Community Awareness Campaigns Research Articles

Community-Based Delivery and Administration of Sars-CoV-2 Antigen Rapid Diagnostic Tests: An Operational Research Study in Marketplaces in Malawi and Zambia.

To expand access to testing beyond public health facilities and to strengthen surveillance efforts for COVID-19, community testing using COVID-19 antigen-based rapid diagnostic tests (Ag-RDTs) was identified as a major area of focus in Malawi and Zambia. This research aimed to gather evidence on the feasibility and acceptability of community testing in marketplaces. A cross-sectional study with a mixed-methods design was conducted in marketplaces in Malawi and Zambia to understand operational considerations for the implementation of Ag-RDTs for SARS-CoV-2 in a community setting. Programmatic data were collected prospectively as individuals were tested from June to September 2022. COVID-19 testing was done using Abbott Panbio nasal swab test kits. Semi-qualitative questionnaires were administered to individuals who tested, healthcare workers, and site-based personnel. Data were collected electronically via the SurveyCTO platform and analyzed using STATA. In Malawi, 2,348 participants were tested, and in Zambia, 1,723 people were tested for COVID-19. In Zambia, participants were 46% female, with a median age of 28 years, whereas in Malawi, participants were 69% female, with a median age of 37 years. In Malawi, 78 positive cases were reported (3.3% positivity rate), and in Zambia 10 positive cases were reported (0.5% positivity rate). In Zambia, 99% of 300 participants and in Malawi, 92% of 1,158 testers found the market testing experience and sample collection acceptable. Community testing is a feasible and acceptable intervention to increase testing access in Malawi and Zambia, especially when coupled with community awareness campaigns and mobilization.

The challenges of delivery in pre-hospital emergency medical services ambulances in Iran: a qualitative study

BackgroundAlthough unplanned deliveries in ambulances are uncommon, Emergency Medical Services (EMS) providers may encounter this situation before reaching the hospital. This research aims to gather insights from Emergency Medical Technicians (EMTs), midwives, and expectant mothers to examine the causes of giving birth in ambulances and the challenges EMTs, pregnant women, and midwives face during delivery.MethodsA qualitative study was conducted, and 28 EMTs, midwives, and pregnant women who had experience with pre-hospital births in the ambulance were interviewed. Data were analyzed using thematic content analysis. The MAXQDA/10 software was employed for data analysis and code extraction.ResultsThe analysis of the interviews revealed two main categories: factors that cause delivery in the ambulance and its challenges. The factors include cultural problems, weak management, and inaccessibility to facilities. The challenges consist of fear and anxiety, native culture, and lack of resources.ConclusionsSeveral approaches should be implemented to reduce the number of births in ambulances and Pre-hospital Emergency Medical Services (PEMS). These include long-term community cultural activities, public education, awareness campaigns, education and follow-up for pregnant women, and improved accessibility to health facilities. Additionally, EMTS need to receive proper education and training for ambulance deliveries. Enhancing ambulance services and supporting EMTs in dealing with litigation claims are also critical.

P043 PREACH IMPLEMENTATION PROJECT A SOCIO-ECOLOGICAL FRAMEWORK FOR HYPERTENSION IN PAKISTAN

Background: Worldwide hypertension prevalence is projected to reach 1.56 billion by 2025, affecting 29% of the global population according to the WHO1. It contributes to 7.5 million deaths, 3.7% of total disability-adjusted life years (DALYs) and is responsible for causing stroke in 54% of hypertensives2,3. Pakistan has a prevalence of 43% hypertension with merely 12.5% of controlled hypertensives4,5. There is a pressing need for a national level intervention through uniform clinical approaches for optimum hypertension prevention, treatment and control6, 7. Through PREACH project, we prioritize primary care physicians as first-line responders and are training them on standardized hypertension guidelines to alleviate the burden from tertiary care hospitals. To detect new onset hypertension the project also incorporates early surveillance and community level screenings. Objectives: • To build capacity of practitioners on standardized guidelines endorsed by health ministry, PCS (Pakistan Cardiac Society) & PHL (Pakistan Hypertension League) • To raise community awareness, to screen and develop self-referral pathways to specialty care • To develop a robust national hypertension registry • To include hypertension in essential primary healthcare packages Methodology: Hypertension guidelines are developed. Accredited national certified workforce of more than 14,000 general practitioners (GPs) will be built through guidelines trainings via train the trainer model. Impact assessment studies will be done to assess training effectiveness and implementation at clinics. Community mobilization and awareness campaigns will be run to identify and direct self-referral pathway to an accredited GP. Development of national hypertension registry as a centralized system for data collection to report actual disease burden. Ministry of health will be advocated to prioritize hypertension management via multi-sectoral collaboration i.e. medical societies, academic, non-profit and private-sector for incorporations into annual development programs. Results \Conclusion: We aim to create an impact in the lives of 4.3 million beneficiaries (anti-hypertensive naïve hypertensive patients of Pakistan) by increasing self-referral of hypertensive cases to specialists through PREACH implementation project at all healthcare service delivery levels.

Community Health Awareness and Health Education on Diphtheria Among Residents of a Local Government Area in Edo State, Nigeria

This study investigated community health awareness and health education on diphtheria among residents of a local government area in Edo State. Two research questions and two hypotheses were formulated for the study. The population comprised 117,209 from which a sample of 399 was selected by means of cross sectional descriptive research design. Data collection was by means of a structured questionnaire and analyzed using descriptive and inferential statistics with hypotheses tested at 0.05 level of significance. Reliability coefficients of 0.84 and 0.79 were obtained for awareness and health education respectively. Results revealed low awareness on diphtheria among majority (93.5%), 24.1% had moderate awareness, 2.0% had high awareness. 93.5% claimed there had never been community awareness campaign on diphtheria in their community, 85.7% reported never to have attended seminar/health talks on diphtheria infection. Level of education on diphtheria was low (21.2%). Majority of the respondents (61.4%) had low level of education on diphtheria. Gender and educational background were significantly associated with community health awareness on diphtheria (p = .000). The study recommends that since the level of health awareness and education was low among the population, nursing practitioners should consider community health awareness campaign on diphtheria in communities in other to raise awareness. Females and those with low educational background, should be targeted to ensure they seek information on diphtheria to protect their health.

The Use of Eco-Enzyme as a Larvacide for Aedes aegypti Mosquito Larvae

Nearly half of the world's population is at risk of dengue infection, an arboviral infection that is typically spread by the mosquito Aedes aegypti. Insecticide use and community awareness campaigns are the main vector control strategies currently in use in some countries, and they didn’t done many ways to reduce dengue. Eco-enzyme is the product of fermentation from organic waste such as vegetable, fruit, and sugar. Eco-enzyme can be used in agriculture, medicine, and others. This study aims to analyze the toxicity level of ecoenzyme as the larvicide for Aedes aegypti larvae. An analytical experimental study were conducted in Bionas Parasitology Laboratory from February to March 2024. As many as 20 Aedes aegypti larvae were used in each of exposure. Each exposure were replicated four times. The mortality of Aedes aegypti larvae was analyzed by a two-way ANOVA test, followed by a Fisher's least significant defference (LSD) post hoc test with a significance level of (p<0.01). This data was analysed by Statistical Product and Service Solutions(SPSS)Inc. 25.0. The concentrations of ecoenzyme induce mortality of the third instar of Aedes aegypti larvae were started from 2% concentration, and the highest was found in 10% concentrations which resulted in average of 50% mortality. In this context, the analysis results show that time, concentration, and the interaction between time and concentration have a significant influence on the observed quantities. These findings can have important implications in the context of studies or experiments related to the variables being tested. Below are the profile plots of each variable (concentration and time of exposure) which give significant influence on the mortality of Aedes larvae

Antibiotic prescription pattern among Primary Healthcare General Practitioners in the South Batinah Governorate of Oman, 2019

BackgroundMisuse and overuse of antibiotics comprise leading causes of antimicrobial resistance. The study aims to assess the pattern of antibiotic prescription among primary healthcare general practitioners in the South Batinah Governorate of Oman.MethodA cross-sectional study of 600 antibiotic prescriptions issued in the South Batinah Governorate in 2019 was conducted to verify the triggering diagnoses and determine the appropriateness of the prescribed antibiotic. Logistic regression analysis was used to determine the association between predictors and inappropriate use.ResultsRespiratory infections accounted for 62% of antibiotic prescriptions, of which 92.2% were inappropriately prescribed. Extended-spectrum antibiotics were inappropriately prescribed in 33.3% of cystitis cases, while 14.3% of gastroenteritis received incorrect spectrum of antibiotics. Amoxicillin represented 46.2% of antibiotic prescriptions, of which 84.4% were unnecessarily prescribed. Lower inappropriate antibiotic prescribing rate was linked to patients ≥ 18 years (OR = 0.46, 95% CI: [0.26, 0.82]), those who underwent laboratory tests (OR = 0.22, 95% CI: [0.12, 0.39]), and consultations at health centers (OR = 0.44, 95% CI: [0.24, 0.79]). Arabic-speaking physicians were more likely to prescribe antibiotics inappropriately.ConclusionInappropriate antibiotic prescription was frequently observed in mild respiratory infections and associated with specific patient and physician characteristics. Appropriateness of antibiotic prescriptions issued can be improved through enhanced testing capacities as well as implementation of physician and community awareness campaigns.

Education For Community Transformation

The Tanzanian Government has made several efforts to guarantee the accessible and equitable education to all children irrespective of their race, creed or sex. However, there are some predominant socio-cultural practices which are impediments to young women’s education. Using a case of Monduli district -Tanzania, this study explored the influence of socio-cultural practices toward schooling of Maasai Young Women. A cross- sectional research design was adopted to obtain a sample of 120 respondents. Data were collected using Questionnaires, Key Informants’ Interview (KII) and Focus Group Discussions (FGDs) methods and analysed by using IBM-SPSS. 20.0 and content analysis. Overall, the study found that, Nomadic Lifestyle, Female Genital Mutilation (FGM) and Early Marriages are tremendously affecting schooling of young Maasai women. While the two earlier mentioned practices were found to waste a lot of girls’ learning hours; the latter has been causing a substantial number of school girls to drop out. Subsequently the girls became vulnerable to illiteracy of which jeopardizes their chances to participate in community development projects as well as in decision-making process. The illiterate people are not always invited to participate because they do not understand the nitty gritty of their participation. In order to eliminate these harmful practices, it is recommended the government and other stakeholders to create or strengthening community awareness campaigns and capacity-building programs.

From drops to drums: Assessing rainwater storage’s quality and quantity for addressing water demands in dry periods – A case study from Arusha Tanzania

Sustainable Development Goal 6 highlight the importance of providing reliable, affordable, and safe source of clean drinking water and sanitation for all by 2030. In Tanzania there is a dire need of a water supply strategy due to high levels of natural fluoride contamination in ground water (upto 74 mg/L) and the challenge of meeting water demand during 5 months long dry period. This study assesses social and technical feasibility of implementing rainwater harvesting (RWH) along with treatment technologies that includes Denutritor® to remove ammonia/pesticides and ultrafiltration to eliminate carbon. This integrated technology known as “Mbinguni Maji” is aimed for the long-term water storage to supply drinking water throughout the dry season. The methodology involves i) Assessing the technical feasibility of RWH using database from QGIS and Water Productivity Open-access portal (WaPOR) from the Food and Agricultural Organization of the United Nations; ii) conducting pilot demonstration in 5 different locations in Tanzania; and iii) conducting socio-economic survey for social acceptance of the technology through detailed questionnaires administered to residential homes, medical facilities, schools, hotels, and water kiosk owner. The result indicates that, from technical perspective, there is ample rainfall (average of 1036 mm/year) to supply water throughout the dry season, primarily for drinking and cooking purpose only (upto a maximum of 10 lpcd). The pilot demonstration confirms that the Mbinguni Maji RWH technology produce water that meets WHO water quality standards. The produced water is free from nutrients like carbon and ammonia, ensuring the possibility of long-term storage without bacterial and algal growth. Furthermore, Lab scale demonstration of Denutritor® show promising result of removing nitrite, ammonia even at high elevated temperature (30 °C), which can be effectively applied in Tanzania. In terms of social acceptance, RWH technology is already widely practised in Tanzania during the rainy season. However, the initial investment costs and operation & maintenance (O&M) concerns hinder the usage of RWH technology. Therefore, to ensure the long-term sustainability of RWH technologies, there is a need of development of comprehensive business plan and community awareness campaign.

Profiles of child labour: prevalence, activities, contexts, and children’s harm extent in Raya-Kobo and Angot Districts, Ethiopia

Using a mixed research design, the overall objective of this study is to investigate the profiles of child labour in Ethiopia’s districts of Raya-Kobo and Angot. The study’s specific objectives are to examine types of activities and prevalence of child labour, to identify the children’s working contexts, and to evaluate the extent of harm children face in workplaces. The study hypothesizes the existence of significant variations in the profiles of child labour (activity types, prevalence rates, settings, and level of harm to children) as a result of several circumstances. While survey methodology was used to collect primary data from 431 randomly selected respondents, desk review and document analysis were also used to gather secondary data. The sampling procedures used include multi-stage purposive and systematic random sampling. Descriptive and inferential (Ordered Probit Regression model) methods of data analysis are utilized to analyze the data. The results of the descriptive analysis demonstrate a high incidence and magnitude of child labour, as well as children’s early entry to work. The regression analysis reveals children’s exposure to high levels of harm at work, which is directly exacerbated by household age, income diversification, land fragmentation, livestock number, shocks, and the predicted value of remittances. Contrarily, access to rural transportation, household heads’ education level, cart ownership, and family size reduce children’s harm extent while working. The study highlights the need to design strategies for age-appropriate work to protect children from hazardous and high-intensity activities, undertake community awareness campaigns about the impact of child labour on children, and strengthen local stakeholders’ capacity. Additionally, connecting rural areas and farmers’ croplands to towns or major routes via repaired or new roads would be beneficial.

Protocol for the crowdsourced image-based morbidity hotspot surveillance for neglected tropical diseases (CIMS-NTDs).

Efficient NTDs elimination strategies require effective surveillance and targeted interventions. Traditional methods are costly and time-consuming, often failing to cover entire populations in case of movement restrictions. To address these challenges, a morbidity image-based surveillance system is being developed. This innovative approach which leverages the smartphone technology aims at simultaneous surveillance of multiple NTDs, enhancing cost-efficiency, reliability, and community involvement, particularly in areas with movement constraints. Moreover, it holds promise for post-elimination surveillance. The pilot of this method will be conducted across three states in southern Nigeria. It will target people affected by Neglected Tropical Diseases and members of their communities. The new surveillance method will be introduced to target communities in the selected states through community stakeholder's advocacy meetings and awareness campaigns. The pilot which is set to span eighteen months, entails sensitizing NTDs-affected individuals and community members using signposts, posters, and handbills, to capture photos of NTDs manifestations upon notice using smartphones. These images, along with pertinent demographic information, will be transmitted to a dedicated server through WhatsApp or Telegram accounts. The received images will be reviewed and organized at backend and then forwarded to a panel of experts for identification and annotation to specific NTDs. Data generated, along with geocoordinate information, will be used to create NTDs morbidity hotspot maps using ArcGIS. Accompanying metadata will be used to generate geographic and demographic distributions of various NTDs identified. To protect privacy, people will be encouraged to send manifestation photos of the affected body part only without any identifiable features. NTDs prevalence data obtained using conventional surveillance methods from both the pilot and selected control states during the pilot period will be compared with data from the CIMS-NTDs method to determine its effectiveness. It is expected that an effective, privacy-conscious, population inclusive new method for NTDs surveillance, with the potential to yield real-time data for the identification of morbidity hotspots and distribution patterns of NTDs will be established. The results will provide insights into the effectiveness of the new surveillance method in comparison to traditional approaches, potentially advancing NTDs elimination strategies.

Preterm Birth and Its Associated Factors among Mothers Delivered at Lira Regional Referral Hospital in Lira District

This study aimed to assess the prevalence of preterm birth and its associated factors among mothers delivered at Lira Regional Referral Hospital in Lira District in 2022. A hospital-based cross-sectional study and non-probability systematic sampling technique were employed to assess the prevalence of preterm birth and its associated factors among mothers delivered at Lira Regional Referral Hospital between August 2022 and November 2022. The normative sample was N-325; however, only 278 were analysed. Preterm birth and its associated factors were measured using a face-to-face pre-test interview, and additional data was extracted from medical records, an antenatal care chart, and a baby chart. Data was collected, coded, sorted, and processed using manual compilation and analysed using SPSS Version 25. Results showed that the prevalence of preterm birth was at 14%, mid-upper arm circumference p>0.000, baby delivered p>0.002, birth weight p>0.000, antenatal care number of times attended p>0.001, urinary tract infection p>0.000, premature rupture of membrane p>0.000, antepartum haemorrhage p>0.000, and pregnancy-induced hypertension p>0.000 were significantly associated with preterm birth. Preterm birth was more likely to occur in mothers who didn’t attend ANC and was higher in mothers who got PROM, UTI, APH, and PIH. Early detection of diseases, especially hypertension, hyperemesis gravidarum, and UTI, as well as improving health care quality delivery and carrying out community health education and awareness campaigns, can reduce the prevalence of preterm birth. Keywords: Preterm birth, Lira Regional Referral Hospital, Mothers, Antenatal care, Hypertension.

Study of Mosquito Borne Deasease Found in Yavatmal Region

Abstract: Mosquito-borne diseases are a significant public health concern in the Yavatmal region of Maharashtra, India. Malaria, dengue fever, and Japanese encephalitis are among the prominent diseases transmitted by mosquitoes in this region. Malaria, caused by the Plasmodium parasite, is endemic in Yavatmal, with transmission occurring mainly during the monsoon and post-monsoon seasons. Dengue fever, caused by the dengue virus and transmitted by Aedes mosquitoes, has seen periodic outbreaks in the region, with increased incidence during the rainy season. Japanese encephalitis, caused by the Japanese encephalitis virus and transmitted by Culex mosquitoes, poses a threat to the population, particularly in rural areas. Several factors contribute to the spread of mosquito-borne diseases in the Yavatmal region, including inadequate sanitation, stagnant water bodies, deforestation, and climate change. Socioeconomic factors such as poverty and limited access to healthcare further exacerbate the problem. Control and prevention efforts in the region primarily focus on vector control measures, including insecticide spraying, larval source management, and the use of bed nets. Community education and awareness campaigns play a crucial role in promoting preventive behaviors such as the use of insect repellents and proper waste disposal. Challenges in addressing mosquito-borne diseases in Yavatmal include inadequate healthcare infrastructure, insufficient funding, and the emergence of insecticide resistance among mosquito populations. Collaborative efforts involving government agencies, healthcare providers, researchers, and community organizations are essential to effectively combat these diseases. Strengthening surveillance systems, improving access to diagnostic and treatment facilities, and implementing integrated vector management strategies are necessary steps towards reducing the burden of mosquito-borne diseases in the Yavatmal region and improving public health outcomes.

IJCM_389A: A community based cross-sectional study on perception, attitude, and stigma towards mental illness among the rural community in Mangalore

Introduction: Mental disorder is a behavioral pattern which causes either suffering or poor ability to function in ordinary life. According to WHO health report 2022, 970 million people suffer from mental illness globally. 80% people with mental illness live in low and middle-income countries, which is a matter of concern for India being the most populated country in the world. This study aims to assess the attitude and perception of people towards mental illness and to identify the presence of stigma towards mental illness in the community. Methodology: This cross-sectional study was conducted among 320 individuals aged above 18 years from Jeppinamogaru, Boloor, Shiv Nagar and Neermarga of Mangalore. Data was collected using a pretested semi-structured questionnaire of the CAMI scale rates a total of 40 items on a 5-point Likert scale (1 = strongly agree to 5 = strongly disagree) and analyzed using SPSS version 25. Results were expressed as proportions using appropriate tables and graphs. P< 0.05 was considered as statistically significant. Results: Out of 320 individuals assessed, 73.1% were females, with 50% aged over 45 years. The lower middle class constituted 35.3%, while only 0.6% belonged to the lower class. Awareness of mental illnesses was low, with only 42 individuals (13%) are knowledgeable. Most relied on behavior to identify mental illness, and 54.1% favored hospital treatment. 31.6% believed mental illness was genetically inherited as it is running through families. Medium stigma was prevalent across all domains of the CAMI scale, with the least stigma observed among the upper class. Conclusions: The study revealed low to medium level of stigma toward mental illness among lower and upper middle-class SEC individuals, alongside insufficient knowledge about mental health issues. Addressing these gaps, necessitates community awareness campaigns, enhanced education in schools, and increased accessibility to community-based mental health services and health camps.

Community-Based Strategies for Disaster Preparedness in Mauritius

Mauritius is Small Island Developing State (SIDS) of volcanic origin which lies in the South-West Indian Ocean Basin and is vulnerable to the consequences of global environmental challenges. The fourth priority action of the Sendai Framework for Disaster Risk Reduction 2015-2030 is to consolidate disaster preparedness for an effective response and to have a Build Back Better agenda that will improve recovery, rehabilitation, and reconstruction. This research aimed at examining the disaster management system in Mauritius through community-based approaches. The National Disaster Risk Reduction and Management Centre’s (NDRRMC) involvement with the community living in high-risk zones was investigated. This study used quantitative data gathered from secondary sources and included the number of field training simulation exercises, training of volunteers under the Community Disaster Response Programme (CDRP), awareness campaigns and formulation of contingency plans based on documentation across Mauritius. The NDRRMC identified 109 high-risk zones across Mauritius out of which 13.7 per cent benefitted from all four forms of mitigation activities. Results indicated that contingency plans in Mauritius were evidence-based and had been developed after identification of disaster risk in selected regions, and therefore, they were limited to some types of disasters only. Findings also revealed that flooding was the most common type of simulated disaster exercise undertaken. The greatest number of field simulation exercises was carried out in Poste de Flacq. Results also demonstrated that only 38.5% of the community were exposed to disaster-related awareness campaigns, making it the least common form of disaster risk reduction (DRR) activity in Mauritius.

Exploring and prioritising strategies for improving uptake of postnatal care services in Thyolo, Malawi: A qualitative study.

Although postnatal care services form a critical component of the cascade of care in maternal, newborn, and child health the uptake of these services has remained low worldwide. This study explored and prioritised the strategies for optimising the uptake of postnatal care (PNC) services in Malawi. A qualitative descriptive study followed by nominal group techniques was conducted at three health facilities in Malawi from July to December 2020 and in October 2021. We conducted focus group discussions among postnatal mothers, fathers, healthcare workers, elderly women, and grandmothers. We conducted in-depth interviews with midwives and key health managers. Nominal group techniques were used to prioritise the main strategies for the provision of PNC. The demand strategies include appointment date reminders, provision of free health passport books, community awareness campaigns, and involvement of men in the services. The supply strategies included training health providers, improving clinic operations: task-shifting and hours of operation, having infrastructure for the services, and linkage to other services. Having services delivered near end-user residences was a crosscutting strategy. Refresher training and improvement in the clinic operations especially on hours of operation, appointment date reminders, and linkage to care were the prioritised strategies. There is a need to use acceptable and contextualised strategies to optimise the uptake and delivery of postnatal care services. Educating the healthcare workers and the community on postnatal services is key to increasing the demand and supply of the services.

Community antibiotic consumption and associated factors in Lusaka district of Zambia: findings and implications for antimicrobial resistance and stewardship.

Antimicrobial resistance (AMR) is a global public health crisis. This study assessed the general public's consumption of antibiotics and associated factors in the Lusaka district of Zambia. This cross-sectional study was conducted among 2038 participants between December 2022 and January 2023. Data were analysed using Stata 13.0. Multivariable regression techniques were used to determine the factors that influenced antibiotic consumption. Of the 2038 participants, 53.4% were female, and 51.5% had attended at least secondary school. Antibiotic use was 99.2%, of which 40.9% were appropriately used. Overall, 79.1% of antibiotics were prescribed in hospitals, while 20.9% were used from leftovers and accessed without prescriptions. This study found that the appropriate use of antibiotics was associated with being female, being aged 35 years and above, attaining secondary school or tertiary education, having a monthly expenditure of 195 USD and above, being aware that antibiotics were not the same as painkillers, and being confident that when someone was hospitalized, they would get well. This study found that the appropriate use of antibiotics was low, and this is an urgent public health issue requiring community engagement in tackling AMR and adherence to treatment guidelines in healthcare facilities. Additionally, there is a need to implement and strengthen antimicrobial stewardship programmes in healthcare facilities to promote the rational use of antibiotics in Zambia. There is also a need to heighten community awareness campaigns and educational activities on the appropriate use of antibiotics.

Molecular Detection and Isolation of Lumpy Skin Disease Virus during an Outbreak in West Hararghe Zone, Eastern Ethiopia.

Lumpy skin disease (LSD) is a highly contagious viral disease that causes significant economic losses in cattle populations globally. This study aimed to isolate and detect the LSD virus responsible for an outbreak in selected areas (Daaroo Labuu, Hawwii Guddina, and Gumbi Bordede district) of the West Hararghe Zone in Ethiopia between January 2020 and December 2021. Out of the 625 animals examined for the presence of LSD, only 73 animals showed clinical signs, and skin scrapes were collected from these animals for further analysis. Among those, 12 animals (1.9%) succumbed to the disease. Skin biopsy samples from 45 animals displaying clinical signs of LSD were inoculated in Vero cell lines because of limited equipment. After three blind passages, all samples developed cytopathic effects (CPEs). The presence of the LSD virus was confirmed using real-time PCR. Conventional PCR detected LSDV in 47 (64.4%) of the skin scrap samples, while high-resolution melt qPCR detected it in 49 (67.1%) samples. The study revealed a morbidity rate of 11.68%, a mortality rate of 1.92%, and a case fatality rate of 16.44% based on clinical data. The findings suggest that LSD causes significant economic losses, even in vaccinated animals prior to an outbreak. To effectively control and eradicate LSD, the government should develop new strategic policies. Community awareness campaigns are necessary to improve vector control measures and drainage systems. In addition, the present vaccination policy and strategy should be re-evaluated for effectiveness. This study focused on a specific region and timeframe, limiting generalizability. Factors such as environmental conditions and management practices were not extensively explored. Similar studies should be conducted in different regions to assess the prevalence and genetic diversity of LSDV. The effectiveness of control measures and vaccination strategies should be investigated. The impact of environmental factors and management practices on LSD transmission and disease severity warrants further exploration. This study provides insights into the detection and isolation of the LSD virus during an outbreak in the West Hararghe Zone of Ethiopia. The results highlight the need for continued surveillance and monitoring of emerging infectious diseases in the region. Furthermore, the importance of using molecular methods for detecting and characterizing viral outbreaks in livestock populations is emphasized.

COVID-19 surveillance in fragile health systems, armed conflict and humanitarian crisis, the case of Yemen

ABSTRACT Background Yemen is a poor country facing armed conflict which significantly disrupted the Health System. Yemen reported fewer COVID-19 cases than neighbouring countries, yet the case fatality rate (19.6%) remained five times the global average. Conflict typically hinders surveillance, however obtaining representative mortality and morbidity indicators remains essential to efficacious epidemic planning. We aimed to explore challenges hindering COVID-19 surveillance in Yemen and opportunities for addressing them, to increase surveillance effectiveness in such conflict and resource-constraint settings. Methods Qualitative study question guide was used for in-depth interviewswith 30 healthcare workers who worked in Yemen’s surveillance system during the pandemic. Participants were recruited through in-country gatekeepers using a ‘snowball’ sampling technique. Thematic framework analysiswas used. Findings A basic level of preparedness existed following responses to previous epidemics, including activating Rapid Response Teams (RRTs), and electronic disease surveillance. Key challenges included the ongoing conflict, an unstable health system, minimal infrastructure restorations, misinformation, community incompliance, and inadequate laboratory diagnostics or transportation capabilities. Participants recommended addressing these barriers through strengthening RRTs, transportation and laboratory testing capacities, implementing community awareness campaigns, alongside improving primary health care services and inter-governorate governance. Conclusion Active community surveillance by RRTs supplemented with community volunteers is imperative and necessary nationwide. National community awareness campaigns on case detection, reporting, and addressing misinformation are essential to implementing such community surveillance. Increased utilization of mobile laboratories could enhance laboratory testing capacity in underserved areas. For each recommendation to be effectively implemented, the international community must provide sufficient resources and financial aid.

Road to maternal death: the pooled estimate of maternal near-miss, its primary causes and determinants in Africa: a systematic review and meta-analysis

BackgroundMaternal near-miss (MNM) is defined by the World Health Organization (WHO) working group as a woman who nearly died but survived a life-threatening condition during pregnancy, childbirth, or within 42 days of termination of pregnancy due to getting quality of care or by chance. Despite the importance of the near-miss concept in enhancing quality of care and maternal health, evidence regarding the prevalence of MNM, its primary causes and its determinants in Africa is sparse; hence, this study aimed to address these gaps.MethodsA systematic review and meta-analysis of studies published up to October 31, 2023, was conducted. Electronic databases (PubMed/Medline, Scopus, Web of Science, and Directory of Open Access Journals), Google, and Google Scholar were used to search for relevant studies. Studies from any African country that reported the magnitude and/or determinants of MNM using WHO criteria were included. The data were extracted using a Microsoft Excel 2013 spreadsheet and analysed by STATA version 16. Pooled estimates were performed using a random-effects model with the DerSimonian Laired method. The I2 test was used to analyze the heterogeneity of the included studies.ResultsSixty-five studies with 968,555 participants were included. The weighted pooled prevalence of MNM in Africa was 73.64/1000 live births (95% CI: 69.17, 78.11). A high prevalence was found in the Eastern and Western African regions: 114.81/1000 live births (95% CI: 104.94, 123.59) and 78.34/1000 live births (95% CI: 67.23, 89.46), respectively. Severe postpartum hemorrhage and severe hypertension were the leading causes of MNM, accounting for 36.15% (95% CI: 31.32, 40.99) and 27.2% (95% CI: 23.95, 31.09), respectively. Being a rural resident, having a low monthly income, long distance to a health facility, not attending formal education, not receiving ANC, experiencing delays in health service, having a previous history of caesarean section, and having pre-existing medical conditions were found to increase the risk of MNM.ConclusionThe pooled prevalence of MNM was high in Africa, especially in the eastern and western regions. There were significant variations in the prevalence of MNM across regions and study periods. Strengthening universal access to education and maternal health services, working together to tackle all three delays through community education and awareness campaigns, improving access to transportation and road infrastructure, and improving the quality of care provided at service delivery points are key to reducing MNM, ultimately improving and ensuring maternal health equity.

Risk communication and community engagement in the context of COVID-19 response in Bangladesh: a qualitative study.

The global COVID-19 pandemic profoundly impacted nations worldwide, and Bangladesh was no exception. In response, the government of Bangladesh implemented community awareness initiatives aimed at containing the spread of the virus, aligned with international guidelines and recommendations. Despite these efforts, a lack of comprehensive community awareness programs played an essential role during the pandemic, not the preventive measures. A qualitative study employing framing theory was conducted to gain a deeper insight into how the social context influenced risk communication and community response throughout the COVID-19 pandemic in Bangladesh. The study was conducted in four selected districts of Bangladesh from February to May 2022 using complementary data collection methods, including key informant interviews, in-depth interviews, and focus group discussions with purposely selected participants. Data were analyzed thematically by following six steps of the thematic analysis process. Codes were developed based on the data and summarized into themes and sub-themes grounded on the codes. The findings indicate that the government of Bangladesh, along with development partners and non-government organizations, made a significant effort to raise awareness about COVID-19 in the community. However, there were certain limitations to this effort. These include a lack of social science and public health approaches to understanding the pandemic; inadequate coordination among the authorities for COVID-19 prevention and control; technological and geographical barriers for disseminating messages; the living conditions and lack of facilities; socio-cultural norms in understanding the COVID-19 health messages, and the gendered understanding of the messages. The findings also revealed that the awareness activities remained a one-way approach to inform the people and faced challenges to actively engage and create ownership of the community in the pandemic response. The study identified gaps in implementing risk communication and community engagement strategies in Bangladesh during the COVID-19 pandemic. Increasing focus on public health and prioritizing community ownership is essential to designing a more effective community awareness campaign. This approach will help ensure that health messages are communicated effectively and tailored to different communities' needs.