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Evaluation of Adherence to Anti-Retroviral Treatment: Experience of SANRU, DRC
Lukanu Ngwala Philippe,
Izale Kwazimi Bibiche,
Kanku Kalukusa Patrick,
Balanda Musoko Freddy,
Kalonji Ntumba Albert,
Minuku Felix,
Ngoma Miezi Kintaudi Leon,
Ogunbanjo Gboyega Adebola
Issue:
Volume 4, Issue 5, October 2018
Pages:
131-136
Received:
16 August 2018
Accepted:
3 September 2018
Published:
30 September 2018
Abstract: Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Global fund in DRC with around 40000 people living with HIV/AIDS (PLWHIV) receiving ART in 129 health zones in the country. The continuous success of ART critically depends on sustained ART adherence. The objective of this study was to identify the determinants of adherence among PLWHIV in SANRU managed health zones in the Democratic Republic of Congo. Two thousand five hundred eighty-six PLWHIV’s files were extracted. Eighty-two percent (82%) were adherent to ART, while 85. 5% were alive after 12 months on anti-retroviral treatment, 5.2% were lost from follow-up and 2.2% were transferred. The average age was 37 years, and predominantly women formed 65.5% of the sample. The median distance between facilities and patient’s habitat was 5 kms. Close to three-fifth of the PLWHIV were living in urban settings (64.4%). Among 2586 patient’s files retrieved, 2495 (96, 5%) were followed up in facilities with at least an HIV-care trained physician and nurses, 1566 (60.6%) were followed up in facilities with at least one HIV care trained pharmacist; 1645 (63.6%) among the PLWHIV did not report ART stock run-outs. These findings highlight the relevance of healthcare providers’ training on HIV to improve HIV patient outcomes.
Abstract: Access to antiretroviral treatment (ART) has substantially increased in the Democratic Republic of Congo (DRC) over the past 5 years. Santé Rural (SANRU), a non-governmental organization established by l’Eglise de Christ du Congo (Christ’s Church of the Congo) in the 1980s to improve rural health in the DRC, is one of the principal recipients of Gl...
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Pattern of Smartphone Use Among Clinical Medical Students of Bingham University Teaching Hospital, Jos
Maryam Shehu,
Hassan Shehu,
Michael Bundepuun Ode
Issue:
Volume 4, Issue 5, October 2018
Pages:
137-142
Received:
23 August 2018
Accepted:
6 September 2018
Published:
8 October 2018
Abstract: Background: Mobile phones are one of the most common information access devices with almost 31% of the global population having access. Mobile phones are now in the hands of 2 billion people out of the 6.47 billion people on this planet. The knowledge on the pattern of use of mobile phones among students will shed more light on the advantages and disadvantages of the use of mobile phones so as to find ways of channeling the usage into being more beneficial and useful to the students. The aim is to determine the pattern of use of smartphones among clinical medical students in Bingham University Teaching Hospital, Jos. The study was a cross- sectional descriptive study among medical clinical students of BHUTH, Jos. The sampling method was consecutive sampling of all the students until sample size was obtained. A total of 134 questionnaires were distributed and all 134 were duly filled and returned. Results: The analyses of the pattern showed that majority of the students spend more than three hours on their phones per day. The commonest applications in use by the students include; Google play store, word documents and blogging applications. Thirteen (10.2% spends >20 hours) on academic sites, while (6.0% spends > 20hrs) on chatting sites, and (5.7% spends >20hrs) on social networking sites per week. A lot of students put their phone on vibration during lectures and there is a gender difference in the use of mobile phone. About one third of the students use their phones at night and most agreed that it is a form of distraction. The study concludes by recommending seminars on the appropriate use of mobile phone in the university.
Abstract: Background: Mobile phones are one of the most common information access devices with almost 31% of the global population having access. Mobile phones are now in the hands of 2 billion people out of the 6.47 billion people on this planet. The knowledge on the pattern of use of mobile phones among students will shed more light on the advantages and d...
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DRC Is Not Ready for Transition from Anonymous Unlinked Sero-surveillance to Using PMTCT Program Data for HIV Surveillance, According to the WHO Criteria Assessment Results
Jack Hyyombo Tambwe Kokolomami,
John Shungu Okende,
Placide Okitayemba Welo,
Felly Isumeliko Ekofo,
Etienne Mutombo Mpoyi,
Patrick Kalambayi Kayembe
Issue:
Volume 4, Issue 5, October 2018
Pages:
143-148
Received:
28 August 2018
Accepted:
6 September 2018
Published:
10 October 2018
Abstract: Since 2003, the Democratic Republic of Congo (DRC) has carried on HIV surveillance through Anonymous Unlinked Testing in Sentinel Surveillance sites (AUT-SS) amongst pregnant women attending Antenatal Clinics (ANC). However, this expensive process raises ethical limitations. In 2013, the World Health Organization (WHO) recommended countries to evaluate the possibility of transitioning from the AUT-SS to surveillance based on data from the routine diagnosis of HIV in Prevention of Mother-To-Child Transmission (PMTCT) programs. The authors carried out this evaluation for DRC. An evaluation of four of the five criteria proposed by the WHO was conducted by following the defined procedure, and comparing with the determined benchmarks, to assess whether DRC can undergo the transition. Data for this assessment were collected in 2013 and 2015 during sentinel surveillance activities. AUT- SS data of 26,301 pregnant women were collected from 60 sentinel sites, while data from PMTCT routine testing were available for 12,291 women. The overall rate of agreement between routine PMTCT and AUT-SS test results (Cohen's Kappa coefficient of agreement) was 0.7% (95% CI: 0.65 - 0.76%), the proportion of positive agreement (PPA) was 65.7% (95% CI: 59.8%-71.1%), and the proportion of negative agreement (PNA) was 99.5% (95% CI: 99.4%-99.7%). The level of non-consent bias in the routine screening test was 4.8%, with a ratio of difference in prevalence of 1 to 10. Eighty-three per cent of sentinel surveillance sites also offered PMTCT service, which was discontinued for 34% of them. DRC must still strengthen the robustness of routine HIV testing, the overall rate of access to this test, its permanence/regularity, and the quality of the data collected in routine, before claiming to use the data from the PMTCT program for purposes of HIV surveillance, in lieu of the ANC AUT- SS.
Abstract: Since 2003, the Democratic Republic of Congo (DRC) has carried on HIV surveillance through Anonymous Unlinked Testing in Sentinel Surveillance sites (AUT-SS) amongst pregnant women attending Antenatal Clinics (ANC). However, this expensive process raises ethical limitations. In 2013, the World Health Organization (WHO) recommended countries to eval...
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Magnitude of Anemia and Associated Factors Among Pregnant Women Visiting Public Health Institutions for Antenatal Care Services in Adama Town, Ethiopia
Ebrahim Mohammed,
Ephrem Mannekulih,
Mayrema Abdo
Issue:
Volume 4, Issue 5, October 2018
Pages:
149-158
Received:
13 August 2018
Accepted:
10 October 2018
Published:
25 October 2018
Abstract: Anemia is a global public health problem. It affects more than 2 billion people worldwide, both in developing and developed countries. It affects people of all age groups. However, it is more prominent in pregnant women. It is estimated that approximately 41.8% of pregnant women worldwide affected by anemia. Institution based cross sectional study design was employed. A total of 424 pregnant women visiting public Health Institutions in Adama Town for Antenatal Care service was randomly selected. Data was collected using semi structured questioner and participants were interviewed at the exit of the Antenatal Care unit. Blood and stool sample was collected to determine the level of anemia and Middle Upper Arm Circumference measurement was measured to determine nutritional status of the mother. Data was entered into EPI-Info version 7 and imported into Statistical Package and Service Solution (SPSS) version 21 for data processing and analysis. Descriptive statistics were used to explore the characteristics of women and the magnitude of anemia. The association between the outcome variable (Anemia) and explanatory variable was analyzed using binary logistic regression. The effect of explanatory variable on Anemia was estimated using adjusted odds ratio (AOR) and 95% confidence interval was used for tests of significance. A total of 424 respondents participated in the study. The magnitude of Anemia was found to be 28.1% (P=28.1; 95% CI: 23.6, 32.1). The highest level of anemia 79 (37.3%) and 14 (31.1%) was observed among women of age 25 – 34 years old and third trimester respectively. Birth interval of more than 2 years (AOR, 0.29; 95% CI: 0.13, 0.63), Nutritional status of MUAC < 23 cm (AOR, 8.91; 95% CI: 3.95, 20.11), taking tea (AOR, 5.49; 95% CI: 2.16, 13.96) and taking coca cola or chocolate (AOR, 6.81; 95% CI: 2.01, 23.12) and taking stimulant within 30 minutes after taking meal (AOR, 3.64; 96% CI: 1.47, 8.99) found to be significantly associated with the odds of having anemia during pregnancy. Magnitude of anemia is high (28.1%) among pregnant women in Adama Town. Respondents’ birth interval, nutritional status, type of stimulant and time of stimulant taking were found to be significantly associated to anemia in pregnant women. Health works should work on counseling of benefits of lengthening birth interval and delaying of taking stimulants after taking their meals.
Abstract: Anemia is a global public health problem. It affects more than 2 billion people worldwide, both in developing and developed countries. It affects people of all age groups. However, it is more prominent in pregnant women. It is estimated that approximately 41.8% of pregnant women worldwide affected by anemia. Institution based cross sectional study ...
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An Assessment of Level of Compliance with Smoke-Free Provision of the Tobacco Control Act 2007 in Licensed Liquor Establishments in Nakuru County, Kenya
Josephine Githaiga,
Mutuku A. Mwanthi,
Tom Olewe
Issue:
Volume 4, Issue 5, October 2018
Pages:
159-167
Received:
10 September 2018
Accepted:
4 October 2018
Published:
30 October 2018
Abstract: The study sought to assess the level of compliance with smoke-free environment provisions of the Tobacco Control Act, 2007 in licensed liquor establishments in Nakuru East sub-County. This was a descriptive cross-sectional study. The target population consisted of 264 licensed liquor establishments in Nakuru East Sub County. Quantitative data were collected using structured questionnaire and observational checklist. The independent variables were awareness of Smoke-Free Environment provisions of TCA, 2007, awareness about health impacts of SHS and type of licensed liquor establishment. The dependent variable was the level of compliance with SFE provisions of TCA, 2007. The data was analyzed using Statistical Package for Social Science (SPSS) version 23. Measures of strength of association between the independent and dependent variables were evaluated using the Pearson’s chi-square test. Ninety-six point three percent of the licensed liquor establishments allowed smoking within their premises. Presence of ‘no smoking' sign displayed in non-designated smoking areas within the premise was found to be in (42.0% (21) restaurants, 50.0% (4) nightclubs and 57.7% (45) bars). Very few licensed liquor establishments were compliant with the SFE provisions of TCA, 2007 that require the signs to be written in both English and Swahili only 9.1% (2) of restaurants complied with no bar or nightclub complying. For the provision that penalty should be indicated in the sign, only a few (2.6% (1) bars, none in nightclubs and restaurants) establishments had met the requirement of the provision. Majority of the licensed liquor establishments had designated smoking area (66% (33) restaurants, 75% (6) nightclubs and 45.1% (42) bars). Fifty-four percent (73) of the owners and/or managers were aware of the provisions of the TCA, 2007. Employees accessed designated smoking area (80% (28) restaurants, 66.7% (4) nightclubs and 100% bars (42) while smoking was ongoing. Challenges to compliance of the TCA, 2007 were found to be the fear of losing clients, use of abusive language in the premises and lack of proper implementation of the policy. Conclusion and recommendations: The level of awareness is high but compliance with TCA, 2007 is low. Based on the findings of the study, recommendations are made that; owners and managers of licensed liquor establishments should attend training organized by the government to improve their understanding of TCA, 2007 and be made aware of the penalty for contravention of the provisions of the act.
Abstract: The study sought to assess the level of compliance with smoke-free environment provisions of the Tobacco Control Act, 2007 in licensed liquor establishments in Nakuru East sub-County. This was a descriptive cross-sectional study. The target population consisted of 264 licensed liquor establishments in Nakuru East Sub County. Quantitative data were ...
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