Knowledge, Attitude, and Practice Towards COVID-19 Among People Living with HIV/AIDS in Kigali, Rwanda.

As with other countries globally, Rwanda has faced a recent outbreak of the coronavirus disease 2019 (COVID-19) against a backdrop of an HIV epidemic. At present, there is no successful cure or vaccine for both COVID-19 and HIV. People with underlying conditions, including HIV, are at increased risk of severe COVID-19 manifestations. This underscores the need to enhance the knowledge, attitudes, and practice of people living with HIV (PLWH) to protect this population against COVID-19. An institution-based cross-sectional study was conducted from August 31 to September 18, 2020 among 376 participants who were selected by a simple random sampling technique. A pretested and structured self-administered questionnaire was used to collect data. Quality scores were calculated as a measure of the participants' knowledge, attitudes, and practice (KAP) levels. The student t-test was used to compare continuous variables between low (<65%) and high (≥65%) KAP scores. The chi-square test was used to determine the association between KAP scores and categorical variables. All decisions on statistical tests were concluded at 5% level of significance. All statistical analysis was performed using STATA statistical package version 11.2 (STATA Corp., Texas, USA). Of the 376 participants, 363 (97%) obtained a high knowledge score, while more than a quarter of the participants (26%) had a poor attitude score, and the majority (90%) having a high practice score. There was no association between gender, age, place of residence, employment, or duration on ART and knowledge score. Employment status and duration on antiretroviral treatment (ART) were significantly associated with attitude scores (p = 0.004 and p = 0.013, respectively). Gender and duration on ART were significantly associated with practice scores (p = 0.02 and p = 0.012, respectively). There was a moderate positive correlation (r = 0.57) between knowledge and attitude scores, and knowledge and practice scores (r = 0.55). There was a strong positive correlation (r = 0.67) between attitude scores and practice scores. Health education programs tailored for PLWH and aimed at mobilizing and improving COVID-19-related knowledge, attitude, and practice should be prioritized in the Rwandan COVID-19 response.

A critical review of mpox outbreaks, risk factors, and prevention efforts in Africa: lessons learned and evolving practices.

Objectives: In recent years, mpox, a zoonotic disease caused by the mpox virus, has transcended its primary association with Central and West Africa, emerging as a global public health concern. The virus poses a substantial threat, particularly, to vulnerable demographics such as young children and individuals with compromised immune systems. This critical literature review aimed to comprehensively evaluate the burden, risk factors, and current management strategies associated with mpox in Africa. Methods: This critical literature review was guided by Jesson & Laccy's guidelines on conducting critical literature reviews. We searched PubMed and Google Scholar databases and websites of the World Health Organization and health ministries in different African countries. We included articles written in English and published between 2010 and 2023. The synthesis of findings involved several steps, including summarizing themes, integrating themes, and linking themes to research questions. Results: A total of 25 articles were included in this review. The review revealed that mpox cases are concentrated in Central African countries. The risk factors for mpox identified include being in contact with bushmeat or rodents, not having been vaccinated against smallpox, being HIV-positive, and having close physical contact with someone with the disease. The clinical presentation of mpox revealed in this review includes a skin rash, fever, lymphadenopathy, headache, pruritus, sore throat, and body aches. Four themes arose on strategies to prevent and control mpox in Africa. Conclusions: The prevention and control of mpox in Africa require an improvement in community education, vaccination, disease surveillance, and infection control measures.

Postnatal care services availability and utilization during the COVID-19 era in sub-Saharan Africa: A rapid review.

BACKGROUND: Considerable progress has been made globally in improving maternal and newborn babies' health. The COVID-19 pandemic has posed considerable challenges for countries to maintain the provision of high-quality, essential maternal and newborn healthcare services. METHODS: A rapid review was carried out on 20 March 2022 on postnatal care (PNC) services availability and utilization during the COVID-19 era in sub-Saharan Africa. PubMed, Google Scholar, and Africa Journals Online (AJOL) databases were searched for relevant studies. Studies included in the review utilized both primary data and secondary data. FINDINGS: Nineteen studies met the inclusion criteria. The review revealed that there were significant declines in the availability and utilization of PNC services during and after the COVID-19 lockdown. Several reasons were found to contribute to the decline. DISCUSSION: New, innovative strategies are therefore required to ensure that mothers and their newborn babies receive essential PNC to reduce maternal and neonatal morbidity and mortality in sub-Saharan Africa. Some of the strategies that can be used include home-based PNC visits, the use of telemedicine, phone-based referral networks, social media, and community radios.

Epidemiological surveillance of enteric viral diseases using wastewater in Africa - A rapid review.

Viral enteric pathogens remain an important cause of diarrhoeal outbreaks among children in sub-Saharan Africa (SSA). Consequently, diarrhoeal illness remains a significant cause of morbidity and mortality in the under-fives in SSA. These outbreaks associated with viral pathogens tend to be seasonal and early warning systems for impending outbreaks could be very crucial for triggering preventive public health response and building public health resilience to deal with increased demand for medical services. Wastewater surveillance for pathogens is an important epidemiological component that could inform early warning systems. The objective of this rapid review was to evaluate the use of wastewater for epidemiology surveillance of enteric viral pathogens. Nine studies met the inclusion criteria. Eight viral pathogens were reviewed and analysed from 6 countries that performed wastewater analysis. Six studies explored the epidemiologic significance of viral pathogens in wastewater. The findings of this review revealed that monitoring of wastewater can provide an additional tool to determine the epidemiology of viral pathogens circulating in the community thereby providing early warning of potential outbreaks using wastewater-based epidemiology methods. Five of the included studies revealed the occurrence of viral pathogens in raw sewage and treated wastewater as an indication of inefficient elimination of viruses leading to potential release into water sources which presents a public health risk, increasing the risk of inducing gastroenteritis in the population. Six studies revealed the need for public health authorities to realise the potential benefit of environmental surveillance (ES) as an additional tool to determine the epidemiology of viral pathogens circulating in each community. Despite the significant public health challenge associated with enteric viral pathogens in sub-Saharan Africa, there remains remarkable underinvestment in potentially epidemiologically beneficial research, including wastewater-based epidemiology for these infections.

A qualitative study on oral-fluid-based HIV self-testing experiences among men in Kigali, Rwanda.

INTRODUCTION: there has been a global call to engage men in the fight against the HIV epidemic. Poor uptake of HIV testing services among men has been reported in most of sub-Saharan Africa where the HIV epidemic continues to be a major public health problem. HIV self-testing (HIVST) has potential to bridge the gap; however, there is a paucity of research evidence on oral-fluid-based HIVST experiences among men in Rwanda. The aim of this study was to assess oral-fluid-based HIVST experiences among men. METHODS: a qualitative study based on individual interviews was employed on 21 men who voluntarily obtained oral-fluid-based HIV self-test kits and consented for follow-up post-test interviews. Interview guides explored men´s perspectives on the oral-fluid-based HIV self-screening experience. A conventional content analysis qualitative approach was adopted, entailing inductive thematic analysis. RESULTS: the majority of participants expressed satisfaction with the experience of self-testing, citing privacy and turn-around time. Participants presented contradicting views on usability of test kits and post-test status disclosure to sexual partners. One participant reported post-test distress resulting from unexpected results. CONCLUSION: HIVST is attractive to men and may have potential for improving uptake of HIV testing services in this group without compromising the testing experience. Concerns on missing linkage to care and potential social harms and adverse events should not be ignored.

A scoping review on barriers to implementation of health education programs in low to middle income countries

We aimed to map literature on the barriers to effective implementation of health education programs (HEPs) in low to middle income countries (LMICs) to guide future implementation research. We employed a rigorous scoping review design. Our review was guided by the Arksey and O’Malley framework, 2005, further enhanced by Levac et al. The keyword search was comprehensive for relevant studies presenting evidence on barriers to implementation of HEPs in LMICs from Google Scholar, PubMed, EBSCOHost (CINAHL and Academic Search Complete) databases and grey literature. The first search identified 3,092 articles, of which 1,412 duplicates were eliminated. An additional 1,632, 34 and 7 articles did not meet the inclusion criteria based on sequential title screen, abstract review and full text review respectively. Seven studies met the inclusion criteria for the actual scoping review. Findings of the review revealed three categories of barriers to effective implementation of HEPs in LMICs grouped as individual or patient level, community level and population level barriers. A key barrier to effective implementation of HEPs in LMICs revealed from the review was socio-economic challenges, which result from resource constraints. This calls for adequate allocation of the limited resources toward health education to ensure effective implementation of HEPs in LMICs and improve health outcomes.