Facteurs associés à l'acceptation du vaccin anti-COVID-19 parles professionnels de santé de la région de l'ouest du Cameroun / Factors associated with Covid-19 vaccines acceptance among health care professionals in the West Region of Cameroon

Introduction.Plusieurs hésitations ont été observées dans la population en général et parmi les professionnels de santé en particulier concernant la vaccination COVID-19. L'objectif de cette étude était de déterminer les facteurs associés à l'acceptation du vaccin COVID-19 parmi les professionnels de santé dansla région de l'Ouest Cameroun. Méthodologie. : Il s'agissait d'une étude mixte composée d'une étude quantitative du type descriptif et analytique et une étude qualitative sur une période de 11 mois, allant de Janvier 2022 à Novembre 2022 portant sur les professionnels de santé de cinq districts sanitaires de la région de l'Ouest Camerounà savoir Ds Baham, Bandjoun, Foumban, Mbouda, Mifi.Résultats.Nous avons enregistré 665 professionnels de la santé avec un sex ratio de 0,3.La tranche d'âge de 19 à 29 ans était la plus représentée (49,76 %). Le taux de vaccination contre le COVID-19 parmi le personnel de santé était de 48,53 % (IC 95 % : 44,67 % -52,39 %). Les facteurs indépendants associés à l'acceptation au vaccin COVID-19 parmi le personnel de santé étaient : le sexe féminin ([OR:0,65 (0,43-0,92)]), la religion chrétienne ([OR:0,48 (0,28-0,63)]), le témoignage d'une personne atteinte de laforme sévère du covid-19 ([OR:0,24 (0,07-0,76)]), la connaissance d'un centre de vaccination contre le covid-19 ([OR:0,75 (0,03-0,98)])et la recommandation du vaccin contre le covid-19 à un proche parent ([OR:0,23 (0,09-0,55)]).Conclusion.Les facteurs sociodémographiques, socioprofessionnels et socioculturels influencent l'acceptation des vaccins COVID-19 parmi les professionnels de santé.

Situation Analysis of a New Effort of Community-Based Health Planning and Services (CHPS) for Maternal Health in Upper West Region in Rural Ghana.

A free maternal health policy started in Ghana in 2008, however, health facility utilization is still low, and out-of-pocket payments (OOPPs) are putting households at risk of catastrophic expenditure. To improve this situation, some rural communities have assigned a midwife to a health post called community-based health planning and services (CHPS), where only assistant nurses are allocated. This study explored the effectiveness of the new approach in Upper West Region, Ghana. We conducted a cross-sectional study and interviewed women who gave birth in the last year. We systematically selected communities matched into four criteria: communities near CHPS (functional CHPS), communities near CHPS with a midwife (advanced CHPS), communities near a health centre, and communities without a health facility in their neighbourhood. In total, 534 women were interviewed: functional CHPS 104, advanced CHPS 131, near health centre 173, and no facility 126. About 78% of the women were 20 to 34 years old. About half of the women incurred OOPP, however, catastrophic payment (household spending > 5% of annual income) was significantly lower in advanced CHPS communities for normal delivery compared with the other three communities. The new local approach of assigning a midwife to CHPS functioned well, improving access to healthcare facilities for childbirth.

Indications and complications of lower extremity amputations in two tertiary hospitals in the North West Region of Cameroon.

Introduction: the study aimed to outline the common indications and complications of lower extremity amputations among amputated patients in two tertiary hospitals in the North West Region of Cameroon. Methods: this hospital based retrospective study was conducted in the Bamenda Regional Hospital and Mbingo Baptist Hospital over a 5-year period from 2015-2019. We identified and reviewed amputee´s medical records over the 5-year period. A well designed extraction form was used for data collection and the data obtained was analysed using Epi-info version 7.2.4. Results: a total of 148 patients underwent 159 amputations in Bamenda Regional Hospital and Mbingo Baptist Hospital with a mean age of 54.28 years (SD ±19.28). Males out-numbered females with a ratio of 2: 1. The most common indication for lower extremity amputation was Diabetic foot gangrene (42.14%) followed by trauma (22.01%). The most frequently performed procedure was Below Knee Amputation (48.42%). Post-amputation complication rate was recorded at 40.25% with surgical site infection being the most common (25.8%). Mortality rate was recorded at 6.28%. Conclusion: diabetic foot gangrene is the leading indication of lower limb amputation in our setting and the most frequently performed procedure is Below Knee Amputation with surgical site infection being the most common complication.

Mobile health technology in providing maternal health services - Awareness and challenges faced by pregnant women in upper West region of Ghana.

Objectives: The study assessed awareness on Mobile Health (mhealth) Technology as well as challenges pregnant women encounter in the utilization of mhealth technology to improve maternal health in rural settings in the Upper West Region (UWR) of Ghana. Study design: The study was an exploratory design that employed the qualitative method of data collection. Methods: Semi-structured interview guide was used to conduct six (6) Focus Group Discussions (FGDs) and nine (9) Key Informant Interviews (KIIs) among pregnant women and health workers respectively from three (3) selected rural districts in the Upper West Region. Data was collected in August 2020. Thematic analysis was conducted and some statements from participants were presented verbatim to illustrate the themes realized. Results: Participants were aware of the mhealth intervention that had been implemented by Savanna Signatures in their districts. Major sources of information on the mhealth services were from durbars, health education sessions and health care providers. Challenges faced by pregnant women, in the mhealth technology intervention were; financial challenges, lack of mobile network connectivity, lack of electricity in some rural areas, low female literacy rate at household level and cultural barriers. Conclusion: The Savanna Signatures mhealth intervention is widely known but some challenges exist that impede the smooth implementation of the intervention. The mhealth technology intervention implementers should partner with other sectors and policy makers to address the challenges identified by the study.

Factors associated with a measles outbreak in three health districts of Cameroon in 2019: a cross-sectional study.

Introduction: measles is an infectious viral disease that affects susceptible individuals of all ages. It is a leading cause of death among young children globally due to suboptimal vaccination coverage. In 2019, measles outbreaks affected several parts of the world, including three health districts (HDs) of Cameroon's South West Region (SWR) experiencing armed conflict. Herein, we assessed the factors associated with the outbreak in the SWR. Methods: we conducted a comparative study from March to August 2020. Data on study participants were compared between the three HDs that experienced a measles outbreak and three other HDs of the region that reported a case of measles but did not get into an outbreak. Records on vaccination between 2015 and 2019 were reviewed. Results: information was obtained from 56 participants with known measles status, 32 from outbreak districts, and 24 from non-outbreak districts. The population in the outbreak group was more likely to have traveled from an area in a measles outbreak (OR 2, 95%CI 1.1-11.20). There was a suboptimal availability of measles vaccines in both categories of districts compared to the needs, and there was a downward trend in vaccination coverage in both groups. In addition, vaccines were more exposed to extreme temperatures in HDs with the outbreak (P<0.01) from 2015 to 2019. We found no statistically significant difference between both groups concerning the preexisting comorbidities of participants. Conclusion: there is an urgent need to improve the cold chain and intensify vaccination activities in these districts.

Allelic frequencies of mutants of the Plasmodium falciparum, quinoline and folate metabolizing genes in the west region of Cameroon.

The emergence and spread of Plasmodium falciparum (P.f) drug resistance is still a major concern in Sub-Saharan Africa and warrants that its evolution be monitored continuously. The present study aimed at determining the distribution of key P.f drug resistance-mediating alleles in circulating malaria parasites in the West region of Cameroon. A cross sectional hospital-based study was conducted in Dschang and Ngounso in the West region of Cameroon. The Pfcrt, Pfmdr1, and the Pfdhps genes were amplified through nested PCR in 208 malaria-infected samples of the 301 febrile outpatients enrolled. The presence or absence of mutations in the K76T, N86Y, A437G and A581G codons of these P.f. genes respectively were determined through restriction digestion analysis. The proportion of different alleles were estimated as percentages and compared between two study sites using the Chi square test. A p value <0.05 was considered significant. A high prevalence (75.6%) of the 437G allele was observed. It was significantly different between Dschang and Ngounso (62% vs. 89.2%, X2 = 19.6, P = 0.00005). Equally observed was a 19.2% (95%CI: 13.3-25.6) of the dhps-581G mutant allele. Furthermore, we observed the Pfcrt-76T, Pfmdr1-N86 mutations in 73.0% (67.5-79.7) and 87.2% (83.2-91.9), and 3.0% (0.0-9.6) and 12.8% was observed for the Pfcrt-K76T and Pfmdr1-N86Y respectively. When biallelic haplotypes were constructed from alleles of the three genes, same pattern was seen. Overall, 73% and 87% of circulating P. falciparum isolates carried wild type alleles at Pfmdr1-N86Y and Pfcrt-K76T. On the other hand, we found more parasites with mutant alleles at dhps (437G and 581G) loci which may reflect possible drug-related selection of this mutant in the parasite population. Continuous monitoring of these mutations is recommended to pre-empt a loss in sulphadoxine-pyrimethamine efficacy in malaria chemoprevention programs.

Cost of childbirth in Upper West Region of Ghana: a cross-sectional study.

BACKGROUND: Out-of-pocket payment (OOPP) is reported to be a major barrier to seeking maternal health care especially among the poor and can expose households to a risk of catastrophic expenditure and impoverishment.This study examined the OOPPs women made during childbirth in the Upper West region of Ghana. METHODS: We carried out a cross-sectional study and interviewed women who gave birth between January 2013 and December 2017. Data on socio-demographic characteristics, place of childbirth, as well as direct cost (medical and non-medical) were collected from respondents. The costs of childbirth were estimated from the patient perspective. Logistics regression was used to assess the factors associated with catastrophic payments cost. All analyses were done using STATA 16.0. RESULTS: Out of the 574 women interviewed, about 71% (406/574) reported OOPPs on their childbirth. The overall average direct medical and non-medical expenditure women made on childbirth was USD 7.5. Cost of drugs (USD 8.0) and informal payments (UDD 5.7) were the main cost drivers for medical and non-medical costs respectively. Women who were enrolled into the National Health Insurance Scheme (NHIS) spent a little less (USD 7.5) than the uninsured women (USD 7.9). Also, household childbirth expenditure increased from primary health facilities level (community-based health planning and services compound = USD7.2; health centre = USD 6.0) to secondary health facilities level (hospital = USD11.0); while home childbirth was USD 4.8. Overall, at a 10% threshold, 21% of the respondents incurred catastrophic health expenditure. Regression analysis showed that place of childbirth and household wealth were statistically significant factors associated with catastrophic payment. CONCLUSIONS: The costs of childbirth were considerably high with a fifth of households spending more than one-tenth of their monthly income on childbirth and therefore faced the risk of catastrophic payments and impoverishment. Given the positive effect of NHIS on cost of childbirth, there is a need to intensify efforts to improve enrolment to reduce direct medical costs as well as sensitization and monitoring to reduce informal payment. Also, the identified factors that influence cost of childbirth should be considered in strategies to reduce cost of childbirth.

Impact of periodic intensification of routine immunization within an armed conflict setting and COVID-19 outbreak in Cameroon in 2020.

INTRODUCTION: Cameroon's Southwest Region (SW) has been hit by an armed conflict for over half a decade now, negatively affecting the region's routine immunization and disease surveillance activities. This negative effect was further acerbated by the COVID-19 pandemic, which alongside the conflict, caused thousands of children to miss out on life-saving vaccinations. Herein, we present the contribution of periodic intensification of routine immunization in improving immunization and surveillance activities amid crises. METHOD: Periodic intensification of routine immunization (PIRI) and disease surveillance were carried out in three rounds per health district. Before the intervention, the security profile of each district involved was reviewed. Data for this study was extracted on vaccination and surveillance activities from the District Health Information Software and monthly regional reports for 2019 and 2020 from the SW delegation of health. RESULTS: 54,242 persons were vaccinated in the SW following these interventions. An increase in performance was observed in all 18 health districts in 2020 compared to 2019. Both DPT-HebB-Heb-3 vaccine and OPV-3 coverage rose by 28% points. Similarly, the proportion of health districts that investigated at least a case of acute flaccid paralysis increased by 83%, rising from just three districts in 2019 to all 18 in 2020. CONCLUSION: PIRI was a practical approach to improving vaccination coverage and surveillance indicators in this region amidst the ongoing armed conflict and COVID-19 pandemic.

A situational analysis of the mental health system of the West Region of Cameroon using the World Health Organization's assessment instrument for mental health systems (WHO-AIMS).

BACKGROUND: The publication of the World Health Report of 2001 by the World Health Organization (WHO) raised awareness of mental health worldwide. It reported a higher burden of mental illnesses in developing countries, with fewer resources to address the conditions. Since then, many initiatives have been taken in Cameroon to improve the mental health of the population, but these efforts lack local scientific evidence to support them. This study aims to describe the mental health services available in the West Region of Cameroon and to provide evidence-based support to this process. METHOD: We used the World Health Organization Assessment Instrument for Mental Health systems (WHO-AIMS) version 2.2 to collect, analyze, and report the data on mental health services offered in 2020 in the West Region of Cameroon. We extracted our data from the registers of 10 mental health facilities of the region, and we interviewed the staff in these facilities and at the Ministry of Public Health. RESULTS: The region is divided into 20 health districts, of which six offered mental health services. As a whole, Cameroon had a mental health policy, mental health plan, but no mental health legislation or emergency plan. There was no specific budget for mental health in the country. In the West Region there were not any psychiatrists. Mental health services were provided by nurses, psychologists, general practitioners, and neurologists. There were 1.87 human resources in mental health facilities per 100,000 population, of which 1.4 were nurses. 1 in 1.4 of these nurses worked in the main city. There was no formal link of mental health services with other sectors and no publication in the previous five years about mental health in the region referenced on PubMed. CONCLUSION: In 2020, the access to mental health services in the West Region of Cameroon was inequitable. The approach to mental health system development was not inclusive and not supported by enough scientific evidence.

Assessment of men involvement in family planning services use and associated factors in rural Ghana.

BACKGROUND: In low-and-middle income countries (LMICs) less attention is paid to men's involvement in Family Planning (FP) programs where public health officials have advocated the involvement of men as a strategy for addressing the dismal performance of FP programs. The study assessed the involvement of men in FP use and the factors which promote or hinder the uptake of FP services among partners in a rural setting of northern Ghana. METHODS: A cross-sectional descriptive study was used to collect data from 200 respondents. Study respondents were selected through random cluster sampling. RESULTS: The findings showed that male partners' knowledge (95.5%) and approval (72.8%) of FP services were high. About 48% of men were involved in FP service utilization. Having living children (aOR; 1.71(1.27, 2.15)) and being knowledgeable (aOR; 6.14(1.38, 10.90)) about FP were positively associated men's involvement in FP service utilization. The findings also indicated that men had a higher propensity (X2 = 4.5534, p = 0.033) of supporting a FP method use. Women who reported that their spouse supported FP method use were more likely to use a contraceptive method (X2 = 9.5223, P = 0.002) if their spouse supported FP method use (X2 = 9.5223, P = 0.002) and if their partners had some education (X2 = 14.1133, P = 0.000). Reasons for low contraceptive use were health risks, side effects, and socio-cultural norms. CONCLUSION: Family planning programs need to include men at all levels of health promotion and education of FP programs to help reduce misconceptions about contraceptive methods to increase acceptance and use among partners in rural settings of Ghana.

Spatial epidemiology of bacterial meningitis in the Upper West Region of Ghana: Analysis of disease surveillance data 2018-2020.

Background: The use of a Geographic Information System in identifying meningitis hotspots in the Upper West Region (UWR) remains underutilized, making spatial targeting of meningitis hotspots difficult. We therefore utilized surveillance data enabled with GIS technology to target meningitis outbreaks in the UWR. Methods: Secondary data analysis was conducted in the study. The dynamics of bacterial meningitis in space and time were studied using epidemiological data from 2018 to 2020. Spot map and choropleths were used to depict the distribution of cases in the region. Moran's I statistics were used to assess spatial autocorrelation. Getis-Ord Gi*(d) and Anselin Local Moran's statistics were used to identify hotspots and spatial outliers within the study area. A Geographic Weighted Regression model was also used to examine how socio bio-climatic conditions influence the spread of meningitis. Results: There were 1176 cases of bacterial meningitis, 118 deaths, and 1058 survivors between 2018 and 2020. Nandom municipality had the highest Attack Rate (AR) at 492/100,000 persons, followed by Nadowli-Kaleo district at 314/100,000 persons. Jirapa had the highest case fatality rate (CFR) at 17%. The spatio-temporal analysis showed spatial diffusion of meningitis prevalence from the western half of the UWR to the east with a significant number of hotpots and cluster outliers. Conclusion: Bacterial meningitis does not occur at random. Populations (10.9%) under sub-districts identified as hotspots are exceptionally at higher risk of outbreaks. Targeted interventions should be directed towards clustered hotspots, focusing on zones with low prevalence fenced off by high prevalence zones.

Home-Based Intervention for the Prevention and Treatment of Malaria Among Children Younger Than 5 Years in the West Region of Cameroon: Protocol for a Randomized Controlled Trial.

BACKGROUND: Although malaria is preventable and curable, 1 child dies of this disease every 2 minutes in Africa. Home-based management of malaria reduces the progression of severe malaria by more than 50%. Scalable, efficacious, and cost-effective strategies are needed to empower the capacities of home caregivers of children younger than 5 years of age in health education, diagnosis, and treatment of malaria at home. OBJECTIVE: The main objective of this trial is to assess the impact of the management provided by home caregivers on the prevention, diagnosis, and treatment of malaria in children younger than 5 years as compared to the home-based malaria management component of the integrated community-directed intervention (CDI) strategy of community health workers (CHWs). METHODS: A randomized controlled trial will be conducted. CHWs have conducted a census of all households where there is at least one child younger than 5 years with their home caregivers. These children and their home caregivers have been randomly placed into the intervention or control groups among the households identified. The trial will allow malaria home-based prevention, diagnosis, and treatment of 350 children younger than 5 years old by home caregivers in the Fombap area (intervention group) where the integrated CDI strategy will not implemented. This group will be compared to the home-based malaria management component of the integrated CDI strategy in which 350 children in the same age group will be followed up by CHWs in the Baneghang area (control group). The primary outcomes will be the prevention, diagnosis, and treatment of malaria in children younger than 5 years of age by home caregivers at home. The secondary outcomes comprise the malaria follow-up indicators produced by home caregivers in the intervention group and those produced by CHWs in the control group. Both descriptive and one-way analysis of variance estimation techniques will be used to compare the mean difference in the 2 strategies. RESULTS: From September 2019 to October 2019, all home caregivers with children younger than 5 years of age were identified in the intervention and control group by CHWs. Following this, 203 home caregivers with their 350 children younger than 5 years were randomly selected and enrolled in the intervention group, while 225 home caregivers with their 350 children younger than 5 years were enrolled in the control group. In the intervention group, 203 home caregivers were trained in November 2019. This home treatment effectively started in December 2019 and will continue until May 2020. CONCLUSIONS: Findings from this randomized controlled trial will contribute to resolving the challenges of severe malaria and to limiting the death due to malaria of children younger than 5 years. This will bring benefits to home caregivers who will know how to promptly diagnose and properly treat malaria in their children at home. TRIAL REGISTRATION: Pan African Clinical Trial Registry (PACTR) 202003487018009; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9788. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/19633.

Differentiated agrarian vulnerabilities and generalized national responses to COVID-19 in the Upper West Region of Ghana.

The experiences of COVID-19 differ at both micro and macro levels. This emphasizes the need for differentiated responses that account for the varying vulnerabilities of diverse groups regarding the pandemic. In Ghana, much of the attention on COVID-19 has been on urban centres, particularly the country's two largest metropolises in southern Ghana. This has created a gap between national level policy and the experiences of COVID-19 among rural dwellers in Ghana. This is despite evidence that the world's poorest populations will bear the brunt of COVID-19 effects, and that globally, four out of five people living below the poverty line reside in rural areas. Using the Upper West Region as a case study, we discuss the differentiated vulnerabilities that agrarian communities in Ghana face regarding the pandemic. We situate our discussions within the theories of vulnerability and feminist political economy to highlight how interlocking vulnerabilities regarding historical, environmental, geopolitical, socio-economic, health, and gendered inequalities affect the disposition of agrarian communities to cope with and recover from the COVID-19 pandemic. We call for more nuanced COVID-19 responses that account for the needs and experiences of agrarian communities in Ghana.

Hepatitis B knowledge among women and men in the upper west region of Ghana: What sources of health information matter?

Despite the vital role of accurate health information in reducing the spread of Hepatitis B virus (HBV) in endemic contexts such as Ghana, little is known about how health information sources may influence disparities in the knowledge of HBV transmission among women and men. This study examines the association between sources of health information and knowledge of HBV transmission in the Upper West Region (UWR) of Ghana. Data from a cross-sectional survey (n = 1061) was analyzed using gender-specific multivariate ordered logistic regression models. The results show that, women who obtained health information from religious-based programs (OR = 4.04, P < .05), higher-level facilities (OR = 2.37, P < .05), and primary health facilities (OR = 1.83, P < .1) were more likely to have good knowledge of HBV transmission compared to non-facility-based programs. Similarly, men who accessed health information from religious-based programs only, were more likely to have good knowledge of HBV transmission (OR = 2.14, P < .05) compared to non-facility-based programs. The results demonstrate the importance of health information sources on knowledge of disease transmission and prevention in a resource-poor context. Based on our findings, we suggest the scaling-up of information programs at health facilities in rural areas and the expansion of HBV services in the UWR in contribution towards the attainment of SDG #3.3.

Assessing implementation modalities of mhealth intervention on pregnant women in Dschang health district, West region of Cameroon.

INTRODUCTION: Every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. METHODS: This was a cross sectional descriptive study in the Dschang health district, West region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. RESULTS: Majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced. Out of the 335 women that declared wanting an mHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmed using telephone services. CONCLUSION: This study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.

Knowledge and practice of pregnant women and health care workers on hepatitis B prevention in the Limbe and Muyuka health districts of the south west region of Cameroon.

INTRODUCTION: Hepatitis B virus (HBV) infection is a major health problem worldwide owing to its high prevalence and significant morbidity and mortality. There are about 2 billion people living with HBV worldwide and over 360 million chronic carriers. The purpose of this study was to assess the knowledge and practices of pregnant women and health care workers in the ANC and maternity units on HBV infection and its transmission. METHODS: About 270 women attending ANC and 31 health care workers were selected by convenience sampling. They were evaluated using a structured questionnaire to assess their knowledge and practices on HBV prevention and transmission. RESULTS: Pregnant women in the Limbe Health District demonstrated good knowledge but adopted poor practices whereas in the Muyuka Health District, pregnant women demonstrated poor knowledge and adopted poor practices regarding the mode of transmission and prevention of HBV infection. Health care workers in both the Limbe and Muyuka Health Districts however, demonstrated good knowledge and adopted good practices. CONCLUSION: There was a significant relationship between the knowledge and practice of pregnant women and health care workers on Hepatitis B prevention in the Muyuka Health District (P = 0.0006).

Prevalence of stillbirth at the Buea Regional Hospital, Fako Division south-west region, Cameroon.

INTRODUCTION: The study investigated the prevalence of stillbirth at the Buea regional hospital, by taking cases of pregnant women who attended antenatal clinic(s) and those who did not attend but had their deliveries at the Buea regional hospital. The study specifically estimated the prevalence of stillbirths; identified possible risk factors associated with stillbirths, and determined whether the number of antenatal clinic visits is related to the occurrence of stillbirths-because during antenatal clinic visits, pregnant women are educated on risk factors of stillbirths such as: preterm deliveries; sex of the stillbirth; history of stillbirth; history of abortion(s); what age group of mothers are more likely to have a stillbirth. METHODS: The study was a hospital based retrospective study at the maternity in which there were 3577 deliveries registered at the Buea regional hospital dated May 1st, 2014 to April 30th, 2017. With the aid of a checklist data was collected, analysed and presented with the use of tables, pie-charts and bar charts. RESULTS: The prevalence of stillbirths was 26‰; possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; sex of stillbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendance) had more stillbirths. CONCLUSION: The study established that stillbirths can occur in any woman of child-bearing age. possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; gender of stillbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendance) had more stillbirths.

Maternal determinants of low birth weight and neonatal asphyxia in the Upper West region of Ghana.

BACKGROUND: Adverse birth outcomes continue to be a global public health challenge, particularly in low resource settings. Therefore, the present study aimed at assessing maternal determinants of low birth weight and neonatal asphyxia in the Upper West region of Ghana. METHODS: An analytical cross sectional survey was conducted among mothers who attended child welfare clinics (CWC) in six sub-districts. Pregnancy outcome data and maternal nutritional, health service and socio-demographics were obtained using a pre-tested questionnaire. Determinants of low birth weight (LBW) and neonatal asphyxia were analyzed using chi-square and multivariable logistic regression modelling. RESULTS: The results showed that the prevalence of low birth weight and neonatal asphyxia were 8.2% and 9.3% respectively. Multiple logistic regression showed that the risk of giving birth to a LBW baby was high among mothers who consumed alcoholic beverages [AOR = 5.93; 95% CI (1.22-28.84); p = 0.03], those who had food taboos during pregnancy [AOR = 3.31; 95% CI (1.02-10.77); p = 0.047] and not having additional meals [AOR = 3.16; 95% CI (1.0-10.0); p = 0.05] during pregnancy. Neonatal asphyxia was higher among new born babies whose mothers did not receive nutritional counselling in pregnancy [AOR = 5.64; 95% CI (1.48-21.60); p = 0.01] and those who had anaemia at 36 weeks gestation [AOR = 2.69; 95% CI (0.95-7.65); p = 0.06]. CONCLUSION: Maternal dietary practices during pregnancy could positively affect birth outcome in the Upper West Region of Ghana.

Mitochondrial DNA control region haplotypes and haplogroup diversity in a sample from Brasília, Federal District, Brazil.

Brazilians form one of the most heterogeneous populations in the world, as the result of five centuries of miscegenation between its native populations with migrants from Europe, Africa and Asia. The present study intended to characterize the frequencies of mtDNA haplotypes in a dataset of 306 individuals from Brasília, Federal District of Brazil. Brasília was built from scratch in the late 1950s and its construction attracted migrants from different regions of Brazil, mostly from Central-West, Northeast and Southeast regions. Due to its formation, its population is admixed. The goal of this study was to collect mtDNA population data and contribute to databases for a better use of mtDNA for forensic purposes. The haplotypes are available at EMPOP website under accession number EMP00695.

Access to primary health care among women: the role of Ghana's community-based health planning and services policy.

BACKGROUND: Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country's population, especially women who lack access to basic health care services. AIM: The aim of this paper is to understand the contribution of Ghana's CHPS policy to women's access to PHC services in the Upper West Region (UWR) of Ghana. METHODS: A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR. FINDINGS: We found that women who resided in CHPS zones (OR = 1.612; P ≤ 0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.