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Record No. 10173 Record ID 010173 Publication type Journal Article Title Reproductive Health Knowledge and Practices among Junior Secondary School Grade one Students in Enugu State: Threat to Achieving Millennium Development Goals in Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Nwaorgu, O. C.; Onyeneho, N. G.; Okolo, M.; Obadike, E.; Enibe, G. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 126-131, fig., tab. Language English Descriptor Reproductive Medicine; Health Knowledge, Attitudes, Practice; Students; Schools Descriptor-Local Millennium Development Goals Descriptor-Geographic Nigeria-Enugu; Abstract Objective: This was designed to provide background information for the implementation of family life and HIV/AIDS education in post primary schools in the Enugu State. Methods: A cross sectional survey of the reproductive health knowledge and practices of 412 junior secondary school pupils from 12 schools in Enugu State, Nigeria was undertaken using a uniform set of structured self-administered questionnaire. Results: The results revealed that while the pupils demonstrated fair knowledge of human biology, they lacked knowledge of selfprotective mechanisms as it related to sexual health. About (50) of the participants reported that they have had sex, at the age of less than 11 years when they must have been in the primary school and most (89.3) at age 11-14 years. Half (50.9) of the respondents hold the belief that a girl would not get pregnant in her first sexual encounter. Statistically more of those who have ever had sex were betrayed this ignorance (p=0.004). The boys were less certain about what constitutes the wrong ideas about reproductive health systems than the girls (p=0.042). In the same vein, there was a difference (p0.0001) in the proportion of the rural residents, vis-à-vis their urban counterparts that could correctly identify the wrong ideas about human reproduction. Conclusion: This situation urgently calls for concerted efforts at addressing the poor reproductive health knowledge of these sexually active young people, for the millennium development goals (MDGs) target to be realized in Nigeria Electronic Access :  Full Text-1

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Record No. 10172 Record ID 010172 Publication type Journal Article Title Poor Knowledge on New Malaria Treatment Guidelines among Drug Dispensers in Private Pharmacies in Tanzania: the Need for Involving the Private Sector in Policy Preparations and Implementation Source of Record 0WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Minzi, O.M.S.; Haule, A. F. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 117-121, tab. Language English Descriptor Malaria-therapy; Antimalarials Pharmacies Private Sector Guideline Descriptor-Geographic Tanzania Abstract Objective: To assess the knowledge of dispensers in private pharmacies on new malaria treatment guidelines which involved switching from chloroquine (CQ) to sulfadoxine pyrimethamine (SP) and from SP to artemether-lumefantrine. Methods: A structured questionnaire was used for data collection and the questions focused on whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense new antimalarial medicines as recommended in the introduced new treatment guidelines. Results: The study revealed that none of the participants had been involved in the preparation of the treatment guidelines, nor had they undertaken any training on their implementation. As many as 49of the visited private pharmacies were found to continue stocking and selling CQ tablets and injections. Only 30 and 7knew the correct dose regimen of SP and ALU respectively and none of them knew the condition of taking ALU with a fatty meal for improved absorption. Conclusion: Lack of involvement of the pharmaceutical personnel working in the private pharmacies, from the preparation of new malaria treatment guidelines to their implementation, contributed to their poor knowledge and skill on how to correctly dispense the medicines. Electronic Access :  Full Text-1

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Record No. 10171 Record ID 010171 Publication type Journal Article Title Evaluation of Cervical Cancer Screening Program at a Rural Community of South Africa Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Hoque, M.; Hoque, E.; Kader, S. B. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 111-116, tab. Language English Descriptor Uterine Cervical Neoplasms; Mass Screening; Rural Population; Cross-Sectional Studies Descriptor-Geographic South Africa Abstract Objective: Cervical cancer is a leading cause of deaths among women worldwide. But the condition is preventable through regular screening of women those are 'at risk' for abnormal changes in the cervix and treating them who have positive results. Although screening facilities are available in South Africa, the incidence and mortality from cervical cancer remains very high and many women present health facilities with late stage diseases. Purpose of the study is to determine the baseline information on knowledge and practices on risk factors for cervical cancer and Pap smear and to design an intervention to improve Pap smear uptake. Methods: A cross-sectional population based descriptive study was undertaken at a rural community of South Africa targeting women 30 years and over. The assessment was performed by means of a questionnaire survey. Outcome measures were percentage of women with the knowledge on risk factors for cervical cancer and use of Pap smear test and had undertaken Pap smear test. Binary logistic regression analysis was carried out to identify possible predictors of Pap smear test undertaken. A total of 611 women (random samples) were recruited from the selected households. Results: The mean age of the sample was 43 years and 54of them had no education. Only 6knew all and 65knew any one of the risk factors of cervical cancer whereas less than half (49) of them knew that Pap smear is used for prevention of cervical cancer. Only 43respondents received information on Pap smear from health care workers. Among all the respondents only 18(95CI, 15-21) had ever done Pap smear test. Conclusions: This study showed low uptake of Pap smear test and low level of knowledge on prevention of cervical cancer and risk factors thus warrants urgent extensive health education program for this rural communities Electronic Access :  Full Text-1

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Record No. 10170 Record ID 010170 Publication type Journal Article Title The Effectiveness of the TBA Programme in Reducing Maternal Mortality and Morbidity in Malawi Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Bisika, T. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 103-110, tab. Language English Descriptor Maternal Mortality; Morbidity; Midwifery; Risk Factors; Delivery of Health Care Descriptor-Geographic Malawi Abstract Objective: The main objective of this study was to assess the role of TBAs and the quality of their services in contributing to the reduction of maternal deaths in Malawi. Methods: This study used a qualitative research methodology involving key informant and in-depth interviews, observation and focus group interviews. Results: The study found that most of the people rely on traditional birth attendants although the quality of their services is poor due to illiteracy, their ailing age, lack of supplies and equipment and general absence of supervision. The study further observed that although the hospital sees many pregnant women during antenatal care, very few women actually come back to the hospital for delivery. The study also found that there was high awareness among TBAs about what they were supposed to do but that their actual practices did not reflect compliance with their roles as assigned by the formal health system. Conclusion: The study concludes that TBAs are an important source of maternal care especially in rural areas and that they need to be empowered to comply with the requirement of ensuring infection free deliveries. This entails adequate supervision and provision of supplies. The study further observed that the utilization levels of TBAs is far much greater that presently acknowledged suggesting severe inadequacies within the formal health system. Electronic Access :  Full Text-1

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Record No. 10169 Record ID 010169 Publication type Journal Article Title Management and Organization Reforms at the Muhimbili National Hospital: Challenges and Prospects Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Mwangu, M. A.; Mbembati, N. A. A.; Muhondwa, E. P. Y.; Leshabari, M. T. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 94-102, fig., tab. Language English Descriptor Health Care Reform; Management Service Organizations Descriptor-Geographic Tanzania Abstract Objective: To establish the state of organization structures and management situation existing at the Muhimbili National Hospital (MNH) and Muhimbili University College of Health Sciences (MUCHS) prior to the start of the MNH reforms and physical infrastructure rehabilitations. Methods: A checklist of key information items was used to get facts and figures about the organization of the MNH and management situation. Interviews with MNH and MUCHS leaders, and documentation of existing hospital data were done to gather the necessary information. Results: The survey reveals that there are a number of organizational, managerial and human resource deficiencies that are impinging on the smooth running of the hospital as a national referral entity. The survey also revealed a complex relationship existing between the hospital and the college (MUCHS) that has a bearing on the functioning of both entities. Conclusion: In order for the hospital to function effectively as a referral hospital with a training component inbuilt, four basic things need to be put in place among others: a sound organization structure; adequate staffing levels especially of specialist cadre; a functional information system especially for inpatient services and a good working relationship with the college Electronic Access :  Full Text-1

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Record No. 10166 Record ID 010166 Publication type Journal Article Title Status and Visions for the School Health Service as Reported by Local Health Care Workers in Northern Tanzania Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Borge, A. M.; Manongi, R. N.; Masatu, M. C.; Klepp, K. I. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 79-85, tab. Language English Descriptor School Health Services; Delivery of Health Care; Health Promotion; World Health Organization Descriptor-Geographic Tanzania Abstract Objective: The World Health Organization's (WHO) Global School Health Initiative provides a strategy to utilize schools to promote health and reduce the burden of diseases worldwide. The aim of this study was to investigate local school health work in Tanzania in relation to existing national guidelines and the WHO initiative. Methods: We intervie- wed 30 health care workers employed at 15 health institutions throughout Arusha and Kilimanjaro regions. Results: The results indicate a wide gap between the national and international guidelines for school health programs and the health workers' current practices. We found the main obstacles to providing adequate health care to be related to the burden of poverty that influences all levels of school health services, lack of clarity regarding the current official guidelines for school health services, and lack of appropriate offers for continuing education in the area of school health services. Conclusion: In order to successfully establish an integrated school health service, the working relationship between schools, health centres and the community clearly needs improvement. Electronic Access :  Full Text-1

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Record No. 10165 Record ID 010165 Publication type Journal Article Title Factors Affecting Antiretroviral Drug Adherence among HIV/AIDS Adult Patients Attending HIV/AIDS Clinic at Moi Teaching And Referral Hospital, Eldoret, Kenya Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Talam, N. C.; Gatongi, P.; Rotich, J.; Kimaiyo, S. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 74-78, tab. Language English Descriptor Anti-Retroviral Agents; Medication Adherence; HIV Infections; Acquired Immunodeficiency Syndrome; Referral and Consultation Descriptor-Geographic Kenya-Eldoret; Abstract Objective: To determine important factors that affect antiretroviral drug adherence among HIV/AIDS male and female adult patients (18 years and above) attending Moi Teaching and Referral Hospital, Eldoret, Kenya. Methods: A cross sectional study involving 384 HIV/AIDS adult patients attending Moi Teaching and Referral Hospital, Eldoret was conducted. These patients were on ARV drugs. They were investigated for factors that affected their drug adherence based on observing the timing of doses and keeping of clinic appointments for drug refills during the months of May, June and July 2005. Data were collected from the respondents using interviewer-administered questionnaires to patients and self-administered questionnaires by ten key informants (nurses and clinicians in charge of HIV/AIDS clinic) selected by purposive sampling. The key variables examined were demographic, other characteristics of the patients and adherence factors. Data were analysed using Statistical Package for Social Sciences (SPSS) version 10.0 for frequencies, cross-tabulations and Chi-Squared test and statistical significance set at p0.05. Results: Sixty-eight percent of the respondents on ARVs were females. 52.1had secondary and post secondary education. They were aged between 18-63 years (mean age 36.1 ±8.5 years). Results showed that only 43.2adhered to the prescribed time of taking drugs. The most commonly cited reasons for missing the prescribed dosing time by the patients were: Being away from home 68.8, being too busy 58.9, forgetting 49.0, having too many medicines to take 32.6and stigma attached to ARVs 28.9. There was no significant difference between males and females based on timing of taking medications (?2= 2.9412, p = 0.0861). On the basis of keeping clinic appointments, all the respondents claimed to adhere to scheduled clinics. However, from hospital records, it was established that only 93.5of the respondents kept clinic appointments. The most common reasons for poor adherence to clinic appointments were; Being away from home (50), forgetting (50), being too busy (50), stigma (70), feeling sick (80) and changes in work routine (60). Conclusion: The key factors affecting adherence were; being away from home, being busy and forgetting. It was recommended that patients should be educated on the importance of strict adherence to the prescribed doses of ARVs as a suitable measure of intervention. Future research should explore multiple-target interventions to resolve the barriers to adherence. Electronic Access :  Full Text-1

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Record No. 10164 Record ID 010164 Publication type Journal Article Title Patient Satisfaction at the Muhimbili National Hospital in Dar Es Salaam, Tanzania Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Muhondwa, E. P. Y.; Leshabari, M.T.; Mbembati, N.; Ezekiel, M. J. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 67-73 Language English Descriptor Patient Satisfaction; Health Care Reform; Referral and Consultation Descriptor-Geographic Tanzania-Dar Es Salaam; Abstract Objectives: Patients are the primary beneficiaries of the services and care that hospitals provide. The Patient Satisfaction study examined the extent to which patients at the Muhimbili National Hospital (MNH) were satisfied with the services and care they received at MNH. This was part of a baseline study that sought to determine the level of performance of the hospital before massive restructuring, reform, and renovations were undertaken. Methodology: Exit interviews were the main research method used to determine patient satisfaction. Patients were interviewed as they were leaving the OPD clinics, laboratory, X-ray, pharmacy and inpatient wards. Results: The study found that most patients were satisfied with the services and care they received. This high level of satisfaction must be viewed within the context of a hierarchical public health care delivery system, with MNH at the apex. The services and care MNH provides can only be excellent compared to that provided by lower level health facilities. Indeed, patients covered by this study perceived the services provided by MNH as superior, and this was reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction with specific aspects of the services that they received. They were particularly dissatisfied with long waiting times before receiving services, the high costs of treatment and investigations charged at MNH, poor levels of hygiene in the wards, and negative attitudes of staff towards patients. Conclusion: Although only a small proportion of patients expressed dissatisfaction with these aspects of the services provided, they are significant in that they constitute a call for action by the MNH management to encourage the health personnel to embrace a new staffpatient relationship ethos, in which the patient is a viewed as a customer Electronic Access :  Full Text-1

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Record No. 10163 Record ID 010163 Publication type Journal Article Title Risk Factors of Anaemia among Rural School Children in Kenitra, Morocco Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) EL Hioui, M.; Ahami, A. O. T; Aboussaleh, Y.; Rusinek, S.; Dik, K.; Soualem, A.; Azzaoui, F. Z.; Loutfi, H.; Elqaj, M. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 62-66 Language English Descriptor Anemia, Iron-Deficiency; Ferritins; Risk Factors; Schools; Rural Health Descriptor-Geographic Morocco-Kenitra; Abstract Objective: To determine the prevalence of anaemia and factors associated with iron deficiency among school children in rural Kenitra, Morocco. Methods: 295 students between 6 and 16 years old composed the study group. The level of haemoglobin was measured in a group of 295 school children. The iron status was determined by ferritin level in serum, and anaemia was defined when haemoglobin 11.5 g/dl. Iron deficiency was defined as ferritin level 5 µg/l. A questionnaire was developed to obtain information on the socio-economic and demographic status of the family such as the size of household, the income and possessions as well as educational status of the parents. Results: The mean haemoglobin concentration was 12.4 g/dl in boys and 12.5 g/dl in girls, whereas the mean ferritin level was 26.7 Wg/l in boys and 27.9 Wg/l in girls. The overall prevalence of anaemia in the studied population was 12.2and iron deficiency was 20.4. There was a significant relationship between education of the mother and anaemia in children (p= 0.01). Serum ferritin (SF), serum iron concentrations and mean corpuscular volume (MCV) were significantly correlated with haemoglobin by multiple regression analysis. However, using logistic regression analysis, the results showed that anaemia was not significantly associated with gender, parents' employment and monthly family income. Conclusion: Anaemia remains a common problem in the young children particularly the primary education school boys of the households of low income. The results suggest also, that iron deficiency is an important determinant of anaemia in this population; however, whole anaemia cannot be solely explained by iron deficiency. Further studies are needed to consider micronutrients status and exposure to environmental pollutants Electronic Access :  Full Text-1

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Record No. 10162 Record ID 010162 Publication type Journal Article Title Disabled Persons and HIV/ AIDS Prevention: a Case Study of Deaf and Leprosy Persons in Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Enwereji, E. E.; Enwereji, K. O. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 55-61 Language English Descriptor Leprosy HIV Infections-prevention & control; Acquired Immunodeficiency Syndrome Disabled Persons Deafness Case Reports Descriptor-Geographic Nigeria Abstract Objective (s): (i) To investigate factors and conditions that influence HIV/AIDS prevention among leprosy and deaf persons in leprosy settlements in Nigerian; (ii) to examine the extent to which the Government includes leprosy and deaf persons in HIV prevention programmes; (iii) To identify immediate needs of leprosy and deaf patients in settlements (iv) to determine possible areas for improving services so as to explore potential solutions Methods: Total sample of 227 inmates and 34 Health Care Workers were studied in three purposively selected settlements. Two intervention concepts, participatory reservation approach (PRA) and planned action (PLA) were utilized in the study. The concepts enabled researchers to examine factors that influenced provision of HIV/AIDS prevention programmes to inmates in settlements. Data collection instruments were questionnaire and focus group discussions for inmates and interview guides for Health Workers. Data were analysed qualitatively and quantitatively with the help of Stat Pac Gold package. Results: Findings showed that there were no reproductive health and and HIV prevention programmes in the settlements. There was lack of Governments' commitment to fund health programmes and to train Health Workers, as well as rejection, isolation, discrimination and discouragement of HIV/AIDS prevention programmes in settlements. There was poor knowledge of mode of transmission of HIV/AIDS among inmates. About 59 (53.6) of inmates in Abia, and 60 (51.3) in Oyo were not interested in voluntary counselling and sex education. Findings showed that inmates in the leprosy settlements were at risk of unprotected sex. About 99 (43.6) in Oyo and 88 (38.8) in Abia State, especially those who were single cohabited with opposite sexes to have babies in settlements (p = 003). Conclusion: Number of inmates that had babies in settlements justifies providing sex education, reproductive health and HIV/AIDS prevention programmes. This will assist in reducing HIV/AIDS prevalence among disabled persons in Nige Electronic Access :  Full Text-1

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Record No. 10161 Record ID 010161 Publication type Journal Article Title Fear of Stigmatization as Barrier To Voluntary HIV Counselling and Testing In South Africa Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Meiberg, A. E.; Bos, A. E. R; Onya, H. E. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(2) Pages 49-54 Language English Descriptor HIV; Acquired Immunodeficiency Syndrome; Stereotyping; Counseling; Voluntary Workers Descriptor-Geographic South Africa Abstract Objective: The objective of this qualitative study was to identify psychosocial correlates of HIV voluntary counselling and testing (VCT), with an emphasis on the association between fear of AIDS-related stigma and willingness to have an HIV test. Methods: The study was executed in Limpopo Province at University of Limpopo, Polokwane, South Africa. Focus group interviews were held among 72 students, divided over 10 groups. Results: Results showed that participants had different levels of knowledge about HIV/AIDS and VCT, and that AIDS was still strongly associated with 'death'. Results further demonstrate that HIV/ AIDS related stigma is still a very serious problem in South Africa. Lack of HIV/ AIDS related knowledge, blaming persons with HIV/AIDS for their infection, and the life-threatening character of the disease were seen as the most important determinants of AIDS-related stigma. The main benefit to go for VCT was 'knowing your HIV status', whereas main barriers for testing were 'fear of being stigmatised' and `fear of knowing your HIV positive status'. Conclusion: Fear of stigmatization is an important barrier to HIV testing and has negative consequences for AIDS prevention and treatment. Interventions to reduce HIV-related stigma are needed in order to foster voluntary HIV counselling and testing in South Africa Electronic Access :  Full Text-1

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Record No. 10160 Record ID 010160 Publication type Journal Article Title The Role of Changing Diet and Altitude on Goitre Prevalence in Five Regional States in Ethiopia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Abuye, C.; Berhane, Y.; Ersumo, T. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 163-168, fig., tab. Language English Descriptor Nutrition Disorders; Iode; Manihot; Diet Therapy; Altitude Descriptor-Geographic Ethiopia Abstract Objective: Iodine Deficiency Disorders (IDD) as one of the leading nutritional problems has been increasing through time due to iodine deficiency, aggravating factors and IDD knowledge in many parts of Ethiopia. The effect of changing diet and altitude on goitre prevalence is assessed. Methodology: Randomly selected five regional states (Amhara, Oromiya, Tigray, SNNP and Benshangul-Gumuz) were used to conduct cross-sectional study on IDD. In each region cluster sampling method was applied to select study subjects. Low land and adjacent high land were independently sampled to investigate the role of altitude on goiter prevalence. Totally 6960 children and the same number of biological mothers of the children were included in the clinical examination for goiter and household interview. Urine samples were collected from children for urinary iodine examination/analysis (UIE). Besides, in all clusters qualitative data were collected on IDD knowledge and cassava introduction, cultivation and consumption. Results: Cassava consumption and living in high altitude were found to be risk factors for IDD. In the two regions (SNNP and Benshangul-Gumuz) among three where cassava is cultivated, those who consume cassava frequently were significantly (p0.001) affected by goitre than those consuming rarely or not. In the last thirty years cassava consumption has been increasing with the concomitant increase in goitre rate and other associated health problems. Acute cyanide intoxication in children from cassava meal was reported. In Amhara region, goitre rate was significantly (p0.05) higher in high altitudes than in low both for children and mothers. This was due to significantly (p0.01) low level of iodine intake in high lands than in low as indicated by UIE. Due to stigma, parents do not send goitrous children to schools and goitrous girls are not wanted for marriage. Conclusion: Besides low level of iodine intake, cassava consumption and living in high altitude were responsible for the observed variation and severity in goitre rates. IDD affects several dimensions of human life including school enrolment and marriage. Addressing IDD in-terms of salt iodization and training communities on cassava processing techniques to remove cyanide, awareness creation on IDD and soil conservation are highly recommended. Electronic Access :  Full Text-1

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Record No. 10159 Record ID 010159 Publication type Journal Article Title Should Public Health be Exempt from Ethical Regulations? Intricacies of Research Versus Activity Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Gitau-Mburu, D. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 160-162 Language English Descriptor Public Health; Social Control, Formal; Ethics, Research; Research; Literature Review Abstract Objective: To assess the role of ethical regulations in public health practice, and to review the need to exempt any public health activity from such ethical regulations. Methods: Literature review of published papers regarding ethical regulations in public health practice. Results: There is a current criticism of public health ethics as hindering rather than facilitating public health research. There is also an existing dilemma as to which Public health activities constitute research and are therefore subject to ethical regulations and which ones are exempt from such regulations. Conclusion: Exempting some public health activities from ethical regulation may occasion an inherent risk of subjective interpreta- tion of the criteria guiding the distinction between Public health research and non-research. In order to avoid inadvertent breach of ethical regulations, ethical regulations should be applied to all public health activities whether formally classified as research or not. Electronic Access :  Full Text-1

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Record No. 10158 Record ID 010158 Publication type Journal Article Title Iron Deficiency in Frequent and First Time Female Blood Donors Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Boulahriss, M.; Benchemsi, N. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 157-162 Language English Descriptor Anemia, Iron-Deficiency; Blood; Tissue Donors; Female Descriptor-Geographic Morocco-Casablanca; Abstract Background: Blood donation has a marked influence on the body iron stores especially in female blood donors . Iron deficiency anaemia is an important limiting factor for the number of donations in female regular blood donors. Aim of the study: This study was conducted to evaluate the frequency of iron deficiency and relevant factors in frequent and first time female blood donors at Casablanca blood transfusion centre, Morocco. Methods: Between November 2005 and April 2006, twenty-one female first time and twenty-one frequent female blood donors were selected randomly. In frequent blood donors, only females with at least 10 donations were included. Haemoglobin concentration, serum ferritin, serum iron and total transferrine binding capacity were measured and analysed. Results: The results of haemoglobin concentration, serum ferritin, serum iron were significant lower in frequent female blood donors when compared with the results of same parameters in first time female blood donors. The results show that the frequency of iron deficiency in frequent female blood donors is 43and in the first time female blood donors is 14. Conclusion: Iron deficiency is very common in regular female blood donors at Casablanca's transfusion centre. Frequent blood donation has marked influence on the body iron stores in frequent female blood donors. It is therefore recommended that blood transfusion centres focused on maintaining iron balance by measuring serum ferritin and total transferrine binding capacity in frequent female blood donors .They have also to educate the donors about iron supplementation and yearly ferritin checking. Electronic Access :  Full Text-1

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Record No. 10157 Record ID 010157 Publication type Journal Article Title Why Patients Miss Follow-Up Neoplasms: a Prospective Control-Matched Study Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Van Der Meer, G.; Loock, J. W. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 154-156, fig. Language English Descriptor Neoplasms; Appointments and Schedules; Outpatients; Follow-Up Studies; Case-Control Studies Descriptor-Geographic South Africa Abstract Objectives: To investigate missed appointments in a South African tertiary hospital. Study Design: Prospective, descriptive series with controls. Setting: T he ENT/Oncology clinic at Tygerberg Academic Hospital, South Africa. Subjects: 305 patients with a head and neck malignancy who had follow-up appointments over 4 consecutive months between June and September 2006. A control group of 31 patients who attended the clinic was recruited in September 2006. Method: Analysis of the clinic attendance statistics to identify patients who missed follow-up appointments followed by a file review and interview of these patients. The results were compared with a control group. Outcome measures: 1) Incidence rate of failure to attend follow-up. 2) Causative factors Results: 51 (17) booked patients missed their appointments. Non-attenders were most likely to miss their follow-up between 6 and 12 months (17/31) after treatment. No correlations were found between diagnosis, disease stage and missed appointments. Reasons include: transport (19 responses), ill-health (6) and financial constraints (5). State transport was unavailable to almost twothirds of the responders who cited transport as a problem. Conclusions: The 17 missed appointment rate is largely due to transport constraints. The commonest time for patients to miss appointments is the 6-12 month follow-up period. The authors seek to identify patients at risk of missed appointments and suggest interventions to decrease this incidence. Electronic Access :  Full Text-1

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Record No. 10156 Record ID 010156 Publication type Journal Article Title Home Management of Diarrhea among Underfives in a Rural Community in Kenya: Household Perceptions and Practices Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Othero, D. M.; Orago, A. S. S; Groenewegen, T.; Kaseje, D. O.; Otengah, P. A. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 142-146, fig., tab. Language English Descriptor Diarrhea, Infantile; Signs and Symptoms; Infant; Child, Preschool; Home Care Services Descriptor-Geographic Kenya; Developing Countries Abstract Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urbancommunities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood Illness (C-IMCI) strategy. Objective: The aim of this study was to determine the perceptions of mothers/caregivers regarding the causes of diarrhea among under-fives and how it was managed in the home before seeking help from Community Health Workers or health facilities. Design: A household longitudinal study was conducted in Nyando district, Kenya in 2004-2006 adopting both qualitative and quantitative approaches. Subjects: A total of 927 mothers/caregivers of under-fives participated in the study. Main outcome measures: Perceived causes of childhood diarrhoea, action taken during diarrhea, fluid intake, recognition of signs of dehydration, feeding during convalescence, adherence to treatment and advice. Results: Majority of the respondents 807(87.1) reported that their children had suffered from diarrhea within the last 2 weeks before commencement of the study. Diarrhea was found to contribute to 48of child mortality in the study area. Perceived causes of diarrhea were: unclean water 524(55.6), contaminated food 508(54.9), bad eye 464 (50.0), false teeth 423(45.6) and breast milk 331(35.8). More than 70of mothers decreased fluid intake during diarrhea episodes. The mothers perceived wheat flour, rice water and selected herbs as anti-diarrheal agents. During illness, 239(27.8) of the children were reported not to have drunk any fluids at all, 487(52.5) drunk much less and only 93(10.0) were reported to have drunk more than usual. A significant 831(89.6) withheld milk including breast milk with the notion that it enhanced diarrhea. Conclusion: Based on these findings, there is need to develop and implement interactive communication strategies for the health workers and mothers to address perceptions and miscon- ceptions and facilitate positive change in the household practice on management of diarrhea among under-fives. Electronic Access :  Full Text-1

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Record No. 10155 Record ID 010155 Publication type Journal Article Title «Delivering» on the MDGS?: Equity and Maternal Health in Ghana, Ethiopia and Kenya Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Wirth, M.; Sacks, E.; Delamonica, E.; Storeygard, A.; Minujin, A.; Balk, D. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 133-141, fig., tab. Language English Descriptor Maternal Welfare; Health Status Indicators; Health Facilities; Socioeconomic Factors Descriptor-Local Millennium Development Goals Descriptor-Geographic Ethiopia; Kenya; Ghana Abstract Objective(s): The Millennium Development Goals (MDGs) have put maternal health in the mainstream, but there is a need to go beyond the MDGs to address equity within countries. We argue that MDG focus on maternal health is necessary but not sufficient. This paper uses Demographic and Health Survey (DHS) data from Kenya, Ethiopia and Ghana to examine a set of maternal health indicators stratified along five different dimensions. The study highlights the interactive and multiple forms of disadvantage and demonstrates that equity monitoring for the MDGs is possible, even given current data limitations. Methods: We analyse DHS data from Ghana, Kenya and Ethiopia on four indicators: skilled birth attendant, contraceptive prevalence rate, AIDS knowledge and access to a health facility. We define six social strata along five different dimensions: poverty status, education, region, ethnicity and the more traditional wealth quintile. Data are stratified singly (e.g. by region) and then stratified simultaneously (e.g. by region and by education) in order to examine the compounded efect of dual forms of vulnerability. Results: Almost all disparities were found to be significant, although the stratifier with the strongest effect on health outcomes varied by indicator and by country. In some cases, urban-dwelling is a more significant advantage than wealth and in others, educa- tional status trumps poverty status. The nuances of this analysis are important for policymaking processes aimed at reaching the MDGs and incorporating maternal health in national development plans. Conclusion(s): The article highlights the following key points about inequities and maternal health: 1) measuring and monitoring inequity in access to maternal health is possible even in low resource settings-using current data 2) statistically significant health gaps exist not just between rich and poor, but across other population groups as well, and multiple forms of disadvantage confer greater risk and 3) policies must be aligned with reducing health gaps in access to key maternal health services. Conflict of Interest: The authors declare that there are no conflicts of interest. The lead author had full access to the data used in this paper and the final responsibility for the decision to submit for publication. Electronic Access :  Full Text-1

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Record No. 10154 Record ID 010154 Publication type Journal Article Title Social Factors, Social Support and Condom Use Behavior among Young Urban Slum Inhabitants in Southwest Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adedimeji, A. A.; Heard, N. J.; Odutolu, O.; Omololu, F. O. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 215-222 Language English Descriptor Condoms-utilization; Sexual Behavior Sexually Transmitted Diseases-prevention & control; Psychology Social Support Urban Population Descriptor-Geographic Nigeria Abstract Objectives: Despite widespread knowledge that condoms offer protection against STIs/HIV when used correctly and consistently, many young people do not regularly use condoms, thus leading to new sexually transmitted infections, including HIV and AIDS. This study explored condom use behaviour, specifically the extent to which beliefs, self efficacy, risk perception and perceived social support act as predictors of use or non-use of condoms among sexually active young people aged 15-24 years. Methods: Data was obtained from sexually active 448 boys and 338 girls, who were selected through multistage sampling techniques. Analysis of data, which was done with EPI Info and SPSS version 12, focused on predictors of condom use or non-use. Result: Generally, there is widespread knowledge and low levels of condoms use, despite high levels of risky sexual behaviour. Although, half of boys and one third of girls report ever using condoms, a considerably lower proportion of male and female adolescents regularly use condoms. Logistic regression models show that among girls, those who perceived social support from peers and non-parental figures were more likely to use condoms while among boys, earning an income, high risk perception and self efficacy were associated with higher odds of condom use. Conclusions: Programs aiming to increase condom use among young people need to address these factors through community-based strategies. Electronic Access :  Full Text-1

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Record No. 10153 Record ID 010153 Publication type Journal Article Title Seroprevalence of Toxoplasma Ghondii in Nazareth Town, Ethiopia Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Negash, T.; Tilahun, G.; Medhin, G. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2009 Volume and n° 5(3) Pages 211-214, tab. Language English Descriptor Toxoplasmosis; Seroepidemiologic Studies; Questionnaires Descriptor-Geographic Ethiopia Abstract Objective: To determine the seroprevalence of toxoplasmosis, assess its zoonotic importance and identify factors associated with seroprevalence. Methods: Questionnaire survey was conducted on 65 serum samples collected from male and female urban and peri-urban residents aged between 15 days and 65 years. Main outcome measures were feeding habits, purpose of keeping cats and association with family members. Serologic evidence of toxoplasmosis was conducted by the Modified Direct Agglutination Test (MDA T) and determination of HIV status using the HIV - Spot Test. Results: Over 50of the interviewed people had a history of consumption of raw or undercooked mutton and had close contact with cats. 60of the serum samples analyzed by the MDA T had serologic evidence of Toxoplasma infection. Significantly higher MDA T tiers were encoun- tered both in pregnant and immunocompromised individuals. The risk factors associated to Toxoplasma infection, i.e. raw or undercooked mutton consumption and presence of cats appeared significant. Conclusion and recommendations: The significance of toxoplasmosis as a disease of zoonotic importance was demonstrated. Close contact between family members and the consumption of raw or undercooked mutton were the major risk factors in the transmission of the disease. Considering the relatively high prevalence as revealed by this study it would be important to conduct studies on a wider scale. It would also be important to increase public awareness and upgrade the knowledge on congenital toxoplasmosis. Electronic Access :  Full Text-1

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Record No. 10152 Record ID 010152 Publication type Journal Article Title Self-Perceived and Unmet General Health Need among PLWHA in Nigeria Source of Record WHO Regional Office for Africa, Library, Brazzaville, Congo Author(s) Adedigba, M. A.; Ogunbodede, E.; Jeboda, S. O.; Naidoo, S. Journal Title East African Journal of Public Health ISSN 0856-8960 Place of Publication Dar Es Salaam Publisher Muhimbili University College of Health Sciences Date of publication 2008 Volume and n° 5(3) Pages 199-210, tab. Language English Descriptor HIV; Acquired Immunodeficiency Syndrome; Patients; Health Services Needs and Demand; Prospective Studies Descriptor-Geographic Nigeria Abstract Objective: This study set out to determine the self-reported unmet health needs of people living with HIV/AIDS (PLWHA) in a Nigerian population. Methods: A prospective study conducted among consecutive 209 consenting PLWHA in the South-western Nigeria; who sought for care in the Obafemi Awolowo University Teaching Hospitals complex, Ile-Ife and General Hospital, Ilesa were recruited. Participants completed a comprehensive survey seeking information to determine their unmet needs in the following areas: Medica- tion, Dental, Mental, Home care, Hospital admission, access to antiretroviral therapy and emergency services. Results: One or more unmet needs were reported by 79.4of the sample. Needs for medication, home-based care and mental care were more likely to be unmet. There was a statistically significant relationship between unmet needs and living arrangements (p0.05). Conclusions: Perceived oral health status was the factor that best predicted the unmet need. Perceived oral health status of these patients should be improved to reduce the level of the unmet needs. Electronic Access :  Full Text-1

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