The Diagnosis of Extrapulmonary Tuberculosis in Malawi

2003 ◽  
Vol 33 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Anthony D Harries ◽  
Nicola J Hargreaves ◽  
John H Kwanjana ◽  
Felix M Salaniponi
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Smear Microscopy ◽  
Cross Sectional ◽  
Extra Pulmonary Tuberculosis ◽  
Diagnostic Practices ◽  
Hospital Resources ◽  
Sub Saharan ◽  
Made In

There is little information on a country-wide basis in sub-Saharan Africa about how the diagnosis of extra-pulmonary tuberculosis (EPTB) is made. A country-wide cross-sectional study was carried out in 40 non-private hospitals in Malawi which register and treat (TB) patients in order to assess diagnostic practices in adults registered with EPTB. All patients aged 15 years and above in hospital on treatment for EPTB were reviewed using TB registers, case note files and clinical assessment. There were 244 patients, 132 men and 112 women whose mean age was 36 years. In 138 (57%) patients, all appropriate procedures and investigations, commensurate with hospital resources, had been carried out. Of 171 EPTB patients with cough for 3 weeks or longer, 138 (81%) submitted sputum specimens for smear microscopy of acid-fast bacilli (AFB). A confirmed diagnosis of TB was made in 15 (6%) patients based on finding AFB or caseating granulomas in specimens. In 157 (64%) patients, the diagnosis of EPTB was considered to be correct. In 46 (19%) patients the diagnosis was considered to be TB, although different from the type of EPTB with which the patient was registered. In 39 (16%) patients an alternative non-TB diagnosis was made and in two (1%) patients it was not possible to make a decision. Diagnostic practices need to be improved, and ways of doing this are discussed.

scholarly journals Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045992
Author(s):  
Eugene Budu ◽  
Bright Opoku Ahinkorah ◽  
Richard Gyan Aboagye ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Abdul-Aziz Seidu ◽  
...  
Keyword(s):  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Childhood Vaccination ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Sectional Study ◽  
Maternal Healthcare ◽  
Cross Sectional ◽  
Sub Saharan

ObjectiveThe objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.DesignOur study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.ParticipantsA total of 60 964 mothers of children aged 11–23 months were included in the study.Outcome variablesThe main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).ResultsThe average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.ConclusionThe study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.

scholarly journals Unravelling the Perspectives of Day and Night Traders in Selected Markets within a Sub-Saharan African City with a Malaria Knowledge, Attitude and Practice Survey

2021 ◽  
Vol 18 (7) ◽  
pp. 3468
Author(s):  
Patience B. Tetteh-Quarcoo ◽  
Nicholas T. K. D. Dayie ◽  
Kevin Kofi Adutwum-Ofosu ◽  
John Ahenkorah ◽  
Emmanuel Afutu ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
African City ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Treatment Type ◽  
Significant Difference ◽  
High Knowledge ◽  
Sub Saharan

Background: Malaria is still endemic in sub-Saharan Africa, with a high disease burden. Misconceptions about malaria contribute to poor attitudes and practices, further increasing the burden in endemic countries. Studies have examined the knowledge, attitudes, and practices (KAP) of malaria among different populations. However, there seems to be no available literature reporting on the perspectives of day and night market traders. To the best of our knowledge, this is the first report on malaria KAP with a focus on day and night market traders. Methods: A descriptive cross-sectional study involving day and night market traders in 10 selected markets within the Greater Accra Region of Ghana was carried out. Data were collected from consenting respondents using a structured questionnaire. Results: Of the 760 respondents (33.3% (n = 253) night and 66.7% (n = 507) day traders) interviewed, there was no significant difference between the day and night market traders in terms of malaria KAP. Although the market traders had an overall moderate knowledge (54.0% of the day traders and 56.5% of the night traders), misconceptions about malaria (especially that it could be caused by exposure to the sun) still existed among the traders. Moreover, the majority of the traders who demonstrated high knowledge (43.98%, n = 250) did not always take laboratory tests to confirm their suspicion, indicating poor attitude. Furthermore, the market traders’ choice of drug for malaria treatment (p = 0.001) and preferred malaria treatment type (orthodox or herbal) (p = 0.005) were significantly associated with their knowledge level. Conclusions: Despite the observation that no significant difference in KAP exists between day and night market traders, appropriate health education programs and interventions still need to be directed at misconceptions, poor attitudes, and poor practices revealed by this study. This will ultimately help in the prevention and control of malaria in Ghana, and globally.

scholarly journals Predictors of HIV Testing among Youth in Sub-Saharan Africa: A Cross-Sectional Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (10) ◽  
pp. e0164052 ◽  
Author(s):  
Ibitola O. Asaolu ◽  
Jayleen K. Gunn ◽  
Katherine E. Center ◽  
Mary P. Koss ◽  
Juliet I. Iwelunmor ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

scholarly journals Prevalence of Anemia and Undernutrition of Adolescent Females in Selected Schools in Ghana

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Aferiba Tandoh ◽  
Abigail Owusuaa Appiah ◽  
Anthony Kwaku Edusei
Keyword(s):  
Public Health Problem ◽  
Cross Sectional Study ◽  
Adolescent Females ◽  
Sub Saharan Africa ◽  
Health And Wellness ◽  
Cross Sectional ◽  
High Prevalence ◽  
Sub Saharan ◽  
Poor Nutrition ◽  
Prevalence Of Anemia

Anemia among adolescent females is a major worldwide public health problem which should be given appropriate attention. Half of all anemic cases are caused by iron deficiency. In addition to anemia, poor nutrition is also a challenge in sub-Saharan Africa. This study determined the prevalence of anemia and undernutrition among adolescent females in school. A cross-sectional study was conducted among 151 adolescent females in four basic schools in the Ahafo region of Ghana. The hemoglobin level and anthropometry measures of participants were taken to determine their anemic and nutritional status. The prevalence of anemia among adolescent females in school was 50.3%. Out of the 151 participants, 6.6%, 19.9%, and 23.8% were severely anemic, moderately anemic, or mildly anemic, respectively. Only 2% of the participants were underweight, but the rate of stunting was 26.5%. The notable high prevalence of anemia that was found among adolescent females was correlated with other health and wellness concerns. Anemia and under nutrition negatively affect academic performance, productivity, and general wellbeing of adolescents; therefore, effective measures should be put in place to correct and eradicate these nutritional problems.

scholarly journals Attitudes towards early marriage and related factors among adolescent girls in Ethiopia

2019 ◽  
Author(s):  
Hanna Gulema ◽  
Ayah Hamdan ◽  
Jessica Gingles ◽  
Lauren E. Friedman ◽  
Bizu Gelaye ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Early Marriage ◽  
Final Decision ◽  
Related Factors ◽  
Cross Sectional ◽  
Decision Making Processes ◽  
Sub Saharan ◽  
Structured Questionnaire

Abstract Background Early marriage, although it remains a common practice in sub-Saharan Africa, has detrimental effects on women’s sexual and reproductive health, social networks, and educational attainment. We sought to investigate the association between attitudes towards early marriage and marital status among adolescent girls in Ethiopia. Methods A cross-sectional study was conducted among 3,013 adolescent girls aged 13-17 years of age, living in four districts of the Oromia region of Ethiopia. Sociodemographic characteristics and were participants’ attitudes towards early marriage were measured using a pre-tested structured questionnaire. Results The prevalence of early marriage among adolescent girls was 8.3% and approximately 87.0% of girls had an overall positive attitude towards early marriage. Compared to adolescent girls who were unmarried, those who were married or living with a partner were less likely to believe they should have a say whether they want to marry or not (OR=0.32; 95%CI: 0.18-0.57), believe they should get to decide when to marry (OR=0.52; 0.31-0.88), and believe they should have the final decision over the decision to marry (OR=0.48; 0.32-0.73). Conclusions Interventions to prevent early marriage should strengthen women decision-making processes and promote women’s agency.

scholarly journals High residual prevalence of vaccine-serotypeStreptococcus pneumoniaecarriage after introduction of a pneumococcal conjugate vaccine in Malawi: a prospective serial cross-sectional study

2018 ◽  
Author(s):  
Todd D. Swarthout ◽  
Claudio Fronterre ◽  
José Lourenço ◽  
Uri Obolski ◽  
Andrea Gori ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Relative Reduction ◽  
Cross Sectional ◽  
Rigorous Evaluation ◽  
Pneumococcal Carriage ◽  
Sub Saharan ◽  
Induced Immunity ◽  
Indirect Protection ◽  
Carriage Prevalence

ABSTRACTBackgroundThere are concerns that pneumococcal conjugate vaccines (PCV) in sub-Saharan Africa sub-optimally interrupt vaccine-serotype (VT) carriage and transmission, thus limiting vaccine-induced direct and indirect protection. We assessed carriage in vaccinated children and unvaccinated populations targeted for indirect protection, between 4 and 7 years after Malawi’s November 2011 introduction of PCV13 using a 3+0 schedule.MethodsWe conducted sequential prospective nasopharyngeal carriage surveys between 2015 and 2018 among healthy PCV-vaccinated and PCV-unvaccinated children, and HIV-infected adults. VT and NVT carriage risk by age was analysed by non-linear regression.ResultsAmong PCV-vaccinated children, there was a 24% relative reduction in carriage, from a mean 21.1% to 16.1%; 45% reduction among older PCV-unvaccinated children, from 27.5% to 15.2%; 41.4% reduction among adults, from 15.2% to 8.9%. Using carriage data from children 3.6 to 10 years of age, VT carriage probability declined with age, with a similar prevalence half-life among PCV-vaccinated (3.34 years) and PCV-unvaccinated (3.26 years) children.ConclusionCompared to high-income settings, the 3+0 schedule in Malawi has led to a sub-optimal reduction in pneumococcal carriage prevalence. This is likely due to recolonisation of vaccinated children with waning vaccine-induced immunity, resulting in insufficient indirect protection of unvaccinated populations. Rigorous evaluation of strategies to augment vaccine-induced control of carriage, including alternative schedules and catch-up campaigns is required.

scholarly journals High-Prevalence Stunting in Preschool Children (1–5 Years) Attending Selected Health Centers in a Food Rich Area-Bushenyi District Southwestern Uganda

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Douglas Mugarura ◽  
Herbert Izo Ninsiima ◽  
Hellen Kinyi ◽  
Ejike Daniel Eze ◽  
Sam Tumwesigire ◽  
...  
Keyword(s):  
Preschool Children ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Sub Saharan Africa ◽  
Cross Sectional ◽  
High Prevalence ◽  
Development Goals ◽  
Chronic Undernutrition ◽  
Sub Saharan

The prevalence of stunting among children in Uganda and Sub-Saharan Africa is still high, and if Uganda is to achieve the food-related Sustainable Development Goals (SDGs), it must urgently invest in improving nutrition and sanitation. In a food rich area like Bushenyi, chronic undernutrition could be due to several other factors than mere scarcity of food. The Objective(s). This study was carried out to determine the prevalence and socioclinical factors responsible for chronic undernutrition (stunting) among preschool children aged 1–5 years in selected Health facilities in Bushenyi district. Methodology. This was a cross-sectional study assessing the prevalence of stunting and its associated factors among children aged 1–5 years attending selected health centers in Bushenyi District. Data was collected using a pretested questionnaire, taking anthropometric measurements (height/length), and stool analysis for eggs of soil-transmitted helminthes. Prevalence of stunting was presented as percentages. Logistic regression with adjusted prevalence ratio was performed to test the association between the sociodemographic and clinical factors and stunting at bivariate levels of analysis. Results. Most of the children were female, with a median age of 2.1 years and resided in semiurban areas of Bushenyi with their parents. Prevalence of stunting was 89.3%. Only 10.7% of the children were infested with soil-transmitted helminthes. Children likely to be stunted were those who drank unboiled water and were exclusively breastfed. Conclusion. There is a high prevalence of chronic malnutrition in Bushenyi district associated with parents’/care takers’ low level of knowledge.

scholarly journals Validity of four clinical prediction scores for pulmonary embolism in a sub-Saharan African setting: a protocol for a Cameroonian multicentre cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031322
Author(s):  
Agnès Esiéné ◽  
Paul Owono Etoundi ◽  
Joel Noutakdie Tochie ◽  
Junette Arlette Mbengono Metogo ◽  
Jacqueline Ze Minkande
Keyword(s):  
Pulmonary Embolism ◽  
Emergency Departments ◽  
Diagnostic Performance ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Receiver Operating Curve ◽  
Clinical Prediction ◽  
Sectional Study ◽  
Cross Sectional ◽  
Sub Saharan

IntroductionPulmonary embolism poses one of the most challenging diagnoses in medicine. Resolving these diagnostic difficulties is more crucial in emergency departments where fast and accurate decisions are needed for a life-saving purpose. Here, clinical pretest evaluation is an important step in the diagnostic algorithm of pulmonary embolism. Although clinical probability scores are widely used in emergency departments of sub-Saharan Africa, no study has cited their diagnostic performance in this resource-constrained environment. This study will seek to assess the performance of four routinely used clinical prediction models in Cameroonians presenting with suspicion of pulmonary embolism at the emergency department.Methods and analysisIt will be a cross-sectional study comparing the sensitivity, specificity, positive and negative predictive values and accuracy of the Wells, Simplified Wells, Revised Geneva and the Simplified Revised Geneva Scores to CT pulmonary angiography as gold standard in all consecutive consenting patients aged above 15 years admitted for clinical suspicion of pulmonary embolism to the emergency departments of seven major referral hospitals of Cameroon between 1 July 2019 and 31 December 2020. The area under the receiver operating curve, calibration plots, Hosmer and Lemeshow statistics, observed/expected event rates, net benefit and decision curve will be measured of each the clinical prediction test to ascertain the clinical score with the best diagnostic performance.Ethics and disseminationClearance has been obtained from the Institutional Review Board of the Faculty of medicine and biomedical sciences of the University of Yaounde I, Cameroon and the directorates of all participating hospitals to conduct this study. Also, informed consent will be sought from each patient or their legal next of kin and parents for minors, before enrolment into this study. The final study will be published in a peer-review journal and the findings presented to health authorities and healthcare providers.

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