Prevalence and geo-clinicodemographic factors associated with hepatitis B vaccination among healthcare workers in five developing countries.

BACKGROUND: There is a four-fold risk for hepatitis B infection among healthcare workers compared to the general population. Due to limited access to diagnosis and treatment of hepatitis B in many resource-constrained settings, there is a real risk that only few healthcare workers with viral hepatitis may get screened or diagnosed and treated. Studies on hepatitis B vaccination among healthcare workers in developing countries are sparse and this bodes ill for intervention and support. The aim of the study was to estimate the prevalence and explored the associated factors that predicted the uptake of the required, full dosage of hepatitis B vaccination among healthcare workers (HCWs) in five developing countries using nationally representative data. METHODS: We used recent datasets from the Demographic and Health Surveys Program's Service Provision Assessment Survey. Descriptive summary statistics and logistic regressions were used to produce the results. Statistical significance was pegged at p < 0.05. RESULTS: The proportion of HCWs who received the required doses of hepatitis B vaccine in Afghanistan, Haiti, Malawi, Nepal, and Senegal were 69.1%, 11.3%, 15.4%, 46.5%, and 17.6%, respectively. Gender, occupational qualification, and years of education were significant correlates of receiving the required doses of hepatitis B among HCWs. CONCLUSIONS: Given the increased risk of hepatitis B infection among healthcare workers, policymakers in developing countries should intensify education campaigns among HCWs and, perhaps, must take it a step further by making hepatitis B vaccination compulsory and a key requirement for employment, especially among those workers who regularly encounter bodily fluids of patients.

Correlates of blood pressure and blood glucose screenings in Cameroon: insights from the 2018 Demographic and Health Survey.

BACKGROUND: Hypertension and diabetes, two major risk factors for cardiometabolic diseases, are associated with high morbidity and mortality rates. Early detection through screening can initiate early treatment to reduce adverse outcomes. The current study sought to investigate the correlates of blood pressure and blood glucose screenings in Cameroon. METHODS: We used secondary data from the 2018 Cameroon Demographic and Health Survey. Adjusting for a complex sample design, we performed multivariate prevalence ratio estimates of the blood pressure and blood glucose screenings. RESULTS: Approximately 60% and 30% of Cameroonians had undergone blood pressure and blood glucose screenings, respectively. More females (68%) had undergone blood pressure screenings compared with their male counterparts (44.1%). In the multivariate model, gender, age, education, marital status, household wealth index and region of residence were significantly associated with both blood pressure and blood glucose screenings in the full sample. Previous blood pressure screening was associated with an increased likelihood of blood glucose screening and vice versa. A modification effect of gender was observed in the association between the correlates and both outcomes. CONCLUSION: Our findings uncovered individuals with a decreased likelihood for blood pressure and blood glucose screenings and this can inform policy decisions to ensure targeted screening aimed at early detection and management.

Geographical variations and factors associated with recent HIV testing prevalence in Ghana: spatial mapping and complex survey analyses of the 2014 demographic and health surveys.

OBJECTIVE: To examine the factors associated with recent HIV testing and to develop an HIV testing prevalence surface map using spatial interpolation techniques to identify geographical areas with low and high HIV testing rates in Ghana. DESIGN: Secondary analysis of Demographic and Health Survey. SETTING: Rural and urban Ghana PARTICIPANTS: The study sample comprised 9380 women and 3854 men of 15-49 years. RESULTS: We found that 13% of women and 6% of men of Ghana had tested for HIV in the past 12 months. For women, being within the age groups of 15-39 years, being currently married, attainment of post-secondary education, having only one sexual partner and dwelling in certain regions with reference to greater Accra (Volta, Eastern, Upper West and Upper East) were associated with a higher likelihood of HIV testing. For men, being older than 19 years, attainment of post-secondary education and dwelling in the Upper East region with reference to the greater Accra region were significantly associated with a higher likelihood of HIV testing. The surface map further revealed intra-regional level differences in HIV testing estimates. CONCLUSION: Given the results, HIV testing must be expanded with equitable testing resource allocation that target areas within the regions in Ghana with low HIV testing prevalence. Men should be encouraged to be tested for HIV.

Consistency of the determinants of early initiation of breastfeeding in Ghana: insights from four Demographic and Health Survey datasets.

BACKGROUND: Early initiation of breastfeeding (EIBF) is a key strategy in averting neonatal deaths. However, studies on the facilitators and risk factors for EIBF are rare in Ghana. We examined trends in EIBF and its major facilitators and risk factors in Ghana using data from Demographic and Health Surveys from 1998 to 2014. METHODS: We used complete weighted data of 3194, 3639, 2909 and 5695 pairs of mothers ages 15-49 y and their children ages 0-5 y in the 1998, 2003, 2008 and 2014 surveys, respectively. We accounted for the complex sampling used in the surveys for both descriptive statistics and multiple variable risk ratio analysis. RESULTS: The proportion of children who achieved EIBF increased by about 2.5 times from 1998 to 2003 and there was a marginal increase in the proportion of children who achieved EIBF between 2003 and 2014. Children born by caesarean section were at higher risk of being breastfed later than 1 h across all four surveys. Being born in the Upper East Region (compared with the Western Region) of Ghana facilitated EIBF in 2003 and 2008. CONCLUSIONS: The study revealed that the current estimate of the proportion of children achieving EIBF in Ghana was 55.1%, and delivery by caesarean section and region of residence consistently predicted the practice of EIBF in Ghana.

Covariates and Spatial Interpolation of HIV Screening in Mozambique: Insight from the 2015 AIDS Indicator Survey.

We examined the factors associated with human immunodeficiency virus (HIV) screening and developed a HIV screening prevalence surface map using spatial interpolation techniques to identify the geographical areas with the highest and lowest rates of HIV screening in Mozambique. We analyzed the cross-sectional 2015 Mozambique AIDS Indicator Surveys with an analytic sample of 12,995 participants. Analyses were conducted on SPSS-21, STATA-14, and R freeware 3.5.3. We adjusted for the sample design and population weights. Results indicated that 52.5% of Mozambicans had undergone HIV screening. Mozambicans with these characteristics have a higher probability of undergoing HIV screening: females, those with a primary education or higher, urban dwellers, residents of wealthy households, having at least one lifetime sexual partner, and dwelling in these provinces-Niassa, Tete, Manica, Sofala, Inhambane, Gaza, Maputo Provincia, and Maputo Cidade. The spatial map revealed that the national and regional estimates mask sub-regional level estimates. Generally, zones with the highest HIV screening prevalence are found in southern provinces while the lowest prevalence was found in the northern provinces. The map further revealed intraregional differences in HIV screening estimates. We recommend that HIV screening be expanded, with equitable screening resource allocations that target more nuanced areas within provinces which have a low HIV screening prevalence.

A Multilevel Analysis of Regressors of Access to Improved Drinking Water and Sanitation Facilities in Ghana.

People's access to quality water and sanitation resources significantly improves their health. Using the 2014 Ghana DHS dataset, multilevel robust Poisson regression modelling was performed to investigate the factors that enhance Ghanaian households' access to improved sources of drinking water and toilet facilities. The results indicated that household head and household socioeconomic factors have significant effects on access to improved sources of drinking water and toilet facilities, and this varies from one community of residence to another. The following households had a higher probability of having access to improved sources of drinking water: female-headed households, households with heads who had at least attained middle-school-level education, urban households, and nonpoorest households. Correspondingly, the following households were more likely to have access to improved toilet facilities: female-headed households had a higher chance of access, as well as those whose heads had at least middle-school-level education, were at least 35 years old, or were currently married, rural households, households with a minimum of seven members, and households who attained at least middle wealth status. In their efforts to increase citizens' access to improved water and sanitation facilities, the government and other development organizations should develop citizens' wealth-creation capacities and enable their attainment of formal education.

Care-'less': exploring the interface between child care and parental control in the context of child rights for workers in children's homes in Ghana.

BACKGROUND: This study explored how employed caregivers experience the interface between child care, parental control and child rights in the context of Children's Homes in Ghana. The focus was on investigating caregiver perceptions of proper child care, their experiences with having to work with child rights principles and the implication of these for their relationships with the children and the care services they deliver. METHODS: Adopting a qualitative approach with phenomenological design, data were collected from 41 caregivers in two children's homes in Ghana using focus group discussions and in-depth interviews. RESULTS: It emerged that caregivers experienced frustrations with perceived limitations that child rights principles place on their control over the children describing it as lessening and, at the same time, complicating the care services they provide. CONCLUSIONS: The findings suggest a need for a review of the implementation strategies of the child rights approach in that context. A re-organization of the children's homes environment and re-orientation of caregivers and children regarding their relationship is also suggested.