A Bibliometric Perspective on the Evolution of Research in Sludge Management: Opportunities and Challenges
- Aniyikaiye, Elizabeth Tolulope, Ikudayisi, Akinola
- Authors: Aniyikaiye, Elizabeth Tolulope , Ikudayisi, Akinola
- Date: 2025
- Subjects: Bibliometric , Research trend , Sewage sludge , Sustainable development goals , SwoT analysis
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/15858 , vital:80402 , DOI: https://doi.org/10.53894/ijirss.v8i6.10011
- Description: Conventionally regarded as a liability, sewage sludge (SS) continues to accumulate due to rapid industrialisation and global population growth. However, the conversion of SS into energy and nutrients presents a promising alternative for sustainable waste management. Drawing from the Web of Science database and using VOSviewer for bibliometric mapping, this review investigates the research trends, intellectual structure, and collaborative networks in sludge management over the past decade. It further evaluates the strengths, particularly in alignment with the Sustainable Development Goals (SDGs), as well as the weaknesses, opportunities, and threats associated with current sludge management practices. The analysis reveals that key emerging research themes include microbial diversity in activated sludge, biological treatment processes and their limitations, and thermochemical conversion for energy and nutrient recovery. Future research is encouraged to focus on innovative remediation approaches for emerging contaminants and microplastics, and the development of scalable technologies for the commercial production of energy, nutrients, and value added chemical products from SS. This study offers a comprehensive overview of the evolution of sludge management research and provides critical insights to inform policy direction, investment priorities, and academic engagement. It also advocates for increased financial support, stakeholder incentives, and collaborative partnerships, noting that substantial progress toward achieving multiple SDGs can be made through strategic investment in sludge management initiatives.
- Full Text:
- Date Issued: 2025
- Authors: Aniyikaiye, Elizabeth Tolulope , Ikudayisi, Akinola
- Date: 2025
- Subjects: Bibliometric , Research trend , Sewage sludge , Sustainable development goals , SwoT analysis
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/15858 , vital:80402 , DOI: https://doi.org/10.53894/ijirss.v8i6.10011
- Description: Conventionally regarded as a liability, sewage sludge (SS) continues to accumulate due to rapid industrialisation and global population growth. However, the conversion of SS into energy and nutrients presents a promising alternative for sustainable waste management. Drawing from the Web of Science database and using VOSviewer for bibliometric mapping, this review investigates the research trends, intellectual structure, and collaborative networks in sludge management over the past decade. It further evaluates the strengths, particularly in alignment with the Sustainable Development Goals (SDGs), as well as the weaknesses, opportunities, and threats associated with current sludge management practices. The analysis reveals that key emerging research themes include microbial diversity in activated sludge, biological treatment processes and their limitations, and thermochemical conversion for energy and nutrient recovery. Future research is encouraged to focus on innovative remediation approaches for emerging contaminants and microplastics, and the development of scalable technologies for the commercial production of energy, nutrients, and value added chemical products from SS. This study offers a comprehensive overview of the evolution of sludge management research and provides critical insights to inform policy direction, investment priorities, and academic engagement. It also advocates for increased financial support, stakeholder incentives, and collaborative partnerships, noting that substantial progress toward achieving multiple SDGs can be made through strategic investment in sludge management initiatives.
- Full Text:
- Date Issued: 2025
Lie Symmetry Analysis of a Nonlinear Black–Scholes Equation in Illiquid Markets
- Authors: Sinkala, Winter
- Date: 2025
- Subjects: Illiquid markets , Lie symmetrics , Nonlinear Black-Scholes equation
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14887 , vital:79857 , DOI: https://doi.org/10.1155/ijmm/4823421
- Description: We have conducted comprehensive Lie symmetry analysis of a nonlinear Black–Scholes equation that arises in illiquid markets. The equation incorporates nonlinearities arising from market constraints, such as transaction costs and liquidity effects. We have identifed the admitted Lie point symmetries, derived the optimal system of one-dimensional subalgebras, and constructed invariant solutions. For the first time, we have determined nonclassical symmetries of this equation, resulting in new exact solutions that are inaccessible throughthe classical symmetries of the equation. These results extend and clarify earlier work on the nonlinear Black–Scholes equation andprovide a broader understanding of the solution space for the equation. The work offers new perspectives on nonlinearities in option pricing under realistic market conditions and also highlights the role of Lie symmetry methods in fnancial modeling.
- Full Text:
- Authors: Sinkala, Winter
- Date: 2025
- Subjects: Illiquid markets , Lie symmetrics , Nonlinear Black-Scholes equation
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14887 , vital:79857 , DOI: https://doi.org/10.1155/ijmm/4823421
- Description: We have conducted comprehensive Lie symmetry analysis of a nonlinear Black–Scholes equation that arises in illiquid markets. The equation incorporates nonlinearities arising from market constraints, such as transaction costs and liquidity effects. We have identifed the admitted Lie point symmetries, derived the optimal system of one-dimensional subalgebras, and constructed invariant solutions. For the first time, we have determined nonclassical symmetries of this equation, resulting in new exact solutions that are inaccessible throughthe classical symmetries of the equation. These results extend and clarify earlier work on the nonlinear Black–Scholes equation andprovide a broader understanding of the solution space for the equation. The work offers new perspectives on nonlinearities in option pricing under realistic market conditions and also highlights the role of Lie symmetry methods in fnancial modeling.
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Revisiting the Group Classification of the General Nonlinear Heat Equation ut = (K(u)ux)x
- Authors: Sinkala, Winter
- Date: 2025
- Subjects: Group classification , Nonlinear haet equation , Lie symmetries , Diffusion models
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14910 , vital:79861 , DOI: https://doi.org/10.3390/math13060911
- Description: Group classification is a powerful tool for identifying and selecting the free elements—functions or parameters—in partial differential equations (PDEs) that maximize the symmetry properties of the model. In this paper, we revisit the group classification of the general nonlinear heat (or diffusion) equation ut = (K(u)u) where K(u) is a non-constant function of the dependent variable. We present the group classification framework, derive the determining equations for the coeffecients of the infinitesimal generators of the admitted symmetry groups, and systematically solve for admissible forms of K(u). Our analysis recovers the classical results of Ovsyannikov and Bluman and provides additional clarity and detailed derivations. The classification yields multiple cases, each corresponding to a specific form of K(u), and reveals the dimension of the associated Lie symmetry algebra.
- Full Text:
- Date Issued: 2025
- Authors: Sinkala, Winter
- Date: 2025
- Subjects: Group classification , Nonlinear haet equation , Lie symmetries , Diffusion models
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14910 , vital:79861 , DOI: https://doi.org/10.3390/math13060911
- Description: Group classification is a powerful tool for identifying and selecting the free elements—functions or parameters—in partial differential equations (PDEs) that maximize the symmetry properties of the model. In this paper, we revisit the group classification of the general nonlinear heat (or diffusion) equation ut = (K(u)u) where K(u) is a non-constant function of the dependent variable. We present the group classification framework, derive the determining equations for the coeffecients of the infinitesimal generators of the admitted symmetry groups, and systematically solve for admissible forms of K(u). Our analysis recovers the classical results of Ovsyannikov and Bluman and provides additional clarity and detailed derivations. The classification yields multiple cases, each corresponding to a specific form of K(u), and reveals the dimension of the associated Lie symmetry algebra.
- Full Text:
- Date Issued: 2025
Advancing the scholarship of integration for impactful, sustainable and holistic student success
- Pule, Neo, Madiba, Matete, Mohasoa, Irene
- Authors: Pule, Neo , Madiba, Matete , Mohasoa, Irene
- Date: 2024
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13055 , vital:77162 , ISSN: 2307-6267 , Citation: Pule, N., Madiba, M., & Mohasoa, I. (2024). Advancing the scholarship of integration for impactful, sustainable and holistic student success. Journal of Student Affairs in Africa, 12(2), v–ix. DOI: 10.24085/jsaa.v12i2.5483. , DOI: 10.24085/jsaa.v12i2.5483
- Description: Abstract: University professional and teaching staff are like two sides of the same coin. However, to a great extent, they work in silos – which leads to fragmentation and undermines efforts to achieve significant levels of impactful, sustainable and holistic student success. In this context, this special issue was proposed as a contribution towards closing the gap between the academic part of the university and the professional or support-services part; and as a means of encouraging the work required to forge integrated approaches in support of enhanced student success. The siloed approach, which is indicative of the politics and potential power dynamics that are embedded in university operations and structures, needs to be dismantled...
- Full Text:
- Authors: Pule, Neo , Madiba, Matete , Mohasoa, Irene
- Date: 2024
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13055 , vital:77162 , ISSN: 2307-6267 , Citation: Pule, N., Madiba, M., & Mohasoa, I. (2024). Advancing the scholarship of integration for impactful, sustainable and holistic student success. Journal of Student Affairs in Africa, 12(2), v–ix. DOI: 10.24085/jsaa.v12i2.5483. , DOI: 10.24085/jsaa.v12i2.5483
- Description: Abstract: University professional and teaching staff are like two sides of the same coin. However, to a great extent, they work in silos – which leads to fragmentation and undermines efforts to achieve significant levels of impactful, sustainable and holistic student success. In this context, this special issue was proposed as a contribution towards closing the gap between the academic part of the university and the professional or support-services part; and as a means of encouraging the work required to forge integrated approaches in support of enhanced student success. The siloed approach, which is indicative of the politics and potential power dynamics that are embedded in university operations and structures, needs to be dismantled...
- Full Text:
On the Limited Role of Conservation Laws in the Double Reduction Routine for Partial Differential Equations
- Sinkala, Winter, Kakuli, Charles Molahlehli
- Authors: Sinkala, Winter , Kakuli, Charles Molahlehli
- Date: 2024
- Subjects: Double reduction , Lie symmetry analysis , Invariant solution
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14892 , vital:79859 , DOI: https://doi.org/10.29020/nybg.ejpam.v17i4.5318
- Description: The double reduction method for finding invariant solutions of a given partial differential equation (PDE) provides for the reduction of a q-th order PDE that admits a Lie symmetry and an associated nontrivial conservation law to an ordinary differential equation (ODE) of order q-1.In all the articles we have seen where the method has been used, the algorithm has involved writing the conservation law in canonical variables determined by the associated symmetry. In this paper, we illustrate that it is not necessary to use or even have the associated conservation law. It is enough to know that there exists a conservation law associated with a given Lie symmetry. Canonical variables derived from the symmetry are sufficient to achieve double reduction. In the canonical variables, the PDE is transformed after routine calculations into an ODE of one less than that of the PDE. We have outlined the steps involved in this variation of the double reduction method and illustrated the routine using five PDEs.
- Full Text:
- Date Issued: 2024
- Authors: Sinkala, Winter , Kakuli, Charles Molahlehli
- Date: 2024
- Subjects: Double reduction , Lie symmetry analysis , Invariant solution
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/14892 , vital:79859 , DOI: https://doi.org/10.29020/nybg.ejpam.v17i4.5318
- Description: The double reduction method for finding invariant solutions of a given partial differential equation (PDE) provides for the reduction of a q-th order PDE that admits a Lie symmetry and an associated nontrivial conservation law to an ordinary differential equation (ODE) of order q-1.In all the articles we have seen where the method has been used, the algorithm has involved writing the conservation law in canonical variables determined by the associated symmetry. In this paper, we illustrate that it is not necessary to use or even have the associated conservation law. It is enough to know that there exists a conservation law associated with a given Lie symmetry. Canonical variables derived from the symmetry are sufficient to achieve double reduction. In the canonical variables, the PDE is transformed after routine calculations into an ODE of one less than that of the PDE. We have outlined the steps involved in this variation of the double reduction method and illustrated the routine using five PDEs.
- Full Text:
- Date Issued: 2024
Impact of novel software on laboratory expenditure at an academic hospital in South Africa
- Mayekiso, Zoliswa, Oladimeji, E Kelechi, Estrada, Pulido A Guillermo, Apalata, R. Teke
- Authors: Mayekiso, Zoliswa , Oladimeji, E Kelechi , Estrada, Pulido A Guillermo , Apalata, R. Teke
- Date: 2023/11
- Subjects: Gatekeeping , Medical laboratory expenditure , Cost effectiveness , Intervention , Rural academic hospital , South Africa , Interrupted time series
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13388 , vital:78679 , DOI: 10.4102/ajlm.v12i1.2159
- Description: Background: Countries across the globe report an increase in expenditure associated with medical laboratory testing. In 2020, the United States Department of Health and Human Services reported that laboratory test expenditures increased by $459 million US dollars (USD) from $7.1 billion USD in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million USD in 2014 to $723 million USD in 2021. Objective: This study aimed to evaluate the impact of an innovative software, electronic gatekeeping (EGK), on medical laboratory test expenditures at Nelson Mandela Academic Hospital, in the Eastern Cape, South Africa. Methods: In this cross-sectional study, an interrupted time series analysis technique was used to evaluate trends in expenditure during a 48-month study period. To measure the impact of EGK on laboratory expenditure, we analysed laboratory expenditure over two study periods: a period of 24 months occurring before EGK implementation (01 June 2013 to 31 May 2015) and a period of 24 months occurring during EGK implementation (01 June 2015 to 30 May 2017). Results: There was a significant reduction (211928 fewer tests) in the number of tests performed during the intervention (434790) compared to before the intervention (646718). Laboratory test expenditure was $1 663 756.72 USD before the intervention period and $1 105 036.88 USD during the intervention period, demonstrating a cost savings of $558 719.84 USD. Conclusion: Electronic gatekeeping is a cost-effective intervention for managing medical laboratory expenditures. We recommend that the health sector scale up this intervention nationally.
- Full Text:
- Date Issued: 2023/11
- Authors: Mayekiso, Zoliswa , Oladimeji, E Kelechi , Estrada, Pulido A Guillermo , Apalata, R. Teke
- Date: 2023/11
- Subjects: Gatekeeping , Medical laboratory expenditure , Cost effectiveness , Intervention , Rural academic hospital , South Africa , Interrupted time series
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13388 , vital:78679 , DOI: 10.4102/ajlm.v12i1.2159
- Description: Background: Countries across the globe report an increase in expenditure associated with medical laboratory testing. In 2020, the United States Department of Health and Human Services reported that laboratory test expenditures increased by $459 million US dollars (USD) from $7.1 billion USD in 2018. In South Africa, laboratory testing expenditure in the public sector increased from $415 million USD in 2014 to $723 million USD in 2021. Objective: This study aimed to evaluate the impact of an innovative software, electronic gatekeeping (EGK), on medical laboratory test expenditures at Nelson Mandela Academic Hospital, in the Eastern Cape, South Africa. Methods: In this cross-sectional study, an interrupted time series analysis technique was used to evaluate trends in expenditure during a 48-month study period. To measure the impact of EGK on laboratory expenditure, we analysed laboratory expenditure over two study periods: a period of 24 months occurring before EGK implementation (01 June 2013 to 31 May 2015) and a period of 24 months occurring during EGK implementation (01 June 2015 to 30 May 2017). Results: There was a significant reduction (211928 fewer tests) in the number of tests performed during the intervention (434790) compared to before the intervention (646718). Laboratory test expenditure was $1 663 756.72 USD before the intervention period and $1 105 036.88 USD during the intervention period, demonstrating a cost savings of $558 719.84 USD. Conclusion: Electronic gatekeeping is a cost-effective intervention for managing medical laboratory expenditures. We recommend that the health sector scale up this intervention nationally.
- Full Text:
- Date Issued: 2023/11
The Detection of Mutations and Genotyping of Drug-Resistant Mycobacterium tuberculosis Strains Isolated from Patients in the Rural Eastern Cape Province
- Faye, M Lindiwe, Hosu, C Mojisola, Oostvogels, Selien, Dippenaar, Anzaan, Warren, M Robin, Sineke, Ncomeka, Vasaikar, Sandeep, Teke, Apalata
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Oostvogels, Selien , Dippenaar, Anzaan , Warren, M Robin , Sineke, Ncomeka , Vasaikar, Sandeep , Teke, Apalata
- Date: 2023/10
- Subjects: Drug-resistant TB , Heteroresistance , Mutations , Spoligotyping
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13589 , vital:78960 , DOI: https://doi.org/10.3390/idr15040041
- Description: Drug-resistant tuberculosis (DR-TB) is still a major public health concern in South Africa. Mutations in M. tuberculosis can cause varying levels of phenotypic resistance to anti-TB medications. There have been no prior studies on gene mutations and the genotyping of DR-TB in the rural Eastern Cape Province; hence, we aimed to identify DR-TB mutations, genetic diversity, and allocated lineages among patients in this area. Using Xpert® MTB/RIF, we assessed the rifampin resistance of sputum samples collected from 1157 patients suspected of having tuberculosis. GenoType MTBDR plus VER 2.0 was used for the detection of mutations causing resistance to anti-TB medications. The next step was to spoligotype 441 isolates. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L in INH-resistant strains; the katG gene at codon S315TB and the inhA gene at codon C-15TB had the most mutations; 54.5% and 24.7%, respectively. In addition, 24.6% of strains showed mutations in both the rpoB and inhA genes, while 69.9% of strains showed mutations in both the katG and rpoB genes. Heteroresistance was seen in 17.9% of all cases in the study. According to spoligotyping analysis, Beijing families predominated. Investigation of the evolutionary lineages of M. tuberculosis isolates can be carried out using the information provided by the study’s diversity of mutations. In locations wherein these mutations have been discovered, decision-making regarding the standardization of treatment regimens or individualized treatment may be aided by the detection frequency of rpoB, katG, and inhA mutations in various study areas.
- Full Text:
- Date Issued: 2023/10
- Authors: Faye, M Lindiwe , Hosu, C Mojisola , Oostvogels, Selien , Dippenaar, Anzaan , Warren, M Robin , Sineke, Ncomeka , Vasaikar, Sandeep , Teke, Apalata
- Date: 2023/10
- Subjects: Drug-resistant TB , Heteroresistance , Mutations , Spoligotyping
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13589 , vital:78960 , DOI: https://doi.org/10.3390/idr15040041
- Description: Drug-resistant tuberculosis (DR-TB) is still a major public health concern in South Africa. Mutations in M. tuberculosis can cause varying levels of phenotypic resistance to anti-TB medications. There have been no prior studies on gene mutations and the genotyping of DR-TB in the rural Eastern Cape Province; hence, we aimed to identify DR-TB mutations, genetic diversity, and allocated lineages among patients in this area. Using Xpert® MTB/RIF, we assessed the rifampin resistance of sputum samples collected from 1157 patients suspected of having tuberculosis. GenoType MTBDR plus VER 2.0 was used for the detection of mutations causing resistance to anti-TB medications. The next step was to spoligotype 441 isolates. The most prevalent rifampin resistance-conferring mutations were in rpoB codon S531L in INH-resistant strains; the katG gene at codon S315TB and the inhA gene at codon C-15TB had the most mutations; 54.5% and 24.7%, respectively. In addition, 24.6% of strains showed mutations in both the rpoB and inhA genes, while 69.9% of strains showed mutations in both the katG and rpoB genes. Heteroresistance was seen in 17.9% of all cases in the study. According to spoligotyping analysis, Beijing families predominated. Investigation of the evolutionary lineages of M. tuberculosis isolates can be carried out using the information provided by the study’s diversity of mutations. In locations wherein these mutations have been discovered, decision-making regarding the standardization of treatment regimens or individualized treatment may be aided by the detection frequency of rpoB, katG, and inhA mutations in various study areas.
- Full Text:
- Date Issued: 2023/10
Voices from the Patients: A Qualitative Study of the Integration of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in O.R. Tambo District, Eastern Cape, South Africa
- Dlatu, Ntandazo, Oladimeji, Elizabeth Kelechi, Apalata, Teke
- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
- Full Text:
- Date Issued: 2023/10
- Authors: Dlatu, Ntandazo , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/10
- Subjects: TB-HIV integration , Challenges and barriers , Patients , O.R. Tambo district , Eastern Cape , South Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13590 , vital:78959 , DOI: https://doi.org/10.3390/idr15020017
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
- Full Text:
- Date Issued: 2023/10
A comparative analysis of patient profiles and health services utilization between patent medicine vendors and community pharmacists in Nigeria
- Adepoju, Victor Abiola, Oladimeji, Olanrewaju
- Authors: Adepoju, Victor Abiola , Oladimeji, Olanrewaju
- Date: 2023/09
- Subjects: Tuberculosis , Patent medicine vendors , Drug shops , Community pharmacist , Service utilization , Signs and symptoms
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13169 , vital:78005 , DOI: https://doi.org/10.3390/healthcare11182484
- Description: Background: This study examined Nigeria’s socio-demographic profiles and health service utilization patterns of Patent Medicine Vendors (PMVs) and Community Pharmacists (CPs). Method: A cross-sectional study using a structured self-administered questionnaire among 405 retail outlets (322 PMVs and 83 CPs) across 16 Lagos and Kebbi Local Government Areas (LGAs) between June 2020 and December 2020. Results: Results showed that 60.4% were male, 76.3% from Lagos, 58.3% had tertiary education, and 74.1% had medical training. Cough and fever were common symptoms. Significant differences were found in the utilization of STD services (PMVs: 9.2%, CPs: 12.3%, p = 0.03)), services by age < 0.001), and utilization by males (PMVs: 50.8, CPs: 47.1, p = 0.013). The study revealed that men visited PMVs more, while CPs used more STI services and childhood visits. Conclusions: The findings suggest that expanding health services among PMVs could target male-dominant diseases, and capacity building of CPs on syndromic STI management could reduce the STI burden.
- Full Text:
- Date Issued: 2023/09
- Authors: Adepoju, Victor Abiola , Oladimeji, Olanrewaju
- Date: 2023/09
- Subjects: Tuberculosis , Patent medicine vendors , Drug shops , Community pharmacist , Service utilization , Signs and symptoms
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13169 , vital:78005 , DOI: https://doi.org/10.3390/healthcare11182484
- Description: Background: This study examined Nigeria’s socio-demographic profiles and health service utilization patterns of Patent Medicine Vendors (PMVs) and Community Pharmacists (CPs). Method: A cross-sectional study using a structured self-administered questionnaire among 405 retail outlets (322 PMVs and 83 CPs) across 16 Lagos and Kebbi Local Government Areas (LGAs) between June 2020 and December 2020. Results: Results showed that 60.4% were male, 76.3% from Lagos, 58.3% had tertiary education, and 74.1% had medical training. Cough and fever were common symptoms. Significant differences were found in the utilization of STD services (PMVs: 9.2%, CPs: 12.3%, p = 0.03)), services by age < 0.001), and utilization by males (PMVs: 50.8, CPs: 47.1, p = 0.013). The study revealed that men visited PMVs more, while CPs used more STI services and childhood visits. Conclusions: The findings suggest that expanding health services among PMVs could target male-dominant diseases, and capacity building of CPs on syndromic STI management could reduce the STI burden.
- Full Text:
- Date Issued: 2023/09
Exploring health insurance and knowledge of the ovulatory cycle: evidence from Demographic and Health Surveys of 29 countries in Sub-Saharan Africa
- Zegeye, Betregiorgis, Idriss-Wheeler, Dina, Yaya, Sanni
- Authors: Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Yaya, Sanni
- Date: 2023/09
- Subjects: health insurance , ovulactory cycle , Sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13311 , vital:78423 , DOI: https://doi.org/10.1186/s12978-023-01675-z
- Description: Background Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the infuence of health insurance on ovu‑ latory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multi‑ level logistic regression models among 372,692 women of reproductive age (15–49). The fndings were presented as adjusted odds ratios (AOR) with 95% confdence intervals (CI). A p-value of 0.05 was considered statistically signifcant. Results The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women cov‑ ered by health insurance (AOR=1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR=2.83, 95% CI; 1.95– 4.09), from the richest wealth quintile (richest-AOR=1.39, 95% CI; 1.04–1.87), and from female headed households (AOR=1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR=0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions The fndings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region’s unplanned pregnancy rate. Strategies for improving opportunities that contribute to women’s empower‑ ment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quin‑ tiles, not formally educated, belonging to male headed households, and having high parity should be considered.
- Full Text:
- Date Issued: 2023/09
- Authors: Zegeye, Betregiorgis , Idriss-Wheeler, Dina , Yaya, Sanni
- Date: 2023/09
- Subjects: health insurance , ovulactory cycle , Sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13311 , vital:78423 , DOI: https://doi.org/10.1186/s12978-023-01675-z
- Description: Background Unplanned pregnancy continues to be a major public health concern in Sub-Saharan Africa (SSA). Understanding the ovulatory cycle can help women avoid unplanned pregnancy. Though a wide range of factors for ovulatory cycle knowledge in SSA countries has not been well assessed, the infuence of health insurance on ovu‑ latory cycle knowledge is largely unknown. As a result, we set out to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age. This study aims to investigate the relationship between health insurance enrollment and knowledge of the ovulatory cycle among women of childbearing age in sub-Saharan Africa (SSA). Methods Demographic and Health Surveys (DHSs) data from 29 SSA countries were analyzed. The association between health insurance and ovulatory cycle knowledge was investigated using bivariate and multivariate multi‑ level logistic regression models among 372,692 women of reproductive age (15–49). The fndings were presented as adjusted odds ratios (AOR) with 95% confdence intervals (CI). A p-value of 0.05 was considered statistically signifcant. Results The pooled result shows that the prevalence of knowledge of ovulatory cycle in the studied 29 SSA countries was 25.5% (95% CI; 24.4%-26.6%). Findings suggest higher odds of ovulatory cycle knowledge among women cov‑ ered by health insurance (AOR=1.27, 95% CI; 1.02–1.57), with higher education (higher-AOR=2.83, 95% CI; 1.95– 4.09), from the richest wealth quintile (richest-AOR=1.39, 95% CI; 1.04–1.87), and from female headed households (AOR=1.16, 95% CI; 1.01–1.33) compared to women who had no formal education, were from the poorest wealth quintile and belonged to male headed households, respectively. We found lower odds of ovulatory cycle knowledge among women who had 2–4 parity history (AOR=0.80, 95% CI; 0.65–0.99) compared to those with history of one parity. Conclusions The fndings indicate that the knowledge of the ovulatory cycle is lacking in SSA. Improving health insurance enrollment should be considered to increase ovulatory cycle knowledge as an approach to reduce the region’s unplanned pregnancy rate. Strategies for improving opportunities that contribute to women’s empower‑ ment and autonomy as well as sexual and reproductive health approaches targeting women who are in poorest quin‑ tiles, not formally educated, belonging to male headed households, and having high parity should be considered.
- Full Text:
- Date Issued: 2023/09
Prevalence and Associated Factors of Cigarette Smoking among South Africa Adolescents and Young Adults: A Systematic Review and Meta-Analysis Protocol
- Londani, Mukhethwa, Oladimeji, Olanrewaju
- Authors: Londani, Mukhethwa , Oladimeji, Olanrewaju
- Date: 2023/09
- Subjects: South Africa , adoloscents , young adults , tobacco use , systematic review , meta-analysis
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13301 , vital:78421 , DOI: https://doi.org/10.3390/mps6050085
- Description: Tobacco use, particularly the initiation of smoking during adolescence and young adult hood, represents a significant public health concern in South Africa. The influence of socio-cultural factors, marketing strategies of the tobacco industry, and accessibility of tobacco products have all been implicated in this context. This systematic review and meta-analysis protocol aims to scrutinise the body of literature on this issue, providing a comprehensive understanding of the patterns and determinants of tobacco use among South African adolescents and young adults, with an eye towards informing more effective policy interventions. The available literature for studies on tobacco use will be systematically searched and reviewed. Five international scholarly databases, namely PubMed, MEDLINE, EMBASE, Global Health, and Scopus, will be searched. Peer-reviewed studies will be included if they are conducted in South Africa or South African provinces and if they include the prevalence of tobacco use among adolescents and young adults aged between 12 and 24 years. The results of such an analysis can guide future policy designs, enabling them to be more targeted and thus more effective. The findings can also have implications for shaping global tobacco control strate gies, given the transferability of successful interventions across different populations and cultural contexts. This protocol has been registered in the PROSPERO database.
- Full Text:
- Date Issued: 2023/09
- Authors: Londani, Mukhethwa , Oladimeji, Olanrewaju
- Date: 2023/09
- Subjects: South Africa , adoloscents , young adults , tobacco use , systematic review , meta-analysis
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13301 , vital:78421 , DOI: https://doi.org/10.3390/mps6050085
- Description: Tobacco use, particularly the initiation of smoking during adolescence and young adult hood, represents a significant public health concern in South Africa. The influence of socio-cultural factors, marketing strategies of the tobacco industry, and accessibility of tobacco products have all been implicated in this context. This systematic review and meta-analysis protocol aims to scrutinise the body of literature on this issue, providing a comprehensive understanding of the patterns and determinants of tobacco use among South African adolescents and young adults, with an eye towards informing more effective policy interventions. The available literature for studies on tobacco use will be systematically searched and reviewed. Five international scholarly databases, namely PubMed, MEDLINE, EMBASE, Global Health, and Scopus, will be searched. Peer-reviewed studies will be included if they are conducted in South Africa or South African provinces and if they include the prevalence of tobacco use among adolescents and young adults aged between 12 and 24 years. The results of such an analysis can guide future policy designs, enabling them to be more targeted and thus more effective. The findings can also have implications for shaping global tobacco control strate gies, given the transferability of successful interventions across different populations and cultural contexts. This protocol has been registered in the PROSPERO database.
- Full Text:
- Date Issued: 2023/09
Analysis of Discordance between Genotypic and Phenotypic Assays for Rifampicin-Resistant Mycobacterium tuberculosis Isolated from Healthcare Facilities in Mthatha
- Bokop, Carine, Faye, M Lindiwe, Apalata, Teke
- Authors: Bokop, Carine , Faye, M Lindiwe , Apalata, Teke
- Date: 2023/07
- Subjects: Xpert MTB/RIF , Line probe assay , MGIT 960 system , Mycobacterium tuburculosis , Discrepant results
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13652 , vital:78963 , DOI: https://doi.org/10.3390/pathogens12070909
- Description: The study sought to determine the rate of discordant results between genotypic and phenotypic tests for the diagnosis of drug-resistant tuberculosis (DR-TB). Sputum samples and cultured isolates from suspected DR-TB patients were, respectively, analyzed for Mycobacterium tuberculosis by Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA) and line probe assays (LPA) (Hain, Nehren, Germany). Discrepant rifampicin (RMP)-resistant results were confirmed using BACTEC MGIT960 (BD, New York, NY, USA). Of the 224 RMP-resistant results obtained by Xpert MTB/RIF, 5.4% were susceptible to RMP by LPA. MGIT960 showed a 75% agreement with LPA. The discrepancy was attributed to either heteroresistance or DNA contamination during LPA testing in 58.3% of cases. In 25% of the samples showing agreement in RMP resistance between Xpert MTB/RIF and MGIT960, the discrepancy was attributed to laboratory errors causing false RMP susceptible results with LPA. In 16.7% of the cases, the discrepancy was attributed to false RMP susceptible results with Xpert MTB/RIF. Out of the 224 isolates, susceptibility to isoniazid (INH) by LPA was performed in 73.7% RMP-resistant isolates, of which, 80.6% were resistant. All RMP-resistant isolates by Xpert MTB/RIF were confirmed in 98.5% by LPA if TB isolates were resistant to INH, but were only confirmed in 81.3% if TB isolates were susceptible to INH....
- Full Text:
- Date Issued: 2023/07
- Authors: Bokop, Carine , Faye, M Lindiwe , Apalata, Teke
- Date: 2023/07
- Subjects: Xpert MTB/RIF , Line probe assay , MGIT 960 system , Mycobacterium tuburculosis , Discrepant results
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13652 , vital:78963 , DOI: https://doi.org/10.3390/pathogens12070909
- Description: The study sought to determine the rate of discordant results between genotypic and phenotypic tests for the diagnosis of drug-resistant tuberculosis (DR-TB). Sputum samples and cultured isolates from suspected DR-TB patients were, respectively, analyzed for Mycobacterium tuberculosis by Xpert® MTB/RIF (Cepheid, Sunnyvale, CA, USA) and line probe assays (LPA) (Hain, Nehren, Germany). Discrepant rifampicin (RMP)-resistant results were confirmed using BACTEC MGIT960 (BD, New York, NY, USA). Of the 224 RMP-resistant results obtained by Xpert MTB/RIF, 5.4% were susceptible to RMP by LPA. MGIT960 showed a 75% agreement with LPA. The discrepancy was attributed to either heteroresistance or DNA contamination during LPA testing in 58.3% of cases. In 25% of the samples showing agreement in RMP resistance between Xpert MTB/RIF and MGIT960, the discrepancy was attributed to laboratory errors causing false RMP susceptible results with LPA. In 16.7% of the cases, the discrepancy was attributed to false RMP susceptible results with Xpert MTB/RIF. Out of the 224 isolates, susceptibility to isoniazid (INH) by LPA was performed in 73.7% RMP-resistant isolates, of which, 80.6% were resistant. All RMP-resistant isolates by Xpert MTB/RIF were confirmed in 98.5% by LPA if TB isolates were resistant to INH, but were only confirmed in 81.3% if TB isolates were susceptible to INH....
- Full Text:
- Date Issued: 2023/07
Developing a Model for Integrating of Tuberculosis, Human Immunodeficiency Virus and Primary Healthcare Services in Oliver Reginald (O.R) Tambo District, Eastern Cape, South Africa
- Dlatu, Ntandazo, Longo-Mbenza, Benjamin, Oladimeji, Elizabeth Kelechi, Apalata, Teke
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/07
- Subjects: Model developement , TB-HIV integrated model , TB and HIV , Quantitative and qualitative data
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13643 , vital:78964 , DOI: https://doi.org/10.3390/ijerph20115977
- Description: Despite the policy, frameworks for integration exist; integration of TB and HIV services is far from ideal in many resource-limited countries, including South Africa. Few studies have examined the advantages and disadvantages of integrated TB and HIV care in public health facilities, and even fewer have proposed conceptual models for proven integration. This study aims to fill this vacuum by describing the development of a paradigm for integrating TB, HIV, and patient services in a single facility and highlights the importance of TB-HIV services for greater accessibility under one roof. Development of the proposed model occurred in several phases that included assessment of the existing integration model for TB-HIV and synthesis of quantitative and qualitative data from the study sites, which were selected public health facilities in rural and peri-urban areas in the Oliver Reginald (O.R.) Tambo District Municipality in the Eastern Cape, South Africa. Secondary data on clinical outcomes from 2009–2013 TB–HIV were obtained from various sources for the quantitative analysis of Part 1. Qualitative data included focus group discussions with patients and healthcare workers, which were analyzed thematically in Parts 2 and 3. The development of a potentially better model and the validation of this model shows that the district health system was strengthened by the guiding principles of the model, which placed a strong emphasis on inputs, processes, outcomes, and integration effects. The model is adaptable to different healthcare delivery systems but requires the support of patients, providers (professionals and institutions), payers, and policymakers to be successful.
- Full Text:
- Date Issued: 2023/07
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Oladimeji, Elizabeth Kelechi , Apalata, Teke
- Date: 2023/07
- Subjects: Model developement , TB-HIV integrated model , TB and HIV , Quantitative and qualitative data
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13643 , vital:78964 , DOI: https://doi.org/10.3390/ijerph20115977
- Description: Despite the policy, frameworks for integration exist; integration of TB and HIV services is far from ideal in many resource-limited countries, including South Africa. Few studies have examined the advantages and disadvantages of integrated TB and HIV care in public health facilities, and even fewer have proposed conceptual models for proven integration. This study aims to fill this vacuum by describing the development of a paradigm for integrating TB, HIV, and patient services in a single facility and highlights the importance of TB-HIV services for greater accessibility under one roof. Development of the proposed model occurred in several phases that included assessment of the existing integration model for TB-HIV and synthesis of quantitative and qualitative data from the study sites, which were selected public health facilities in rural and peri-urban areas in the Oliver Reginald (O.R.) Tambo District Municipality in the Eastern Cape, South Africa. Secondary data on clinical outcomes from 2009–2013 TB–HIV were obtained from various sources for the quantitative analysis of Part 1. Qualitative data included focus group discussions with patients and healthcare workers, which were analyzed thematically in Parts 2 and 3. The development of a potentially better model and the validation of this model shows that the district health system was strengthened by the guiding principles of the model, which placed a strong emphasis on inputs, processes, outcomes, and integration effects. The model is adaptable to different healthcare delivery systems but requires the support of patients, providers (professionals and institutions), payers, and policymakers to be successful.
- Full Text:
- Date Issued: 2023/07
Models of integration of TB and HIV services and factors associated with perceived quality of TB-HIV integrated service delivery in O.R Tambo District, South Africa
- Dlatu, Ntandazo, Longo-Mbenza, Benjamin, Apalata, Teke
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Apalata, Teke
- Date: 2023/07
- Subjects: Tuberculosis , HIV , HIV/TB integration , Healthcare services
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13560 , vital:78954 , DOI: https://doi.org/10.1186/s12913-023-09748-2
- Description: Background Tuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care. Methods This is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05. Results Of the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y=3.72–0.06X (adjusted R2=23%, p-value=0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions’ coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk’s Lambda=0.750, p=0.043).
- Full Text:
- Date Issued: 2023/07
- Authors: Dlatu, Ntandazo , Longo-Mbenza, Benjamin , Apalata, Teke
- Date: 2023/07
- Subjects: Tuberculosis , HIV , HIV/TB integration , Healthcare services
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13560 , vital:78954 , DOI: https://doi.org/10.1186/s12913-023-09748-2
- Description: Background Tuberculosis is the leading infectious cause of death among people living with HIV. Reducing morbidity and mortality from HIV-associated TB requires strong collaboration between TB and HIV services at all levels with fully integrated, people-centered models of care. Methods This is a qualitative study design using principles of ethnography and the application of aggregate complexity theory. A total of 54 individual interviews with healthcare workers and patients took place in five primary healthcare facilities in the O.R. Tambo district. The participants were purposively selected until the data reached saturation point, and all interviews were tape-recorded. Quantitative analysis of qualitative data was used after coding ethnographic data, looking for emerging patterns, and counting the number of times a qualitative code occurred. A Likert scale was used to assess the perceived quality of TB/HIV integration. Regression models and canonical discriminant analyses were used to explore the associations between the perceived quality of TB and HIV integrated service delivery and independent predictors of interest using SPSS® version 23.0 (Chicago, IL) considering a type I error of 0.05. Results Of the 54 participants, 39 (72.2%) reported that TB and HIV services were partially integrated while 15 (27.8%) participants reported that TB/HIV services were fully integrated. Using the Likert scale gradient, 23 (42.6%) participants perceived the quality of integrated TB/HIV services as poor while 13 (24.1%) and 18 (33.3%) perceived the quality of TB/HIV integrated services as moderate and excellent, respectively. Multiple linear regression analysis showed that access to healthcare services was significantly and independently associated with the perceived quality of integrated TB/HIV services following the equation: Y=3.72–0.06X (adjusted R2=23%, p-value=0.001). Canonical discriminant analysis (CDA) showed that in all 5 municipal facilities, long distances to healthcare facilities leading to reduced access to services were significantly more likely to be the most impeding factor, which is negatively influencing the perceived quality of integrated TB/HIV services, with functions’ coefficients ranging from 9.175 in Mhlontlo to 16.514 in KSD (Wilk’s Lambda=0.750, p=0.043).
- Full Text:
- Date Issued: 2023/07
Causes and outcomes of intensive care admission refusals: A retrospective audit from a rural teaching hospital in Eastern Cape, South Africa
- Ninise, Ezile Julie, Mrara, Busisiwe
- Authors: Ninise, Ezile Julie , Mrara, Busisiwe
- Date: 2023/06
- Subjects: ICU triage , Refusal rates , Nelson Mandela Academic Hospital , A retrospecive cross-sectional study
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13200 , vital:78090 , DOI: https://doi.org/10.3390/clinpract13040066
- Description: (1) Background: Patients who deserve intensive care unit (ICU) admission may be denied due to a lack of resources, complicating ICU triage decisions for intensive care unit (ICU) clinicians. Among the resources that may be unavailable are trained personnel and monitored beds. In South Africa, the distribution of healthcare resources is reflected in the availability of ICU beds, with more ICU beds available in more affluent areas. Data on ICU refusal rates, reasons for refusal, patient characteristics, and outcomes are scarce in resource-constrained rural settings. Hence, this study sheds light on the ICU refusal rates, reasons for refusal, characteristics, and outcomes of refused patients at NMAH. (2) Methods: This was a three-month retrospective cross-sectional record review of refused and admitted patients from January to March 2022. COVID-19 patients and those younger than 13 years old were excluded. Refusal rates, reasons for refusal, characteristics, and outcomes of refused patients were analysed quantitatively using SPSS VS 20 software. Reasons for refusal were categorised as “too well”, “too sick”, and “suitable for admission but no resources”. (3) Results: A total of 135 patients were discussed for ICU admission at NMAH during the study period; 73 (54.07%) were refused admission, and 62 (45.92%) were admitted. Being considered too sick to benefit from ICU was the most common reason for refusal (53.23%). Too well and no resources contributed 27.42% and 19.35%, respectively. Patients with poor functional status, comorbidities, medical diagnoses, and those referred from the ward or accident and emergency unit rather than the operating room were more likely to be refused ICU admission. Refused patients had a seven-day mortality rate of 47%. (4) Conclusions and recommendations: The study found an unmet need for critical care services at our institution, as well as a need for tools to help clinicians make objective triage decisions for critically ill patients. Therefore, the study suggests a need to improve the quality of services provided outside of the ICU, particularly for patients who were refused ICU admission, to improve their outcomes.
- Full Text:
- Date Issued: 2023/06
- Authors: Ninise, Ezile Julie , Mrara, Busisiwe
- Date: 2023/06
- Subjects: ICU triage , Refusal rates , Nelson Mandela Academic Hospital , A retrospecive cross-sectional study
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13200 , vital:78090 , DOI: https://doi.org/10.3390/clinpract13040066
- Description: (1) Background: Patients who deserve intensive care unit (ICU) admission may be denied due to a lack of resources, complicating ICU triage decisions for intensive care unit (ICU) clinicians. Among the resources that may be unavailable are trained personnel and monitored beds. In South Africa, the distribution of healthcare resources is reflected in the availability of ICU beds, with more ICU beds available in more affluent areas. Data on ICU refusal rates, reasons for refusal, patient characteristics, and outcomes are scarce in resource-constrained rural settings. Hence, this study sheds light on the ICU refusal rates, reasons for refusal, characteristics, and outcomes of refused patients at NMAH. (2) Methods: This was a three-month retrospective cross-sectional record review of refused and admitted patients from January to March 2022. COVID-19 patients and those younger than 13 years old were excluded. Refusal rates, reasons for refusal, characteristics, and outcomes of refused patients were analysed quantitatively using SPSS VS 20 software. Reasons for refusal were categorised as “too well”, “too sick”, and “suitable for admission but no resources”. (3) Results: A total of 135 patients were discussed for ICU admission at NMAH during the study period; 73 (54.07%) were refused admission, and 62 (45.92%) were admitted. Being considered too sick to benefit from ICU was the most common reason for refusal (53.23%). Too well and no resources contributed 27.42% and 19.35%, respectively. Patients with poor functional status, comorbidities, medical diagnoses, and those referred from the ward or accident and emergency unit rather than the operating room were more likely to be refused ICU admission. Refused patients had a seven-day mortality rate of 47%. (4) Conclusions and recommendations: The study found an unmet need for critical care services at our institution, as well as a need for tools to help clinicians make objective triage decisions for critically ill patients. Therefore, the study suggests a need to improve the quality of services provided outside of the ICU, particularly for patients who were refused ICU admission, to improve their outcomes.
- Full Text:
- Date Issued: 2023/06
Health-Seeking Behavior Regarding Coughs in Urban Slums in Lagos, Nigeria
- Adepoju, Victor Abiola, Oladimeji, Olanrewaju, Sokoya, Olusola Daniel
- Authors: Adepoju, Victor Abiola , Oladimeji, Olanrewaju , Sokoya, Olusola Daniel
- Date: 2023/06
- Subjects: tuberculosis , health-seeking , urban , patent proprietary medicine vendor , World TB day , Nigeria , active case finding , outreaches
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13290 , vital:78420 , DOI: https://doi.org/10.3390/medicines10070038
- Description: Background: TB is a major cause of morbidity and mortality, with slum residents being disproportionately affected. This study aimed to assess health-seeking behavior among adult residents of slum communities presenting with coughs in Lagos, Nigeria. Methods: A community-based, cross-sectional study was conducted across six urban slums in Nigeria as part of community outreaches to mark World TB Day. A structured, pretested questionnaire was used to capture relevant sociodemographic details and questions regarding symptoms of coughs and related symptoms as well as care-seeking behavior. Data were explored, analyzed, and presented using descriptive statistics. Results: A total of 632 respondents participated in this study...
- Full Text:
- Date Issued: 2023/06
- Authors: Adepoju, Victor Abiola , Oladimeji, Olanrewaju , Sokoya, Olusola Daniel
- Date: 2023/06
- Subjects: tuberculosis , health-seeking , urban , patent proprietary medicine vendor , World TB day , Nigeria , active case finding , outreaches
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13290 , vital:78420 , DOI: https://doi.org/10.3390/medicines10070038
- Description: Background: TB is a major cause of morbidity and mortality, with slum residents being disproportionately affected. This study aimed to assess health-seeking behavior among adult residents of slum communities presenting with coughs in Lagos, Nigeria. Methods: A community-based, cross-sectional study was conducted across six urban slums in Nigeria as part of community outreaches to mark World TB Day. A structured, pretested questionnaire was used to capture relevant sociodemographic details and questions regarding symptoms of coughs and related symptoms as well as care-seeking behavior. Data were explored, analyzed, and presented using descriptive statistics. Results: A total of 632 respondents participated in this study...
- Full Text:
- Date Issued: 2023/06
Health facility delivery and early initiation of breastfeeding: Cross-sectional survey of 11 sub-Saharan African countries
- Ameyaw, Edward K, Adde, Kenneth S, Paintsil, Jones A, Dickson, Kwamena S, Oladimeji, Olanrewaju, Yaya, Sanni
- Authors: Ameyaw, Edward K , Adde, Kenneth S , Paintsil, Jones A , Dickson, Kwamena S , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/05
- Subjects: Early initiation of breastfeeding , Newborn , Neonatal health , Global health , sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13253 , vital:78414 , DOI: https://doi.org/10.1002/hsr2.1263
- Description: Background and Aims: Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub‐ Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods: We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results: The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73–1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16–1.27). Women with a primary education (aOR = 1.26, CI = 1.20–1.32), secondary education (aOR = 1.12, CI = 1.06–1.17), and higher (aOR = 1.13, CI = 1.02–1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23–1.43). Conclusion: Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.
- Full Text:
- Date Issued: 2023/05
- Authors: Ameyaw, Edward K , Adde, Kenneth S , Paintsil, Jones A , Dickson, Kwamena S , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/05
- Subjects: Early initiation of breastfeeding , Newborn , Neonatal health , Global health , sub-Saharan Africa
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13253 , vital:78414 , DOI: https://doi.org/10.1002/hsr2.1263
- Description: Background and Aims: Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub‐ Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods: We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results: The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73–1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16–1.27). Women with a primary education (aOR = 1.26, CI = 1.20–1.32), secondary education (aOR = 1.12, CI = 1.06–1.17), and higher (aOR = 1.13, CI = 1.02–1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23–1.43). Conclusion: Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.
- Full Text:
- Date Issued: 2023/05
Prevalence and Antibiotic Resistance Pattern of Streptococcus, Staphylococcus, Neisseria meningitidis and Enterobacteriaceae in Two Reference Hospitals of Yaoundé: An Overview before and during COVID-19 Pandemic Era
- Djuikoue, Ingrid Cecile, Djonkouh, Yamdeu Willy, Bekolo, Epie Cavin, Wouambo, Kamga Rodrigue, Fonou, Carrel Raspail, Djoulako, Djouela Dana Paule, Temgoua, Tonfak Gilder, Pokam, Thumamamo Benjamin D., Antoine-Moussiaux, Nicolas, Apalata, Teke R.
- Authors: Djuikoue, Ingrid Cecile , Djonkouh, Yamdeu Willy , Bekolo, Epie Cavin , Wouambo, Kamga Rodrigue , Fonou, Carrel Raspail , Djoulako, Djouela Dana Paule , Temgoua, Tonfak Gilder , Pokam, Thumamamo Benjamin D. , Antoine-Moussiaux, Nicolas , Apalata, Teke R.
- Date: 2023/05
- Subjects: Resistant bacteria , Covid-19 pandemis era , Antibiotics
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13358 , vital:78660 , DOI: https://doi.org/10.3390/antibiotics12050929
- Description: The COVID-19 pandemic led to tremendously use of antimicrobial due to the lack of proper treatment strategies, raising concerns about emergence of antimicrobial resistance (AMR). This study aimed at determining the prevalence and antibiotic resistance pattern of selected bacteria isolates in 02 referral health facilities in Yaoundé before and during the COVID-19 pandemic era. We conducted a retrospective study over a period of 03 years (from 1 January 2019 to 31 December 2021) in the bacteriology units of the Central and General Hospitals of Yaoundé, Cameroon. Data on bacteria genera (Streptococcus, Staphylococcus, Neisseria meningitidis and Enterobacteriaceae) as well as their corresponding specifics antibiotics: Cefixime, azythromycin and erythromycin were obtained from laboratory records. The global resistance rate of bacteria as well as their correlation with antibiotics according to COVID-19 pandemic era was determined and compared. For p 0.05, the difference was statistically significant. In all, 426 bacterial strains were included. It appeared that the highest number of bacteria isolates and lowest rate of bacterial resistance were recorded during the pre-COVID-19 period in 2019 (160 isolates vs. 58.8% resistance rate). Conversely, lower bacteria strains but greater resistance burden were recorded during the pandemic era (2020 and 2021) with the lowest bacteria amount and peak of bacteria resistance registered in 2020, the year of COVID-19 onset (120 isolates vs. 70% resistance in 2020 and 146 isolates vs. 58.9% resistance in 2021)…
- Full Text:
- Date Issued: 2023/05
- Authors: Djuikoue, Ingrid Cecile , Djonkouh, Yamdeu Willy , Bekolo, Epie Cavin , Wouambo, Kamga Rodrigue , Fonou, Carrel Raspail , Djoulako, Djouela Dana Paule , Temgoua, Tonfak Gilder , Pokam, Thumamamo Benjamin D. , Antoine-Moussiaux, Nicolas , Apalata, Teke R.
- Date: 2023/05
- Subjects: Resistant bacteria , Covid-19 pandemis era , Antibiotics
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13358 , vital:78660 , DOI: https://doi.org/10.3390/antibiotics12050929
- Description: The COVID-19 pandemic led to tremendously use of antimicrobial due to the lack of proper treatment strategies, raising concerns about emergence of antimicrobial resistance (AMR). This study aimed at determining the prevalence and antibiotic resistance pattern of selected bacteria isolates in 02 referral health facilities in Yaoundé before and during the COVID-19 pandemic era. We conducted a retrospective study over a period of 03 years (from 1 January 2019 to 31 December 2021) in the bacteriology units of the Central and General Hospitals of Yaoundé, Cameroon. Data on bacteria genera (Streptococcus, Staphylococcus, Neisseria meningitidis and Enterobacteriaceae) as well as their corresponding specifics antibiotics: Cefixime, azythromycin and erythromycin were obtained from laboratory records. The global resistance rate of bacteria as well as their correlation with antibiotics according to COVID-19 pandemic era was determined and compared. For p 0.05, the difference was statistically significant. In all, 426 bacterial strains were included. It appeared that the highest number of bacteria isolates and lowest rate of bacterial resistance were recorded during the pre-COVID-19 period in 2019 (160 isolates vs. 58.8% resistance rate). Conversely, lower bacteria strains but greater resistance burden were recorded during the pandemic era (2020 and 2021) with the lowest bacteria amount and peak of bacteria resistance registered in 2020, the year of COVID-19 onset (120 isolates vs. 70% resistance in 2020 and 146 isolates vs. 58.9% resistance in 2021)…
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- Date Issued: 2023/05
The Effect of Cardiorespiratory Exercise in the Prevention and Treatment of Hypertension among HIV-Infected Individuals on Antiretroviral Therapy in Mthatha, South Africa
- Tsuro, Urgent, Oladimeji, Elizabeth Kelechi, Pulido-Estrada, Guillermo-Alfredo, Apalata, Ruffin Teke
- Authors: Tsuro, Urgent , Oladimeji, Elizabeth Kelechi , Pulido-Estrada, Guillermo-Alfredo , Apalata, Ruffin Teke
- Date: 2023/05
- Subjects: Cardiorespiratory fitness , Concurrent training , Hypertension , HIV , Black people , Randomized control trial
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13577 , vital:78958 , DOI: https://doi.org/10.3390/healthcare11131836
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
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- Date Issued: 2023/05
- Authors: Tsuro, Urgent , Oladimeji, Elizabeth Kelechi , Pulido-Estrada, Guillermo-Alfredo , Apalata, Ruffin Teke
- Date: 2023/05
- Subjects: Cardiorespiratory fitness , Concurrent training , Hypertension , HIV , Black people , Randomized control trial
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13577 , vital:78958 , DOI: https://doi.org/10.3390/healthcare11131836
- Description: Tuberculosis (TB), a disease of poverty and inequality, is a leading cause of severe illness and death among people with human immunodeficiency virus (HIV). In South Africa, both TB and HIV epidemics have been closely related and persistent, posing a significant burden for healthcare provision. Studies have observed that TB-HIV integration reduces mortality. The operational implementation of integrated services is still challenging. This study aimed to describe patients’ perceptions on barriers to scaling up of TB-HIV integration services at selected health facilities (study sites) in Oliver Reginald (O.R) Tambo Municipality, Eastern Cape province, South Africa. We purposely recruited twenty-nine (29) patients accessing TB and HIV services at the study sites. Data were analyzed using qualitative content analysis and presented as emerging themes. Barriers identified included a lack of health education about TB and HIV; an inadequate counselling for HIV and the antiretroviral drugs (ARVs); and poor quality of services provided by the healthcare facilities. These findings suggest that the O.R. Tambo district needs to strengthen its TB-HIV integration immediately.
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- Date Issued: 2023/05
Prevalence and factors associated with HIV treatment non-adherence among people living with HIV in three regions of Cameroon: A cross-sectional study
- Buh, Amos, Deonandan, Raywat, Gomes, James, Krentel, Alison, Oladimeji, Olanrewaju, Yaya, Sanni
- Authors: Buh, Amos , Deonandan, Raywat , Gomes, James , Krentel, Alison , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/04
- Subjects: hiv treatment , non-adherence , young people
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13281 , vital:78419 , DOI: https://doi.org/10.1371/journal.pone.0283991
- Description: Background: In Cameroon, HIV care decentralization is enforced as a national policy, but follow-up of people living with HIV (PLWH) is provider-driven, with little patient education and limited patient participation in clinical surveillance. These types of services can result in low antiretroviral therapy (ART) adherence. The objective of this study was to assess the prevalence and predictors of ART non-adherence among PLWH in Cameroon. Methods: A cross-sectional descriptive study of PLWH in HIV treatment centres in Cameroon was conducted. Only PLWH, receiving treatment in a treatment centre within the country, who had been on treatment for at least six months and who were at least 21 years old were included in the study. Individuals were interviewed about their demographics and ART experiences. Data were collected using a structured interviewer-administered questionnaire and analyzed using STATA version 14...
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- Date Issued: 2023/04
- Authors: Buh, Amos , Deonandan, Raywat , Gomes, James , Krentel, Alison , Oladimeji, Olanrewaju , Yaya, Sanni
- Date: 2023/04
- Subjects: hiv treatment , non-adherence , young people
- Language: English
- Type: Article
- Identifier: http://hdl.handle.net/11260/13281 , vital:78419 , DOI: https://doi.org/10.1371/journal.pone.0283991
- Description: Background: In Cameroon, HIV care decentralization is enforced as a national policy, but follow-up of people living with HIV (PLWH) is provider-driven, with little patient education and limited patient participation in clinical surveillance. These types of services can result in low antiretroviral therapy (ART) adherence. The objective of this study was to assess the prevalence and predictors of ART non-adherence among PLWH in Cameroon. Methods: A cross-sectional descriptive study of PLWH in HIV treatment centres in Cameroon was conducted. Only PLWH, receiving treatment in a treatment centre within the country, who had been on treatment for at least six months and who were at least 21 years old were included in the study. Individuals were interviewed about their demographics and ART experiences. Data were collected using a structured interviewer-administered questionnaire and analyzed using STATA version 14...
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- Date Issued: 2023/04