The use of social media networks for healthy nutritional practices by deaf and hearing students.

Background: Social media networks such as Facebook, Twitter, WhatsApp, and YouTube are among the most commonly used social networks among people. If used properly, they can contribute to enhancing individual knowledge and scientific values. Aim: The study aimed to investigate the use of social media networks for healthy nutritional practices among deaf and hearing students. Methods: The sample of the study consisted of 103 students (50 deaf and 53 hearing). The researchers used a descriptive approach and adopted a questionnaire for data collection. Results: The findings of the study showed that the use of social media networks for healthy nutritional practices among deaf and hearing students was at a moderate level. However, there were statistically significant gender differences in the average responses of deaf and hearing students in the use of social media networks for healthy nutritional practices. For the status of students (deaf and hearing students), there were statistically significant differences in the average responses to the use of social media networks for healthy nutritional practices. Conclusion: Social media networks play an important role in raising awareness and promoting healthy nutrition practices for both deaf and hearing students.

Retention of healthcare workers 1 year after recruitment and deployment in rural settings: an experience post-Ebola in five health districts in Guinea.

BACKGROUND: Guinea undertook health workforce reform in 2016 following the Ebola outbreak to overcome decades-long shortages and maldistribution of healthcare workers (HCWs). Specifically, over 5000 HCWs were recruited and deployed to rural health districts and with a signed 5-year commitment for rural medical practice. Governance structures were also established to improve the supervision of these HCWs. This study assessed the effects of this programme on local health systems and its influence on HCWs turnover in rural Guinea. METHODS: An exploratory study design using a mixed-method approach was conducted in five rural health districts. Data were collected through semi-structured questionnaires, in-depth interview guides, and documentary reviews. RESULTS: Of the 611 HCWs officially deployed to the selected districts, 600 (98%) took up duties. Female HCWs (64%), assistant nurses (39%), nurses (26%), and medical doctors (20%) represented the majority. Findings showed that 69% of HCWs were posted in health centres and the remaining in district hospitals and the health office (directorate); the majority of which were medical doctors, nurses, and midwives. The deployment has reportedly enhanced quality and timely data reporting. However, challenges were faced by local health authorities in the posting of HCWs including the unfamiliarity of some with primary healthcare delivery, collaboration conflicts between HCWs, and high feminization of the recruitment. One year after their deployment, 31% of the HCWs were absent from their posts. This included 59% nurses, 29% medical doctors, and 11% midwives. The main reasons for absenteeism were unknown (51%), continuing training (12%), illness (10%), and maternity leave (9%). Findings showed a confusion of roles and responsibilities between national and local actors in the management of HCWs, which was accentuated by a lack of policy documents. CONCLUSION: The post-Ebola healthcare workers policy appears to have been successfully positive in the redistribution of HCWs, quality improvement of staffing levels in peripheral healthcare facilities, and enhancement of district health office capacities. However, greater attention should be given to the development of policy guidance documents with the full participation of all actors and a clear distinction of their roles and responsibilities for improved implementation and efficacy of this programme.

Ebola virus disease outbreak in Guinea: what effects on prevention of mother-to-child transmission of HIV services?

BACKGROUND: An unprecedented epidemic of Ebola virus disease (EVD) affected Guinea in 2014 and 2015. It weakened the already fragile Guinean health system. This study aimed to assess the effects of the outbreak on Prevention of Mother-to-Child Transmission of HIV (PMTCT) services in 2014. METHODS: We conducted a cross-sectional retrospective study. Data was collected from 60 public health centers (30 in the EVD affected areas and 30 in the unaffected areas). The comparison of PMTCT indicators between the period before Ebola (2013) and during Ebola (2014) was done using the t- test for the means and the Chi-square test for the proportions. RESULTS: This study showed a substantial and significant reduction in the mean number of antenatal care visits (ANC) in the affected localities, 1617 ± 53 in 2013 versus 1065 ± 29 in 2014, p = 0.0004. This would represent 41% drop in health facilities' performance. On the other hand, in the unaffected localities, the fall was not significant. The same observations were made about the number of HIV tests performed for pregnant women and the number of HIV positive pregnant women initiating ARVs. The study also noted an increase in the proportion of women tested HIV+ but who did not receive ARVs (12% in 2013 versus 44% in 2014) and HIV+ pregnant women who delivered at home (18% in 2014 versus 7% in 2013). CONCLUSION: This study showed that PMTCT services, which are one of the key services to improve maternal and child health, were affected in Guinea during this Ebola outbreak in 2014 compared to 2013.

Environmental bioavailability of arsenic, nickel and chromium in soils impacted by high geogenic and anthropogenic background contents.

High arsenic, chromium and nickel in soils can pose a hazard to the ecosystem and/or human health. Large areas can be affected by elevated potentially toxic elements (PTE) background contents, entailing a significant effort for managing the potential risk. Assessing the environmental hazard associated to PTE-contaminated soils requires the determination of soil PTE environmental bioavailability, which reflects the capacity of these elements to be transferred to living organisms. Here we assess the environmental bioavailability of As, Cr and Ni in topsoils from the Liège basin and Belgian Lorraine, two areas in Wallonia, Belgium, affected by elevated As, Cr and Ni background contents. The source of soil As, Cr and Ni differs in Liège and Lorraine: anthropogenic in the former location and geogenic in the latter. The environmental bioavailability of PTE was determined using two complementary approaches: (1) by chemical fractionation with the Community Bureau of Reference (BCR) three-step sequential extraction protocol and (2) by estimating the phytoavailability using a plant-based biotest (Lolium multiflorum as plant model). The results show that total As (6-130 mg·kg-1), Cr (15-268 mg·kg-1), and Ni (8-140 mg·kg-1) contents in the Liège and Lorraine soils frequently exceed the soil clean-up standards. However, no positive correlation was found between the total contents and BCR extraction results or rye-grass contents, except for As in Liège soils. Total As, Cr or Ni contents surpassing soil standards do not necessarily result in elevated mobile, potentially mobilizable and phytoavailable contents. In general, environmental bioavailability of As, Cr and Ni is higher in soils from Liège basin compared to those sampled in Belgian Lorraine. The mobile and potentially mobilizable fractions of As, Cr and Ni account for <30 % of their total contents following the BCR extractions. Our study provides valuable information for sustainable management at the regional scale of soils containing high PTE contents.

Gold Panning-Related Chronic Cutaneous Ulcers in Guinea, West Africa.

Chronic cutaneous ulcers caused potentially by several pathogens are of increasing concern in endemic tropical countries, including Guinea in West Africa, in rural populations exposed to aquatic environments during recreational, domestic, or agricultural activities. By plotting 1,011 cases of chronic cutaneous ulcers classified under the name Buruli ulcer in 24 of 33 Guinea health districts (72%) between 2018 and 2020 against the gold map and gold-panning map of Guinea, we revealed a significant spatial association between chronic cutaneous ulcer foci and gold-panning foci (P < 0.05), but not with nongold-panning foci (P = 0.12) in Guinea. Gold panning should be listed as an additional economic activity exposing populations to chronic cutaneous ulcers. Further research may aim to clarify whether any geological and biologic factors underlie such an association, besides the possibility that the unprotected skin of gold panners may be exposed to opportunistic, pathogen-contaminated environments in gold-panning areas.

Implementation of DHIS2 for Disease Surveillance in Guinea: 2015-2020.

A robust epidemic-prone disease surveillance system is a critical component of public health infrastructure and supports compliance with the International Health Regulations (IHR). One digital health platform that has been implemented in numerous low- and middle-income countries is the District Health Information System Version 2 (DHIS2). In 2015, in the wake of the Ebola epidemic, the Ministry of Health in Guinea established a strategic plan to strengthen its surveillance system, including adoption of DHIS2 as a health information system that could also capture surveillance data. In 2017, the DHIS2 platform for disease surveillance was piloted in two regions, with the aim of ensuring the timely availability of quality surveillance data for better prevention, detection, and response to epidemic-prone diseases. The success of the pilot prompted the national roll-out of DHIS2 for weekly aggregate disease surveillance starting in January 2018. In 2019, the country started to also use the DHIS2 Tracker to capture individual cases of epidemic-prone diseases. As of February 2020, for aggregate data, the national average timeliness of reporting was 72.2%, and average completeness 98.5%; however, the proportion of individual case reports filed was overall low and varied widely between diseases. While substantial progress has been made in implementation of DHIS2 in Guinea for use in surveillance of epidemic-prone diseases, much remains to be done to ensure long-term sustainability of the system. This paper describes the implementation and outcomes of DHIS2 as a digital health platform for disease surveillance in Guinea between 2015 and early 2020, highlighting lessons learned and recommendations related to the processes of planning and adoption, pilot testing in two regions, and scale up to national level.

'Never let a crisis go to waste': post-Ebola agenda-setting for health system strengthening in Guinea.

INTRODUCTION: Guinea is a country with a critical deficit and maldistribution of healthcare workers along with a high risk of epidemics' occurrence. However, actors in the health sector have missed opportunities for more than a decade to attract political attention. This article aims to explain why this situation exists and what were the roles of actors in the agenda-setting process of the post-Ebola health system strengthening programme. It also assesses threats and opportunities for this programme's sustainability. METHODS: We used Kingdon's agenda-setting methodological framework to explain why actors promptly focused on the health sector reform after the Ebola outbreak. We conducted a qualitative explanatory study using a literature review and key informant interviews. RESULTS: We found that, in the problem stream, the Ebola epidemic caused considerable fear among national as well as international actors, a social crisis and an economic system failure. This social crisis was entertained by communities' suspicion of an 'Ebola-business'. In response to these problems, policy actors identified three sets of solutions: the temporary external funds generated by the Ebola response; the availability of experienced health workers in the Ebola control team; and the overproduction of health graduates in the labour market. We also found that the politics agenda was dominated by two major factors: the global health security agenda and the political and financial interests of national policy actors. Although the opening of the policy window has improved human resources, finance and logistics, and infrastructures pillars of the health system, it, however, disproportionally focuses on epidemic preparedness and response. and neglects patients' financial affordability of essential health services. CONCLUSION: Domestic policy entrepreneurs must realise that agenda-setting of health issues in the Guinean context strongly depends on the construction of the problem definition and how this is influenced by international actors.