| 1 |
Author(s):
Omosebi Oluwafunmilayo, Olanrewaju Samuel Olayemi, Adejumo Oluwasegun Agbailu.
Page No : 1-16
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Modelling Outcome of Drug Resistant Tuberculosis and Drug Susceptible Tuberculosis Patients in Oyo State
Abstract
TB is perhaps the most important contagious disease in the world and the leading cause of mortality by an infectious disease. As a result, WHO declared that achieving the reduction in TB incidence rate for achievement of the 90-90-90 target of the END-TB strategy will be an illusion, if something severe is not done. Therefore, it is imperative to assess the visibility of achieving the END-TB goal in the country (Nigeria) by assessing the success of TB treatments so far in the country. Hence, this paper aims to model the outcome of drug-resistant-tuberculosis and drug-susceptible-tuberculosis patients in Oyo state of Nigeria using the logit function of estimating binary logistic regression model vis-à-vis identifying the success of these TB treatments. At baseline, based on WHO categorization, the study revealed the commonest cases of patients receiving DS-TB seen are ‘New’ (90.5%) followed by relapse after failure (4.2%). Contrarily, the commonest cases of patients receiving DR-TB seen are treatment after failure (44.3%), new (27.5%) and relapse after failure cases (20.6%). Four months after starting treatment, 91.5% and 3.2% were reportedly alive and dead respectively for patients receiving DS-TB treatment while 85.3% and 11.5% were reportedly alive and dead respectively for receiving DR-TB treatment. Hence, the percentage success of DS-TB recorded was higher than the recorded for DR-TB patients. Furthermore, the chi-square results for DS-TB patients indicated that mortality significantly associated with DS-TB categorised patients (i.e. Relapse) and HIV status (i.e. Negative). Also, for the DR-TB patients, the results depicted that mortality significantly associated with DR-TB categorised patients (i.e. TAF, Treatment after Loss to Follow Up and New), both HIV status and Sputum Smear status (i.e. Positive). Nevertheless, among other findings, the binary logistic regression model estimations revealed that categorised New patients and Sputum Smear status unfavourably and significantly predicted the treatment outcome (mortality) of DS-TB and DR-TB patients. As well, categorised Relapse patients unfavourably and significantly predicted the treatment outcome (mortality) of DR-TB patients. Thus, the DS-TB method of treatment is recommended in order to achieve the target goal of the END-TB strategy in Oyo state Nigeria.
| 2 |
Author(s):
Tananzio Nabimanya, Novatus Nyemara, Francis Kazibwe.
Page No : 17-32
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The Effect of the Community-Based- Directly Observed Therapy on the Treatment Outcome of Tuberculosis Patients in Mitooma District, Western-Uganda
Abstract
Tuberculosis (TB) remains the ninth leading cause of death in the world and a leading cause of death among infectious diseases. Sub-Saharan Africa has nearly all high TB burden countries including Uganda which contributes to the highest Tuberculosis related mortality globally. Poor adherence to Tuberculosis treatment can lead to prolonged infection and poor treatment outcomes. Directly Observed Treatment (DOT) seeks to improve adherence to TB treatment by observing patients while they take their anti-TB medications. The aim of the study was to determine the effect of the Community Based- DOT on the Treatment Outcomes of Tuberculosis Patients in Mitooma District, Western Uganda. A cross-sectional survey research design was adopted and data were collected from the TB patients. Results revealed that TB patients who were not educated were 9.01 times more likely to get cured compared to the educated patients (AOR=9.01; 95% CI (1.6-5.9); p=0.013). Duration or time spent on TB medication was associated with TB treatment outcome because the patients who had spent 6 months on TB medication (AOR=2.9; 95% CI (1.14 – 7.9); p=0.004) were threefold more likely to get cured compared to those who had spent less than one month. Similarly, patients who had spent six months and above (AOR=4.1; 95%CI (0.07 – 0.87); p=0.026) were more than four times more likely to get cured compared to those who had spent less than one month. Results further showed that patients who were neutral in attributing their health state to the way they swallowed the TB medication (AOR = 0.33; 95%CI (0.12 – 0.9); p=0.001) were 67% less likely to get cured compared to patients who strongly agreed that their health status were attributed to the way they swallowed TB medication. Majority of the TB patients described the program as vital in treatment of TB disease as health caregivers would work closely with TB patients to adhere to treatment. Further, the study revealed that CB-DOT improved TB treatment outcomes. Monitoring the swallowing of TB drugs by health workers, health education and regular visits were highly recommended. Therefore, studies on policies for implementation of patient-centered and community-centered CB-DOT deserve further attention.
| 3 |
Author(s):
Mpati Evelyn Fosa.
Page No : 33-42
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Exploring Occupational Health and Safety Practices Implemented in Filling Stations, Maseru, Lesotho
Abstract
Compliance with occupational health and safety is essential to ensure the protection of workers, their families, and the customers' well-being. Moreover, it improves the business image, its productivity and avoids incurring unnecessary costs related to compensating for occupational diseases and hazards occurring in the filling stations premises. The study employed the quantitative approach and a cross-sectional study design was used. All-inclusive sampling was used on 50 participants. The findings of the study indicated that 88.9% of employees can use fire extinguishers and 72.2% can use the spill kit. Most filling stations provided employees with proper Personal Protective Equipment. Research in this field has not been conducted to much of a degree in Lesotho, which made this study priority and a need for the field of occupational health and safety in the country.
| 4 |
Author(s):
Mpati Evelyn Fosa.
Page No : 43-59
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Assessing Programme Strategies in Managing Child Stunting at the Health Facility Level in Matelile Community Council
Abstract
Stunting is an important indicator for child growth and health facilities have played a pivotal role in contributing to the overall reduction in stunting rates. This qualitative study aimed at understanding interventions employed by health facilities to reduce under 5s stunting. Health facilities have reported an increase in stunting in Matelile Community Council. Although the study revealed available health strategies including nutrition education, health promotion and breastfeeding programs to curb the disproportionate rates of stunting, the challenges facing the implementation of such programmes included lack of funding and failure for caretakers to cooperate. The study recommended therefore that, increasing funding into nutrition related programs and training appropriate health personnel on stuntedness could go a long way to reduce stunting in under 5s.
| 5 |
Author(s):
Christogonus Ifeanyichukwu Ugoh, Emwinloghosa Kenneth Guobadia, Chukwuemeka Thomas Onyia, Akindele Emmanuel Oni, Momoh Besiru.
Page No : 60-70
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Evaluation of Modifiable Risk Factors Associated with Type 2 Diabetes Mellitus in Federal Medical Centre, Asaba, Nigeria
Abstract
This study aims to evaluate the prevalence of type 2 diabetes mellitus among the adults from 30 years of age and above and to assess the association between the risk factors and type 2 diabetes. A total of 522 patients diagnosed with diabetes at Federal Medical Centre (FMC) Asaba from August 2022 to February 2023 were collected for the study. We employed the method of logistic multinomial regression to assess the association between the risk factors and the type 2 diabetes mellitus, descriptive statistics to ascertain the prevalence of type 2 diabetes mellitus, and the likelihood ratio test to check which of the risk factors is significant. The female was taken as a reference category. The results showed that the prevalence of type 2 diabetes mellitus was higher in females (284, 54.4%) and also in the age group 45-64 years of age. Risk factors that had a significant association with type 2 diabetes mellitus are age (Chi-square = 10.589, p = 0.005), BMI (chi-square = 1.038, p = 0.092), hypertension (chi-square = 1.370, p = 0.042), alcohol consumption (chi-square = 73.319, p = 0.000), and smoking (chi-square = 142.096, p = 0.000). The results further revealed that with female patients as the reference category, a male patient in the age bracket 45-64 years (p = 0.028, AOR = 0.538, 95% C.I: 0.310 – 0.935), a male that is obese (p = 0.090, AOR = 0.962, 95% C.I: 0.524 – 1.765), male with hypertension (p = 0.044, AOR = 1.362, 95% C.I: 0.810 – 2.292), male that consumes alcohol (p = 0.000, AOR = 0.129, 95% C.I: 0.077 – 0.214), and male that smokes (p = 0.000, AOR = 0.014, 95% C.I: 0.005 – 0.042) had 72.3% fewer odds, 3.8% fewer odds, 36.2 higher odds, 87.1 fewer odds, and 98.6% fewer odds of having type 2 diabetes mellitus compared to a female patient. This study suggests appropriate actions for community awareness of regular blood sugar testing and preventive measures.
| 6 |
Author(s):
Taunyane Edwin Matube, Mpati Evelyn Fosa.
Page No : 71-91
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Determining the Level of Health Management Information System Data Use in Southern Region of Lesotho
Abstract
Health management information system (HMIS) has been implemented in many countries to promote evidence-based decision making. The aim of this study was to generate information that will help the Ministry of Health (MOH) to improve the use of HMIS data at district level in southern region, Lesotho. This was a descriptive cross-sectional study which employed explanatory mixed methods approach. Quantitative data were collected through records reviews while qualitative data were collected through interviews and records reviews. The findings have shown that DHMTs and district hospitals are using HMIS data quite satisfactorily. Also, data demand by managers and possession of HMIS skills influences the use of data. In conclusion, the main enablers to a satisfactory level of HMIS data use in the southern region were ability of managers to demand data from their subordinates and improved data quality because of intensive interventions aimed at strengthening Lesotho’s HMIS by external donors.
| 7 |
Author(s):
Naomy Cheptoo Kiprop, Lucy W. Kivuti-Bitok.
Page No : 92-102
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Factors Affecting Access to Healthcare Systems for Children under Five Years with Disability in Low Resource Setting: A Case Study of Wajir County Referral Hospital, Kenya
Abstract
Background: Children with disabilities face inequalities in accessing healthcare systems, particularly in low-resource settings. The situation is particularly dire in Kenya, where disability is still widely viewed as a curse or a punishment, and where many traditional healers claim to have the ability to cure disabilities. As a result, many children with disabilities in Kenya frequently have unmet special healthcare needs. Understanding the challenges faced by differently-abled children under five years old in accessing healthcare in low-resource settings is crucial to developing more responsive and effective healthcare systems for this population. Methods: In this hospital-based cross-sectional study, we aimed to investigate the factors affecting access to healthcare for disabled children under five years old in Wajir County, Kenya. We used a simple random sampling technique to recruit 69 caregivers of disabled children, who were interviewed using an interviewer-administered questionnaire. Ethical approval was granted by the KNH/UON Ethical Committee. We used descriptive and inferential statistics, including chi-square tests, to analyze the data using SPSS version 25.0. Results: The majority of the caregivers were women (75.4%). We found that several factors were significantly associated with healthcare accessibility, including the belief that disability was caused by demon possession (p=0.019), reliance on traditional healers for the treatment of disabilities (p=0.034), accessibility of healthcare facilities (p=0.034), distance to the health facility (p=0.042), perceived differential treatment of disabled children (p=0.047), medical costs (p=0.028), lack of access to physiotherapist services (p=0.008), and difficulty in getting appointments suitable for the child (p=0.015). Conclusion: Our findings suggest that children with disabilities in Wajir County face significant barriers in accessing healthcare services, which are compounded by socio-cultural beliefs and economic challenges. A more coordinated, collaborative, and multidisciplinary approach is needed to improve healthcare access for this vulnerable population. Policymakers, healthcare providers, and caregivers should work together to address the identified barriers and ensure that disabled children under five years old have access to the healthcare services they need to thrive.
| 8 |
Author(s):
Lineo Florina Motsieloa, Mpati Evelyn Fosa.
Page No : 103-123
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Investigating the Availability of Nutrition Management Service for Hypertensive Elderly People in Khubetsoana and Thamae Health Centres
Abstract
: Many elderly people have hypertension, and health systems are faced with the challenge of responding to the needs of this population. The availability of Nutrition Management Service (NMS) in Out Patient Department (OPD) services is one of the strategies that have the potential to control these patients' blood pressure. The study sought to investigate the availability of NMS for the hypertensive outpatient elderly in Thamae Health Centre and Khubetsona Health Centre. The study was a descriptive cross-sectional study employing both qualitative and quantitative data collection methods. NMS was found to be available in the facilities, but incomplete. Of all the patients followed, 16.2% received nutrition counseling and 9.5% received nutrition follow-up, but none of them received nutrition screening. NMS is available in the facilities but it is incomplete, due to many factors which originate from the planners' failure to plan for it.
