Journal of Public Health in Africa <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> en-US <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>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.</li> <li>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.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>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.</li> <li>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.</li> <li>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.</li> </ol> (Emanuela Fusinato) (Tiziano Taccini) Fri, 03 May 2019 11:34:23 +0200 OJS 60 Trends of and factors associated with cesarean section related surgical site infections in Guinea <p>Since the adoption of free obstetric care policy in Guinea in 2011, no study has examined the surgical site infections in maternity facilities. The objective of this study was to assess the trends of and factors associated with surgical site infection following cesarean section in Guinean maternity facilities from 2013 to 2015. This was a retrospective cohort study using routine medical data from ten facilities. Overall, the incidence of surgical site infections following cesarean section showed a declining trend across the three periods (10% in 2013, 7% in 2014 and 5% in 2015, P&lt;0.001). Women who underwent cesarean section in 2014 (AOR: 0.70; 95%CI: 0.57-0.84) and 2015 (AOR: 0.43; 95%CI: 0.34-0.55) were less likely to develop surgical site infections during hospital stay than women operated in 2013. In the contrary, women with comorbidities were more likely to experience surgical site infection (AOR: 1.54; 95% CI: 1.25-1.90) than those who did not have comorbidities. The reductions achieved in 2014 and 2015 (during the Ebola outbreak) should be sustained in the post-Ebola context.</p> Alexandre Delamou, Bienvenu Salim Camara, Sidikiba Sidibé, Alioune Camara, Nafissatou Dioubaté, Alison Marie El Ayadi, Katy Tayler-Smith, Abdoul Habib Beavogui, Mamadou Dioulde Baldé, Rony Zachariah ##submission.copyrightStatement## Fri, 03 May 2019 11:52:54 +0200 Genital hygiene behaviors and practices: A cross-sectional descriptive study among antenatal care attendees <p>The female genital tracts harbor a wide variety of microorganisms’ knowns as microflora mostly constituted by lactobacilli, involved in the healthy state of the vagina without causing infection. Urinary tract infections (UTI) are frequent in pregnant women due to physiological and anatomical changes that occur during pregnancy. These infections can result to disabilities or serious health problems both for the mother and the new-born. Vaginal douching has been reported among risky practices associate with UTIs. However, this remains debatable and contradictory when other studies report the benefit effects of vaginal cleaning in infection prevention. The aim of this study was to assess pregnant women behaviors and practices regarding genital hygiene. This was a cross sectional descriptive study conducted on exhaustive sample of pregnant women coming for antenatal visits in Lafé Sub-divisional Hospital (SDH) and Baleng Catholic Health Center (BCHC) between 16 and 30 September 2013. Data were collected using a paper based standardized questionnaire directly self-administered after obtain a free consent. Overall, 80 pregnant women were enrolled. The majority of them had attended at least primary education (97.5%; n=78/80) and many were lived in couple (81.25%; n=65/80). Almost one on three participants identified antenatal consultation (ANC) as a key element to be taken into account by pregnant women. 70.1% (n=56/80) of women declared wearing undergarments in cotton. Regarding the daily vaginal douching behaviors, the majority (76.3%; n=61/80) of participants used the recommended gynecological measure, while the remaining use self-prescribed measures. Both genital parts (vulva area and vagina) were cleaned and use of water was mostly cited (63.8%; n=51/80). Almost one participant on four (n=29/80) use antiseptic solutions for genital cleaning. Antiseptic solutions were associated with water in 34.5% of cases (n=10/29), and in 65.5% (n=19/29) of cases it was used only for the vagina. Our findings suggest that knowledge and genital hygiene cleaning practices are acceptable among our study population. Risky practices such as use of antiseptic solutions and synthetic underwear’s were reported. Skills of health care providers on good hygiene practices for pregnant should be improved and community-based communication strategies need to be implemented to reach all women of child bearing age.</p> Patrick Martial Nkamedjie Pete, Rodrigue Mabvouna Biguioh, André Gael Bita Izacar, Sali Ben Béchir Adogaye, Cecile Nguemo ##submission.copyrightStatement## Fri, 03 May 2019 11:33:55 +0200 The role of health insurance in the coverage of oral health care in Senegal <p>Oral diseases costs are among the most expensive health care benefits. In Senegal, households contribute up to 37.6% of the national health spending through direct payments. The aim of this work was to study the role of health insurance in the coverage of oral health care in Senegal. The study was based on health insurance agents and policyholders. The study reveals that oral health care coverage through health insurance still does not meet requirements for treatment of oral infections. In financial terms, oral health care costs health insurance too much. As a result, carriers cover them partially. On top of that, the majority of the population’s lack of knowledge about mutual, because they have a little background on oral health care, the latter weighs heavily on health insurance leading to the use of self-medication, traditional medicine&nbsp;and handicraft prosthetists. The analysis reveals an unequal access to oral health care through the health insurance system. To bring under control the expenditure for oral health care, carriers and dental surgeons must work together to raise the populations’ awareness on community solidarity.</p> Mbathio Diop, Aida Kanouté, Massamba Diouf, Amadou Diaw Ndiaye, Cheikh Mouhamadou Mbacké Lo, Daouda Faye, Daouda Cissé ##submission.copyrightStatement## Mon, 31 Dec 2018 00:00:00 +0100 Prevalence and correlates of alcohol use disorders among bipolar patients at Amanuel Mental Specialized Hospital, Addis Ababa (Ethiopia): A cross-sectional institution based study <p>At this time, alcohol use is increasing in African countries. The prevalence of alcohol use disorders (AUDs) remains unknown in patients with psychiatric disorders. This study aimed to assess the prevalence of AUDs among individuals with bipolar disorder in the outpatient department at Amanuel Mental Specialized Hospital. An institution-based cross sectional study was conducted among 412 bipolar patients attending the outpatient department at Amanuel Mental Specialized Hospital from May – July 2015.Participants were selected using a systematic random sampling technique. Semi-structured questionnaires were used to collect socio-demographic and clinical data. Alcohol use disorder was measured using the Alcohol Use Disorders Identification Test (AUDIT-10). Binary logistic regression analysis was performed. The prevalence of alcohol use disorder was found to be 24.5%. Those affected were predominantly female (58.5%). Being18-29 years of age(AOR=3.86, 95% CI: 1.34, 11.29), being 30-44 years of age (AOR=4.99, 95%CI: 1.85, 13.46), being unable to read and write (AOR=5.58, 95%CI: 2.026, 13.650), having a secondary education (AOR=3.198, 95%CI: 1.149, 8.906), being a farmer (AOR=4.54, 95%CI: 1.67, 12.32), being employed by the government (AOR=3.53, 95%CI: 1.36, 4.15), being a day labourer (AOR=3.5, 95%CI: 1.14, 10.77), use of other substances during past 12 months (AOR=2.06, 95%CI: 1.06, 3.99), having a family history of alcohol use (AOR=2.18, 95%CI: 1.29, 3.68), having discontinued medication (AOR=2.78, 95%CI: 1.52, 5.07), having suicidal thoughts (AOR=4.56, 95%CI: 2.43, 8.54), and having attempted suicide (AOR=5.67, 95%CI: 3.27, 9.81) were statistically significant to alcohol use disorder using multivariate logistic analysis. The prevalence of co-morbid alcohol use disorder was high. This finding suggests that screening for risky alcohol use should be integrated into routine hospital outpatient care. Further, preventive measures against alcohol use disorder should be established.</p> Debebe W. Tensae, Haddis Solomon, Berhanu Boru, Wondale Getinet ##submission.copyrightStatement## Mon, 31 Dec 2018 00:00:00 +0100 Mass media awareness campaign and the prevention of the spread of Lassa fever in the rural communities of Ebonyi State, Nigeria: Impact evaluation <p>This paper investigates the impact of media campaign on the prevention and spread of Lassa fever in Ebonyi state. 354 respondents were randomly selected from six rural communities in the state as study sample, while structured questionnaires were used for collecting data. SPSS version 20.0 was used to analyze the data. Results of analysis reveal that the media campaign has rural reach but has little or no impact. The results also reveal that the campaign failed to create appropriate awareness of the disease, its preventive/curative health behaviors. It further reveals that there are no&nbsp;health behavior modifications among the people because of the campaign. Therefore, this paper recommends the modification of media contents to incorporate the required preventive/curative health behaviors. Secondly, mandatory mass media awareness campaign and jingles in every news hour is recommended.</p> Joseph Oluchukwu Wogu ##submission.copyrightStatement## Fri, 21 Dec 2018 13:10:33 +0100 Establishing common leadership practices and their influence on providers and service delivery in selected hospitals in Lusaka province, Zambia <p>In an evolving health care environment, hospitals need managers with high levels of technical and professional expertise who do not only concentrate on patient care, but also go further to demonstrate good leadership practices. In Zambia, the health sector’s mission is “to provide equity of access to cost-effective quality health services as close to the family as possible”. Only competent leadership can drive such an agenda. This study, conducted in selected 1st level Lusaka hospitals aimed at establishing the existing common leadership practices and their influence on healthcare providers and service delivery. The study employed a cross-sectional qualitative research method design, to establish and examine the leadership practices through 10 health system managers and 32 healthcare providers. The data was obtained using in-depth interviews, focus group discussion, participant observation and document review. Data analysis was done by first transcribing audio-recorded interviews and grouping them into data sets (matrixes) where emerging themes were categorized manually. The information obtained assisted in making conclusions and interpretations by providing eminent explanations pointing to specific leadership styles and influence caused on healthcare providers and service delivery. The common leadership practices obtained in this study was the transformational leadership followed by transactional leadership while laissez-faire was rare type of leadership. This conclusion was arrived at through the practices that were pointing to transformational and transactional leadership as preferred by the leaders and perceived or experienced by providers. These practices were explained as networking, interpersonal relationships, human/material resources management, monitoring and evaluation, dictatorial tendencies and overworking of employees. Furthermore, these practices were seen to have strong influence on healthcare providers through enhanced confidence, motivation for hard work and compromised quality of care. The resultant impact on service delivery was high quality performance as well as poor performance. Leadership styles affect employees’ commitment, motivation, satisfaction, extra effort and efficiency. This in turn has a bearing on performance and directly or indirectly influences patient care and its quality. Health system managers have a significant role in using leadership styles that promote good practice. It can be safely concluded that hospital performance and quality health care delivery services is a product of several factors. The analysis of leadership practices in this study shows two of the factors influencing hospital performance. The first factor is the effectiveness of leaders within the hospital and secondly the dedication, motivation, commitment and performance of employees that will improve health care services.</p> Regina M. Mulenga, Selestine Nzala, Wilbroad Mutale ##submission.copyrightStatement## Fri, 21 Dec 2018 13:01:59 +0100 Investigation of medicinal plants traditionally used as dietary supplements: A review on Moringa oleifera <p>Diet and nutrition are important factors in the promotion and maintenance of good health throughout the entire life course. A plant-based diet may be able to prevent and treat chronic diseases such as diabetes, heart disease and hypertension, obesity, chronic inflammation and cancer. Phytonutrient rich foods are found in traditional African diet which is mostly vegetarian, and most of these food plants are often used for medicinal purposes. This review focuses on a peculiar plant <em>Moringa oleifera</em>, called the “Miracle Tree”, considered to be one of nature’s healthiest and most nutritious foods. Countless studies describe the benefits of <em>Moringa</em> leaves, pods, seeds and flowers. Its well-documented role in prevention and treatment of chronic diseases is hypothesized here as a result of possible of cross-kingdom regulation by exogenous vegetal microRNAs and synergistic action of plant bioactive components on endogenous human microRNA regulation. The potential health impact of phytocomplexes from African dietary plants within the context of cross-kingdom and endogenous microRNA regulation on health improvement and the overall economic well-being of the continent is estimated to be enormous.</p> Ivana Matic, Arianna Guidi, Maurice Kenzo, Maurizio Mattei, Andrea Galgani ##submission.copyrightStatement## Fri, 21 Dec 2018 12:50:40 +0100 Assessment of adverse drug reactions in the home management of malaria cases of children under 5 years using artemisinin-based combination therapy in Mfou health district, Center region of Cameroon <p>health concerns in Cameroon. Its treatment is frequently initiated at home, most often with street drugs. The home management of malaria cases entails the prescription of Artemisinin-based combination (ACTs) as first-line therapy for treatment of uncomplicated&nbsp;malaria after having confirmed the malaria case using rapid diagnostic tests. But induced adverse reactions of this therapy are not well known in Cameroon. Thus, a prospective, observational, cohort study of adverse events associated with ACTs was conducted from January 2013 to November 2013 in the health district of Mfou. Children under 5 years receiving ACTs for malaria treatment at home were enrolled. Suspected ADRs and other clinical events were recorded. Data were managed and analysed using Epi Info version 3.5.3 and Statistical Package for Social Sciences, statistical software version 20. Of the 479 children investigated, 56.8% (n=272/479) were males, the age group 25-59 months (49.5%; n=237/479) was most represented, 27.1% (n=130/479) had experienced one form of ADRs, male children (56.2%; n=73/130) and the age group 25-59 months (50.8%; n=66/130) were most affected. No significant association was found between age, sex and incidence of adverse ACTs reactions. The main experienced ACTs reactions were tiredness (43.1%; n=56/130) followed by lack of appetite (24.6%; n=32/130). The incidence ACTs ARDs was found to be relatively low and tolerable. Home management of malaria cases using ACTs should be encouraged and community members should be trained to improve the recognizing and reporting of adverse effects.</p> Louis Essengue Bahina, Christian Jean Youmba, Rodrigue Biguioh Mabvouna, Joëlle Sobngwi ##submission.copyrightStatement## Fri, 21 Dec 2018 11:38:43 +0100 Design of a typical residence for the elderly in Morocco <p>The population of Moroccan elders is in full increase; their requirements for quality and quantity of services are becoming increasingly important. On the basis of this, reality and extension of many major innovative projects in Morocco (industrial expansion plan, renewable energy stations, the road infrastructure network, rural electrification, drinking water, accelerated urbanization, globalization...) gain importance. Reflection on the design of a typical residence for the elderly has become an ambitious idea possessing all the chances of its success; it is also worth noting that it is a citizen opportunity to be seized by all political decision-makers for the promotion of health and the improvement of the quality of life of a growing category of the population. The typical residence of the elderly remains not only a place of life but also an environment of therapeutic care and at different levels of autonomy and dependence of our elders.</p> M. Bouaoudate, J. El Harti, M. Maamar, R. Abouqal ##submission.copyrightStatement## Fri, 21 Dec 2018 11:36:07 +0100 Field application of the Micro Biological Survey method for the assessment of the microbiological safety of different water sources in Tanzania <p>Access to safe water is stated within human rights as essential for life, as water can be a source of severe enteric infections threatening human health, in particular children from Developing Countries. Along with reference methods, need is pressing for alternative methods to flank reference ones to improve water safety on-site monitoring and in the absence of scientific facilities or even electricity supply. The Micro Biological Survey (MBS) method has already been successfully applied to water safety assessment in Developing Countries. A total of 18 water samples were collected from different sources (rivers, dug wells, tap water) within the Rukwa Region, Tanzania, and underwent analysis for Total Coliforms following the MBS method. Globally, rivers showed more frequently contamination, followed by dug wells, tap water and tanks. Results demonstrate the need for continuous monitoring of water sources, even in difficult frameworks lacking electric supply, to help improve control over water quality, possibly using alternative methods to simplify existing protocols.</p> Matteo Gionfriddo, Beatrice Nicolosi, Lorenza Murgia, Alyexandra Arienzo, Laura De Gara, Giovanni Antonini ##submission.copyrightStatement## Fri, 21 Dec 2018 11:34:22 +0100