Overview of Some Factors Affecting the Durability and Efficacy of LLINs Used by the Communities in South Region of Cameroon, Central Africa

Abstract Background: Long-lasting insecticidal nets (LLINs) are widely used in sub-Saharan Africa to control the transmission of malaria parasites by Anopheles mosquitoes. However, their operational lifespan depends on numerous factors that are often not considered. This paper investigates on some of the factors likely associated with the rapid breakdown of LLINs efficacy in urban and rural settings of the seaport city of Kribi, South Region of Cameroon. Methods: A cross-sectional survey was conducted in June 2019 including: (i) a household survey using standard questionnaire for brands of LLINs used, their maintenance, and coverage rates in study communities, (ii) assessment of the physical integrity of nets, and (iii) WHO cone bioassays to determine the residual efficacy of the nets against wild strains and susceptible reference laboratory strains of Anopheles gambiae s. l. species. Results: A total of 540 households were surveyed, 235 in Kribi- urban and 305 in Kribi-rural. The overall net coverage rate per sleeping space was 68.82%, irrespectively with a similar trend between Kribi-rural (68.98%) and Kribi-urban (68.62%) (p = 0.929). Of the 1,211 LLINs recorded, 64.73% were Interceptor®, 25.44% were PermaNet®, 4.68% were Olyset Net ; the remainder (05.13%) belonged to Yorkool®, Royal Sentry®, Netto®, Super Net® and Panda Net®. The hole indices were significantly correlated to the frequency of washes in kribi-urban as well as kribi-rural settings (p≤ 10-3). Nets washed with ordinary soap had lower hole indices compared to nets washed with corrosive detergents in the two groups of settings in the study area (p≤ 10-4). Likewise, nets dried under the sun significantly recorded a higher hole indices compared to nets dried in a shaded area (p≤ 0.04) in the two groups of settings. Polyethylene fibers were significantly less degraded than polyester fibers. The bio efficacy results revealed 21.6% - 99.6% mortality rates of the Kisumu strain exposed to LLINs washed more than 20 times and from 0.8% to 76.50% for the wild strain. LLINs washed with ordinary soap significantly retained their lethal properties more than LLINs washed with corrosive detergents (p=10-4). Similarly, LLINs dried in the shade retained their lethal properties more than those spread in the sun.Conclusion: Excessive washes, Corrosive detergents and drying regimes are factors that degrade the toxic effect of insecticide impregnated on LLINs. Awareness campaigns are needed to encourage people to adopt good LLIN maintainance practices.

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Overview of Some Factors Affecting The Durability And Efficacy of LLINs Used By The Communities In South Region of Cameroon, Central Africa

10.21203/rs.3.rs-876554/v1 ◽

2021 ◽

Author(s):

Patrick NTONGA AKONO ◽

Serge Mbongue ◽

Odette Ngo Hondt ◽

Francis Noel Nopowo Takap ◽

Rachel Ngaha ◽

...

Keyword(s):

Wild Strain ◽

Central Africa ◽

Household Survey ◽

Cross Sectional Study ◽

Sub Saharan Africa ◽

Reference Laboratory ◽

Cross Sectional ◽

Factors Affecting ◽

Anopheles Mosquitoes ◽

Awareness Campaigns

Abstract Background: Long-lasting insecticidal nets (LLINs) are widely used in sub-Saharan Africa to control the transmission of malaria parasites by Anopheles mosquitoes. However, their operational lifespan depends on numerous factors that are often not considered. This paper investigates on some of these factors likely associated with the rapid breakdown of LLINs efficacy in urban and rural locations of the seaport city of Kribi, South Region of Cameroon.Methods: The cross-sectional study conducted in June 2019 included: (i) a household survey using standard questionnaire for brands of LLINs used, their maintenance, and coverage rates in study communities, (ii) assessment of the physical integrity of nets, and (iii) WHO cone bioassays to check the residual efficacy of the nets against wild strains and susceptible reference laboratory strains of Anopheles gambiae s. l. species.Results: A total of 540 households were surveyed, 235 in urban Kribi and 305 in rural Kribi. The overall net coverage rate per sleeping space was 68.82%, irrespectively with a similar trend between rural Kribi (68.98%) and urban Kribi (68.62%) (p = 0.929). Of the 1,211 LLINs counted, 64.73% were Interceptor®, 25.44% were PermaNet®, 4.68% were Olyset Net ; the remainder (05.13%) belonged to Yorkool®, Royal Sentry®, Netto®, Super Net® and Panda Net®. Proportional hole index analysis showed that Permanet 2.0 nets (1435±117.462) were more degraded than other brands after more than 36 months of use in rural Kribi, whereas Yorkool nets (2004±328.833) were more degraded in urban Kribi. Polyethylene fibers were not significantly more degraded than polyester fibers. The bio efficacy tests showed that LLINs washed more than 20 times induced mortality from 21.6% to 99.6% for the Kisumu strain and from 0.8% to 76.50% for the wild strain. LLINs washed with Marseille soap retained their lethal properties significantly more than LLINs washed with corrosive detergents (p=0.000). Similarly, LLINs spread in the shade retained their lethal properties more than those spread in the sun.Conclusion: Corrosive detergents and sunlight are factors that negate the toxic effect of insecticide impregnation of LLINs. Awareness campaigns are needed to encourage people to adopt good LLIN care practices.

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Economic Consequences of Caesarean Section Delivery: Evidence From a Household Survey in Tanzania

10.21203/rs.3.rs-690554/v1 ◽

2021 ◽

Author(s):

Peter Binyaruka ◽

Amani Thomas Mori

Keyword(s):

Caesarean Section ◽

Health Resources ◽

Household Survey ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Important Indicator ◽

Normal Delivery ◽

Public Facilities ◽

Life Saving

Abstract Background: Caesarean section (C-section) delivery is an important indicator of access to life-saving essential obstetric care. Yet, there is limited understanding of the costs of utilising C-section delivery care in sub-Saharan Africa. Thus, we estimated the direct and indirect patient cost of accessing C-section in TanzaniaMethods: Cross-sectional survey data of 2012 was used, which covered 3000 households from 11 districts in three regions. We interviewed women who had given births in the last 12 months before the survey to capture their experience of care. We used a regression model to estimate the effect of C-section on costs, while inequality on C-section coverage and delivery costs were assessed with a concentration index. Results: C-section increased the likelihood of paying for health care by 16% compared to normal delivery. The additional cost of C-section compared to normal delivery was 20 USD, but reduced to about 11 USD when restricted to public facilities. Women with C-section delivery spent an extra 2 days at the health facility compared to normal delivery, but this was reduced slightly to 1.9 days in public facilities. The distribution of C-section coverage was significantly in favour of wealthier than poorest women (CI=0.2052, p<0.01), and this pro-rich pattern was consistent in rural districts but with unclear pattern in urban districts. Conclusions: C-section is a life-saving intervention but is associated with significant economic burden especially among the poor families. More health resources are needed for provision of free maternal care, reduce inequality in access and improve birth outcomes in Tanzania.

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Economic consequences of caesarean section delivery: evidence from a household survey in Tanzania

BMC Health Services Research ◽

10.1186/s12913-021-07386-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Peter Binyaruka ◽

Amani Thomas Mori

Keyword(s):

Caesarean Section ◽

Health Resources ◽

Household Survey ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Important Indicator ◽

Normal Delivery ◽

Public Facilities ◽

Life Saving

Abstract Background Caesarean section (C-section) delivery is an important indicator of access to life-saving essential obstetric care. Yet, there is limited understanding of the costs of utilising C-section delivery care in sub-Saharan Africa. Thus, we estimated the direct and indirect patient cost of accessing C-section in Tanzania. Methods Cross-sectional survey data of 2012 was used, which covered 3000 households from 11 districts in three regions. We interviewed women who had given births in the last 12 months before the survey to capture their experience of care. We used a regression model to estimate the effect of C-section on costs, while the degree of inequality on C-section coverage was assessed with a concentration index. Results C-section increased the likelihood of paying for health care by 16% compared to normal delivery. The additional cost of C-section compared to normal delivery was 20 USD, but reduced to about 11 USD when restricted to public facilities. Women with C-section delivery spent an extra 2 days at the health facility compared to normal delivery, but this was reduced slightly to 1.9 days in public facilities. The distribution of C-section coverage was significantly in favour of wealthier than poorest women (CI = 0.2052, p < 0.01), and this pro-rich pattern was consistent in rural districts but with unclear pattern in urban districts. Conclusions C-section is a life-saving intervention but is associated with significant economic burden especially among the poor families. More health resources are needed for provision of free maternal care, reduce inequality in access and improve birth outcomes in Tanzania.

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Suicidal ideation and associated factors among school-going adolescents in rural Ghana

Current Psychology ◽

10.1007/s12144-021-01378-3 ◽

2021 ◽

Author(s):

Emmanuel Nii-Boye Quarshie ◽

Samuel Kofi Odame

Keyword(s):

Suicidal Ideation ◽

Associated Factors ◽

Attempted Suicide ◽

Sub Saharan Africa ◽

Rural Adolescents ◽

African Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Rural Ghana ◽

Sub Saharan

AbstractSuicidal ideation is a critical risk for attempted suicide and eventual suicide. Little is known about suicidal ideation among rural adolescents in most sub-Saharan African countries. We aimed to estimate the 12-month prevalence of suicidal ideation and to describe some of the common and gender-specific associated factors among in-school adolescents in rural Ghana. We conducted a cross-sectional survey involving a random sample of 1101 in-school adolescents aged 10–19 years in a rural district in Eastern Ghana. The Suicidal Behavior Questionnaire-Revised was used to assess suicidal ideation. Overall, 25.1% participants (95% CI = 22.5–27.7), representing 28.3% females (95% CI = 24.7–32.2) and 21.5% males (95% CI = 18.0–25.2) reported suicidal ideation during the previous 12 months. Females who experienced personal and interpersonal adversities mainly outside the family context were likely to report suicidal ideation, while suicidal ideation among males was associated with conflict with parents. Regardless of gender, adolescents who reported exposure to a friend’s attempted suicide were about two times more likely to report suicidal ideation. The prevalence of suicidal ideation among adolescents in rural Ghana compares with in-school estimates from other countries within sub-Saharan Africa, but also underscores the need for targeted and universal prevention programmes and intervention efforts to mitigate the potential transition from suicidal ideations to suicidal attempts and eventual deaths by suicide among rural adolescents.

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Hepatitis B Vaccination in Senegalese Children: Coverage, Timeliness, and Sociodemographic Determinants of Non-Adherence to Immunisation Schedules (ANRS 12356 AmBASS Survey)

Vaccines ◽

10.3390/vaccines9050510 ◽

2021 ◽

Vol 9 (5) ◽

pp. 510

Author(s):

Lauren Périères ◽

Fabienne Marcellin ◽

Gora Lo ◽

Camelia Protopopescu ◽

El Ba ◽

...

Keyword(s):

Hepatitis B ◽

Dose Schedule ◽

World Health Organisation ◽

Sub Saharan Africa ◽

World Health ◽

Hepatitis B Vaccination ◽

Detailed Knowledge ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Hbv Vaccination

Detailed knowledge about hepatitis B virus (HBV) vaccination coverage and timeliness for sub-Saharan Africa is scarce. We used data from a community-based cross-sectional survey conducted in 2018–2019 in the area of Niakhar, Senegal, to estimate coverage, timeliness, and factors associated with non-adherence to the World Health Organisation-recommended vaccination schedules in children born in 2016 (year of the birth dose (BD) introduction in Senegal) and 2017–2018. Vaccination status was assessed from vaccination cards, surveillance data, and healthcare post vaccination records. Among 241 children with available data, for 2016 and 2017–2018, respectively, 31.0% and 66.8% received the BD within 24 h of birth (BD schedule), and 24.3% and 53.7% received the BD plus at least two pentavalent vaccine doses within the recommended timeframes (three-dose schedule). In logistic regression models, home birth, dry season birth, and birth in 2016 were all associated with non-adherence to the recommended BD and three-dose schedules. Living over three kilometres from the nearest healthcare post, being the firstborn, and living in an agriculturally poorer household were only associated with non-adherence to the three-dose schedule. The substantial proportion of children not vaccinated according to recommended schedules highlights the importance of considering vaccination timeliness when evaluating vaccination programme effectiveness. Outreach vaccination activities and incentives to bring children born at home to healthcare facilities within 24 h of birth, must be strengthened to improve timely HBV vaccination.

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Stigmatising Attitudes Towards Co-workers with HIV in the Workplace of a Metropolitan State, Southwestern Nigeria

The Open AIDS Journal ◽

10.2174/1874613601711010067 ◽

2017 ◽

Vol 11 (1) ◽

pp. 67-75 ◽

Cited By ~ 1

Author(s):

Idongesit Godwin Utuk ◽

Kayode Omoniyi Osungbade ◽

Taiwo Akinyode Obembe ◽

David Ayobami Adewole ◽

Victoria Oluwabunmi Oladoyin

Keyword(s):

Sampling Technique ◽

Sub Saharan Africa ◽

Good Knowledge ◽

People Living With Hiv ◽

Cross Sectional Survey ◽

Southwestern Nigeria ◽

Cross Sectional ◽

Sub Saharan ◽

Living With Hiv ◽

Hiv Aids

Background:Despite demonstrating global concerns about infection in the workplace, very little research has explored how co-workers react to those living with HIV in the workplace in sub-Saharan Africa. This study aimed to assess the level of stigmatising attitude towards co-workers living with HIV in the workplace.Methods:The study was a descriptive cross-sectional survey involving 403 respondents. They were recruited from selected companies through a multistage sampling technique. Survey was carried out using pre-tested semi-structured questionnaires. Data were analyzed using the Statistical Package for the Social Sciences to generate frequencies, cross tabulations of variables at 5% level of significance. Logistic regression model was used to determine the predictors at 95% confidence intervals.Results:Mean age of respondents was 32.9 ± 9.4 years with 86.1% being females. Overall, slightly below two-third (63.0%) had good knowledge on transmission of HIV/AIDS while 218 (54.1%) respondents had a high stigmatising attitude towards co-workers with HIV in the workplace. More female respondents (69.6%) demonstrated high stigmatising attitudes towards co-workers with HIV in the workplace (p = 0.012). Female workers were twice more likely to have high stigmatising attitudes towards co-worker with HIV [OR 2.1 (95% CI: 1.13 – 3.83)].Conclusion:Stigma towards people living with HIV/AIDs is still very persistent in different settings. Good knowledge amongst our participants about HIV/AIDs did not translate to low stigmatising attitudes among workers. Concerted efforts and trainings on the transmission of HIV/AIDs are essential to reduce stigma that is still very prevalent in workplace settings.

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Prevalence and Correlates of Pregnancy Self-Testing Among Pregnant Women Attending Antenatal Care in Western Kenya

10.21203/rs.3.rs-78174/v1 ◽

2020 ◽

Author(s):

Nina Njeri Nganga ◽

Julia Dettinger ◽

John Kinuthia ◽

Jared Baeten ◽

Grace John-Stewart ◽

...

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Sub Saharan Africa ◽

Future Research ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Western Kenya ◽

Self Testing ◽

Sub Saharan ◽

Exposure Prophylaxis

Abstract In sub-Saharan Africa little is known about how often women use pregnancy self-tests or characteristics of these women despite evidence that pregnancy self-testing is associated with early antenatal care (ANC) attendance. Understanding the characteristics of women who use pregnancy self-tests may facilitate early access to ANC and preventive interventions in pregnancy. We conducted a cross-sectional survey on an ongoing pre-exposure prophylaxis (PrEP) implementation study which enrolled pregnant women to determine the prevalence and factors associated with pregnancy self-testing among women in western Kenya. Overall in our study population, the prevalence of pregnancy self-testing was 22% and higher among women who were employed, currently in school, had previous pregnancy complications, received services from urban health facilities, and had partners who had at least attended secondary school. The most reported reasons for non-use of pregnancy self-tests included not thinking it was necessary, lack of knowledge, and lack of money to pay for the test. Future research should focus on understanding the knowledge and attitudes of women toward pregnancy self-testing.

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Strengthening district healthcare in rural Africa: a cross-sectional survey assessing difficulties in pulse oximetry use and handoff practices

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20185227 ◽

2018 ◽

Vol 6 (1) ◽

pp. 57

Author(s):

Herbert G. Masigati ◽

Grant W. Potter ◽

Masahiro J. Morikawa ◽

Rashid S. Mfaume

Keyword(s):

Pulse Oximetry ◽

Patient Care ◽

Point Of Care ◽

Sub Saharan Africa ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Information Reporting ◽

Rural Africa ◽

Sub Saharan ◽

Developing Settings

Background: Rural hospitals in sub-Saharan Africa suffer from numerous disparities in resources and practices, and subsequently patient care is affected.Methods: In order to assess current practices and opportunities for improvement in pulse oximetry use and patient-care handoffs, a cross-sectional survey was administered to clinicians at a referral level hospital serving a large rural area in Shinyanga, Tanzania.Results: Respondents (n=46) included nurses (50%), medical doctors (48%), and clinical officers (2%). A response rate of 92% was achieved, and 81% of clinicians acknowledged routine difficulties in the use of current devices when obtaining pulse oximetry. Although 83% of respondents reported using a written handoff at shift change, information reporting was inconsistent and rarely included specific management guidance.Conclusions: Further research is needed to elucidate handoff practices in developing settings, but there is a large opportunity for novel point-of-care devices and tools to improve both pulse oximetry use and patient care handoffs in rural Africa.

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Survey of ophthalmologists-in-training in Eastern, Central and Southern Africa: A regional focus on ophthalmic surgical education

Wellcome Open Research ◽

10.12688/wellcomeopenres.15580.1 ◽

2019 ◽

Vol 4 ◽

pp. 187

Author(s):

William Dean ◽

Stephen Gichuhi ◽

John Buchan ◽

Ibrahim Matende ◽

Ronnie Graham ◽

...

Keyword(s):

Surgical Training ◽

Southern Africa ◽

Surgical Education ◽

Training Programme ◽

Sub Saharan Africa ◽

African Region ◽

Cross Sectional Survey ◽

Small Incision Cataract Surgery ◽

Cross Sectional ◽

Recent Graduates

Background: There are 2.7 ophthalmologists per million population in sub-Saharan Africa, and a need to train more. We sought to analyse current surgical training practice and experience of ophthalmologists to inform planning of training in Eastern, Central and Southern Africa. Methods: This was a cross-sectional survey. Potential participants included all current trainee and recent graduate ophthalmologists in the Eastern, Central and Southern African region. A link to a web-based questionnaire was sent to all heads of eye departments and training programme directors of ophthalmology training institutions in Eastern, Central and Southern Africa, who forwarded to all their trainees and recent graduates. Main outcome measures were quantitative and qualitative survey responses. Results: Responses were obtained from 124 (52%) trainees in the region. Overall level of satisfaction with ophthalmology training programmes was rated as ‘somewhat satisfied’ or ‘very satisfied’ by 72%. Most frequent intended career choice was general ophthalmology, with >75% planning to work in their home country post-graduation. A quarter stated a desire to mainly work in private practice. Only 28% of junior (first and second year) trainees felt surgically confident in manual small incision cataract surgery (SICS); this increased to 84% among senior trainees and recent graduates. The median number of cataract surgeries performed by junior trainees was zero. 57% of senior trainees were confident in performing an anterior vitrectomy. Only 29% of senior trainees and 64% of recent graduates were confident in trabeculectomy. The mean number of cataract procedures performed by senior trainees was 84 SICS (median 58) and 101 phacoemulsification (median 0). Conclusion: Satisfaction with post-graduate ophthalmology training in the region was fair. Most junior trainees experience limited cataract surgical training in the first two years. Focused efforts on certain aspects of surgical education should be made to ensure adequate opportunities are offered earlier on in ophthalmology training.

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Youth Empowerment as a Pathway towards Attaining the Demographic Dividend in Sub-Saharan Africa: Evidence from Ghana

Commonwealth Youth and Development ◽

10.25159/2663-6549/9208 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Claudious Chikozho ◽

Emmanuel Sekyere ◽

Akanganngang Joseph Asitik

Keyword(s):

Quantitative Research ◽

Sub Saharan Africa ◽

Full Potential ◽

Youth Empowerment ◽

Demographic Dividend ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Quantitative Research Methods ◽

Targeted Interventions ◽

Sub Saharan

While empowerment of the youth in Ghana could enable them to make a more meaningful contribution to the economy, a myriad of challenges faces the youth during their transition from school into the employment sector and limits the realisation of their full potential. As a result, the recent and significant increase in the size of the youth population in Ghana cannot justifiably be romanticised as an obvious stepping stone towards the realisation of a demographic dividend. In this study, qualitative and quantitative research methods were deployed to carry out a cross-sectional survey that enabled a detailed exploration of the main challenges and opportunities facing the youth in Ghana. Some of the options for enabling greater youth empowerment in the country were also identified. The study established that unemployment, skills limitations, lack of access to finance, and poorly coordinated institutional structures for implementing youth empowerment policies and programmes are major barriers to youth empowerment in Ghana. We conclude that there is a need for more targeted interventions that address these challenges and leverage any evident opportunities available for increased youth empowerment before Ghana can confidently expect to reap a demographic dividend.

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