Knowledge of malaria prevention among pregnant women and non-pregnant mothers of children aged under 5 years in Ibadan, South West Nigeria.

BACKGROUND: Adequate knowledge of malaria prevention and control can help in reducing the growing burden of malaria among vulnerable groups, particularly pregnant women and children aged under 5 years living in malaria endemic settings. Similar studies have been conducted but with less focus on these vulnerable groups. This study assessed knowledge of malaria prevention and control among the pregnant women and non-pregnant mothers of children aged under 5 years in Ibadan, Oyo State, South West Nigeria. METHODS: In this cross sectional study, data on socio-demographic, clinical and knowledge on malaria prevention was collected using interviewer administered questionnaires from consenting study participants attending Adeoyo maternity hospital between May and November 2016. Data was described using percentages and compared across the two maternal groups in the study population. Knowledge scoring from collected data was computed using the variables on causes, symptoms and prevention of malaria and thereafter dichotomised. Multivariate analyses were used to assess the interactive effect of socio demographic and clinical characteristics with malaria knowledge. Level of statistical significance was set at p < 0.05. RESULTS: Of the 1373 women in the study, 59.6% (818) were pregnant women while 40.4% (555) were mothers of children aged under 5 years. The respondents mean age was 29 years ± 5.2. A considerable proportion of both the pregnant women (n = 494, 60.4%) and the non-pregnant mothers of children aged under 5 years (n = 254, 45.8%) did not have correct knowledge on malaria prevention measures based on our assessment threshold (p < 0.001). Having a tertiary level education was associated with better knowledge on malaria (4.20 ± 1.18, F = 16.80, p < 0.001). Multivariate analyses showed that marital status, educational attainment, gravidity, and HIV status were significantly associated with knowledge of malaria prevention and control. CONCLUSION: The findings indicate that socio-demographic factors such as marital and educational status greatly influence knowledge on malaria prevention and control measures. Key health stakeholders and authorities need to implement strategies and direct resources to improve the knowledge of mothers on malaria prevention and control. This would stem the tides of malaria related deaths among pregnant women and children aged under 5 years.

Socio-economic predictors of uptake of malaria interventions among pregnant women and mothers of under 5 children in Oyo State, Nigeria: a cross-sectional study.

Introduction: socio-economic status (SES), especially for women, influence access to care. This study aimed to determine the relationship between SES and uptake of malaria intervention by pregnant women and non-pregnant mothers of children under 5 years old in Ibadan, Oyo state, Nigeria. Methods: this cross-sectional study was conducted at Adeoyo teaching hospital located in Ibadan, Nigeria. The hospital-based study population included consenting mothers. Data were collected using an interviewer-administered modified validated demographic health survey questionnaire. The statistical analysis involved both descriptive (mean, count, frequency) and inferential statistics (Chi-square, logistic regression). Level of statistical significance was set at 0.05. Results: mean age of the study´s total of 1373 respondents was 29 years (SD: 5.2). Of these, 60% (818) were pregnant. The non-pregnant mothers of children under five years old showed a significantly increased odds (OR: 7.55, 95% CI: 3.81, 14.93) for the uptake of malaria intervention. Within the low SES category, women aged 35 years and above were significantly less likely to utilize malaria intervention (OR=0.08; 95% CI: 0.01-0.46; p=0.005) compared to those younger. In the middle SES, women who have one or two children were 3.51 times more likely than women with three or more children to utilize malaria intervention (OR=3.51; 95% CI: 1.67-7.37; p=0.001). Conclusion: the findings provide evidence that age, maternal grouping, and parity within the SES category can significantly impact on uptake of malaria interventions. There is a need for strategies to boost the SES of women because they play significant roles in the wellbeing of members of the home.

Status of malaria and its implications for elimination in an endemic province of South Africa: retrospective analysis.

South Africa set a target to eliminate malaria by 2018. Kwa-Zulu-Natal (KZN) province was earmarked to reach the elimination goal first. However, recent evidence suggests that the province has not yet achieved the elimination goal. This study set out to assess the status of malaria in KZN province of South Africa and its implications for elimination. Using retrospective analysis, the study quantified and described 5 787 cases of malaria for the years 2010-2019 in KZN province of South Africa. Data on reported malaria cases were obtained from the Malaria Information System of the KZN Provincial Department of Health. More than 65% of the cases came from male patients aged 16 years and above. A high number of cases were reported in the years 2014, 2017 and 2018. More than 40% of the cases were imported from countries outside of South Africa. The study confirms an increase in malaria cases, especially during the elimination year. The imported malaria cases and other related factors pose a threat to achieving the elimination goal. The KZN province needs to strengthen elimination efforts, including strategies to prevent imported malaria cases to achieve the new elimination goal.

Prevalence of cervical abnormalities among rural women in KwaZulu-Natal, South Africa.

Introduction: despite the availability of screening facilities in South Africa, cervical cancer prevalence and mortality is still high. Most women present to the health facilities at an advanced stage of disease. This study aimed to determine the prevalence of cervical abnormalities using the revised Bethesda System among rural women in KwaZulu-Natal, South Africa. Methods: this was a cross-sectional descriptive study using a retrospective medical record review method to collect data on Pap smears from three rural clinics in KwaZulu-Natal. Clinical data and cytology reports were obtained for the years January 2016 to January 2019. Women aged 18-65 years were included. Results: of 246 randomly-selected medical records, 245 Pap smears were analysed. Half (47.8%) of the women were in the age group 30-44 years. HIV, as a risk factor, was found in 41.2% of the women. A total of 48.6% Pap smears were negative for malignancy. Of the 49.8% abnormal screened results, 25.7% women had low-grade squamous intraepithelial lesion, 13.9% high-grade squamous intraepithelial lesion (HSIL), 8.6% atypical squamous cells of undetermined significance, and 1.6% squamous cell carcinoma (SCC). All SCC cases were found in HIV-infected patients. HSIL and SCC were less common among patients younger than 30 years. Conclusion: this study´s results accentuate the importance of well-organised cervical screening programmes. Cervical screening, through Pap smears, is a useful, non-invasive and cost-effective method for early detection of pre-invasive lesions. Women, especially those over 30 years, should be educated on the importance of Pap smears and encouraged to uptake the test.

A Four-Year Hospital-Based Retrospective Study of the Predictors of Tuberculosis in People Living with HIV and Receiving Care at Bamenda Regional Hospital, Cameroon.

BACKGROUND: Tuberculosis (TB) and Human Immunodeficiency Virus (HIV) co-infections place immense burdens on healthcare systems with particularly diagnostic and therapeutic challenges. TB is high among opportunistic diseases and the most leading cause of death among patients with HIV/AIDS. HIV infection is the most-known risk factor for Mycobacterium tuberculosis infection and progression to active disease, which increases the risk of latent TB reactivation by 20-fold. We present a four-year descriptive analysis of TB in people living with HIV in the Bamenda Regional Hospital (BRH) from 2012-2016. METHODS: This was a hospital-based descriptive chart review. We conducted manual reviews of medical records of HIV/TB co-infected patients from June 2017-July 2017 at BRH's AIDS Treatment Centre, North West region of Cameroon. Socio-demographic and clinical characteristics of cases were captured using a pre-tested data collection sheet and analyzed with Statistical Package for Social Sciences (SPSS) software, version 25. RESULTS: Out of the 1078 HIV patients, 36.5% (393) of them were diagnosed with TB; 75% (808) of the People living with HIV (PLWHIV) were active; among the remaining 25%, 10.2% were bedridden, 13.0% were jobless, and 1.8% were retired. The greater proportion of the participants were females 65.5% (705). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: The baseline anemia, smoking tobacco, drinking alcohol, detectable (≥50copies/mL), CD4 count ≤ 200cells/µl and gender of the PLWHIV were associated with the incidence of TB. We recommend early diagnosis and treatment of anemia, modification of patient's lifestyle, and strengthening of immunization programs to reduce the risk of TB occurrence among HIV-infected people.

Factors associated with the uptake of intermittent preventive treatment of malaria in pregnancy in the Bamenda health districts, Cameroon.

INTRODUCTION: The World Health Organization (WHO) recommends that in malaria endemic areas with moderate to high transmission rates, pregnant women presenting for antenatal clinic (ANC) should receive at least three doses of intermittent preventive treatment in pregnancy (IPTp) for malaria between the 16th and 36th weeks of pregnancy at intervals of 4 weeks between doses. Several challenges remain in effective implementation of IPTp policy making the targeted coverage (80%) of the third doses of IPTp far from being achieved. The main objective of this study was to assess factors associated with the uptake of IPTp among pregnant women attending ANCs in the Bamenda Health District. METHODS: To reach our objectives, we carried out a cross-sectional study following informed consent with thirty-nine (39) healthcare workers (HCW) and four hundred (400) pregnant women who were either in the third trimester of pregnancy or had recently given birth in any of thirty-six (36) health facilities (HF) within the Bamenda Health District (BHD) from May to August 2014. All sites within the BHD were included. The participants were selected by simple random sampling. The principal research instrument was a structured and pre-tested questionnaire that was designed to capture socio-demographic data and data related to stage of pregnancy and knowledge about IPTp. Data was entered using Ms Excel and analysed using SPSS v20.0. Descriptive statistics (frequencies and percentages) was used to report findings. We used Chi-Square test to compare the categorical variables (Fischer's exact test was used in cases were conditions for Chi-Square test were not met). RESULTS: Uptake for at least one dose of IPTp was 95.3% (381/400) and 54.9% (209/400) had received all three doses, 15.5% (59/400) received only one dose and 4.8% (19/400) did not receive any of the doses of IPTp. Knowledge about IPTp was associated with an increase uptake of IPTp (P<0.001). All health care providers were knowledgeable about the importance and use of IPTp. However, 35.9% reported not receiving any training on IPTp. Among the health providers, 28.2% did not know when to start IPTp and 43.59% did not know when to stop IPTp. Out of all the health care providers, 30.77% complained of medication (sulfadoxine-Pyrimethamine) stock out and 84.62% practiced the policy of direct observed therapy. CONCLUSION: The uptake of the third dose of IPTp is poor in the Bamenda Health District and this may be attributed to medication stock out and inadequacy of routine trainings for the health providers. The good practice observed was that of direct observed therapy by HCWs. Patient knowledge about IPTp in our study was associated with better uptake of IPTp. Encouraging education of pregnant women on the importance of IPTp, providing routine training to HCWs and promoting direct observation of therapy may improve on IPTp uptake during pregnancy.

Assessment of minor psychiatric morbidity, stressors, and barriers of seeking help among medical students at the University of Khartoum, Khartoum, Sudan.

INTRODUCTION: Medical education can be stressful and a source of psychiatric morbidity for medical students with the potential of causing serious professional and personal negative consequences. With the limited studies investigating this issue in Sudan, this study aimed at assessing psychiatric morbidity, determine stressors, evaluate mental health care seeking behavior and barriers to seeking help among medical students in Khartoum, Sudan. METHODS: This was a cross-sectional study with data collection for a period of one month, during the survey. Following ethical clearance and administrative approval, 644 students who gave consent were selected randomly from the university of Khartoum's faculty of medicine. The "12-General Health Questionnaire (GHQ12)" was used as a tool to assess prevalence of psychiatric morbidity, determine stressors and evaluate barriers to seeking mental health care among students for a period of a month. RESULTS: The overall prevalence of psychiatric morbidity was 56% (n = 356). The mean score of the GHQ12 was 6.7. There was a statistically significant association between GHQ12-score and level of study (in medical school), age, student's income (student financial allowance). Stressors mostly experienced by students were fear of academic failure, dissatisfaction with academic performance and examination stress. The most frequent barriers to seeking mental health care elicited by participants were fear of stigmatization 63% (n = 401), preference for dealing with the problem alone 60% (n = 379), fear of the unknown 59% (n = 365) and failure to recognize symptoms 58% (n = 366). CONCLUSION: Psychiatric morbidity is commonly experienced by students in medical school as can be seen from the high prevalence (56%). The reported high figures of psychiatric morbidity among medical school students points to the urgency for interventions to address this problem with potential for negative sequelae (personal and professional). Our findings suggest that interventions to improve the social and economic conditions of students in medical school as well as addressing stigma related to mental health and educating students to recognize signs and symptoms of psychiatric morbidity while making help accessible might go a long way to address this challenge.

Prevalence of onchocerciasis, attitudes and practices and the treatment coverage after 15 years of mass drug administration with ivermectin in the Tombel Health District, Cameroon.

INTRODUCTION: Onchocerciasis is an infection caused by Onchocerca volvulus. It affects 37 million people of which 99% are in Africa. This study assessed the prevalence of onchocerciasis after 15 years of mass drug administration with ivermectin. METHODS: This was a population based cross sectional study. Questionnaires covering participants' identity and attitudes and practices of community respondents towards ivermectin were administered. The treatment coverage was obtained by review of records of mass drug administration from 1999 to 2015. The epidemiological evaluation of infection status was done by parasitological examination of skin snips and nodule palpation in individuals in five health areas of the district. RESULTS: A total of 400 participants were randomly selected. Of these, 56.0% were males, 62.0% single, 59.5% farmers and 98.0% Christians. Participants with good attitudes towards community directed treatment with ivermectin made up 80.5% while 47.8% of the participants had good practice. The highest treatment coverage achieved was 88.0% in 2010 while lowest was 57.0% in 2002. Less than 2% had microfilaria and 6.0% had nodules. There was no statistically significant difference in the prevalence of microfilaria with respect to age. There was a statistically significant difference in the distribution of nodules (χ2=73.6, p=0.001) among the different age groups. The greatest rate of infection (2.1%) was among farmers. CONCLUSION: This study showed that the prevalence reduced compared to other prevalence studies in Cameroon. The study area was hypo-endemic for onchocerciasis.

Determinants to late antenatal clinic start among pregnant women: the case of Saint Elizabeth General Hospital, Shisong, Cameroon.

INTRODUCTION: To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system. The World Health Organisation (WHO) cites distance to health facility and inadequate health institutions as factors that prevent women from receiving or seeking care during pregnancy and childbirth. Specifically, we intended to determine factors associated with late start of late Antenatal Care (ANC) among pregnant women in the Saint Elizabeth General Hospital Shisong (SEGHS), Cameroon. METHODS: This was a cross sectional study carried out from the 24th October to 24th November 2016. A total of 602 pregnant women were recruited from ANC units of SEGHS and its satellite institutions. The outcome variable was gestational age at start of ANC (estimated by counting from last menstrual period to day of first ANC consultation) while the independent variables were individual, community and institutional factors. Data was analyzed using Epi info version 7. Chi square test was used to appreciate the influence of different variables on risk of late ANC initiation (> 14 weeks of pregnancy). The level of significance was set out at (p: < 0.05). RESULTS: Out of the 602 pregnant women included in our study, 75% initiated ANC late (after 14 weeks of pregnancy). Factors associated with late ANC start were; age (p = 0.001), level of education (p = 0.002), marital status (p = 0.016), religion (p = 0.034), parity (p = 0.001), having a source of income (p=0.001), cost of services (p = 0.010), distance to health facility (p = 0.021) and dissatisfaction with previous ANC services (p = 0.014). CONCLUSION: Cameroon is one of the countries with a high maternal mortality ratio. WHO estimated it to be 529 per 100000 live births in 2017. Prompt and adequate ANC services can improve on maternal and child outcomes of pregnancy. The results of this study suggest tackling issues related to cost of ANC services and improving geographical (distance) barrier to accessing ANC services (in addition to addressing other identified measures) may lead to an increase in pregnant women starting ANC early and thus potentially improve pregnancy outcomes.

Vaccination Coverage Under the Expanded Program on Immunization in South West Cameroon.

BACKGROUND: Inadequate vaccination coverage with increased risk of vaccine preventable disease outbreaks remain a problem in Africa. The aim of this study was to assess the vaccination coverage levels under the Expanded Program on Immunization (EPI) in a health area and to identify factors that affect vaccination coverage in view of providing valuable data for disease prevention. METHODS: A cross-sectional household survey was conducted in August 2017 in the Mbonge health area, Southwest Cameroon. Clustered sampling technique was used to select study communities and a purposive sampling design was used to select households. An interviewer-administered questionnaire was used to obtain information from consenting caregivers of children aged 9-23 months. Vaccination coverage was assessed by consulting the vaccination cards and parents' recall. In households with more than one child aged 9-23months, the youngest was chosen. RESULTS: Overall, 300 caregivers were enrolled into the study. The average vaccination coverage for the past three years (2014-2016) was 34.0%. Two hundred and fifty-five (85%) children had vaccination cards. Amongst the children, 143 (47.7%) had taken all vaccines as recommended while 30 (10%) had not received a single dose. Factors significantly associated with incomplete vaccination status included: occupation (being a farmer) (p-value=0.011), marital status (married) (p-value=0.048), caregiver's utilization of health facility (p-value=0.003), low levels of mothers' utilization of antenatal care (ANC) services (p-value=0.000), and low knowledge on vaccination (p-value=0.000). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Adequate vaccination coverage can be attained through good sensitization and health education for primary caregivers. Targeting families living far away from vaccination centers, using appropriate communication and vaccination strategies may improve vaccination coverage in the Mbonge Health Area of South West Region, Cameroon.

Contraceptive use and associated factors among sexually active female adolescents in Atwima Kwanwoma District, Ashanti region-Ghana.

INTRODUCTION: Unintended pregnancies and adolescent childbearing are on the increase in Sub-Saharan Africa. In Ghana, 14% of adolescents aged 15-19 are already mothers or pregnant with their first child. Most of these pregnancies are associated with poor outcomes such as miscarriages, stillbirths, unsafe abortions and other complications that might result in infant or mortality. In addition, sexually-active adolescents (16-19 years) are at higher risk of contracting STIs. Evidence suggest that contraceptive use help reduce fertility rate and adolescent reproductive health. This study therefore sought to understand the magnitude and associated factors that influence female adolescents' use of contraceptive in the Atwima Kwanwoma District, Ghana. METHODS: A descriptive and analytic cross-sectional study design was used for this study. Using a structured questionnaire, data were collected from randomly sampled 200 sexually active female adolescents; aged 16-19 for a three month period; June to September 2017. The questionnaire elicited data on the socio-demographic characteristics of respondents, their knowledge and perception, use of contraceptives and factors influencing their contraceptive use. Data were analyzed using STATA version 12.1 software. RESULTS: Ninety-five percent of the respondents exhibited some knowledge about contraceptives, but this high knowledge did not translate into its use as the prevalence rate was 18%. Condom was the most widely used contraceptive (33%) and perceived side effects of contraceptives was found to be the main reason for not using the contraceptives (53.66%). Marital status and the participants who were staying with both parents were found to be associated with contraceptive use with their p-values of 0.023 and 0.002 respectively. CONCLUSION: Considering the fact that contraceptive knowledge does not necessarily translate into use, further studies (qualitative), are needed to understand why high knowledge levels are not associated with high usage patterns.

Assessment of the knowledge of the modes of transmission and prevention of malaria among pregnant women attending antenatal clinic at the Nkwen Health Center Bamenda, Cameroon.

INTRODUCTION: Malaria is a life threatening disease caused by the Plasmodium parasite, transmitted through the bites of infected female anopheles' mosquitoes. According to the latest WHO data published in 2017, malaria deaths in Cameroon reached 9.161 deaths accounting for 4.14% of total deaths. The age adjusted death rate is 29.11 per 100,000 and Cameroon is ranked the 30th in the world with a high prevalence of malaria. The aim of this study was therefore, to access the knowledge of the modes of transmission and prevention of malaria among pregnant women attending Antenatal Clinic (ANC) at the Nkwen Health Center, Bamenda. METHODS: This was a cross-sectional hospital based survey study. The researchers recruited 51 eligible women in the Nkwen Health Centre and used a validated and pre-tested questionnaires to collect data. Collected data were entered into Excel and analysed using descriptive statistics and the results presented in tables and figures. RESULTS: Sixty four percent of the women have basic knowledge about the mode of malaria transmission. Thirty six percent of the women had little knowledge about malaria transmission modes and the possible dangers of the disease. CONCLUSION: Slightly above 50% of pregnant women have basic knowledge on the modes of malaria transmission. Lack of knowledge regarding the modes of malaria transmission can be one of the reasons why there is still quite a high level of malaria prevalence among pregnant women attending ANC at the Nkwen Health Center, Bamenda. There is therefore, a need to educate women on malaria transmission modes.

Exploring cultural beliefs and practices associated with weaning of children aged 0-12 months by mothers attending services at Maternal Child Health Clinic Kalisizo Hospital, Uganda.

INTRODUCTION: Despite the fact that mothers know the exact age to wean their infants, majority of the mothers do not practice exclusive breastfeeding due to cultural beliefs and practices. The purpose of the study was to explore cultural beliefs and practices associated with weaning children at the Maternal Child Health Clinic Kalisizo Hospital. METHODS: This was a simple qualitative study. Seven in-depth-interviews were conducted among 7 mothers of children within the ages 0-12 months attending post-natal care services using self-generated semi-structured key informant's guide. This took place at the Maternal Child Health Clinic Kalisizo Hospital. Purposive sampling method was used to select mothers for the study. Three themes were generated namely: identification of the different cultural beliefs and practices associated with weaning, how the different cultural beliefs are practiced and the impacts of these cultural beliefs and practices. Data were analysed using thematic analysis. RESULTS: Although a majority of the mothers knew the recommended age to wean their infants, they did not ignore the ill-informed cultural beliefs, taboos and practices from their elders such as peer pressure, advice and counselling from mother-in laws and teachings from older women who are seen as role models. CONCLUSION: Adherence to cultural beliefs, taboos and practices, have a powerful influence on weaning, hence hindering exclusive breast feeding.

Prevalence and risk factors associated with hypertension among adults in a rural setting: the case of Ombe, Cameroon.

INTRODUCTION: High blood pressure is the most common cardiovascular disorder affecting approximately one billion people globally and remains a major contributor to the global burden of non-communicable diseases and mortality. Hypertension, once rare in traditional African societies, is now a major public health problem probably because of a rise in its risk factors. In sub-Saharan Africa, an estimated 74.7 million individuals live with hypertension. This study was designed to determine the prevalence and identify risk factors associated with hypertension in adults aged 21 years and above in Ombe village, a rural Cameroonian setting in sub-Saharan Africa. METHODS: This study was a cross-sectional community based survey from March to September 2016 (seven months) in the village of Ombe, a rural community in the southwest region of Cameroon. Following ethical clearance from the Institutional Review Board (IRB) of the Faculty of Health Science, University of Buea and administrative authorization, 243 participants (141 males and 102 females) through multi-stage sampling were randomly selected to take part in the study following consent which was voluntary and without any form of coercion. The principal research instrument was a questionnaire adapted from the WHO STEPwise approach to chronic disease risk factor surveillance- Instrument v2.1 which was administered to participants. The self-administered questionnaire collected socio-demographic information, data related to knowledge and practices related to hypertension, anthropometric data (weight and height from which the body mass index (BMI) was calculated). The blood pressure of study participants was measured. Data was entered using Microsoft Excel, then imported and analysed in SPSS v22.0. Frequencies and percentages were determined for categorical variables. Means and standard deviations (mean ± SD). Univariate and multivariate logistic regression analysis were used to investigate factors associated with high blood pressure (hypertension). RESULTS: The results showed that 19.8% of the adult population had hypertension. Of the 243 respondents, 77.7% understood what is hypertension, 85% indicated that they could tell some consequences of high blood pressure (they indicated hypertension affects the heart, brain and kidneys) and 63.3% of study participants had never checked their blood pressure. Age greater than 40 years, harmful alcohol intake for more than 10 years, physical inactivity and obesity (BMI ≥ 25Kg/m2) were variables associated with hypertension on univariate analysis. Following multivariate analysis, independent risk factors for hypertension in our study were: physical inactivity (Adj. OR 2.6, 95%CI: 1.3-4.4, p = 0.021), regular alcohol consumption for more than 10 years (Adj. OR 2.9, 95%CI: 1.6-5.1, p = 0.014) and being older than 40 years of age: Adj. OR 2.5, 95%CI: 1.02-4.1, p = 0.002 in age category 41-60 years and this age related risk was even higher in persons older than 60 years of age Adj. OR 4.5, 95%CI: 2.1-6.3, p = 0.002. CONCLUSION: The findings of this study showed the prevalence of high blood pressure among adults in Ombe (a rural community in Cameroon) was 19.8%. Old age, alcohol consumption, and physical inactivity were independent risk factors for hypertension. Despite the population demonstrating knowledge about hypertension and its possible poor consequences on health, less than half had ever gone for blood pressure checks. Interventions to improve physical activity, reduce alcohol consumption and boost health seeking (high blood pressure screening) behaviour will be beneficial as preventive measures in combatting hypertension.

Cervical cancer in the Bamenda Regional Hospital, North West Region of Cameroon: a retrospective study.

INTRODUCTION: Cervical cancer is ranked the 7th most common cancer in the world. Cancer of the cervix is the second most commonly diagnosed cancer after breast cancer and the third leading cause of cancer deaths among females in less developed countries. Incidence rates are highest in countries with low income. Nearly 90% of cervical cancer deaths occur in developing parts of the world. The study researchers therefore, carried out a retrospective study to determine the proportion of cervical cancer among other types of cancer in the cancer registry of the Bamenda Regional Hospital. METHODS: The objective of this study was to determine the proportion of cervical cancer among other types of cancers in the cancer registry of the Bamenda Regional Hospital, North West Region of Cameroon from past records. We reviewed all records from the registry of patients who attended the Bamenda Regional Hospital to screen and/or be operated upon for cervical cancer and other types of cancer. Socio-demographic and clinical characteristics of cases were captured using a data collection sheet: age, type of cancer, stage of cancer, type of surgery carried out and date of surgery. Data were entered and analysed in Statistical Package for Social Sciences (SPSS) version 25 software. RESULTS: 59 cancer cases were received in the center between 2012 and 2017. Of these, 31 (52%) had cervical cancer. Most patients who screened positive for cancer of the cervix were of the 50-54 age groups. Most of these patients (47.5%), were received at late stages (stages 3 and 4). CONCLUSION: Over half (52%) of the patients receiving cancer care in this center have cervical cancer and generally turn up late for management.

Stigma on epileptic patients attending the outpatient clinic of Soba University Hospital and the National Center for Neurological Science (NCNS) Khartoum, Sudan.

INTRODUCTION: Epilepsy is one of the most prevalent neurological conditions for people of different age group, race, gender and socio-economic status in various nations, affecting 50 million people around the world; 80% of them living in developing countries. In Sudan, literature has well documented epilepsy stigma and it related elements of labelling, negative typecasting, isolation, devaluing and discrimination that are significantly affecting patients living standards and social life. This study focuses on understanding the prevailing, different types of stigma among people living with epilepsy (PWE) in Sudan and to determine its frequency in connection with demographic factors and patients coping ability of PWE. METHODS: A health facility-based cross-sectional descriptive study was conducted on 270 people between the ages of 16-70years who are affected by epilepsy in an outpatient clinic. Standardized questionnaires were used to interview the patients with assistance gotten from their relative where necessary. The data is analyzed using SPSS version 20. The study was conducted in the outpatient clinic of The National Center for Neurological Sciences (NCNS), Ibrahim-Malik Teaching Hospital Sudan. RESULTS: The study realized that 16.6% of the patient had a positive self-stigma score, half of them having coaching stigma and 25% courtesy stigma. One third of people with epilepsy had poor coping score that was strongly determined by self- stigma and courtesy stigma score. CONCLUSION: Parents and relatives related sigma is a major problem facing people of epilepsy in Sudan; thus, raising such group awareness and education about the disease can markedly improve the quality of life of people with epilepsy in Sudan.

Acute respiratory infection related to air pollution in Bamenda, North West Region of Cameroon.

INTRODUCTION: Air pollution is a global health problem. It's responsible for over 4 million deaths each year and constitutes a risk factor for acute respiratory infections (ARI). The aims of this study was to assess knowledge about air pollution, and to determine environmental risk factors associated with ARIs occurence in the city of Bamenda, Cameroon. METHODS: We conducted a cross sectional study and performed a rectrospective analysis of ARI consultation within the period March 2016 to July 2016 in the Bamenda Health District. We interviewd 201 patients and recorded 1849 cases from hospital registers of patients diagnosed ARI from January 2013 to April 2016. Epi-info 7.2 was used for data entry and analysis. Logistic regression analysis was conducted to determine the importance of the different environmental risk factors. RESULTS: Over 70% of the participants used at least a form of solid fuel for cooking. The Odds of developing an ARI was 3.62 greater among those exposed to indoor cooking compared to the unexposed (OR 3.62, CI 1.45-4.90). Participants exposed to open fire burning were 1.91 times more like to develop ARI compared to unexposed (OR: 1.91, CI 1.03-3.55: p : 0.03). Particulate Matter (PM 2.5) levels was 13.2 times higher than the World Health Organization (WHO) recommended levels. Dry and dusty weathers increased the risk of ARIs (OR 3.24; CI 1.47-7.13). The prevalence of ARIs in the Bamenda Health District was 6% of all consultations. CONCLUSION: Using solid fuels in poorly ventilated homes increase the total air particle suspension indoor. Inhalling this poor air irritates the repiratory tract, eyes while longterm exposure increases the odds of cancers. Ventilating homes with indoor cooking space reduces exposure while using clean fuels like electricity reduces the odds of ARI associated with pollution.

The effect of subsidized malaria treatment among under-five children in the Buea Health District, Cameroon.

INTRODUCTION: Access to free diagnoses and treatments has been shown to be a major determinant in malaria control. The Cameroon government launched in 2011 and 2014 the exemption of the under-fives' simple and severe malaria treatment policy to increase access to health care and reduce inequality, so as to reduce the mortality related to malaria among the under-fives. This study assessed the effect of providing free malaria treatment in the Buea health district. METHODS: This retrospective and cross sectional study was carried out in the Buea health district. Aggregated monthly data from (2008-2010) before and (2012-2014) after the implementation of free malaria treatment was compared, to assess the attributable outcomes of free treatment. A semi-structure questionnaire was also used to assess barriers faced in providing free malaria treatment services by health care workers. Data was collected using a semi-structure questionnaire and a data review summary sheet. The data was analysed using Epi-Info 7, Excel and SPSS (Statistical Package for the Social Sciences) version 20.0 for Windows. All statistical tests were performed at 95% confidence interval (significance level of 0.05). RESULTS: Increase utilisation of health care; as general and malaria related consultations (by 5.7% (p=0.001) witnessed an increase after the implementation of free malaria treatment services. Severe malaria hospitalisation also increased, indicating that most caregivers used the health facility when complications had already set in, which could have led to no significant reduction in mortality due to malaria among under-five children (4.4%, p=0.533). CONCLUSION: Utilisation of health care increased; as consultation and morbidity rate increased after the implementation of free malaria treatment services. Communication strategy should therefore be strengthened so as to better disseminate information, so as to enhance the effectiveness of the program. There is the need to make a large-scale study to assess the impact of subsidized malaria treatment.

The level of knowledge and associated socio-demographic factors on cervical cancer among women: a cross-sectional study at Kenyase Bosore community, Ghana.

INTRODUCTION: Cervical cancer is a major cause of death amongst women around the world. In Ghana, it accounts for over 2,119 female deaths and about 3,151 new diagnoses of the disease. It is usually diagnosed at an advanced stage, making it difficult to treat. This study aims at assessing the knowledge on risk factors, prevention and treatment of cervical cancer among women in Kenyase Bosore, Ghana. METHODS: This study was a cross-sectional descriptive study conducted among women in Bosore Kenyase, Ghana. A total of 200 women were selected for the studies using the convenience sampling technique. Structured questionnaires were used for data collection and statistical package for social sciences application was also used to analyse the data. Pearson chi-square test was used to find associations between knowledge and awareness level and socio-demographic characteristics of the participants. RESULTS: Overall, 9.7% of the respondents had high knowledge on cervical cancer, 20.6% had moderate knowledge and 69.7% had low knowledge on cervical cancer. There was a significant association between educational background (p=0.000) and awareness level of the respondents. There was also a significant association between the occupation (p=0.003), educational background (p=0.000) and knowledge level of the respondents. CONCLUSION: The knowledge level of the respondents was very low. Specifically, the respondents had inadequate knowledge on risk factors, signs and symptoms, prevention and treatment of cervical cancer. The authors recommend the intensification of cervical cancer education in Kenyase Bosore, and Ghana as a whole.

Investigating the influence of contextual factors in the coordination of chronic mental illness care in a district health system.

BACKGROUND: The global shift from institution-based to community-based care for chronic mental illness (CMI) care resulted in the de-institutionalization of clients with CMI. However, health systems which have been originally designed for acute hospital-based care do not seem to be appropriately transformed to manage CMI care at a community level. AIM: The aim of this study was to investigate how contextual factors influenced care coordination for chronic mental illness care within the eThekwini District. METHODS: This study employed a qualitative multiple case study design with instrumental approach. Maximum variation sampling was used to select five Community Health Centres (CHC's) and 48 health providers who worked with mentally ill clients in the sample CHC's. Framework analysis was used to analyze the results. RESULTS: Inequitably resourced catchment areas, unclear referral systems, high staff turnover, freezing of posts, chronic staff shortage and adverse working conditions contributed to care fragmentation, poor client care and client loss in the system. On the other hand, limited community support systems constituted barriers for client reintegration into society and relapses. CONCLUSION: The study concluded that the eThekwini District health facility settings were not adequately equipped to respond to care coordination demands for chronic mental illness care.