Journal of Public Health in Africa <p>The <strong>Journal of Public Health in Africa</strong> <em>(JPHiA)</em> is a peer-reviewed, electronic 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> PAGEPress Publications, Pavia, Italy en-US Journal of Public Health in Africa 2038-9922 <p>PAGEPress has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener">Creative Commons Attribution NonCommercial 4.0 International License</a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.&nbsp;<br><br>An Open Access Publication is one that meets the following two conditions:<br><br>1. The author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.<br>2. A complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.<br><br>Authors who publish with this journal agree to the following terms: 1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. 2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal. 3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</p> Community based health insurance scheme: Preferences of rural dwellers of the federal capital territory Abuja, Nigeria <p>In 2010, community based health insurance scheme (CBHIS) was launched in the Federal Capital Territory (FCT) of Nigeria. Little is known about the preferences and perception of the rural dwellers of the FCT about the scheme. This study aimed to determine the preferences of healthcare consumers towards CBHIS in FCT. A descriptive cross sectional study of 287 household heads was done. Systematic random sampling was used. Information was collected using a semi-structured, interviewer administered questionnaire. Data was analysed with SPSS version 21. Male respondents were 175 (61%), 242 (84.3%) were aware of the existence of CBHIS, 126 (82%) also enrolled their dependents. Annual payment of health insurance premium was preferred by 91 (59.9%) of enrolled respondents, 92 (60.1%) enrolled in the scheme because they perceived it to be a cheap way to access healthcare. No proper understanding was the reason why 33 (28.4%) of those aware of the scheme did not enroll themselves or their dependents. Only 124 (55.1%) were satisfied with the overall services provided to them by their health care provider (HCP). More community enlightenment on CBHIS is required. There is a need to factor in the preferences of the community members into the FCTCBHIS to determine what community members are willing to pay for their healthcare premium and how making contributions will be convenient for them.</p> Christiana Ogben Olayinka Ilesanmi ##submission.copyrightStatement## 2018-07-11 2018-07-11 10.4081/jphia.2018.540 Understanding the concept of health insurance: An innovative social marketing tool <p>Health insurance scheme is relatively new in many low to middle income countries. Awareness about and knowledge of the scheme is poor among potential beneficiaries. There are some misconceptions associated with health insurance, which contributes to its low acceptance in affected nations. The aim of this work is to present an information-education and communication concept that will serve as a social marketing tool that could enhance peoples’ understanding of the modus operandi of health insurance scheme, and as well as to demystify superstitious belief associated with it. This will contribute to a better understanding of the scheme among the people and enhance its uptake.</p> David Ayobami Adewole ##submission.copyrightStatement## 2018-07-11 2018-07-11 An integrated diagnostic device for neonatal sepsis and childhood pneumonia <p>Not available</p> Rashed Shah Gomezgani Jenda Vicoria Lwesha Humpreys Nsona Pavan Dadlani Eric Swedberg ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.780 Human immunodeficiency virus type 1 drug resistance in a subset of mothers and their infants receiving antiretroviral treatment in Ouagadougou, Burkina Faso <p>The emergence of HIV-1 drug resistance (HIVDR) is a public health problem that affects women and children. Local data of HIVDR is critical to improving their care and treatment. So, we investigated HIVDR in mothers and infants receiving antiretroviral therapy (ART) at Saint Camille Hospital of Ouagadougou, Burkina Faso. This study included 50 mothers and 50 infants on ART. CD4 and HIV-1 viral load were determined using FACSCount and Abbott m2000rt respectively. HIVDR was determined in patients with virologic failure using ViroSeq HIV-1 Genotyping System kit on the 3130 Genetic Analyzer. The median age was 37.28 years in mothers and 1.58 year in infants. Sequencing of samples showed subtypes CRF02_AG (55.56%), CRF06_cpx (33.33%) and G (11.11%). M184V was the most frequent and was associated with highlevel resistance to 3TC, FTC, and ABC. Other mutations such as T215F/Y, D67N/E, K70R, and K219Q were associated with intermediate resistance to TDF, AZT, and 3TC. No mutation to LPV/r was detected among mothers and infants. The findings of HIVDR in some mothers and infants suggested the change of treatment for these persons.</p> Serge Theophile Soubeiga Bapio Valéry Jean Telesphore Elvira Bazie Tegwindé Rebeca Compaore Abdoul Karim Ouattara Théodora Mahoukèdè Zohoncon Dorcas Obiri-Yeboah Albert Théophane Yonli Arsène Zongo Lassina Traore Virginio Pietra Simon Akpona Serge Diagbouga Jacques Simpore ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.767 Association between periodontal diseases and cardiovascular diseases in Cameroon <p>To assess the association between periodontal diseases and cardiovascular diseases in dental patients in Cameroon, a prospective observational study was carried out in 3 hospitals in Cameroon from January 2013 to December 2015. Data on general condition, age, gender and lifestyle were collected during medical history taking. The Dutch Periodontal Screening Index assessed periodontal health during oral examination. The Wilcoxon test, the Fisher test and logistic regression analysis were performed. 558 patients (53.9% women) were included in the study. The mean age was 44±13 years (30 to 85). In terms of overall health, 161 (28.9%) had cardiovascular diseases (CVD) and 73 (13.1%) had diabetes. Hypertension accounted for 87.6% of CVD. In terms of periodontal diseases (PD), 431 (77.2%) patients had PD, the break-down by PD was 347 (62.2%) gingivitis and 84 (15%) periodontitis. Statistical associations were found between CVD and gingivitis [OR=4.30 (1.85-10.00), P=0.001], and CVD and periodontitis [OR=2.87 (1.04-7.93); P=0.04].</p> Lawrence Essama Eno Belinga Williams Bell Ngan Daniel Lemougoum Alain Serges Patrick Essam Nlo’o Bienvenu Bongue Annie Ngono Samuel Honoré Mandengue Malick Sembene ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.761 Performance based financing and job satisfaction in a semiurban health district in Cameroon <p>The performance based financing approach is being tested in four regions of Cameroon, including the Littoral region. Our study aimed to study the effects associated with the implementation of the performance based financing approach within the health facilities based in the health district of Edea in the Littoral region in Cameroon. We’ve carried out a crosssectional analytical study among 178 health personnel from 21 health facilities under PBF-contract within the health district of Edea. We have studied their sociodemographic characteristics, the individual and collective effects resulting from the performance based financing subsidies and the level of job satisfaction. Participants’ job satisfaction was measured with the French version of the Minnesota satisfaction scale. The results were presented in a descriptive and analytical form at the alpha = 5% and the P-value 5%. We recruited 113 women and 65 men. The mean age was 39.19 ± 8.95 years. The individual results of the performance based financing were the regular collection of subsidies between F CFA 20-40.000 (42.1%), the improvement of working conditions (74.2%) and living conditions (67.4%) and the acquisition of new skills (69.7%). Collectively, participants confirmed the increase of the users attendance (65.7%), the improvement of the internal organization (79.8%), the purchase of new equipment (84.3%) and the improved quality of health care (86%). Satisfaction is influenced by age (P=0.016), gender (P=0.01), occupational category (P=0.04), type of health facility (P=0.02) and the amount of subsidies (P=0.03). The healthcare personnel’s were satisfied with the improvement of their social conditions (66.67%), working conditions (62.88%), the transparency in health centers management (69%) and their involvement in the health centers’ functioning (76.6%). Participants were dissatisfied with their salaries (70.2%) and the lack of opportunities for advancement (47.8%). The positive effects of the performance based financing approach contributed to the job satisfaction of the healthcare workers in the Edea health district. These results should prompt the government to extend the performance based financing approach to communities and other health districts in Cameroon.</p> Leon Jules Owona Manga André Arsène Bita Fouda Lucien Mbida Come Ebana Mvogo ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.760 Sexual and physical intimate partner violence among women using antenatal care in Nampula, Mozambique <p>The aim was to estimate the prevalence of sexual and physical intimate partner violence (IPV) and its associated factors, in a sample of pregnant women using antenatal care (ANC) in Nampula province - Mozambique. This cross-sectional study was carried out in six health units in Nampula, from February 2013 to January 2014. Overall, 869 participants answered the Conflict Tactics Scale 2. The lifetime and past year prevalence of sexual abuse was 49% and 46%, and of physical abuse was 46% and 44%, respectively. Lifetime and past year sexual abuse was significantly associated with living as a couple, alcohol drinking and having a past diagnosis of gonorrhea. Lifetime and past year physical abuse increased significantly with age and was associated with living as a couple, alcohol drinking and history with syphilis. The prevalence of lifetime and previous year violence among women using ANC was high and similar showing that most women were constantly exposed to IPV. ANC provides a window of opportunity for identifying and acting on violence against women.</p> Eusébio Chaquisse Sílvia Fraga Paula Meireles Glória Macassa Joaquim Soares Francisco Mbofana Henrique Barros ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.744 The status of health promotion in Botswana <p>Health education and promotion remains an integral part of public health. This paper details health promotion activities in Botswana since the establishment of the profession in 1988. It further describes health promotion infrastructure, investment in health promotion, human resource training and collaborations within the country. Infrastructure and services for health promotion in the country are mainly provided by government through educational institutions, faith based organizations, non-governmental organizations, general medical practitioners and mining companies complementing the Ministry’s efforts. More than 1000 health promotion cadres have been trained at certificate, diploma and degree levels by Boitekanelo College and the Ministry of Health through Serowe Institute of Health Sciences.</p> Roy Tapera Sekis Moseki James January ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.699 BRCA1 c.68_69delAG (exon2), c.181T>G (exon5), c.798_799delTT and 943ins10 (exon11) mutations in Burkina Faso <p>The worldwide variation of BRCA mutations is well known. The c.68_69delAG, c.181T&gt;G, c.798_799delTT mutations in BRCA1 were observed in Moroccan, Algerian and Tunisian Breast Cancer families and were described founder mutation in Northern Africa. The 943ins10 is also recognized a founder mutation in West Africa. To our knowledge no study has been published on BRCA1/2 germline mutations and hereditary breast cancer (HBC) in population of Burkina Faso. The aim of the present study (first in Burkina Faso) was to screen for these four mutations in 15 unrelated patients with HBC. Mutation analysis was performed by Sanger sequencing of coding exon2, Exon5 and exon11A sequences of the BRCA1 gene. Blood specimens of 15 patients from Burkina Faso, with HBC were collected at the University Hospital Yalgado OUEDRAOGO( CHU-YO) of Ouagadougou in Burkina Faso. c.68_69delAG (exon2), c.181T&gt;G (exon5), c.798_799delTT and 943ins10 (exon11) mutations were not detected in any of the 15 women diagnosed with family breast cancer history. Genetic analysis in this study, we show that targeting relevant exons in BRCA1 genes did not allow detection of mutations in the population of Burkina Faso. Therefore, such an approach may be of interest to perfom a complete sequencing of BRCA1 and BRCA2 genes in families at a high risk of developing breast cancer in Burkina Faso.</p> Abdou Azaque Zoure Meriem Slaoui Hierrhum Aboubacar Bambara Alexis Yobi Sawadogo Tegwendé Rebeca Compaoré Nabonswindé Lamoussa Marie Ouédraogo Mohammed El Mzibri Mohammed Attaleb Si Simon Traoré Jacques Simpore Youssef Bakri ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.663 Methanol poisoning in South- South Nigeria: Reflections on the outbreak response <p>The methanol poisoning outbreak in Rivers State in May 2015, involved 84 persons in five local government areas. An incident management system comprised of an Emergency Preparedness and Response (EPR) committee and the Local Government Area Rapid Response Teams in an Emergency Operations Centre (EOC). The EOC teams conducted case finding activities, line listing, and descriptive analysis, a retrospective cohort study and collection of local gin samples for laboratory investigation. They also coordinated community mobilization and sensitization activities, intervention meetings with local gin sellers, trace back activities and case management. Those affected were male (72; 85.7%) aged between 20 and 79 years. Of the 55 persons whose socio-demographics were obtained, forty-one persons (74.6%) were married, and 23 (41.8%) had primary education. Case fatality rate was 83.3% with an attack rate of 16 per 100,000 persons. Those exposed to ingestion of adulterated gin were six times more likely to develop methanol poisoning than those not exposed RR=6 (1.0-38.5); P=0.0078. It is hoped that this experience has positioned the state for better preparedness towards future outbreaks.</p> Nnanna Onyekwere Ifeoma Nwadiuto Sylvester Maleghemi Omosivie Maduka Tamuno-Wari Numbere Ndubuisi Akpuh Esther Kanu Ifeoma Katchy Ibitein Okeafor ##submission.copyrightStatement## 2018-07-06 2018-07-06 10.4081/jphia.2018.748