Journal of Public Health in Africa 2020-05-01T04:18:12+00:00 Emanuela Fusinato Open Journal Systems <p>The <strong>Journal of Public Health in Africa</strong>&nbsp;is a peer-reviewed, academic journal that focuses on health issues in the African continent.<br>The journal editors seek high quality original articles on public health-related issues, reviews, comments and more. The aim of the journal is to move public health discourse from the background to the forefront. The success of Africa’s struggle against disease depends on public health approaches.</p> Socioeconomic factors associated with anaemia among children aged 6–59 months in Namibia 2020-05-01T04:18:12+00:00 Panduleni Penipawa Shimanda Hans Justus Amukugo Fredrik Norström <p>Background: Anaemia remains a public health concern, and the its prevalence varies between countries as well as between age, sex and levels of poverty. This study aims at examining the association between socio-demographic factors and anaemia among children aged 6–59 months in Namibia. Methods: Data was extracted from the 2013 Namibian Demographic Health Survey. The association between anaemia and other factors was examined with logistic regression. Results are reported in odds ratio (OR), with 95% confidence intervals (CI). Results: In total, 1,383 children aged 6–59 months had complete data and included in the analyses. Our study shows that there is a statistically significantly increased risk of anaemia among children from poorer households compared with the richest quintile. Also, there was a statistically significance supporting anaemia being more common among boys than girls. There was also a statistically significant negative effect related to age. Discussion: Our study shows that young children, boys and children in poorer households have an increased risk of anaemia. Considering the adverse impact of anaemia on child development, policies must prioritise factors exacerbating anaemia risk.</p> 2020-04-29T10:34:41+00:00 Copyright (c) 2020 the Author(s) Modelling malaria reduction in a highly endemic country: Evidence from household survey, climate, and programme data in Zambia 2020-04-30T04:18:12+00:00 Mukumbuta Nawa Hikabasa Halwindi Peter Hangoma <p>Substantial efforts have seen the reduction in malaria prevalence from 33% in 2006 to 19.4% in 2015 in Zambia. Many studies have used effect measures, such as odds ratios, of malaria interventions without combining this information with coverage levels of the interventions to assess how malaria prevalence would change if these interventions are scaled up. We contribute to filling this gap by combining intervention coverage information with marginal predictions to model the extent to which key interventions can bring down malaria in Zambia. We used logistic regression models and derived marginal effects using repeated cross-sectional survey data from the Malaria Indicator Survey (MIS) datasets for Zambia collected in 2010, 2012 and 2015. Average monthly temperature and rainfall data were obtained from climate explorer a satellite-generated database. We then conducted a counterfactual analysis using the estimated marginal effects and various hypothetical levels of intervention coverage to assess how different levels of coverage would affect malaria prevalence. Increasing IRS and ITNs from the 2015 levels of coverage of 28.9% and 58.9% respectively to at least 80% and rising standard housing to 20% from the 13.4% in 2015 may bring malaria prevalence down to below 15%. If the percentage of modern houses were increased further to 90%, malaria prevalence might decrease to 10%. Other than ITN and IRS, streamlining and increasing of the percentage of standard houses in malaria fight would augment and bring malaria down to the levels needed for focal malaria elimination. The effects of ITNs, IRS and Standard housing were pronounced in high than low epidemiological areas.</p> 2020-04-29T10:15:27+00:00 Copyright (c) 2020 the Author(s) Determinants of unmet need for family planning among married women in Zambia 2020-04-30T04:18:39+00:00 James N. Mulenga Bupe B. Bwalya Mulenga C. Mulenga Kakoma Mumba <p>Unmet need for family planning remains a major family planning problem in most countries around the world. It presents serious consequences for the women, their families and society at large. This study was undertaken to establish the factors that affect total unmet need for family planning and its components in Zambia. This study used the 2013/14 Zambia Demographic Health Survey (ZDHS) dataset focusing on currently married women aged 15 to 49. Data analysis took the form of descriptive, binary logistic and multinomial logistic regressions. The study shows that although there has been a substantial increase in contraceptive use, combined unmet need for family planning has only decreased slightly over time and currently stand at 21%, made up of 14% limiters and 7% spacers. Various factors were identified as determinants of unmet need for spacing, limiting or total unmet need for family planning. These included age, partner’s level of education, contraceptive side effects, husband opposition to contraceptives and number of living children. To enhance utilization, policy should not be blind to the respective factors that influence combined unmet, unmet need for spacing and limiting.</p> 2020-04-29T10:09:51+00:00 Copyright (c) 2020 the Author(s) Time series analysis of Nevirapine syrup consumption in prevention of mother-to-child transmission and optimal supply chain model in Oshana region, Namibia 2020-04-30T04:19:06+00:00 Emmanuel Magesa Honore Mitonga Kabwebwe Penehafo Angula <p>Introduction. HIV/AIDS continue to be serious communicable disease whose impact on public health in Namibia is massive. It is estimated that the prevalence rate of HIV in Namibia is 17.2%, ranking the country as the fifth highest in sub-Saharan Africa (SSA). Some improvement in reducing the number of cases of HIV/AIDS has been made in the country, but the sporadic shortage of medicines continues to slow down government efforts to foster the emergence of an HIV-free generation of Namibians Objective of the study. Develop and demonstrate a mathematical supply-chain model, which can establish parameters to prevent stock-outs of NVP suspension. Method: The study adopted retrospective approach to acquire data from 2012-2016. Results. Gamma supply chain model was developed as the optimal model for NVP syrup and forecasted consumption for 2017-2018 was determined. Conclusion and recommendation. It is a recommendation of this study that new guidelines for implementation of optimal supply-chain models at the regional medical store, health centers and clinics be implemented for Nevirapine syrup.</p> 2020-04-29T09:26:46+00:00 Copyright (c) 2020 the Author(s) Is exclusive breastfeeding an option or a necessity in Africa? A pooled study using the deuterium oxide dose-to-mother technique 2020-04-30T04:19:34+00:00 Helen Mulol Anna Coutsoudis Waliou Amoussa Hounkpatin Elisaphinate Urio Philomène Kenguela Wabolou Yolande Sissinto Khalid El-Kari <p>Given the valuable health, development, and economic benefits of human milk exclusive breastfeeding (EBF) is recommended by the World Health Organisation for the first six months of an infant’s life. Many resource-limited regions in Africa do not line-up with these recommendations therefore EBF promotion efforts on the continent need to be scaled up and monitored. This study explores the human milk intake volumes of 5 countries (Benin, Central African Republic, Morocco, South Africa and Tanzania) both at country level and in a pooled sample at 3 months (n= 355) and at 6 months (n=193). Mean human milk intake volumes in the pooled samples were 697.6 g/day at 3 months and 714.9 g/day at 6 months. EBF was determined both by maternal recall as well as using the deuterium oxide dose-to-mother technique using two different cut-offs of non-milk oral intake. Comparison of these results showed substantial over-reporting of EBF by maternal recall, which suggests that actual rates of EBF are even lower than reported thus highlighting the importance of scaling-up EBF promotion strategies.</p> 2020-04-29T09:15:44+00:00 Copyright (c) 2020 the Author(s) Predictors of HIV stigma among health workers in the Cape Coast metropolis, Ghana 2020-04-30T04:20:12+00:00 James Prah Anna Hayfron-Benjamin Mohammed Abdulai Obed Lasim Yvonne Nartey Dorcas Obiri-Yeboah <p>Background: Stigma against people living with HIV (PLHIV) among health workers remains a barrier to the provision of needed care to HIV patients worldwide. We sought to investigate predictors of HIV stigma among health workers in Cape Coast, Ghana. Methods: This was a cross sectional study conducted in three hospitals from November 2016 to February 2017. The study made use of a pre-existing self-administered questionnaire. Multiple regression analysis and Pearson’s coefficient tests were performed to determine the relationship between the dependent variable, stigmatized attitudes of health workers and some independent variables, and to determine which of the independent variables predict stigma amongst health care workers. Results: A total of 331 health workers of different categories participated. Respondents’ personal opinions on HIV, fears/worries of getting infected and category of staff {F(3,327)= 23.934 p&lt;0.00 }, R2 = 0.180) significantly predicted their stigmatizing behaviour. Compared to other health workers, nurses had higher scores for stigmatizing behaviour. Conclusions: the study found evidence of discriminatory and stigmatizing behaviour towards PLHIV by health workers. Stigma reduction programmes aimed at health workers should be strengthened at all health facilities that provide care to PLHIV.</p> 2020-04-29T00:00:00+00:00 Copyright (c) 2020 the Author(s) Persistence of the inverse care law in maternal health service utilization: An examination of antenatal care and hospital delivery in Ghana 2020-04-30T04:20:45+00:00 Coretta M.P. Jonah <p>The gap in maternal health outcomes, access and utilization between the haves and have-nots continues to be a challenge globally despite improvements over the past decade. Though Ghana has experienced steady gains in maternal health access and utilization over the years, maternal outcomes, on the other hand, remain poor. In this regard, it is essential to know how various groups in the population achieved improvements and whether some women continue to be disproportionately disadvantaged. The paper performs an analysis of cross-sectional data from the 2017 Ghana maternal health survey to examine the existence of the inverse care law in maternal health services in Ghana. Using descriptive techniques and multivariate logistic regression models the study reveals a pro-rich and pro-urban gradient in the use of hospital facilities for delivery and antenatal care attendance — also, regions known for their high levels of poverty feature significantly lower rates of hospital deliveries. The paper concludes by stressing that unless policies are changed to accommodate these groups, overall gains in maternal health will continue to be incremental.</p> 2020-03-20T09:46:38+00:00 Copyright (c) 2019 the author(s) Prevalence and factors associated with hypertension in Anonkoi 3, a peri-urban area in Abidjan (Côte d’Ivoire) 2020-04-30T04:21:13+00:00 Julie K. Sackou Marie L. Tiadé Annita A. Hounsa Simone K. Malik Madikiny Coulibaly Angèle A. Desquith Florence K. Kadjo Serge A. Agoua Serge Oga Luc K. Kouadio <p>Hypertension affects more than a quarter of the world adult population, with ruralurban disparities. In Côte d’Ivoire, the prevalence was 21.7% in 2005. The aim of this study was to determine factors associated with hypertension in a peri-urban community in Abidjan. A cross-sectional study was conducted at Anonkoi 3 a peri-urban area in Abidjan. The sample was of 360 subjects aged 18 and older. Behavioral, anthropometric and blood pressure characteristics were determined using WHO STEPS questionnaire and multivariate logistic regression was performed. Prevalence of hypertension was 18.61%. Subjects were low fruit and vegetable consumption (3.3%), low level of physical activity (64.2%) and abdominal obesity at 40%. The risk of hypertension was significant from age 45, in subjects living with a partner and in those with low level of physical activity. Health education programs are essential to prevent cardiovascular risks.</p> 2020-03-20T09:35:04+00:00 Copyright (c) 2019 the author(s) Mobile health to improve adherence to tuberculosis treatment in Khartoum state, Sudan 2020-04-30T04:21:40+00:00 Ahmed Osman Ahmed Ali Martin H. Prins <p>Although tuberculosis is a treatable disease, the high frequency of treatment default remains a challenge. The use of mobile phones structurally in a TB program has the potential to lower the frequency of default. However, it’s impact on treatment outcome in Sudan has not yet been evaluated. The aim is to evaluate the potential use of cell phones for lowering treatment default. We conducted a controlled intervention pilot study during the period from 1st of May 2017 to 31st of March 2018, in eight TB treatment units in Khartoum state, Sudan. Newly diagnosed patient with positive sputum smear on DOTS therapy were enrolled in intervention and control groups. SMS reminder were sent to the intervention group.Assessments were done at the beginning and at the end of the treatment. One hundred and forty-eight patients were enrolled, seventy-four patients in each group.The participants in the two groups were similar in demographic characteristics and behavioral and knowledge related factors about TB disease at baseline. The patients in the intervention group had a lower default rate (6.8%), higher documented cure rate (78.4%), better knowledge compared to control group. SMS reminder was useful and facilitated good interaction between patients and health personnel. Mobile texting seemed useful and was highly accepted by participants. Further evaluation of it’s potential benefit was warranted.</p> 2020-03-20T09:02:33+00:00 Copyright (c) 2019 the author(s) Factors associated with multi-drug-resistant tuberculosis in Dakar, Senegal, 2010-2016 2020-04-30T04:22:08+00:00 Mbouna Ndiaye Pauline Kiswendsida Yanogo Bernard Sawadogo Fadima Diallo Simon Antara Nicolas Meda <p>According to the World Health Organization, multidrug-resistant tuberculosis (MDR-TB) represents a major obstacle towards successful TB treatment and control. In Dakar, MDR-TB management began in 2010 with the strengthening of diagnostic resources. The objective of this study was to identify the factors associated with multidrug-resistant tuberculosis in Dakar between 2010 and 2016. We conducted a case-control study from January 10 to February 28, 2017 in tuberculosis centers in Dakar. of 169 cases and 507 controls. We used logistic regression with Epi-info version 7.2.1. to estimate the odds ratios of association. Factors significantly associated with MDR-TB were: residing in a periurban area (ORa=1.8; 95% CI (1.5-4.9); p=0.024), presence of MDR-TB in the entourage of patient (ORa=7.0; 95% CI (6.1-9.5); p=0.002), previous treatment failure (ORa=29.5; 95% CI (27.3-30.1); p=0.000), treatment not directly observed by a health care provider (ORa=4.3; 95% CI (4.1-7,2); p=0.000) and irregularity of treatment (ORa=1.7; 95% CI (0.5-5.4); p=0.037). Focusing interventions on population at-risk will prevent MDR-TB.</p> 2020-03-20T08:42:33+00:00 Copyright (c) 2019 the author(s)