Factors associated with non-adherence to standard diagnosis and treatment guideline in the management of malaria in pregnancyPoor adherence to standard malaria diagnosis and treatment guidelines has resulted to the spread of antimalarial drug resistance. This exposes more pregnant women to malaria, which increases the risk of poor health outcomes for mothers and infants. Placental parasitaemia can cause maternal anaemia and low birth weight, both of which are risk factors for neonatal mortality. In areas of Africa where malaria is endemic, the World Health Organization (WHO) recommends three approaches to malaria prevention and control: - uptake of Intermittent Preventive treatment in Pregnancy (IPTp), - sleeping under an insecticide-treated bed net (ITN), - effective clinical diagnosis and treatment of malaria.
Prevalence and outcome of malaria among hospitalized children in Al Sabah Children Hospital, South SudanAccording to the World Malaria Report of 2019, there were 228 million cases of malaria globally. The estimated number of malaria deaths were 405,000 in the same year. The World Health Organization (WHO) report showed that Africa carries a high proportion of the global malaria burden. Overall, there were 93% of malaria cases and 94% of malaria deaths in Africa. In the same year, children aged under five years were the most affected accounting for 67% of all malaria deaths globally. Therefore, reducing the malaria burden would contribute to progress towards achieving the Sustainable Development Goals.
Impact of Community Intermittent Preventive Treatment in Pregnancy (C-IPTp) approach on the uptake of IPTp3+: a randomized controlled trial in Karagwe, TanzaniaMany studies of IPTp uptake have not reported on the impact of Community IPTp (C-IPTp) administration to increase adherence by pregnant women, although some have reported a higher percentage of ANC attendance as a means to increase IPTp uptake. The objective of this study was to assess the impact of C-IPTp in increasing IPTp3+ coverage compared to using routine ANC visits to increase coverage of IPTp.
Inguinodynia and inguinal hernia recurrence amongst Ugandan patients who underwent mesh versus non-mesh inguinal hernia repairThis was a cohort retrospective study conducted at St Francis Hospitals Nsambya and Naggalama. The sample size was two hundred and two patients. A consecutive sampling technique with replacement of missing charts was used. The Principal Investigator and the research assistants then made telephone calls to the patients inviting them for an interview in the two hospitals, and for those who could not attend questionnaires were administered to them on phone. This was done sequentially until the sample size for each hospital was reached. If a given telephone was not available or went unanswered, we telephoned the next patient in the sequence on the register. Inguinodynia was assessed using the Numerical Rating Pain Score (NPS). Recurrence was assessed by physical examination.
Knowledge about continuous positive airway pressure machine usage among nurses at a tertiary hospital in TanzaniaContinuous Positive Airway Pressure (CPAP) provides an air pressure that maintains the patency of the airway in patients with a variety of breathing problems. Nurses provide the hour to hour management of patients who require CPAP. The aim of this study was to assess the knowledge of nurses about CPAP machine usage at the tertiary hospital in Tanzania which serves the largest number of patients who require CPAP.
Health seeking behaviour of small income market vendors: diabetes primary care in Gulu Municipality, northern UgandaOf the 56.4 million deaths occurring worldwide in 2015, more than half (54%) were due to the top 10 causes - of which diabetes was one. Diabetes is one of the multiple health challenges faced by developing countries. A 2006 US study noted that diabetes, not obesity, increases the risk of critical illness, organ failure and early deaths.
Prevalence and factors associated with neonatal sepsis among hospitalized newborns at Ruvuma, southern TanzaniaNeonatal sepsis is one of the most common causes of neonatal morbidity and mortality in developing countries. This study which aimed to determine the prevalence and factors associated with neonatal sepsis among hospitalized new-borns at Ruvuma, southern Tanzania, found that the prevalence of neonatal sepsis in this study setting is very high.
Mothers’ knowledge of mother-to-child transmission of HIV and infant feeding practices in Juba, South SudanWhile exclusive breastfeeding for the first six months of life is recommended for HIV-infected mothers, this may not be practiced fully in South Sudan; exclusive formula feeding, which is the best alternative to breastfeeding, may not be practical. This study aims to assess the knowledge of mother-to-child transmission of HIV (MTCT) and practices of feeding infants in the first six months of life among HIV-infected mothers attending Antiretroviral Therapy Centres in Juba Teaching Hospital (JTH) and Juba Military Hospital (JMH).
The effect of Female Genital Mutilation on perineal injuries among women in labour in Dodoma Region, TanzaniaFemale genital mutilation (FGM) is a problem persisting in Tanzanian culture. The United Nations estimates that over 200 million women in the world have been subjected to FGM/cutting (FGM/C) and 3 million girls are at risk every year. In Tanzania FGM/C overall prevalence is around 15% in girls and women aged 15-49 years. It is estimated that 7.9 million women and girls in the country have undergone FGM. The objective of the study was to assess the association between FGM and perineal injury among women in labour in the Dodoma Region, Tanzania.
Pattern and causes of tympanic membrane perforation at a private hospital in Dar es Salaam, TanzaniaThe tympanic membrane is an important structure lying obliquely between the external and middle ear. It has three layers: an outer squamous, middle fibrous and inner mucous layer. Causes of tympanic membrane perforation include trauma, infectious agents, neoplasms and iatrogenic causes. The aim of this study was to determine the pattern and causes of tympanic membrane perforations among patients attending an ENT clinic at the private hospital which serves the largest number of ENT clients in Dar es Salaam.
The effects of maternal Body Mass Index on placental morphology and foetal birth weight: a study from Dodoma Central Region,TanzaniaThe wellbeing of the foetus is influenced by a number of factors including maternal characteristics, the placenta and umbilical cord morphology and functions. The placenta is a fantastic organ yet often neglected due to its transient existence; it performs functions that are later taken on by separate organs, including the lungs, liver, gut, kidneys and endocrine glands. It is the interface between mother and foetus and influences maternal and newborn mortality. Careful examination of the placenta can shed light on the in-utero environment of the foetus and can help to explain an abnormal neonatal outcome and might have consequences for treatment
Prevalence, clinical pattern and immediate outcomes of HIV-infected children admitted to Al Sabah Children’s Hospital, South SudanAccording to UNAIDS, approximately 36.7 million people were living with HIV globally in 2017, of which 2.1 million were children aged under 15 years. Most HIV-infected African children are never tested for HIV, although some symptoms such as non-specific generalized dermatitis, ear discharge, lobar pneumonia, and tuberculosis are associated with HIV. The prevalence of HIV for hospitalized children in Africa has ranged between (10%-12.5%). This study aimed to determine the prevalence of HIV infection, the clinical pattern of the illnesses, and the immediate outcomes of the admitted children in Al Sabah Children’s Hospital in Juba, South Sudan between January and April 2018.
Prevalence of primary Caesarean Section deliveries among primiparous and multiparous women at Iringa Regional Referral Hospital, TanzaniaCaesarean Section (CS) is the surgical procedure by which a foetus is delivered through an incision in the mother’s abdomen and uterus. It is called a primary CS when it is done for the first time on a pregnant woman. Primary CS is of particular interest because it has an influence on future modes of delivery. There is also a concern about the indication for the procedure in a woman who has never tried her pelvis for vaginal delivery. It is a global issue because CS births are increasing, with short and long term maternal and newborn implications
Multiple-drug resistant (MDR) tuberculosis among HIV sero-positive and sero-negative populations in Ilorin, North-Central NigeriaPulmonary tuberculosis (TB) is an infectious disease causing high morbidity and mortality throughout the world. In 2015, reports showed an estimated 10.4 million cases of tuberculosis globally, including 1.2 million (11%) people living with Human Immunodeficiency Virus (HIV). Recent reports showed that 57% of TB among people living with HIV was not promptly diagnosed or treated, resulting in 390,000 tuberculosis-related deaths in 2015.
Prevention of mother-to-child transmission of HIV: knowledge, attitudes and practice among pregnant women at Juba Teaching HospitalMother-to-child transmission (MTCT) of the human immunodeficiency virus (HIV) accounts for 90% of infancy and childhood HIV infections. This study found that pregnant women’s knowledge on HIV/AIDS, specific knowledge on MTCT, MTCT risk factors during breastfeeding, and PMTCT were moderate.
Prevalence and associated factors of burnout syndrome among healthcare workers in public and private hospitals in Mekelle City, EthiopiaBurnout syndrome, an occupational negative psychosomatic condition, has three components: emotional exhaustion, depersonalization and low personal achievement. This cross-sectional study conducted among 229 healthcare workers in Mekelle, Kay Kalkidan and Ben Meskerem General Hospitals showed that Prevalence of burnout syndrome was high among all respondents.
Orofacial tumours and tumour-like lesions in children treated at Muhimbili National Hospital, TanzaniaOrofacial tumours and tumour-like lesions occur at any age. An increasing occurrence has made these tumours a significant cause of morbidity and mortality in children. The study finds that haemangioma was the most common benign tumour. Dentigerous cyst was the most frequent tumour-like lesion observed, while Burkitt’s lymphoma and squamous cell carcinoma were the most common malignant lesions.
Knowledge, attitude and willingness to accept Caesarean section among women in Ogbomoso, southwest NigeriaCaesarean section (CS) is a common procedure in obstetrics and has contributed immensely to improving maternal and foetal outcome. The study which seeks to assess the level of knowledge, attitude and acceptance of women about CS in Ogbomoso, Nigeria, concludes that mothers should be educated on the process involved in Caesarean delivery.
Knowledge of type 2 diabetes mellitus and adherence to management guidelines: a cross-sectional study in Juba, South SudanInadequate education and the lack of efficient diabetes care centres compounded by high costs are common barriers for diabetes care. This study assesses the level of knowledge and adherence to guidelines for management of type 2 diabetes in South Sudan.
Obstetric fistulae, birth outcomes, and surgical repair outcomes: a retrospective analysis of hospital-based data in Dodoma, TanzaniaObstetric Fistula (OF) among pregnant women remains a widespread condition with devastating consequences and poses a significant challenge in a community as well as globally. The study concludes that timely fistula repair by experienced fistula surgeons will improve outcomes and limit the clinical insult and distress that OF invariably causes.
How culture shapes the sexual and reproductive health practices among adolescent girls in Eastern Equatoria, South SudanSouth Sudan has one of the world’s youngest populations with 72 percent of the population below 30 years of age and 7 percent of adolescent age (15 to 19 years). After decades of political unrest and civil war, South Sudan’s population, especially girls and women, have been left impoverished, undereducated and underemployed with limited access to health services. Data from the 2010 South Sudan Household Health Survey found that 26 percent of adolescent girls (aged 15–19 years) are mothers. However, interventions targeting adolescent girls can both support and empower this group to make safe and healthy choices
Knowledge and practice of exclusive breastfeeding among women with children aged between 9 and 12 months in Al Sabah Hospital, Juba, South SudanBreast milk is the optimal food for infants The World Health Organization (WHO) recommends that infants are breastfed exclusively (EBF) for their first six months, and then start complementary feeding while continuing to breastfeed for a minimum of two years .
Audit of care of severely malnourished children aged 6 - 59 months at Al-Sabah Children Hospital, Juba, South SudanSevere acute malnutrition (SAM) is the most important risk factor for illness and death among young children being responsible for about half of all their deaths . In the developing countries, 50.6 million children under the age of 5 years are malnourished . One in seven South Sudanese children die before their fifth birthday, mainly from preventable diseases such as diarrhoea and malaria. The burden of disease attributable to malnutrition is also substantial with the malnutrition rate exceeding the World Health Organization (WHO) emergency threshold of fifteen percent .
Household air pollution and childhood pneumonia in South Sudan: will clean cooking stoves reduce the incidence and mortality?In 2012, exposure to household air pollution (HAP) caused by cooking and heating with unprocessed biomass (solid) fuels such as wood, charcoal, crop waste, animal dung, and coal claimed 4.3 million lives worldwide. This mostly occurred in low and middle income countries with almost 600,000 deaths in Africa, and out of all the global deaths attributable to HAP, 534000 occurred among children under the age of five years.
Inhaled foreign body mismanaged as TB, finally removed using a rigid bronchoscopy after 6 years of impactionForeign body aspiration (FBA) is one of the leading causes of sudden death among children aged less than three years . Aspiration is common in this age group because of the less effective and protective mechanisms involved in coordination of breathing and swallowing . FBA resembles a number of pulmonary diseases and so poses a great challenge to clinicians for its management .
Epidemiological and antibiotic susceptibility profiles of infectious bacterial diarrhoea in Juba, South SudanDiarrhoeal diseases are a major health problem in developing countries  and accounts for an approximate global mortality of two million people annually . Globally, 88% of diarrhoea cases are attributable to unsafe drinking water, inadequate sanitation or insufficient hygiene. In Africa, an average morbidity rate of 912.9 million diarrhoeal episodes per year in children has been reported with four out of 10 deaths annually caused by diarrhoeal disease
Assessment of knowledge of hand washing among health care providers in Juba Teaching Hospital, South SudanBackground: Nosocomial infections increase mortality and morbidity although adherence to simple hand washing procedures is suggested to reduce these. Purpose: To assess knowledge of hand washing among health care providers in Juba Teaching Hospital (JTH) in South Sudan and establish associations with demographic, professional and clinical factors.
Non-mental health workers’ attitudes and social distance towards people with mental illness in a Nigerian teaching hospital.Background: Studies on attitudes towards mental health in Nigeria have been mainly community-based surveys. Objective: To determine the knowledge and attitudes towards mental illness (MI) of health workers in a Nigerian Teaching Hospital.
Intestinal parasitic infections and the level of immunosuppression in HIV seropositive individuals with diarrhoea in Kilimanjaro, Tanzania: A cross-sectional studyBackground: Opportunistic and non-opportunistic intestinal parasites play a significant role in the morbidity and mortality of HIV/AIDS-infected patients. The frequency of their occurrence strongly correlates with the patient’s level of immunity. The most common clinical manifestation of these intestinal parasites is diarrhoea. Prevalence of intestinal parasites among HIV-infected patients has been found to be as high as 95%.
Immediate post-partum haemorrhage: Epidemiological aspects and maternal prognosis at South N’djamena District Hospital (Chad)Background: Post-partum haemorrhage defined as blood loss after delivery over 500mls, affects all countries and is the commonest cause of maternal mortality. It is a frequent obstetric emergency in developing countries.
A longitudinal study of MUAC as a measure of paediatric malnutrition in Yei, South Sudan: Lessons from a hospital link: Lessons from a hospital linkPaediatric malnutrition is a significant problem in South Sudan, with rates of wasting up to 22% reported in some areas . Severe acute malnutrition (SAM) is associated with a high mortality . Affected patients require thorough assessment and holistic care including appropriate therapeutic feeding, treatment of associated complications and rehabilitation in order to achieve good outcomes.
Knowledge, Attitude and Practice(KAP) of tuberculosis patients enrolled on treatment in Juba City, South Sudan2010. A pilot studyStudy setting: Juba Teaching Hospital, Juba city, Republic of South Sudan, 2010. Objective: To examine, knowledge, attitude and practices of tuberculosis (TB) patients enrolled on tuberculosis treatment, Juba, South Sudan. Design: Descriptive study
Viral transfusion transmissible infections amongst blood donors in Maridi County Hospital, South SudanThe Republic of South Sudan gained independence in July 2011 after nearly two decades of civil war. The increase in cross border traffic following independence and the return of displaced nationals, may have unforeseen effects on the health of the population. The pattern of diseases across East Africa is defined by infectious conditions such as malaria and HIV. It has been suggested that the relocation of individuals from hyperendemic countries, such as Uganda, may influence the prevalence rates of these infections in South Sudan.
Stroke in SSA: Review of current literature concerning the incidence, risk factors and mortality of stroke in this demographic
Polio supplementary immunization campaign evaluation: the Maban experience, Upper Nile state, South Sudan, August 2013Although there are no confirmed polio cases in South Sudan since June 2009, vital indicators for polio eradication activities are not satisfactory . Hence, the recent huge polio outbreak in Somalia, Kenya and Ethiopia demanded a safety net SNIDs for four States, including Upper Nile.
Factors associated with patient and health service delays in the management of TB in Central Equatoria State in 2008Background: Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis. Delays in diagnosis and treatment increase morbidity and mortality from tuberculosis, and the risk of transmission in the community.
Carriage rates, circulating serotypes and antibiotic resistance among Streptococcus pneumoniae in healthy infants in Yei, South SudanThe carriage of Streptococcus pneumoniae, serotypes, antimicrobial susceptibility patterns and disease development are poorly understood in Yei. Availability of affordable antibiotics over the counter, lack of laboratory infrastructure and high rates of penicillin resistance have the potential to aggravate rates of childhood mortality associated with Streptococcus pneumoniae. There is an urgent need to strengthen microbiological and public health services.
Preventing malaria during pregnancy: factors determining the use of insecticide-treated bed-nets and intermittent preventive therapy in JubaThe study was carried out among 334 pregnant and newly delivered women seen at Juba Teaching Hospital in 2009. The objective was to assess the coverage of insecticide-treated bed-nets (ITN) and Intermittent Preventive Therapy (IPT) among these women and the factors associated with their use. Overall 87% of the women used ITN and 61% used IPT. ITN use was positively associated with buying nets, indoor spraying of insecticide and higher household income. IPT use was positively associated with more frequent antenatal clinic visits, indoor spraying and buying
Knowledge, attitudes and practises of caretakers of malnourished children in Aweil East and North counties, South SudanMalnutrition is a chronic public health problem in Aweil East and North counties with an estimated prevalence of between 15% and 25%. Underlying contributing factors include: political instability, poor infrastructures, droughts and floods resulting in low crop yields, poverty and limited awareness of good nutrition and health practices. At the time of the survey there were six decentralised centres feeding severely and moderately malnourished children below 5 years. As well as feeding activities, nutrition and health education was given in order to improve health and nutrition awareness. The objective of this survey was to assess knowledge, attitudes and practices of mothers (or caretakers) of children admitted in the feeding programme.
Evaluation of surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamberFindings from specular microscope studies have demonstrated increased endothelial cell loss associated with the use of air for lens implantation. The objective of this study was to evaluate the surgical outcome after cataract surgery with lens implantation using air or viscoelastic to maintain the anterior chamber
HIV/AIDS: Update on Epidemiology, Prevention and Treatment - including Available South Sudan LiteratureSouth Sudan borders countries with significant HIV epidemic profiles. Data on the status of HIV in South Sudan is limited. More than two decades of war have relatively sheltered the country from experiencing an epidemic similar to that in the neighbouring countries. Ironically the coming of peace has the potential of accelerating the development of an epidemic in South Sudan as a result of increased movement of people and altered economic and social activities...
Summary of a report on the Underlying Causes of Malnutrition in Twic County, Warap State, South Sudan. August 2007Consecutive surveys in Twic County have shown constantly high levels of malnutrition despite the interventions currently being carried out. GOAL, together with other NGOs, has been carrying out feeding responses to alleviate malnutrition, and more recently food security awareness. Programme coverage and meeting international emergency feeding standards have been a challenge due to the low attendance in the various feeding sites.
Knowledge, Attitude, and Practice and service barriers in a tuberculosis programme in Lakes State, South Sudan: a qualitative studyBackground: The World Health Organisation (WHO) estimates the incidence of tuberculosis (TB) in South Sudan to be 79 per 100,000 for new sputum smear positive TB and 140 per 100,000 for all forms of TB cases. The case detection rate of 53% for all forms of TB in South Sudan is below the WHO target of 70%. Objective: To explore knowledge, attitude, and practice barriers as well as service barriers to implementing TB programme in Lakes State, South Sudan. Method: This was a qualitative study conducted in May 2015. Results: Despite some understanding of the symptoms, causes, and consequences of TB, the stigma for TB and lack of disclosure of the disease, is very high among the local community. The limited network of TB facilities for case detection, lack of community distribution of TB drugs and lack of food at hospitals when patients were admitted for treatment, are key barriers to TB service delivery. Conclusion: To overcome barriers it is recommended that the local community worldview should be incorporated into TB awareness, testing, and treatment, and attention should be paid to areas where traditional practices, such as elimination of maize, clash with modern treatments.
Knowledge of tuberculosis and factors responsible for low case detection in the Amansie Central District, GhanaBackground: Tuberculosis (TB) case detection rate has remained consistently low in the Amansie Central District despite the implementation of the National TB Programme (NTP). Objective: To assess the factors influencing this low case detection of TB. Method: Information was collected from 120 individuals and 40 health workers were randomly selected from four health facilities that provided TB treatment. Results: All patients had a good knowledge of TB. There was no statistical association between patients knowledge and educational level (p>0.05). However, knowledge on the causes of TB was strongly associated with occupation (p<0.05). 53% of patients indicated health facilities as the first place of visit when sick and how they are received was dependent on education (p=0.005) and marital status(p<0.05); 60% of health workers were not trained on the NTP despite 93% being aware of the programme, and 62.5% reported not initiating contact tracing after disease confirmation. Only 34 of the 120 patients reported health workers visiting them regarding TB. Conclusion: Development of interventions such as HCW training on TB treatment and care, and establishing referral networks that bring TB information and services closer to community members can contribute to improved TB case notification.
Chronic suppurative otitis media: bacteriology, susceptibility and clinical presentation among ENT patients at Mulago, UgandaChronic Suppurative Otitis Media (CSOM) is a major health concern in developing countries due to its association with hearing impairment, particularly among children as it may affect their communication skills. Serious complications like meningitis and brain abscess have been reported as a cause of death. The commonest isolates implicated in causation of CSOM in this study was Klebsiella pnuemoniae and Pseudomonas aeruginosa, followed by Proteus mirabilis, E.coli and Staphylococcus aureus.
Missed opportunities for immunization among children attending a Paediatric Outpatient Clinic at Juba Teaching HospitalImmunization prevents child morbidity and mortality through the universal access to routinely recommended childhood vaccines. This study which aimed to determine the prevalence and factors associated with missed opportunities for immunization in South Sudan, found that Home delivery and failure to attend antenatal clinic were independently associated with MOI. Lack of information was the most common reason given by the caretakers for incomplete immunization.
Foetal macrosomia: risk factors, maternal and foetal outcomes in N’Djamena Mother and Child Hospital, ChadMacrosomia is a birth weight above the 90th percentile corrected for gestational age and sex, or birth weight of 4000-4500g. This was a cross-sectional study showed that macrosomic neonates are more often delivered by Caesarean Section than normosomic babies. There is a clear need during prenatal care and delivery to minimise maternal and perinatal complications.
Pulmonary tuberculosis among young children with severe pneumonia at Al Sabah Children’s Hospital, Juba, South SudanTuberculosis (TB) is a major public health problem globally. It ranks fourth among the top infectious disease killers, after acute respiratory infections, diarrhoeas, and human immunodeficiency virus (HIV) infection/acquired immunodeficiency syndrome (AIDS). According to World Health Organization (WHO), approximately 10 million people developed TB in 2017, of which 1.0 million (10%) were children.