East African Journal of Health and Science

Stage at Presentation and Associated Factors for Late Diagnosis of Head and Neck Malignancies at Bugando Medical Centre Tanzania

Olivia M. Kimario — 2024-01-16

Head and neck cancer is among the most common cancers with an increase in number worldwide. It has a management challenge due to late-stage presentation. Its epidemiology and characteristics are changing from anatomical to biological due to its viral etiological. This study was done to determine the presentation and factors of head and neck malignancies at Bugando Medical Centre Tanzania. This was an analytical cross-section prospective study involving all patients confirmed to have head and neck malignancy at Bugando Medical Centre from February to June 2019. A total number of 60 patients (M: F=1.4:1) were studied. The median age was 56 years. The associated factors were the symptoms ranging from 1 to 104 weeks at the first consultation, Late-stage observed among patients coming from the rural areas by 58.3% and those using local medicine at 70%. Low level of education, which was primary education, was leading 51.7%. Those who attended the dispensary for their first consultation had an advanced stage of disease at presentation. It showed that the dispensary was the preferred centre for the first consultation of the majority at 41%. The major of patients presented at an advanced stage which was 73% and the contributory factor of delayed presentation of head and neck cancer at Bugando Medical Centre was attributed by patients themselves, whereas health care had a small contribution. The main reasons observed were rural settlement, local medication, and low level of education. Training must be conducted at health care providers in dispensaries and health centres on how to suspect patients with HNC at an early stage and refer them directly to tertiary hospitals without passing through a series of referrals

Critical Success Factors for Deployment of Primary Health Care Networks and their Impact in Kenya

Yvonne Opanga — 2024-01-16

The Government of Kenya through the Bottom-up Economic Transformational Agenda (BETA) acknowledges Primary Health Care (PHC) as a cost-effective and efficient means to achieve Universal Health Coverage (UHC). The aim is to enhance equitable access to high-quality and affordable healthcare for all Kenyan citizens. Primary Health Care Networks (PCNs) are gaining traction as the main mode of achieving PHC in Low- and Middle-Income Countries, and Kenya is no exception. In Kenya, PCNs approach seeks to empower local communities at subcounty level through mobilizing resources and strengthening their decision-making authority to address context specific healthcare needs. The investment in PCNs is geared towards advancing equitable access to quality healthcare at the community level, mitigating fragmentation of health care services, strengthening preventive and promotive healthcare hence creating a more resilient and efficient healthcare system. The Ministry of Health in Kenya, in collaboration with County Governments and Development partners, initiated a Rapid Results Initiative (RRI) to deploy PCNs across the country in August, 2023. The goal was to establish 315 Primary Health Care Networks (PCN) across the 47 counties in Kenya. This was preceded by a Pilot phase in 3 Counties (Kisumu, Garissa, and Kwale) which was conducted in 2021. The pilot phase informed cost-effective approaches for the deployment and critical success factors for scale-up of PCNs countrywide. The nationwide deployment of PCNs followed a 10-step process of establishing PCNs as stipulated in Kenya PHC Guidelines. Data on experiences, progress in implementation and lessons learnt was abstracted from grey literature including reports from PCN establishment at County level, Stakeholder meetings through Accelerator and Sustainability taskforce and data from PCN observatory. The average time taken to establish a PCN was 3 weeks and costed approximately USD 34,000 for its full establishment. As at 20th December, 2023 (within 4 months of initiating the RRI), of the target of 315 PCNs, 93(30%) PCNs were fully established, 27(9%) PCNs were in progress and 195(62%) yet to start. Out of the 47 counties, 37(79%) counties have at least a fully established PCN, 4 Counties are in the process of establishing the first PCN and 6 are awaiting partner readiness. The eight main critical success factors for successful establishment included: County ownership and commitment, availability of Key Policy guidelines and strategies for reference, funding from development partners and donors, leveraging on existing National and County governance structures, multisectoral collaborations and partnerships, tracking of PCN establishment through National PCN observatory and Community engagement. Key process enablers to successful role out included: Meaningful engagement of development and implementing partners, Execution through County trained TOTs, Community engagement through Community Health Workforce and support from National Government. Over time, the Established PCNs in 3 pilot counties have demonstrated significant reduction in facility based maternal mortality, increased access to NCD screening services, coordinated health care workers through MDTs and improved forward and backward referrals. Additionally, incorporated innovation models within PCNs have improved access to medical supplies and specialized healthcare services at level 2 and 3 facilities. To achieve successful scale up of PCNs and sustainability for impact it is critical to contextualize PCNs to the County needs, establish sustainable primary health care financing mechanism for PCN activities, Strengthen PCN governance structures and utilise PCN observatory to continuously track PCN performance measurements and decision making. Adoption of a unified focus on PCN performance improvement including one PCN strategy, one action plan on how to optimally implement PCNs and one monitoring framework is critical. If implemented successfully, PCNs will contribute to long term social return on investments and improved health indicators for the Country

Nurses' Knowledge, Attitude, and Practice on Enteral Feeding of Critically ill Patients at Kenyatta National Hospital Critical Care Unit

Njuguna Joyce Wangari — 2024-01-17

Enteral feeding/nutrition is the most efficient nutritional support strategy used by critical care nurses to feed patients in critical care units (CCUs) who are unable to meet their dietary demands orally. In developing countries, most critically ill patients continue to receive low amounts of their dietary needs in the CCUs. Therefore, it is necessary to carry out investigations on the levels of knowledge, attitudes, and practices of critical care nurses attending to extremely ill patients. This study's objective was to determine the levels of knowledge, attitudes, and practices of critical care nurses on enteral feeding of critically ill patients at Kenyatta National Hospital (KNH) CCUs. The study adopted a cross-sectional quantitative study design. Using a stratified sampling design and proportionate sampling technique, a sample size of 135 critical care nurses was recruited. Data was collected using a standardised questionnaire. Inferential statistics, Pearson Chi-square (χ2) or Fisher's exact tests were used to analyse the relationship between independent and dependent variables. A p-value of <0.05 was set as the significance criterion. Approximately 65.9% of the study participants noted adequate level of knowledge on enteral nutrition, followed by moderate (23.0%) and inadequate (11.1%) levels of knowledge. Most of the respondents (96.3%.) had positive attitudes toward enteral feeding. About 54.7% of the study subjects had competent enteral feeding practices. The gender, age group, terms of service, level of qualification and work experience were not significantly associated with the levels of knowledge, attitudes, and practices on enteral feeding among critical care nurses. This study concluded that the critical care nurses had adequate knowledge, positive attitudes, and competent practices on enteral nutrition. The study recommends that critical care nurses must be provided with regular, continuous medical training on enteral nutrition to maintain a high level of knowledge, positive attitudes, and competent practices on enteral nutrition

Acute Poisoning Emergencies at Gulu University Teaching Hospitals in Northern Uganda: Prevalence, Outcomes and Clinical Challenges

Keneth Opiro — 2024-01-22

Acute poisonings, including envenomation as well as toxicological emergencies stemming from accidental or intentional ingestion of poisonous substances or drug overdose, are significant worldwide causes of morbidity and mortality. The study aimed to characterise acute poisoning emergencies admitted to two major hospitals in Northern Uganda. We conducted a retrospective review of charts of all patients admitted with acute poisoning emergencies between January and December 2021, as well as a structured interview of hospital staff working in these hospitals on challenges faced while managing these emergencies. Of the total 40,653 patient admissions, 416 (1%) were due to acute poisonings. The majority were admitted to SMHL (71.4%), 43.3% were between 20 and 40 years of age, and 59.9% were males. The average length of hospital stay was 1 (0-3). The most frequent diagnoses were acute alcohol intoxications (27.2%, n=113), snake bites (26.0%, n=108), and organophosphate poisonings (21.2%, n=88). Only 29.6% (n=123) of patients received antidotes. Peak admissions were observed in February, May, and July. The majority of poisonings were intentional (61.3%), resulting in a Case Fatality Rate of 6.3%. In the qualitative findings, participants highlighted key challenges in managing these conditions, including the lack of antidotes, patients presenting late at the hospital, economic barriers, staff shortages, and limited community awareness. Acute poisoning, especially acute alcoholic intoxication, snake bites and organophosphate poisoning, are common in northern Uganda, with significant numbers dying from it. The lack of antidotes remains a problem in these hospitals. Restriction of alcohol consumption use of agricultural organophosphates, and training of healthcare workers in managing these emergencies are recommended

Male Erectile Dysfunction Problems in Healthcare Facilities in Dar-es-Salaam, Tanzania

Ever Mkonyi, PhD — 2024-01-31

Male erectile dysfunction is a significant public health problem that considerably impacts one's relationships and affects sexual life. However, few studies have been conducted in Sub-Saharan Africa to explore male erectile dysfunction. This study explored how healthcare professionals identify and manage male erectile dysfunction in Dar es Salaam, Tanzania. Eighteen (18) focus group discussions were conducted with healthcare practitioners (N=60) and students (N=61), stratified by midwifery, nursing, or medicine. Thematic analysis resulted in two main themes: history taking and disease management. Providers and students highlighted different approaches to handling erectile dysfunction, and the results revealed inadequate knowledge among providers on male erectile dysfunction. In addition, the results presented the unmet need of patients with erectile dysfunction in the community, forcing patients to seek care from traditional healers. Therefore, this study recommends comprehensive health training and continuous education for practicing health professionals on sexuality and sexual health across disciplines. Training would potentially increase confidence among healthcare providers when engaging with patients and provide referrals to specialized care to optimize patient outcomes

The Nexus between Climate Change and Nutrition Security and the Impact of this Relationship on Diet-Related Non-Communicable Diseases

Kevin Oduor — 2024-02-01

Life-threatening climate change, and burgeoning nutrition insecurity compounded by a steady rise in chronic non-communicable diseases (NCDs) are the defining issues of our time. This study is an exploration of the nexus between climate change and nutrition and the impact of this relationship on diet related NCDs. Quantitative methodologies, utilizing a descriptive cross-sectional study design was adopted. The study was carried out across Kenya, informed by the devastating climate changes and NCD cases the country has experienced recently. To recruit the study participants, a random sampling technique was adopted to select a sample size of 190. The study utilized an online questionnaire uploaded on KoboCollect and the link to the questionnaire was shared via WhatsApp, Facebook, Twitter, LinkedIn, and email. The quantitative data was downloaded and synchronized with Statistical Package for Social Science (SPSS version 26.0) which was used to analyse the data. The study found that an increase in the price of basic food commodities, reduced amount of reliable agricultural output, destruction of crops, and change in the nutritional content and food composition are some of the major effects of climate change on nutrition security. Moreover, the study found that depletion of nutrition sources leads to diet-related NCDs (diabetes and hypertension) through increased consumption of unhealthy foods (calory and fat-dense diets), reduced access to recommended food for those living with diabetes and hypertension, and lack of food diversification. The study also found that increased demand for healthy foods has both positive and negative implications. Positive impacts reported include increased agricultural activities and innovations to address the growing demand for healthier. Negative impacts reported include strain on food production capacity and unsustainable agriculture practices that have long-term health effects. Policymakers are called upon to formulate policies that guarantee public health even amid the evolution of innovations that promise to address shortfalls in food availability, accessibility, reliability, and utilization

Socio-Demographic Factors Associated with the Uptake of Community Led Total Sanitation: An Empirical Study among the Residents of Isiolo County, Kenya

Osman Mahad Bagaja — 2024-02-10

Despite Kenya aiming to achieve 100% ODF status by 2030 and adopting CLTS, about 5.6 million (14%) of the population practice OD. Thus, this study was guided by the research question: What is the level of uptake of community led total sanitation among residents of Isiolo County? The study used a descriptive cross-sectional methodology and conducted among residents of Isiolo Sub-County, Kenya. The study sampled 373 household heads from population of about 21,870 household heads for the study. Systematic random sampling was used to select the participants. An inclusion and exclusion criteria-based period lived in the county and consent to participate in the study were used. Data collection instruments entailed structured questionnaires for households’ heads, key informant interview (KII) guides for opinion leaders, and an observation checklist. The content validity of the tools was assessed by expert from the department of Environmental Health at Kenyatta University. The tools were piloted in Longopito Sub-location with 37 households. Reliability of the tools was assessed using the piloted data through the test-retest technique. The paired data sets were correlated, giving R=0.75. The study found an association between demographic factors and the uptake of CLTS in Isiolo county. The uptake of CLTS was found to be low with almost half of the sampled residents lacking latrines. The study concludes there were a number of demographic factors that were significantly associated with the utilization of CLTS including the highest level of education (χ2=66.866, p = 0.001), Occupation (χ2=12.690, p = 0.002), Average monthly family income (KShs) (χ2=43.373, p = 0.012) and number of household members (χ2=6.948, p = 0.044). The study also found that Isiolo County had a low uptake rate for community-led total sanitation. Only three out of ten households in the county uptake CLTS. The study recommends that the County Government of Isiolo should scale up health education programs on community led total sanitation

Antimicrobial Action of Sambacus nigra, Symphytum officinale, Urtica dioica, and Mentha pulegium Plant Compounds against Antibiotic Resistant Streptococcus pneumoniae

Ogweno Paulicarp Odhiambo — 2024-02-10

Infections by Streptococcus pneumoniae are among the leading causes of illness and death in children below 5 years, people with underlying debilitating medical conditions, and the elderly worldwide. Over the past three decades, antimicrobial resistance in S. pneumoniae has drastically increased, with resistance reported in Penicillin, erythromycin, trimethoprim/sulfamethoxazole, vancomycin, tetracycline, chloramphenicol and ofloxacin. This phenomenon has necessitated a continuous search for alternative compounds against S. pneumoniae, such as Plants. The objective was to investigate antimicrobial natural compounds present in S. nigra, S. officinale, U. dioica, and M. pulegium against antibiotic-resistant S. pneumoniae. The study utilised cross-sectional design where S. nigra leaves, S. officinale roots, U. dioica leaves, and M. pulegium leaves were collected from Kisii highland forests. Phytochemicals were identified by gas chromatography (GC/MS). Microbiological testing of the resistant strain of S. pneumoniae was done at Jaramogi Oginga Odinga Teaching and Referral Hospital Laboratory (JOOTRHL). The MBC and MIC were determined using disk diffusion. Data was analysed using ANOVA (P<0.05). Results showed alkaloids, phenols, tannins, flavonoids, saponins, glycosides, steroids and terpenoids at different extraction solvent concentrations. S. nigra, U. dioica, S. officinale and M. pulegium phytochemical compounds showed significant differences at 0.825 < 3.01. S. nigra and U. dioica showed considerable activity on resistant strains of S. pneumoniae. The MIC of S. nigra and U. dioica were 0.625 mg/L and 1.25 mg/L, while MBC was 0.3125 mg and 0.625 mg respectively. GC/MS analysis of phytochemical compounds on S. nigra and U. dioica showed a total of 8 NIST drug compounds. GC/MS study data; thymol, metharbital, Diethyltoluamide, Cyclohexanol, 5-methyl-2-(1-methylethyl)-, (1. alpha., 2. beta., 5. alpha.)-, aspirin, Piperonyl butoxide, triamterene and Glycine, N-benzoyl- are the most effective phytochemical compound in S. nigra and U. dioica against S. pneumoniae. The study concluded that S. nigra and U. dioica leaves pose active compounds that could be further used as alternatives in the treatment of antibiotic-resistant S. pneumoniae

Assessment of Knowledge, Attitude, and Preventive Practices Towards Dengue Fever Among the Community in Qardho District

Ahmed Nur Hersi — 2024-02-12

Dengue fever is caused by a virus belonging to the Flaviviridae family, which is spread by Aedes eypti mosquitoes and is the most rapidly spreading mosquito-borne viral disease in the world. The objectives of this study were to assess knowledge, attitude, and preventive practices towards dengue fever among the community in the Qardho district. A descriptive, cross-sectional study was conducted by using a structured questionnaire. A sample size of 384 participants was selected, and face-to-face interviews through structured questionnaires were done between August and November 2023. Although 77.2% of the respondents had heard about dengue fever, the study found that Qardho residents had poor knowledge of the disease. Only 27.6% of the respondents recognised the agent causing dengue fever as a virus. About 40% of them thought that mosquitoes were responsible for the disease. Further, only 7% of them maintained that clean water and clean water holding containers might be breeding sites for mosquitoes. Taken together, 73.8% of the respondents had poor knowledge. Despite their poor knowledge, circa 52% of the participants had good attitudes towards dengue-suspected patients, and most of them (71.9%) took preventive measures against the disease. Most of the respondents (43.6%) used mosquito nets. This preventive practice might be due to their prior awareness that mosquitoes are vectors for another serious illness, malaria. Most of the residents in the Qardho district had poor knowledge about dengue fever, the agent causing the disease, its mode of transmission, breeding sites of the vector, treatment, and biting behaviour. The study suggests there is a need to increase health education activities, such as awareness campaigns and mass media, to enhance knowledge about dengue fever. Also, community awareness of vector control plays an important role in disease prevention and control

High Levels of Fungal and Aflatoxin Contamination of the Production Stages of the Local Brew (Ajono) consumed in Uganda

Sarah Nantumbwe — 2024-02-13

Local brew commonly known as Ajono is a widely consumed alcoholic beverage in Uganda. Handling practices along the production stages of the local brews may create a conducive environment for fungal colonization. This study aimed to assess fungal and aflatoxin contamination along the different production stages of Ajono from Soroti District in Eastern Uganda. A total of 180 samples were collected from the different stages along Ajono production. An interview guide was used to assess the processing practices while fungal contamination was assessed using standard microbiological methods. The study found that there are three main stages during Ajono production, namely; millet grain, fermented paste, and the liquid (Ajono) stages. During the paste fermentation stage, brewers used plastic drums (50%), pits (47%) or pots (3%) as fermentation vessels. Samples from plastic drum fermentation vessels had higher levels of fungal contamination than those from the pits and pots. Furthermore, several moulds genera including Aspergillus spp., Fusarium spp., Alternaria spp., Rhizopus spp., Penicillium spp., Cladosporium spp., and Acremonium spp. were identified along the production stages, with Aspergillus spp. as the most prevalent moulds at all stages of Ajono production. Two yeast genera; Saccharomyces spp. and Candida spp. were also isolated. Total Aflatoxin B and G group was detected along the production stages of Ajono with the highest prevalence (78.6%) seen in the liquid Ajono from pit fermenters and 68.8% in drum fermenters. Overall, all three stages of Ajono production; millet grain, fermented paste, and the liquid Ajono stages were highly contaminated with aflatoxigenic fungi which may cause adverse health effects under continued and sustained consumption of the brew

'Hospitals Are Medicine and More….' An Assessment of Subsidised Health Insurance Beneficiaries' Experience in Western Kenya

Salome Sijenyi — 2024-02-27

Financial protection remains an important hurdle to overcome if Universal Health Coverage is to be achieved in sub-Saharan Africa. An innovative model of subsidised health insurance to vulnerable households was implemented in one level four and two primary health care facilities in Western Kenya. The project aimed to determine whether reduced insurance costs, socioeconomic empowerment, and the availability of drugs would improve patients' experience and encourage them to co-pay. This was a secondary analysis of a mixed methods study with a cross-sectional household survey consisting of 18 semi-structured interviews conducted with NHIF subsidy program beneficiaries. Most beneficiaries accessed care as a result of the program. However, challenges of stockouts and inadequate healthcare workers persisted and discouraged some of them from going to the participating facilities. Community Health Promoters were very instrumental in enlightening the community on the cover and getting the sick beneficiaries to go to the hospital. The socioeconomic empowerment programme was beneficial but was mostly long-term and required financial input from the community members before they could sell the poultry or agricultural produce. Most community members were willing to pay after receiving health services using the cover. The study recommends contextualisation of socioeconomic empowerment programs, which are very important in enabling families to generate income to pay for health insurance. Additionally, improving the service delivery experience is important by reducing stockouts, having sufficient healthcare workers, and eliminating facility-related delays, which would improve the confidence of communities in public health facilities, thus retaining health insurance

Domestic Solid Waste and Health related Challenges among men and women: a case of Kiandutu informal settlement, Kiambu County, Kenya

Willy W. Mwangi — 2024-02-27

Health is a life component that cannot be ignored. In developing economies, the migration of people, both men and women, from rural areas into urban areas results from multiple factors. The social dynamics that include a search for a better life take the lead. This dire and never-ending relocation has led to an ever-increasing mushrooming of informal settlements in the urban areas. Among the devastating consequences is the increase in domestic solid waste and its poor management. This poor domestic solid waste management health challenges is coupled with gendered socialization and perceptions, some knowledge and practices. Social Context Theory was used to guide this study. The theory assumes that there exists flexibility of gender within a defined context. The study employed exploratory research design whose choice allowed an in-depth view of the generation of both qualitative and quantitative data. Random sampling of the villages and purposive sampling of the respondents were used to identify the study sample. A total number of 264 households was used as the sample size. This was a representation of 10% of all the households in the randomly sampled villages with each village being allocated a number of the respondents in regard to gender. The unit of analysis was the household, with the household heads, male and female being the respondents. Key informants were also considered in the study. They included the village elders, community health workers and the local administration. Tools that were considered for the generation of data included observation checklists, guided questionnaires and interview guides. Qualitative data was thematically coded and analysed using SPSS V24. The study concluded that early gendered socialisation has the capacity to contribute to poor methods household solid waste for both men and women, hence contributing to health challenges. The study also observed that inadequate knowledge among men and women in the management of solid waste was linked to inequitable health challenges experienced by both genders in informal settlements. The social realities plug into the dominant arrangements of gendered social behaviour that have great capacity to affect individuals’ health. The findings suggest that gender-sensitive policies can be used to promote community awareness creation and education to modify the behaviour of men and women in protecting their own lives in terms of health

Prevalence and Risk Factors of Hearing Loss at Bugando Medical Centre Mwanza Tanzania

Olivia Michael Kimario — 2024-02-27

Hearing enable us to communicate and interact all over the world. When hearing is reduced or not there at all then is a major problem. In Africa more so in the Sub Sahara, this problem is on the rise due to the activities that are been carried out. There is no clinical data that is available from our national and zonal referral hospital, this study is a stepping stone for more studies. The outcome will show the burden of the people with reduced or has no ability to hear, distribution of hearing loss and the contributing factors. The engagement was conducted in a tertiary hospital serving more than five regions of the country. It`s a descriptive cross-sectional study. The study spanned from July 2020 to December 2020 with the total number of patients visited the otorhinolaryngology and audiology clinic being 6,234 the ones hearing loss 526. The study found prevalence of 8.4% for reduce/inability to hear. Females found to be more by 1.3%. Sensorineural hearing was the leading (51%), followed by conductive hearing (41%). The group most affected by sensorineural hearing were 40-59 (53.7%). On conductive hearing, the leading group being affected were 3-39 years (46.6%). In the distribution of sensorineural hearing the leading one was mild hearing in the age group of 3-39 (63%), followed by moderate hearing at 25.5%. The contributory factors were inflammation, such as allergic rhinitis (38%), otitis (34%), and wax (9.5). These factors contributed to about 60% of hearing loss. A group of young adults have been found to have mild hearing (63%); this shows that in a few years, the majority of the young group will have severe hearing problems, hence decreasing the manpower of our economy. Public knowledge about ear care should be offered to people, and this should be done by the media and the health sector as a whole

Insights of Healthcare Workers and Community Members on Mental Health Perception and Practices in Meru County, Kenya

Colleta Kiilu — 2024-03-06

Mental health is a neglected field in many low and middle-income countries, such as Kenya, where information on the prevalence of mental health conditions is scarce. This problem is aggravated by an uneven distribution of mental health service providers and widespread ignorance and stigma around mental illness in the general population. The study in Meru County, Kenya, aimed to assess the knowledge, attitudes, and practices of healthcare workers and community members regarding mental health. The study, a descriptive cross-sectional survey, involved 535 community members and 109 healthcare workers, employing both qualitative and quantitative methods. Data was collected through household surveys, key informant interviews, and focus group discussions and analysed using univariate frequencies, descriptive statistics, and thematic analysis. The study revealed that 39% of community members had a family member with a mental health condition, while 68% of HCWs had been diagnosed with such conditions. Mental illness was often attributed to supernatural causes, genetics, substance abuse, and socio-economic pressures. A significant gap was found in the availability of counselling services in health facilities, with only 29.4% of HCWs reporting their presence. The perception of the affordability and accessibility of mental health services varied greatly between HCWs and community members. Additionally, while HCWs reported the availability of free medication, community members experienced shortages. The study also noted differing attitudes towards patients with mental illness in terms of respect and dignity and highlighted the use of traditional healers and religious leaders for mental health issues. This study contributes valuable insights into the state of mental health in Kenya, highlighting the high burden of mental illness, limited availability of services, and prevalent myths and misconceptions. It underscores the need for improved healthcare worker training, public awareness, and stronger health systems to address mental health issues effectively in Kenya and similar rural environments

Influence of Air Pollution and Climate on Daily Health of Gabonese Students in the Capital (Libreville): A Pilot Study

Robert Vancelas Obiang Zogo — 2024-03-11

Air pollution is a global issue affecting billions of people, especially urban populations in low- and middle-income countries. Since air pollution is a health problem that also involves the climate, this study assessed the relationship between the individual health of 50 college students living in Libreville (Gabon) and air quality, temperature, and humidity using low-cost equipment. The study utilised 81 days of data from the air pollution monitoring network in Libreville. These data were paired with measurements of heart rate, breathing, and stress measured using 5 Garmin vívosmart® smartwatches. In addition to the environmental and health data, participants were also asked about their state of health and their lifestyle during the study. We found average concentrations of PM2.5 (25.25 µg/m3) and PM10 (29.50 µg/m3) that exceed the 24-h WHO air quality standards. The daily average of PM1 was around 17.84 µg/m3. Temperatures observed during the study period varied between 27 and 35 °C (mean = 30.15 °C), and humidity was around 51-77% (mean = 59.5%). Overall, the relationships between the environmental conditions and the health observations were negligible, with correlation coefficients R ≤ 0.36. Despite their weakness, coefficients between 0.31 and 0.36 showed that stress levels are associated with temperature, PM2.5 and PM10. The average stress level was associated with PM10 (R = 0.34) and PM2.5 (R = 0.36). Finally, the study reveals that smokers, mosquito repellent users, and fan users have reduced breathing capacities compared to non-smokers, non-users of mosquito repellent products, non-users of fans, users and non-users of air conditioning. The study recommends the use of portable sensors to measure individual exposure to environmental parameters for similar studies, which will resolve the problem of spatial representativeness highlighted in this study. It is also recommended that Gabon's health policies incorporate early warnings of forecast high temperatures or pollution peaks, in order to limit health risks

Assessment of Knowledge, Attitudes, and Practices in relation to Mycotoxin Contamination in Tanzania

Chacha Nyangi — 2024-03-16

This study assessed the knowledge, attitude, and practices (KAP) of the population in three districts in Tanzania on issues related to mycotoxin contamination and exposure. The study employed a cross-sectional design. Data were collected using a questionnaire survey, which was administered to gather quantitative data in 180 randomly selected households in three districts of Tanzania. In addition, qualitative data were collected using key informant interviews (KIIs) of 12 purposively selected respondents and 6 focus group discussions (FGDs) of six to twelve participants. Quantitative data were analysed in SPSS version 20 for Windows 180 using descriptive statistics and a chi-square test. While the qualitative data were analysed in ATLAS.ti 8 for Windows. A majority of respondents (25.1%) had never heard of mycotoxins, 20.1% were not aware of how mycotoxins are acquired, and none (0%) of the respondents claimed to never become sick after eating moulded/contaminated crops. The majority, 14.5% and 2.8% of the respondents, were not aware of prevention measures for animals and humans from mycotoxins, respectively. Only 8.9% agree that they are at risk of getting mycotoxins, 14% agree that it is safe to eat contaminated food, and 52.5% do not discard the mycotoxins contaminated food. The majority, 81.6%, dry their crops on top of the floor or bare grounds, almost 42.5% do not sort their crops before storage, and 28.5% agree to consume the defective/sorted crops. Therefore, it is recommended that health education interventions to create awareness among the public should be a priority and should be integrated into the existing control strategies

Covid 19: Ethical Impact on Healthcare and Lessons Learned in Preparation for Future Pandemics

Dipuo Masege — 2024-03-25

The Covid 19 pandemic had a severe impact on healthcare services throughout the world. The impact was seismic, and countries were struggling to cope with the demands of the pandemic and provide healthcare to the populace. In allocating scarce resources, certain decisions were made that were not always favourable to the individual patient, healthcare practitioners, and the general population. In South Africa, doctors were forced to make life-and-death decisions to safeguard access to limited resources. Lessons were learned during this pandemic, which hopefully will help in dealing decisively with future pandemics without infringing on patients' rights. In this article, medical ethics were explored, and it was noted which of the four principles of autonomy, beneficence, nonmaleficence, and justice were overlooked and how these can be avoided in future pandemics. We explored the impact that the pandemic had on vulnerable patients, the elderly, those with cancer, and children. There was also an exploration of the Covid pandemic's impact and how the South African government can prevent these in the future

Assessment of Health Practices of Food Vendors in the University of Benin

Osato Harriet Obasuyi, PhD — 2024-04-05

This study assessed the health practices of food vendors in the University of Benin. Four research questions and one hypothesis were raised to guide the research. Literatures related to the study were reviewed. The study adopted a school-based descriptive cross-sectional research design and the population of the study comprised 144 food vendors within the University of Benin Ugbowo Campus. The census method was used to recruit respondents for the study. A self-structured checklist and questionnaire was used for the collection of data. The questionnaire was content validated and a reliability coefficient of 0.73 was obtained using the test re-test reliability method. Data obtained were analysed using descriptive statistics of frequency counts, percentages and inferential statistics of Chi-square. The findings revealed that majority of the food vendors in the University of Benin had good health practices as it relates to food safety and moderate level of knowledge of foodborne diseases. The result also showed a calculated chi-square value of 0.16 showing that there is no significant relationship in the observed health practices of food vendors by gender in the University of Benin. The study recommends among others the establishment of a recognition or certification system that acknowledges and rewards vendors who consistently demonstrate good food safety practices