Healthcare Providers in Africa Face HIV and AIDS Challenges in Providing Services to a Key Population: Infant and Young Child Feeding

There is agreement on the benefits of exclusive breastfeeding for 6 months and the introduction of appropriate complementary foods at 6 months, followed by continued breastfeeding, for all infants. However, infant, and young child feeding (IYCF) guidelines for HIV-positive mothers have changed on a regular basis since 2000. Considering new HIV treatment guidelines, implementation challenges, and knowledge gaps, this article investigates issues and Evidence related to IYCF for the prevention and care of paediatric HIV in resource-limited settings. The effectiveness of antiretroviral medications (ARVs) in decreasing the incidence of HIV transmission from mother to child prompted WHO to urge countries to support either avoidance or treatment. Significant progress has been made in terms of preserving the lives of moms but also decreasing the spread of HIV among children, but long-term political, financial, and scientific commitment is essential for ensuring effective postnatal HIV prevention programs and providing for the nutritional requirements of HIV-exposed and HIV-infected infants.

Use of Simple Mobile Technology to Create an Electronic Vaccination Registry in Kenya

Vaccination is one of the high-impact public health interventions against the spread of disease. Over time, developed countries have been able to reduce the burden of disease through improving access to vaccination and achieving high vaccine coverage. In low-income countries, the situation is different as most countries still report low coverages of less than 90%, which is the global target recommended by the World Health Organization. The main reasons for this low coverage include poor access to vaccination, stock-outs, and poor documentation and targeting for vaccination services. To address these problems, we developed an electronic vaccine registry using Unstructured Supplementary Service Data (USSD) technology that registered births, vaccines administered and sent short message reminders to mothers about their clinic dates. The study was conducted in Nyandarua County, Kenya, between June 2018 to March 2019. To participate in the study, mothers had to reside within the jurisdiction of the study site. Mothers who moved into the study site also had their children registered and previous vaccines updated. A total of 4,823 births and 20,515 vaccines administered were captured into the system. The system sent 12,554 short message reminders to mothers; 3 days before the due day and on the due day. Additionally, it generated a birth register, vaccination register, defaulter list, dropout rate report, vaccine coverage, and timeliness reports. The intervention improved vaccination coverage and timeliness of vaccination by up to 8.7%.

The Era of Covid-19; Its’ Impact on Cancer Patient Experience in Southwest Nigeria

Patients have developed a well-informed sense of validation concerning maintaining hygiene standards. The pandemic, somehow in disguise, presented the valuable perspective of life reflection and gratitude. The attitude of a majority of patients engaged was immensely that of a deep reflection of the privilege of having access to early diagnosis, treatment, and adequate support. However, the complaints of the past, knowing that they are alive and have hope to keep fighting on with gratitude and sense of acceptance. However, they wished that the experience of the social media – health engagement platform should continue as it provided a good level of the bridge of gap of information. The cost of treatment remains a major concern as it largely translates to possible dropout from treatment courses for most cancer patients who can’t afford the current cost. The concerns of the cancer patients and survivors during and after the covid-19 pandemic are similarly a concern to public health professionals worldwide. The need to aid their return to routine health care services is more important and therefore requires an urgent reorganization of cancer management services. An urgent intervention should be focused on patient re-orientation /pandemic control, staff training and retraining, awareness campaign, screening and result accessibility, special pandemic services, amongst others. The outcome reflected a very huge level of poor cancer patient experience in the public cancer treatment centres, while the reverse is the case with the private cancer treatment centres. This can be managed if an urgent intervention as proffered is implemented.

Influence of Community-Based Interventions on Routine Immunization Uptake among Children Under Five Years in Ntungamo District-Uganda

Evidence of the effectiveness of community-based interventions in improving immunization coverage in populations of low coverage is limited. Vaccine-preventable diseases is a major public health challenge in low-income countries where Uganda lies, and immunization is the only reliable strategy for child survival. The study's objective was to assess the influence of a community-based intervention on the uptake of immunization services to recommend strategies to health stakeholders to improve immunization coverage. A quasi-experimental study was conducted in three phases. Structured and key informant interviews were used as data collection tools. Phase one provided baseline data before the intervention, the second phase was a community-based intervention, and the third phase was post-intervention evaluation. There was no significant difference on the uptake of BCG, POLIO-0, POLIO-1, POLIO-2, DPTHeP-Hib1, DPTHeP-Hib2, PCV1 and PCV2 immunizations between the intervention and control group post-intervention (P= 1.00, α =0.5). The level of knowledge on immunization was 68.8% and 29.6% in the intervention and control groups, respectively. The difference between the two was statistically significant (P=0.00 = α= 0.5). There was a significant association between the level of knowledge of the caregivers on immunization and the uptake of immunization services (P=0.00, α=0.5). There was also a statistically significant difference in immunization coverage between the intervention and control groups (97.5%) and (75.1%) for the intervention and control groups, respectively. The difference was statistically associated with the community-based intervention (P =0.00, α=0.5). Community-based interventions influenced the uptake of routine immunization services.

Factors Affecting Uptake of Covid 19 Vaccines – A Case of Mbala District, Northern Zambia

The desire to control Covid 19 pandemic has continued to exist in the Mbala district of Zambia, with the latest trend showing a significant increase in a number of people testing positive, with a corresponding increase in vaccines (AZ, JJ) hesitancy resulting in a low (2.8 %) vaccination rate in the district. Thus, the need to probe further on covert factors under acceptability (myths, AEFs) and accessibility (vaccines availability, adequacy of vaccination sites) that could be reducing Covid 19 vaccine uptake in Mbala district. The study used a cross-sectional survey, a mixed (quantitative & qualitative) method in eliciting information from data sources covering a period of six months (April – September 2021). In all, 341 research respondents were interviewed through self-administered questionnaires. Data were analysed using descriptive statistics and binary logistic regression under SPSS v16. Study findings provide sufficient evidence that high myth (89.8%) reduced acceptability levels, while a low number of vaccination sites (59%) reduced accessibility, resulting in a low uptake rate in Mbala district. Therefore, the study recommended; building up of well-financed District Covid 19 task forces with educational aims on acceptability and accessibility, Governments to introduce specific funding lines for Covid 19 vaccination campaign and enshrine it into monthly grants for routine-outreach Covid 19 vaccination services, and Local Governments through the directorate of Public Health to introduce by-laws on mandatory Covid 19 vaccination passports for the public. With proper implementation of all these study recommendations, Covid 19 vaccination coverage rates can increase drastically across all districts of northern Zambia.

The Role of Non-Governmental Organisations (NGOs) in Community-based Mental Health Services in Northern Nigeria: Prospects and Challenges

Despite the role of non-governmental organisations (NGOs) in many health issues, their role in community mental health services in parts of northern Nigeria is unknown. This study explored the availability and role of NGOs in community-mental health care services, with a view to identifying the prospects and challenges. Using the convergent mixed methods approach, a self-constructed questionnaire and in-depth interviews were used to collect data from 205 conveniently and purposively selected study participants. Descriptive and thematic analyses were done and then triangulated to meet research objectives. There is a scarcity of mental health-related NGOs in the study areas; only one NGO engaged in the mental health activities was identified (13.4%). Surprisingly attempts by the only available NGO at providing the needed community-based mental health care were “frustrated” by certain government policy directions, which appear to paralyse activities and intentions of the only existing one. NGOs for mental health care are lacking. There is a dire need for NGO activities in mental health care. Efforts should be made to attract NGOs to the study areas in view of the increasing burden of mental health issues in the communities in the setting. Governments at all levels, community-based organisations and traditional institutions can be instrumental to this. NGOs within and outside the study areas focusing on community health in general and mental health care, in particular, may also interrogate this situation further for urgent intervention.

Assessment of an Educational Intervention on the Perception of Adolescent Girls towards Menstrual Hygiene in Ogun State, Nigeria

In low and middle-income countries, menstruation is impeded by several misconceptions, taboos and shrouded in secrecy. This serves as a major challenge to proper Education regarding menstrual hygiene and has blocked the access of adolescent girls to the right kind of information, thereby influencing a negative outcome associated with harmful behaviours. The objective of the study was to investigate the assessment of an educational intervention on the perception of adolescent girls towards menstrual hygiene in Ogun state, Nigeria. The study utilized a quasi-experimental design. One hundred and twenty (120) in-school adolescent girls were selected through a multistage sampling technique from four (4) secondary schools within four (4) local government areas in Ogun State, Nigeria. A validated 23-items questionnaire measured on a 69-point rating scale with a Cronbach Alpha scores 0.79 was used for data collection. The mean ±SD age and age at menarche of adolescent girls was 14.92±1.82; 12.73±1.38. The majority of respondents had low scores of perceptions. The educational intervention had an effective change in the level of perception of adolescent schoolgirls between baseline and the 6th-week follow-up, indicating a mean difference of 26.70 (p<0.01) for the peer-led, 26.54(p<0.01) parent-led, 20.16(p<0.01) parent and peer-led and a decrease in mean in the control group (-0.17; p=0.866). The peer-led educational approach had a better impact on adolescent girls’ perception compared to other educational approaches. Hence, this is an indication that peer-education strategies should be utilized for further interventions and in reaching out to adolescents.

Different Modalities to Assess Right Ventricular Function in Post-COVID Taking ST-Elevation as a Gold Standard and Arrhythmias in Post-COVID

The COVID-19 caused by novel single-stranded RNA enveloped severe acute respiratory syndrome coronavirus-2 (SARS CoV-2) first appeared in Wuhan, China. A lot of focus has been given to pulmonary complications. According to several case reports, cardiovascular associated clinical manifestations include myocarditis, arrhythmias, veno-thromboembolic events, acute coronary syndrome (ACS), and pericarditis. Different modalities in diagnosis like 2D, doppler can help in the early diagnosis of right ventricular function. This study evaluates the cardiac changes in recovered COVID-19 positive patients by 2D echocardiogram and other modalities. In this prospective observational study, 139 participants recently recovered from COVID-19 illness were identified and recruited after obtaining the Informed concerned form (ICF). The patients once enrolled were subjected to 2D echo and ECG as part of routine clinical practice. Out of 139 patients, 89 (64.03%) were males, and the rest were females. Based on the severity scale, 13 (9.35%) participants had suffered a severe form of COVID-19 infection. Right ventricular functional assessment, right ventricular global strain (RVGLS) was abnormal in 72 (51.80%) participants. Arrhythmias were reported in 31 (22.30%) participants; among them, 30 participants had sinus bradycardia. Our study demonstrates the association between COVID-19 and cardiac changes/ incidence of cardiovascular complications in recovered COVID-19 patients. This study provides first-hand evidence of the incidence of abnormal LVGLS and RVGLS in COVID-19 recovered patients. In addition, there was a higher incidence of arrythmias.

Dynamic Panel Surveillance of COVID-19 Transmission in the United States to Inform Health Policy: Observational Statistical Study – A Critical Review of Article

This is a critical appraisal of a manuscript outlining additional indicators used in the United States to augment traditional disease surveillance tools. The article went through the peer-review process. Therefore, it may be considered as objective and unbiased. The structure of the article is coherent, and it was published in a journal for digital medicine, health, and health care in the internet age. The article has contributed to the literature and provides a basis for strengthening existing surveillance systems to improve public health outcomes. However, it is suggested that whenever new indicators are being developed, their essential components must be fully defined.

The Prevalence and Determinants of Anaemia among Clients of the AIDS Support Organisation-Entebbe, Uganda

Anaemia, a common hematological disorder in HIV infection, compromises the quality of life and treatment outcomes. At The AIDS Support Organisation (TASO), Entebbe, the records for the 2016-2018 period show a 10% prevalence of anaemia which is lower than that in literature where it is said to be up to 95%. This study determined the prevalence, type, severity, and determinants of anaemia among people living with HIV and AIDS who receive care from TASO Entebbe in Uganda. A questionnaire was used to collect data from 624 TASO clients. A checklist identified the clients’ Antiretroviral Therapy (ART) combination and viral load. The selected clients’ Body Mass Index (BMI) was calculated to assess their nutritional status. A Fully Automated Humacount 60TS Three-Part Hematology Analyzer was used to measure hemoglobin and to do a full blood count. A blood film from each sample was manually examined for the type of anaemia. Data analysis was done with Stata MP 15. The prevalence of anaemia was 44.4%, and the anaemia was mostly mild (54.15%) to moderate (40.80%). Anaemia of inflammation was the commonest type (>58%). Gender, viral suppression, nutritional status, nutritional education, marital and economic status were significantly associated with the anaemia. Duration on ART had a protective effect, but this was not statistically significant. The prevalence of anaemia (44.4%) among the TASO-Entebbe Uganda clients was high, but the anaemia was mostly mild to moderate (>94%) and of inflammation type (>58%). Management of anaemia in HIV requires intentional screening since it compromises treatment outcomes.