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Frequency and Determinants of Prescribing Antibiotics for Internal Medicine at Donka National Hospital (Guinea)
Salifou Talassone Bangoura,
Abdoulaye Toure,
Sidikiba Sidibé,
Alioune Camara,
Djibril Sylla,
Alpha-Kabinet Keita,
Mamadou Saliou Sow,
Alimou Camara,
Mamadou Saliou Kalifa Diallo,
Mohamed Cisse
Issue:
Volume 6, Issue 1, February 2020
Pages:
1-4
Received:
21 November 2019
Accepted:
17 December 2019
Published:
6 January 2020
Abstract: Background: In hospitals, antibiotics are one of the most prescribed drug classes. The purpose of this study was to describe the extent and factors associated with the prescription of antibiotics in the Internal Medicine Department of Donka National Hospital. Material and Methods: A cross-sectional study was conducted from July 30, 2018 to January 31, 2019 among prescribers and patients hospitalized or seen on an outpatient basis. Data were collected by direct interview and through patient records. A multivariate logistic regression was performed to identify the factors associated with antibiotic prescribing. Results: Out of a total of 400 consultants, 82 (21%) patients received antibiotic therapy. Beta-lactam antibiotics were the most prescribed antibiotic (45%) and urogenital infections (24.3%) were the most common indication. In univariate analysis, the consultation by a trainee physician [OR = 3.06 (95% CI: 1.56-6)] was associated with a prescription for antibiotics. Students/students [OR = 1.85 (95% CI: 1.01-3.39)], civil servants [OR = 1.82 (95% CI: 1.02-3.26)], patients residing in Conakry [OR = 2.06 (95% CI: 1.08-3.91)], those hospitalized [OR = 3.16 (95% CI: 1.55-6.46)] and those with a fever [OR = 6.49 (95% CI: 3.84-10.96)] were more likely to receive an antibiotic. Only fever [OR adjusted = 4.30 (95% CI: 2.43-7.61)] remained associated with the prescription of antibiotics in multivariate analysis. Conclusion: The results showed that fever was the factor independently associated with the antibiotic prescription. In a country where malaria is the main cause of fever, the results suggest the need for training health care workers in antibiotic prescribing.
Abstract: Background: In hospitals, antibiotics are one of the most prescribed drug classes. The purpose of this study was to describe the extent and factors associated with the prescription of antibiotics in the Internal Medicine Department of Donka National Hospital. Material and Methods: A cross-sectional study was conducted from July 30, 2018 to January ...
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Dyslipidaemia and Its Correlates Among People Living with Human Immunodeficiency Virus in Yenagoa, Southern Nigeria
Bountain Welcome Tebeda,
Hannah Odunola Dada-Adegbola,
Aishat Bukola Usman,
Muhammad Shakir Balogun,
Olufunmilayo Ibitola Fawole
Issue:
Volume 6, Issue 1, February 2020
Pages:
5-12
Received:
7 December 2019
Accepted:
20 December 2019
Published:
6 January 2020
Abstract: People living with HIV/AIDS (PLWHA) are at risk of cardiovascular disease (CVD) morbidity and mortality linked to dyslipidaemia because of plasma lipids alterations. Understanding the magnitude of dyslipidaemia and its correlates is essential for the CVD risk reduction in this population. We conducted this study to determine the prevalence and types of dyslipidaemia, sociodemographic, lifestyle characteristics and selected comorbidities among PLWHA in Yenagoa, Southern Nigeria. This is a cross-sectional study among 278 PLWHA, aged 18 years and above receiving the HIV-laboratory services of the Federal Medical Centre, Yenagoa from March through April 2017. We collected respondents’ sociodemographic data, lifestyle characteristics and selected comorbidities using an interviewer-administered, semi-structured questionnaire adapted from the WHO STEPS instrument. We collected venous blood and assayed for Total Cholesterol (TC), Triglycerides (TG), and High-Density Lipoprotein Cholesterol (HDL-C) using Selectra ProS Chemistry Analyzer and calculated Low-Density Lipoprotein Cholesterol (LDL-C) with Friedewald formula. We measured height and weight and calculated for body mass index, and retrieved CD4+ T-cell count results from the HIV-laboratory workbook. We analyzed the data with Epi Info 7.2 and did a multivariable logistic regression analysis to identify factors associated with dyslipidaemia at 95% confidence level. Respondents mean age was 40.0±8.8 years, 104 (37.4%) were aged 35-44 years, 192 (69.1%) were females and 152 (54.7%) were married or living with a partner. The prevalence of dyslipidaemia was 48.6%. Seventy-six (27.3%) of the respondents had decreased HDL-C as the most prevalent type of dyslipidaemia. Those engaged in harmful alcohol intake were 26 (9.4%), smokers 28 (10.1%), hypertensive 52 (18.7%) while 244 (87.8%) were on antiretroviral therapy. Predictors of dyslipidaemia were age 45-64 years [AOR=2.43 (95%CI: 1.20-4.92)], being married or living with a partner [AOR=1.72 (95%CI: 1.01-2.91)] and being physically inactive and overweight or obese [POR=5.71 (95%CI: 1.76-18.51)]. This study showed that dyslipidaemia was common among the PLWHA in Yenagoa, Nigeria, with decreased HDL-C as the most prevalent type. Being older than 45 years, married or living with a partner or being physically inactive and overweight or obese appears to be the major predictors of dyslipidaemia. There is a need to sustain the lifestyle counselling and laboratory monitoring of lipids among the PLWHA in Yenagoa, Southern Nigeria.
Abstract: People living with HIV/AIDS (PLWHA) are at risk of cardiovascular disease (CVD) morbidity and mortality linked to dyslipidaemia because of plasma lipids alterations. Understanding the magnitude of dyslipidaemia and its correlates is essential for the CVD risk reduction in this population. We conducted this study to determine the prevalence and type...
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Challenges in Implementation of Infection Prevention and Control Measures During the Tenth Ebola Virus Disease in Northeastern of DRC, in 2019
Paul Mansiangi Mankadi,
Aimee Lulebo Mampasi,
Guillaume Kiyombo Mbela,
Jean-Claude Makenga Bof,
Jean Nyandwe,
Jack Hyyombo Tambwe Kokolomami
Issue:
Volume 6, Issue 1, February 2020
Pages:
13-17
Received:
24 October 2019
Accepted:
19 December 2019
Published:
7 January 2020
Abstract: Health Workers (HWs) are most likely to be infected by the Ebola virus disease (EVD) through mainly nosocomial transmission because they treat patients with EVD; this occurs through close contact with patients when infection prevention and control (IPC) measures are not strictly practiced. This study aimed to assess the level of implementation of infection prevention and control measures as well as challenges in their implementation in the north-eastern region of the Democratic Republic of the Congo (DRC). A mixed study was carried out in northeastern of DRC in August 2019. In-depth interviews were conducted with 16 HCW in front-line and with a member of the national coordination team. The quantitative part was focused on the review of the reports of the commission for the prevention and control of infections. Interviews were audiorecorded and transcribed verbatim in Swahili before being translated in French and in English. The IPC packages were implemented in the health Facilities and in the community. We noticed a high proportion of realization of the IPC planned activities. All HCWs interviewed declared to have been trained on IPC and supported with materials and equipment for implementation. Cultural and traditional views of community have been mentioned as the community related factor which impact negatively in IPC implementation by the HCWs. Non-compliance with IPC measures by HCWs has been also mentioned added with the non viability of healthcare facilities. It is urgent to improve communication of importance to comply with IPC measures in community but also among HCWs. Also, Infrastructure of Health Care Facility must be strengthened.
Abstract: Health Workers (HWs) are most likely to be infected by the Ebola virus disease (EVD) through mainly nosocomial transmission because they treat patients with EVD; this occurs through close contact with patients when infection prevention and control (IPC) measures are not strictly practiced. This study aimed to assess the level of implementation of i...
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Declaration of Blood Sugar Levels with Black Raw and Binahong Leaves in Mencit (Mus musululus)
Eni Sumarliyah,
Dede Nasrullah,
Mahardika Putra Tri Utama
Issue:
Volume 6, Issue 1, February 2020
Pages:
18-22
Received:
18 December 2019
Accepted:
4 January 2020
Published:
13 January 2020
Abstract: Diabetes mellitus is a disease marked by an increase in blood sugar levels. At present many sufferers of Diabetes Mellitus whose blood sugar levels are not controlled so that it can cause complications. The purpose of this study was to reduce blood sugar levels with black onion extract and binahong leaf extract on mice (mus musculus). This study uses a Quasy Experimental design with One Group pre-posttest. Samples were taken A total of 32 mice consisted of 16 in the intervention group and the comparison intervention group. The independent variables in this study were black onion extract and binahong leaf extract, while the dependent variable was the blood sugar level of mice. Data were collected by observation sheets and analyzed using Kolmogorov-Smirnov and Independent sample T-tests. The results of this study showed that the difference between pre and post-reduction of black onion extract was 66.4 mg/dl and the difference between pre and post administration of binahong leaf extract was 66.2 mg/dl. While the analysis shows the value of p = value 0.985. The results of this study indicate that extracts of black garlic and binahong leaves are equally effective in reducing blood sugar levels and that there are no significant differences in reducing blood sugar levels in mice. Thus both the black onion extract and the binahong leaf are equally effective in reducing blood sugar levels.
Abstract: Diabetes mellitus is a disease marked by an increase in blood sugar levels. At present many sufferers of Diabetes Mellitus whose blood sugar levels are not controlled so that it can cause complications. The purpose of this study was to reduce blood sugar levels with black onion extract and binahong leaf extract on mice (mus musculus). This study us...
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Risk Score to Predict Time-to Sputum Smear and Culture Conversions in Patients Treated with Shorter MDR Tuberculosis Regime in Guinea: A Retrospective Cohort Study
Boubacar Djelo Diallo,
Alhassane Diallo,
Lansana Mady Camar,
Gladys Djuiga Fotso,
Souleymane Camara,
Boubacar Bah,
Magassouba Aboubacar Sidiki,
Alpha Oumar Barry,
Thierno Hassane Diallo,
Camara Aboubacar,
Néné Mamata Bah,
Fulgence N’Zabintawali,
Souleymane Hassane Haroune,
Oumou Younoussa Sow
Issue:
Volume 6, Issue 1, February 2020
Pages:
23-32
Received:
20 December 2019
Accepted:
4 January 2020
Published:
13 January 2020
Abstract: Background: Sputum smear and culture examination were used as bacteriological marker to monitor multidrug-resistant tuberculosis (MDR-TB) treatment. We aimed to identify the strongest contributing factors that affect time-to sputum bacteriological conversion, and to develop a practical risk score. Methods: Patients treated with shorter MDR-TB treatment regime between June 07, 2016 and June 22, 2018 from three major drug-resistance TB centres in Guinea, who had a positive smear or culture at baseline, and who had rifampicin resistance were analysed. Sputum bacteriological conversion was defined as two consecutive negative smear or culture taken at least 30 days apart. Cox regression model was used to analyse time-to initial sputum conversion, and to identify influencing factors. A simple risk score was constructed using the regression coefficients from each final model. Time-dependent AUC was used to determine the optimal time points of bacteriological conversion. Results: 75% (173/232) of patients with a positive smear and culture at baseline were analyzed. A total, 90.2% (156/173) and 89% (154/173) of the patients had smear and culture conversions in a median of 59 days (inter-quartile range: 59–61) respectively. Lower colony count (<3 +) of initial culture (aHR=1.52, 1.09–2.14) and previously history of TB treatment (aHR=2.10, 1.26–3.51) were more likely to have culture conversion, while only the higher BMI (aHR=1.10, 1.03–1.18) was associated with rapid smear conversion. The predicted risk score from independent predictors showed good discrimination (0.855±0.023 and 0.883±0.02 respectively for smear and culture conversions). Time-to initial culture conversion provided a better discriminative capacity (AUC) to detect patients with higher chance to being treatment success during the first three months. Conclusion: The identified predictors can be considered to improve the management of MDR-TB patients. The optimal time points for culture conversion was three months in shorter regime.
Abstract: Background: Sputum smear and culture examination were used as bacteriological marker to monitor multidrug-resistant tuberculosis (MDR-TB) treatment. We aimed to identify the strongest contributing factors that affect time-to sputum bacteriological conversion, and to develop a practical risk score. Methods: Patients treated with shorter MDR-TB treat...
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Development of a Prognosis Nomogram of Treatment Outcomes for MDR-tuberculosis in Guinea (Conakry): A Retrospective Cohort Analysis
Boubacar Djelo Diallo,
Alhassane Diallo,
Lansana Mady Camara,
Mafouné Diallo,
Souleymane Camara,
Boubacar Bah,
Magassouba Aboubacar Sidiki,
Alpha Oumar Barry,
Thierno Hassane Diallo,
Oumou Younoussa Sow
Issue:
Volume 6, Issue 1, February 2020
Pages:
33-41
Received:
18 December 2019
Accepted:
2 January 2020
Published:
16 January 2020
Abstract: Despite the availability of the drug treatment for tuberculosis (TB) more than 75 years, mortality and drug resistance are increasing. Therefore, little data is available in Guinea. We aimed to develop and validate a prognosis nomogram of MDR-TB treatment outcomes. A retrospective cohort study was conducted among men and women, aged 18 years or older, with MDR-TB, from three major drug-resistance TB centres in Guinea. We used the logistic regression to analyse treatment outcomes. Prognostic factors with a p value less than 0.05 from a multivariate model were used to build nomogram and assessed their performance based on discriminative c-index, and calibration using the Hosmer-Lemeshow (H-L) test. To derive the optimal cut-off point score, the Youden’s index method was used. Among 232 patients with MDR-TB enrolled and followed between June 07, 2016 and June 22, 2018, 218 were analyzed. All patients were resistant to rifampicin, which diagnosed by the Xpert MTB/RIF. The overall rate of success was 73%. Factors associated with successful treatment in drug-resistant TB patients were higher BMI more than 18.5 kg/m2 (p = 0.0253; aOR = 2.94), good adherence to treatment (p = < 0.0001; aOR = 33.92), normal platelets count (p = 0.0053; OR = 1.004), and the absence of clinical symptoms such as chest pain (p = 0.0083; aOR = 3.19) and depression (p = 0.0308; aOR = 8.62). The discrimination (c-index = 0.848 [95% bootstrap CI, 0.780 – 0.916] in the derivation sample and 0.803 after correction for optimism) and calibration (H-LX2 = 2.91 [p = 0.94]) were good. The optimal absolute risk threshold was 20%, corresponding to a sensibility of 95% and specificity of 58%. Treatment success outcomes was lower than those recommended by the World Health Organization (75%). We recommend to improve the MDR-TB patient monitoring during treatment, nutritional status, and considering the psychological state. Our prognosis nomogram needs to be validated in an external population before it can be used in clinical practice.
Abstract: Despite the availability of the drug treatment for tuberculosis (TB) more than 75 years, mortality and drug resistance are increasing. Therefore, little data is available in Guinea. We aimed to develop and validate a prognosis nomogram of MDR-TB treatment outcomes. A retrospective cohort study was conducted among men and women, aged 18 years or old...
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Study of the Determinants of Food Diversification Among Pregnant Women in the Dakar Region in 2017 - Senegal
Maty Diagne Camara,
Oumar Bassoum,
Cheikh Tacko Diop,
Thérésa Foucko Moko,
Mamadou Makhtar Mbacké Leye,
Mayacine Ndiongue,
Jean Augustin Diégane Tine,
Khadim Niang,
Adama Faye
Issue:
Volume 6, Issue 1, February 2020
Pages:
42-47
Received:
2 January 2020
Accepted:
16 January 2020
Published:
21 January 2020
Abstract: As part of the prevention of nutritional deficiencies in pregnant women, the objective of the study is to identify the determinants of food diversity in pregnant women in the Dakar region. Cross-sectional survey in a three-stage cluster design. Two health districts in the Dakar region were randomly selected from urban and peri-urban areas. All pregnant women in the health centers were surveyed until the sample size was obtained. The data collected are socio-demographic, economic, pregnancy-related factors, practices and knowledge about nutrition and food groups consumed the day before the survey. A bivariate analysis was done using R software. Relevant covariables were included in the linear regression analysis to identify the factors associated with food diversity. A total of 300 pregnant women were surveyed in two different health districts, one in urban and one in peri-urban areas. The average age of women varies between 16 and 45 years with an average of 28.02 years, with a standard deviation of 5.4 years. The average dietary diversity score was 5.47, with a standard deviation of 1.24. Women aged 16 to 19 had the highest food diversity score of 6.12 (±1.54) with a β=-1.14 [-1.8; -0.48]. This score is lower in urban areas (CS Gaspard Camara) 5.28 than in peri-urban areas (CS Mbao) 5.67, β=0.39 [0.12; 0.67]. Women with three or more children had a more diversified diet with β=0.56 [0.12; 0.67]. The income of the head of household is decisive for the diversification of pregnant women with β=0.79 [0.24; 1.35]. The dietary knowledge and practices related to dietary diversity of pregnant women was the consumption of mineral water β=0.27 [0.001; 0.5].
Abstract: As part of the prevention of nutritional deficiencies in pregnant women, the objective of the study is to identify the determinants of food diversity in pregnant women in the Dakar region. Cross-sectional survey in a three-stage cluster design. Two health districts in the Dakar region were randomly selected from urban and peri-urban areas. All preg...
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Assessing the Effects of Alcohol Consumption on the Work Performance of Teachers in the Builsa North District of the Upper East Region of Ghana
Akum-Yeri Whittaker Ayom-Bil Robert,
Der Muonir Edmund
Issue:
Volume 6, Issue 1, February 2020
Pages:
48-54
Received:
7 December 2019
Accepted:
19 December 2019
Published:
10 February 2020
Abstract: Background: Alcohol consumption by teachers may impede or reduce productivity and cause lost for employers. The aim of the study was to ascertain the alcohol consumption patterns of teachers in the Builsa north district and the effects on work performance. Material and methods: This was a cross-sectional descriptive study. Data were analysed using SPSS software (version 21.0). Associations determined using Fisher’s exact test. Results: Ninety-nine teachers who consume alcohol were interviewed, with mean age of 33.5±6.1 years. Majority were males (3:1 ratio, p<0.0005). The great majority (83.8%, P<0.0001) were trained; with (66.7%) being University graduates. Approximately 99.0% (P<0.0001) had friends who drink alcohol, and 86 (86.9%) drink alcohol with their friends. Alcohol intake was found to affect a person’s social life (91.9%), family obligations, (97.0%) and finances (93.9%). Approximately 86.9% (P<0.0001) agreed alcohol intake is a problem among teachers. Many (63.6%) of the teachers take in alcohol every day, and approximately 80.8% have been drinking over one year. About 23.2% drink anytime during the day, while 33.0% spending one or hours in a spot. The reasons for alcohol intake among teachers were: socialisation (46.5%), relaxation (31.3%) and to forget problems (21.2%). The negative effects of alcohol intake on productivity were; hangover whiles at work (73.7%), absenteeism (88.9%), missing lessons in school due to time spent at spots (84.9%) and inability to complete syllabus (74.7%). Conclusion: The study concluded that teachers’ alcohol consumption affects their work performance greatly in the Builsa North District.
Abstract: Background: Alcohol consumption by teachers may impede or reduce productivity and cause lost for employers. The aim of the study was to ascertain the alcohol consumption patterns of teachers in the Builsa north district and the effects on work performance. Material and methods: This was a cross-sectional descriptive study. Data were analysed using ...
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