor hygiene practices among caretakers.</p> Carole Nounkeu, Joseph Kamgno, Jigna Dharod ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/951 Wed, 12 Jun 2019 14:35:05 +0200 Potential benefits and harms of the use of UV radiation in transmission of tuberculosis in South African health facilities https://publichealthinafrica.org/index.php/jphia/article/view/742 <p>The incidence and prevalence of transmitted <em>Mycobacterium tuberculosis</em> have risen very rapidly in modern society. Environmental control measure such as ultraviolet radiation has been introduced in various health care facilities. This preventative measure has been extensively explored in the medical, legislative and public forums. However, the guidelines and manufacturer’s claims have created controversies, in terms of prevention of cross-transmission of <em>M. tuberculosis</em> in health care facilities. In this article, the authors reviewed the overall benefits and harms associated with the use of ultraviolet radiation in the prevention of <em>M. tuberculosis</em> transmission. The author concluded that there are still existing gaps in proving beyond any reasonable doubt that ultraviolet radiations absolutely prevent the spread of <em>M. tuberculosis</em> in South African health facilities.</p> Marang Tebogo Mamahlodi ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/742 Wed, 12 Jun 2019 12:21:39 +0200 Isoniazid Preventative Therapy uptake for child household contacts of tuberculosis index cases, Kisumu County, Kenya, 2014-2015 https://publichealthinafrica.org/index.php/jphia/article/view/827 <p>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. 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 of the study database to the TB program IPT register, we described Child contacts as <em>initiated on IPT</em> and TB index cases as <em>having child contacts initiated on IPT</em> 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. Of 555 TB index cases recruited into the study, 243 (44%) had a total of 337 IPT-eligible child 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, 95% 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). 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, job aids and monitoring tools, and ensure continuous supply of medication, and 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## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/827 Wed, 12 Jun 2019 00:00:00 +0200 Cost of treatment among self-referred outpatients in referral hospitals compared to primary health care facilities in East Wollega, western Ethiopia: A comparative cross-sectional study https://publichealthinafrica.org/index.php/jphia/article/view/1024 <p>Patient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals without a formal referral. The study aims to evaluate cost of treatment among self-referred outpatients at referral hospitals compared to primary health care facilities. Comparative cross-sectional study design was used and the required sample size for the study was determined by using formula of double populations mean comparison cost of treatment for diseases leading to outpatient visits. A total of 794 participants (397 from referral hospital and 397 from primary health facilities) were included in the study. Data was collected using face-to-face interview from December 1 to 30, 2017. Data entry and analysis were made using SPSS version 20. Descriptive statistics and independent samples t-test were performed. A total of 783 outpatients responded to the interview of the study and 391 of them were from referral hospital and 392 from primary health facilities. The mean of outpatient visit cost per visit for the treatment of diseases leading to outpatient visits was significantly higher at referral hospitals compared to primary health facilities [95% CI=6.13 (5.07-7.18)] USD. The mean cost of outpatient visits for the treatment of all type of diseases leading to outpatient visits was significantly higher at referral hospitals and at least two times of primary level health facilities. Health care providers should create awareness in the community about referral linkages to inform patients and their families the additional costs they incur when&nbsp;they bypass the proximal primary health facilities.</p> Edosa Tesfaye Geta, Yibeltal Siraneh Belete, Elias Ali Yesuf ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/1024 Tue, 04 Jun 2019 11:34:26 +0200 Knowledge and practice of breast self-examination among undergraduate student in Bahir Dar University, North-West Ethiopia, 2016: A cross-sectional study https://publichealthinafrica.org/index.php/jphia/article/view/805 <p>Breast cancer is the most common cancer in women worldwide, with nearly 1.7 million new cases diagnosed each year which accounts 12% of all new cancer cases and 25% of all cancers in women. Breast self-examination offers women the best opportunity for reducing breast cancer deaths. From a total of 222 respondents about 190 (85.6%) heard about breast self-examination. One hundred forty-three (75.3%) had good knowledge about sign and symptoms of breast cancer and 47 (24.7%) had poor knowledge about the sign and symptoms of breast cancer. From total respondents of the study 120 (54.1%) practiced breast self-examination. Breast self-examination practice is relatively frequent problem in Bahir Dar University, health science students. Negligence, forgetfulness and lack of knowledge are the main factors for poor practice of breast self-examination. Public health education using the media, clubs and leaflet could significantly reduce poor practice of breast self-examination and increases early detection of breast lump.</p> Tilahun Tewabe, Zelalem Mekuria ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/805 Tue, 04 Jun 2019 11:27:31 +0200 Survey on visual acuity among intra-city commercial vehicle drivers in Ibadan, southwestern Nigeria https://publichealthinafrica.org/index.php/jphia/article/view/789 <p>Driving is recognized to be a visually intensive task and accordingly legal minimum standard of vision required for all motorists is stipulated. This study was carried out to find out how many commercial drivers in Ibadan North L.G.A met minimum legal requirement for driving in Nigeria. A cross sectional descriptive study was conducted among 340 commercial vehicle drivers selected by multistage sampling from eight transport stations (motor parks) in the city. Visual impairment was defined as vision acuity (VA) in both eyes which is below 3/18 but above 3/60 (VA &lt;6/18≥3/60) and was assessed with the Snellen’s chart. All participants have valid driving licenses. One sixth [52, (15.3%)] have visual acuity below 6/9 and 18 (5.3%) have visual impairment (VA &lt;6/18≥3/60). More of those drivers aged 40 years and more had visual impairment compared to the younger drivers (P&lt;0.05). These findings suggest that regulatory standards for licensing drivers are being circumvented by some of the drivers. Mechanisms for ensuring compliance to the regulatory standards especially visual acuity is therefore recommended.&nbsp;</p> Magbagbeola David Dairo, Ugochukwu Patricia Okechukwu-Nwankpa, Romanus Nwankpa ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/789 Tue, 04 Jun 2019 00:00:00 +0200 Trends of and factors associated with cesarean section related surgical site infections in Guinea https://publichealthinafrica.org/index.php/jphia/article/view/818 <p>Since the adoption of free obstetric care policy in Guinea in 2011, no study has examined the surgical site infections in maternity facilities. The objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in Guinean maternity facilities from 2013 to 2015. This was a retrospective cohort study using routine medical data from ten facilities. Overall, the incidence of surgical site infections following cesarean section showed a declining trend across the three periods (10% in 2013, 7% in 2014 and 5% in 2015, P&lt;0.001). Women who underwent cesarean section in 2014 (AOR: 0.70; 95%CI: 0.57-0.84) and 2015 (AOR: 0.43; 95%CI: 0.34-0.55) were less likely to develop surgical site infections during hospital stay than women operated in 2013. In the contrary, women with comorbidities were more likely to experience surgical site infection (AOR: 1.54; 95% CI: 1.25-1.90) than those who did not have comorbidities. The reductions achieved in 2014 and 2015 (during the Ebola outbreak) should be sustained in the post-Ebola context.</p> Alexandre Delamou, Bienvenu Salim Camara, Sidikiba Sidibé, Alioune Camara, Nafissatou Dioubaté, Alison Marie El Ayadi, Katy Tayler-Smith, Abdoul Habib Beavogui, Mamadou Dioulde Baldé, Rony Zachariah ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/818 Fri, 03 May 2019 11:52:54 +0200 Genital hygiene behaviors and practices: A cross-sectional descriptive study among antenatal care attendees https://publichealthinafrica.org/index.php/jphia/article/view/746 <p>The female genital tracts harbor a wide variety of microorganisms’ knowns as microflora mostly constituted by lactobacilli, involved in the healthy state of the vagina without causing infection. Urinary tract infections (UTI) are frequent in pregnant women due to physiological and anatomical changes that occur during pregnancy. These infections can result to disabilities or serious health problems both for the mother and the new-born. Vaginal douching has been reported among risky practices associate with UTIs. However, this remains debatable and contradictory when other studies report the benefit effects of vaginal cleaning in infection prevention. The aim of this study was to assess pregnant women behaviors and practices regarding genital hygiene. This was a cross sectional descriptive study conducted on exhaustive sample of pregnant women coming for antenatal visits in Lafé Sub-divisional Hospital (SDH) and Baleng Catholic Health Center (BCHC) between 16 and 30 September 2013. Data were collected using a paper based standardized questionnaire directly self-administered after obtain a free consent. Overall, 80 pregnant women were enrolled. The majority of them had attended at least primary education (97.5%; n=78/80) and many were lived in couple (81.25%; n=65/80). Almost one on three participants identified antenatal consultation (ANC) as a key element to be taken into account by pregnant women. 70.1% (n=56/80) of women declared wearing undergarments in cotton. Regarding the daily vaginal douching behaviors, the majority (76.3%; n=61/80) of participants used the recommended gynecological measure, while the remaining use self-prescribed measures. Both genital parts (vulva area and vagina) were cleaned and use of water was mostly cited (63.8%; n=51/80). Almost one participant on four (n=29/80) use antiseptic solutions for genital cleaning. Antiseptic solutions were associated with water in 34.5% of cases (n=10/29), and in 65.5% (n=19/29) of cases it was used only for the vagina. Our findings suggest that knowledge and genital hygiene cleaning practices are acceptable among our study population. Risky practices such as use of antiseptic solutions and synthetic underwear’s were reported. Skills of health care providers on good hygiene practices for pregnant should be improved and community-based communication strategies need to be implemented to reach all women of child bearing age.</p> Patrick Martial Nkamedjie Pete, Rodrigue Mabvouna Biguioh, André Gael Bita Izacar, Sali Ben Béchir Adogaye, Cecile Nguemo ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 https://publichealthinafrica.org/index.php/jphia/article/view/746 Fri, 03 May 2019 11:33:55 +0200