Deaths In Africa Research Articles

Perspectives of postpartum women on intermittent presumptive treatment in Uganda: implications for malaria prevention: a qualitative study

BackgroundMalaria during pregnancy leads to many deaths in Africa. COVID-19 contributed to more malaria cases due to interruptions in prevention efforts. Intermittent presumptive treatment (IPTP) is an effective malaria prevention strategy for pregnant women, but adoption barriers still exist. The study aim was to explore barriers to the adoption of IPTP at Kawempe National Referral Hospital (KNRH) Uganda.MethodsIn a qualitative study design, data was collected using focus group discussions. A total of 37 postpartum mothers were interviewed in six focus group discussions. The interviews were conducted using a structured guide to explore barriers to IPTP implementation at KNRH. The data was transcribed, coded, and analysed using NVivo 10.ResultsThe study found that mothers lacked adequate knowledge about IPTP, faced socioeconomic and cultural constraints, fear of side effects, a high pill burden, and experience of health system challenges as major themes of barriers to optimal IPTP use.Conclusions and recommendationsChallenges in the service delivery and inadequate information in regard to importance and expected side effects were identified by the users as the major barriers to IPTP delivery in public health care setting. Improving delivery of focused health education talks and health work attitude and delivery chain for IPTP in the health facilities are recommended to increase its uptake.

Impact of air pollution on mortality: Geo-epidemiological study in French-speaking Africa

According to the World Health Organization, air pollution is responsible for 90 % of deaths in Africa. However, limited data on exposure to air pollution is available, and studies are rare, particularly in French-speaking Africa. This study aims to investigate the impact of air pollution on mortality in 12 French-speaking African countries (Algeria, Burkina Faso, Burundi, Cameroon, Guinea, Ivory Coast, Madagascar, Mali, Morocco, Democratic Republic of Congo, Senegal, Tunisia). Using data from the Institute for Health Metrics and Evaluation (IHME), annual concentrations of the PM2.5 pollutant from different cities were integrated into a spatial interpolation model (IDW) at the scale of each country. The interpolation was validated using cross-validation models. For each of the considered cardiorespiratory diseases (LRI, stroke, COPD, IHD), the attributable mortality fraction was estimated using literature data and population exposure calculated using demographic data from each country. Large variations in ambient PM2.5 concentration between the 12 countries are observed, with concentrations ranging from 1.76 μg/m3 in Morocco to 64.99 μg/m3 in Cameroon. Concentrations are higher in West Africa than in Central or North Africa. In 2019, 136 457 deaths attributable to air pollution were recorded in the 12 countries: 40.8 % from ischemic heart disease, 38.5 % from stroke, 13.2 % from lower respiratory infections and 7.5 % from chronic obstructive pulmonary disease. Our model allowed us to obtain a spatial distribution and the number of deaths related to air pollution. However, the estimation of the health impact from air pollution could be improved by more systematic and comprehensive local exposure assessments from a robust air quality monitoring system.

Midwives’ Knowledge, Perceptions and Practices on Utilization of the Partograph at Mbuya Nehanda Maternity Hospital

Globally, maternal death has been an issue of concern, while obstructed and prolonged labour are among the top five causes of these deaths in Africa and Zimbabwe particularly. Proper and effective utilization of the Partograph significantly helps in preventing and reducing the high numbers of birthing complications of such a nature. A Partograph is a labour monitoring chart that provides a pictorial overview of maternal and foetal well-being during the intrapartum period. The study aimed to assess the knowledge, perceptions, and practices on the utilization of the Partograph among midwives working at Mbuya Nehanda Maternity Hospital. A descriptive cross sectional design was used, and a semi-structured questionnaire was administered to 60 participants chosen using the purposive sampling technique. Data were collected and analysed using the Statistical Package for Social Sciences (SPSS version 22) and presented using charts, tables, and narration. The study identified that midwives were knowledgeable, although they had a negative attitude towards the Partograph attributed by a lack of motivation caused by the absence of support from mentors and supervisors, lack of workshops, and on-the-job training on the use of the graphical chart. Underutilization of the tool, which pointed to poor practice, was attributed to understaffing of midwives, high workload, and burnout syndrome among the labour ward midwives. These implications could lead to omissions, litigations, poor maternal service delivery, and lawsuits. Periodic workshops, symposiums, on-the-job training would go a long way in improving attitudes. The study concluded that the Partograph is a very important tool that should be effectively used in the labour ward so that complications are picked up early, thereby improving maternal outcomes. Support for the midwives, supervision, mentorship, non-monetary incentives, and increased staffing with an acceptable midwife-patient ratio of probably 1:2 would improve practice and yield a positive birthing outcome of a live and healthy mother and baby.

Breaking the bad news of cancer: Exploring patient-doctor communication among clinical oncologists in Nigeria.

e23251 Background: Nigeria ranks top on the incidence of cancer as well as on cancer-related deaths in Africa with an estimated 72,000 cancer-related deaths and 124,000 incidences annually. Cancer patients in this population, report some of the worst patient outcomes. Previous studies have explored several systems and patient-level factors responsible for the high cancer mortality, and poor outcomes. The process of breaking the ‘bad’ news of cancer to patients by the clinical oncologists in Nigeria has remained an understudied area. This study aims to explore the process of breaking the ‘bad’ news of cancer to patients by clinical oncologists (COs) in Nigeria. Methods: Participants ( N = 24) were clinical oncologists who treat and care for cancer patients in Nigeria. We used a semi-structured interview for the data collection. All the data were managed using Dedoose and used grounded theory for the data analysis. Results: Five themes were identified: (1) the process of breaking the ‘bad’ news is overwhelming, (2) COs need training on patient-doctor communication, (3) every process of breaking the bad news should be unique (4) patients should be the primary focus and (5) clinical workload is affecting the capacity of CO in breaking the ‘bad’ news. Conclusions: The findings show that there is a need for a more robust patient engagement and navigation program focused on empowering patients to ask the right questions. There is a need for the government to explore ways of reducing clinical workload among COs.

The dynamics embedded in COVID-19 pandemic responses in South Africa: Implications for public healthcare delivery

South Africa recorded the highest number of COVID-19 cases and deaths in Africa despite having what seemed to be one of the best government response mechanisms on the continent. This paper explores the responses of both the government and the citizens of South Africa to the COVID-19 pandemic. Through a literature review, the study established that the government's response to the pandemic was influenced by various factors, including the responsibility to protect citizens' lives, the need to defend the state's sovereignty, and compliance with global health imperatives. This was achieved through strict and coercive government measures, which left little room for public participation in decision-making. The findings also indicate public dissent towards government directives, which may be attributed to a lack of public awareness and preparedness in public health emergencies. The social contract theory provides a useful framework for analysing and understanding the actions of the government and citizens in response to COVID-19 in South Africa. Understanding these aspects is crucial for drawing informative lessons for effective public health and socio-economic interventions in future pandemics and health-related emergencies.

Determination of birth prevalence of sickle cell disease using point of care test HemotypeSC™ at Rundu Hospital, Namibia

BackgroundSickle cell disease (SCD), a noncommunicable disease, has the greatest burden in sub-Saharan Africa. The majority of children (50–90%) with SCD die before their 5th birthday, with approximately 150,000–300,000 annual SCD child deaths in Africa. In developed countries, newborn screening (NBS) has been shown to improve the survival of children with sickle cell disease, with under5 childhood mortality reduced tenfold due to interventions performed before the development of complications. Point –of-care tests have been developed for resource limited settings to expand NBS. The aim of this study was to determine the birth prevalence of sickle cell disease in Namibia using the HemoTypeSC™ point-of-care test.MethodsA cross-sectional descriptive study was carried out at Rundu Intermediate Hospital in the Kavango East Region. Two hundred and two (202) well newborns within 72 h of birth were recruited for the study from 22 February to the 23th March 2023. Descriptive statistics were used to compute the haemoglobin types of the study participants.ResultsThe majority of the participants (n = 105, 52%) were females, and (n = 97,48%) were males. The median age of the participants was 23 h (Q1, Q3; 11; 33),) with an age range of 2–98 h. Sickle cell trait was present in 9.4% of the screened newborns, no homozygous disease was detected, and 90.6% had Hb AA.ConclusionsThis study is the first to measure HbS gene carriage at birth using HemotypeSC point-of-care testing in Namibia. There was a moderate prevalence of sickle cell traits but no SCD. This baseline study may provide the foundation for larger epidemiological surveys to map HbS gene carriage in Namibia to provide evidence for policy makers to fashion appropriate SCD newborn screening services.

Unveiling the Dual Threat: How Microbial Infections and Healthcare Deficiencies Fuel Cervical and Prostate Cancer Deaths in Africa.

Cervical and prostate cancer account for 7.1 and 7.3 deaths per 100,000 people globally in 2022. These rates increased significantly to 17.6 and 17.3 in Africa, respectively, making them the second and third leading cause of cancer deaths in Africa, only surpassed by breast cancer. The human papillomavirus is the prime risk factor for cervical cancer infection. On the other hand, prostate cancer risks include ageing, genetics, race, geography, and family history. However, these factors alone cannot account for the high mortality rate in Africa, which is more than twice the global mortality rate for the two cancers. We searched PubMed, Embase, Scopus, and Web of Science to select relevant articles using keywords related to microorganisms involved in cervical and prostate cancer and the impact of poor healthcare systems on the mortality rates of these two cancers in Africa by carrying out a detailed synopsis of the studies on microbial agents involved and the contributory factors to the deteriorating healthcare system in Africa. It became apparent that the developed countries come first in terms of the prevalence of cervical and prostate cancer. However, more people per capita in Africa die from these cancers as compared to other continents. Also, microbial infections (bacterial or viral), especially sexually transmitted infections, cause inflammation, which triggers the pathogenesis and progression of these cancers among the African population; this has been linked to the region's deficient health infrastructure, making it difficult for people with microbial infections to access healthcare and hence making infection control and prevention challenging. Taken together, untreated microbial infections, primarily sexually transmitted infections due to the deficient healthcare systems in Africa, are responsible for the high mortality rate of cervical and prostate cancer.

What COVID-19 Vaccine Distribution Disparity Reveals About Solidarity

What COVID-19 Vaccine Distribution Disparity Reveals About Solidarity

Determinants of Pre-Eclampsia Incidence among Pregnant Women in Antenatal Care at Fortportal Regional Referral Hospital

Pre-eclampsia stands as a major contributor to maternal mortality, perinatal complications, preterm births, and restricted fetal growth. Globally, it ranks among the top three causes of maternal mortality and affects 6-8% of pregnancies, contributing to approximately nine percent of maternal deaths in Africa. This study aimed to identify factors linked to preeclampsia prevalence among pregnant women receiving antenatal care at Fortportal Regional Referral Hospital. Conducting a hospital-based cross-sectional study involving 60 pregnant women, data collection employed a structured questionnaire. Statistical analysis with SPSS version 25 determined Odds Ratios with 95% confidence intervals, marking significance at p values <0.05. Findings revealed several significant associations. Sociodemographic factors like lower maternal age, limited education, and reduced income were linked to pre-eclampsia, alongside obstetric factors including lower parity (≤ 4), overweight status, a history of gestational diabetes mellitus, shorter interpregnancy intervals (≤ 2 years), and previous diagnoses of gestational hypertension. The study underscores the critical need for urgent interventions in the district to address these identified risk factors and prevent and manage pre-eclampsia effectively among pregnant women attending Fortportal Regional Referral Hospital. Both socio-economic and obstetric factors significantly contribute to the occurrence of pre-eclampsia, necessitating targeted interventions for improved maternal and fetal health outcomes. Keywords: prevalence, pre-eclampsia, pregnant women, antenatal care

Ration health resources to save more statistical lives from cervical cancer death in Africa: Why are we allowing them to die?

AbstractPublic health interventions, particularly in low‐ and middle‐income countries (LMICs), are implemented with the never‐ending challenge of limited resources and the ever‐present challenge of choosing between interventions. While necessary, the application of ethical analysis is absent in most of such decision‐making, resulting in fewer favourable consequences. In applying ethical principles to the saving of women from the burden of cervical cancer, I argue in favour of saving statistical lives (investing in prevention) in LMICs, by mapping the principles of justice in resource allocation to the prevailing circumstance. The key facts in this circumstance are that providing treatment (which is saving identified lives), involves mostly providing palliative treatment, which is associated with a high likelihood of death among the identified lives while undergoing treatment or shortly thereafter. I focus on the dilemma of having a national cancer prevention program versus the expansion of cancer treatment facilities.

Factors leading to the late diagnosis and poor outcomes of breast cancer in Matabeleland South and the Bulawayo Metropolitan Provinces in Zimbabwe.

Breast cancer (BC) is the leading cause of female cancer deaths in Africa, and in Zimbabwe, >80% present with advanced disease. A Needs Project (NP) was carried out to determine the key factors responsible for delayed diagnosis and poor BC outcomes and to investigate possible solutions in 6 rural and urban districts of Matabeleland South and Bulawayo Metropolitan Provinces. A mixed method approach was used to collect data in 2 phases. Phase 1: an exploration of key factors leading to poor BC outcomes with >50 professional stakeholders and patient representatives. Phase 2: (i) Quantitative arm; validated questionnaires recording breast cancer knowledge, demographic information and perceived barriers to care administered to women and their relatives (Group 1) and health professionals (HPs) (Group 2). (ii) Qualitative arm; 10 focus group discussions with medical specialists and interested lay representatives (Group 3). The Cochran sample size formulae technique was used to determine the quantitative sample size and data was aggregated and analysed using SPSS Version 23™. Purposive sampling for the qualitative study selected participants with an understanding of BC and the NP. Focus group discussions were recorded and a thematic analysis of the transcriptions was conducted using NVivo9™. Quantitative analysis of Group 1 data (n = 1107) confirmed that younger women (<30years) had the least knowledge of breast cancer (p<0.001). Just under half of all those surveyed regarded breast cancer as incurable. In Group 2 (n = 298) the largest group of health workers represented were general nurses and midwives (74.2%) in keeping with the structure of health provision in Zimbabwe. Analysis confirmed a strong association between age and awareness of BC incidence (p = 0.002) with respondents aged 30-39 years being both the largest group represented and the least knowledgeable, independent of speciality. Nearly all respondents (90%) supported decentralisation of appropriate breast surgical services to provincial and district hospitals backed up by specialist training. Thematic analysis of focus group discussions (Group 3) identified the following as important contributors to late BC diagnosis and poor outcomes: (i) presentation is delayed by poorly educated women and their families who fear BC and high treatment costs (ii) referral is delayed by health professionals with no access to training, skills or diagnostic equipment (iii), treatment is delayed by a disorganised, over-centralized patient pathway, and a lack of specialist care and inter-disciplinary communication. This study confirms that the reasons for poor BC outcomes in Zimbabwe are complex and multi-factorial. All stakeholders support better user and provider education, diagnostic service reconfiguration, targeted funding, and specialist training.

Uterine torsion with placental abruption and fetal death at term pregnancy: A case report and literature review

Background: Uterine torsion in pregnancy is a rare event that requires urgent recognition and management. Its presentation is non-specific and ranges from asymptomatic to severe life-threatening conditions such as placental abruption with hemorrhagic shock and maternal and fetal death. Here we describe our case and reviewed similar literature on gravid uterine torsion. To our knowledge, this is the first report of term uterine torsion complicated by placental abruption and fetal death in Africa. Case Presentation: A 28 years old Ethiopian woman gravida III, para II, presented at 37 weeks of gestation with acute severe abdominal pain, mild vaginal bleeding, absent fetal movement, and shock. Emergency cesarean section was decided with a presumptive diagnosis of placental abruption with hemorrhagic shock and intrauterine fetal demise. Intraoperatively, it was realized that the placenta and the dead fetus were delivered through an inadvertent posterior lower segment hysterotomy made on 1800 levo-rotated uterine torsion. Then the uterus was restored to its anatomic position and the posterior hysterotomy was closed. Despite medical measures, the uterus became atonic and a hysterectomy was required. The patient had an uneventful postoperative and postpartum course. Conclusion: Even if gravid uterine torsion is uncommon, it should be kept in mind as one of the differentials in pregnancy-related acute abdominal emergencies due to its non-specific nature and dangerous impact. Furthermore, it can be obscured and associated with other obstetric emergencies, especially placental abruption.

OTHER-06 EPIDEMIOLOGY OF BRAIN AND SPINE TUMOURS – A SINGLE CENTRE DESCRIPTIVE RETROSPECTIVE STUDY

Abstract Brain and spine tumours are of significant public health concern and lead to severe morbidities and mortalities. The incidence is on the rise, ranking as the fifth (5th) leading cause of cancer-related deaths in Africa. Treatment and prognosis depend on age, tumour location, functional neurological status, extent of tumour resection and histological subtype of tumour. This study aims to describe the patient demographics, clinical presentation, and histological subtypes of central nervous system (CNS) tumours in the Korle-Bu Teaching Hospital. A retrospective review of the medical records and histopathology reports (reports presented to the unit) of all patients with CNS tumours operated upon in the Neurosurgical Unit, Department of Surgery, Korle-Bu Teaching Hospital over the past 17years (2007-2023) was collated. The patients without definitive histopathological diagnosis were excluded from the study. Epidemiological data retrieved include clinical presentation, histological subtype, patient age and sex and the spatial distribution. A total of 327 tumour were recorded in the Neurosurgery unit: 85.3% were Brain Tumours. 178 (54.4%) were females and 149 (45.6%) males. Overall Meningiomas were the commonest CNS tumour encountered forming 32.1% followed by Gliomas, Glioneuronal and Neuronal tumours with 29.4% then Tumours of the Sella region, 19.6%. The commonest Meningioma subtype was Meningothelial (33%). Of the Gliomas, Low grade gliomas formed 69%. The commonest symptom for brain cases were headaches (59.1%) followed by visual impairment (33.0%). Of the spine cases, the prevalent symptom was paraparesis (46.2%) followed with low back pain and bowel and bladder dysfunction at 23.1% respectively. We concluded that Low grade tumours predominate in our setting. It is prudent that we channel efforts towards prompt diagnosis and treatment of such cases.

Impact of air pollution on mortality: geo-epidemiological study in French-speaking Africa

Abstract According to the WHO, air pollution is responsible for 90% of deaths in Africa. However, few data on exposure to air pollution is available, and studies are rare, particularly in French-speaking Africa. This study aims to investigate the impact of air pollution on mortality in 13 French-speaking African countries (Algeria, Benin, Burkina Faso, Burundi, Cameroon, Ivory Coast, Guinea, Madagascar, Mali, Morocco, Democratic Republic of Congo, Senegal, Tunisia). Using data from the IHME, annual concentrations of the PM2.5 pollutant from different cities were integrated into a spatial interpolation model (IDW) at the scale of each country. The interpolation was validated using cross-validation models. For each of the considered cardiorespiratory diseases (LRI, stroke, COPD, IHD), the attributable mortality fraction was estimated using literature data and population exposure calculated using demographic data from each country. Large variations in concentration between the 13 countries are observed, with concentrations ranging from 1.76µg/m3 in Morocco to 67.03µg/m3 in Benin. Concentrations are higher in West Africa than in Central or North Africa. In 2019, 291,417 deaths attributable to air pollution were recorded in the 13 countries: 19.7% for ischemic heart disease, 6.5% for lower respiratory infections, 3.6% for chronic obstructive pulmonary disease, and 18.8% for stroke. Our model allowed us to obtain a spatial distribution and the number of deaths related to air pollution. However, the health impact of pollution could be improved by more systematic and comprehensive data collection through a system for monitoring concentrations of atmospheric pollutants. Key messages • This study estimates the number of deaths attributable to air pollution in 13 French-speaking African countries using a spatial interpolation model. • This study highlights the need for more data on air pollution exposure in French-speaking Africa.

Vaccine uptake and effectiveness: Why some African countries performed better than the others?

ObjectiveThis study examines the factors influencing vaccination rollout and its effectiveness in reducing infectious disease outbreaks in African countries. It aims to understand why some countries performed better in vaccination coverage than others and explores the impact of COVID-19 vaccinations in conjunction with the stringency index in Africa. MethodsTwo data sources were utilized. Firstly, a scoping review of relevant studies and gray literature was conducted using the Arksey H & O'Malley L methodological framework. Additionally, data from the Oxford COVID-19 Government Response Tracker (OxCGRT dataset) were analysed to explore the effect of COVID-19 vaccines in Africa. Regression discontinuity in time was employed to assess the effects of COVID-19 vaccination on new COVID-19 cases, deaths, and reproduction rate. ResultsThe study found that the number of vaccinated individuals increased from March 2021, while the stringency index steadily declined since January 2021. Despite higher vaccination coverage, new COVID-19 cases and deaths peaked in late 2021 and early 2022, indicating the continued need for non-pharmaceutical interventions. After considering country fixed effects and other covariates, the number of new cases and deaths were negatively associated with the stringency index and vaccine introduction. ConclusionCOVID-19 vaccination was shown to be crucial in reducing new cases and deaths in Africa. However, vaccination progress in the region remains low and is influenced by factors at both structural and micro levels. Further research is required to disentangle the effects of non-pharmaceutical interventions and other measures from vaccination campaigns in the context of Africa while accounting for other contributing factors. Lay summaryThis study aimed to understand why some African countries did better than others in their COVID-19 vaccination efforts and how these vaccinations affected the spread of the virus. Researchers reviewed existing studies and government data along with the Oxford COVID-19 Government Response Tracker. While vaccinations increased from March 2021 and strict measures eased from January 2021, new cases and deaths remained high in late 2021 and early 2022, indicating the need for additional measures. Stricter government actions and higher vaccination rates were linked to fewer cases and deaths. In Africa, COVID-19 vaccinations are crucial, but progress is slow due to various factors at both macro and individual levels. Further research is required to understand the interplay between vaccinations, other measures, and controlling the virus.

The Pandemic of Coronary Artery Disease in the Sub-Saharan Africa: What Clinicians Need to Know.

Cardiovascular diseases (CVDs) are a leading cause of morbidity and mortality globally with an accelerated increase in CVD‑related death in Africa and other low‑middle‑income countries. This review is aimed at highlighting the burden of coronary artery disease CAD, its peculiarities as well as challenges of management in sub-Saharan Africa. Recent data revealed a shift from high incidence of CVDs associated with poverty and malnutrition (such as rheumatic heart disease) initially, which are now falling, to rising incidence of other non-communicable CVDs (such as hypertension, coronary artery disease (CAD), and heart failure). Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide, which is projected to supersede communicable diseases in the future. Previous studies have shown that CAD was rare among Africans. Those studies conducted in Africa in the 1940s-1960s reported that Black Africans were almost immune to developing CAD and were even thought to have specific genetic make-up protecting them from CAD. However, the continent is now experiencing a steady rise in the prevalence of CAD associated with severe disease burden, compared to other regions of the world. The changes seen have been attributed to the current epidemiological transition with increase in CVD risk factors that are poorly controlled, lack of awareness as well as the poor health facilities to tackle the menace of the disease. The Global Burden of Disease (GBD) estimates have also shown that over the past three decades the highest contribution to CVD burden in Africa is attributed to atherosclerotic diseases, with 71.4, 37.7, and 154% increases in the burden of ischemic heart disease, stroke, and peripheral artery disease respectively. There is a steady increase of CAD prevalence in Africa as a result of increase in CV risk factors. Hypertension, obesity, diabetes, dyslipidemia, and cigarette smoking are the rapidly rising risk factors for CAD on the continent. Africa also faces challenges in diagnosis and management of CAD. There is need for increased public and health personnel awareness on prevention and control of commonly identifiable risk factors, provision of prehospital emergency services, and provision of modern therapeutic facilities for treatment of CAD including reperfusion therapy. These are priority areas where efforts could be intensified in the future with potential to improve the current rate of progress of the disease on the continent.

Contribution of cardiovascular disease to the burden of non-communicable diseases in Africa: an analysis of data from Global Burden of Disease database, 1990–2019

Background and purpose: Disease burden of non-communicable diseases (NCDs) has been increasing in low- and middle-income countries, especially in African countries. Cardiovascular disease (CVD) is a common NCDs and the leading cause of death in Africa. Yet, evidence on the contribution of CVD to the total NCDs burden is scarce. This study aimed to investigate the contribution of CVD to the total disease burden caused by NCDs in Africa between 1990 and 2019. Methods: Data on NCDs, including CVD, were extracted from the Global Burden of Disease (GBD) database. Disease burden was measured by disability-adjusted life years (DALYs) and deaths. Results: From 1990 to 2019, the share of CVD in the total NCDs burden increased and remained as the first contributor. In 2019, NCDs caused 204 million DALYs and over 2.18 million deaths in the Africa Union, among which 49.1% of the total DALYs and 66.0% of deaths were caused by the traditional five NCDs, including CVD that accounted for the largest burden of NCDs (20.5% of DALYs and 35.2% of deaths). The proportion of CVD to the total NCDs burden was most considerable, reaching up to 32.4% and 52.4% in Northern Africa for DALYs and deaths, respectively. CVD were important contributors to NCDs burden in Africa, including ischemic heart disease (1334 DALYs per 100,000 and 27.79 deaths per 100,000) and intracerebral hemorrhage (632 DALYs per 100,000 and 13.53 deaths per 100,000) that were the top two causes of NCDs in 2019. Conclusions: CVD has been the biggest contributor to NCDs burden in the Africa Union over the thirty years. Given the increase in the share of NCDs burden attributable to CVD, it demands a close attention to implementing cost-effective policies and interventions for CVD to achieve an improvement in population health and reduction of health loss from NCDs.

Detection of X-Chromosome Inversions in Anopheles Pharoensis Collected from Egypt and Sudan by PCR Assay

Globally, the WHO estimated 241 million malaria cases with 627000 deaths in Africa in 2020. Studying inversions in the X-chromosomes could detect behavioral changes and efficiency of transmission of Malaria in Anopheles phronesis species. These changes may lead to shifting from becoming a major vector of Malaria after the inability to transmit Malaria. The knowledge of the malaria transmission pattern of Anopheles pharoensis in Sudan needs to be improved. We aimed to detect the presence of any inversions or mutations in Anopheles pharoensis species collected from Egypt and Sudan and to undergo a Polymerase Chain Reaction (PCR) technique to detect mutations or X-chromosome inversions in the Sudanese and Egyptian strains of Anopheles pharoensis also to compare between the X-chromosome of the two species. It is an experimental, analytical study that aimed to detect inversions in the X –chromosomes of Anopheles phronesis collected from Egypt (Faiyoum Governate) and Sudan (Khartoum, Gezira, and Sennar states) of Sudanese Mosquito species. From the gel electrophoresis and PCR assay, inversions were detected by the 100Bp PCR products using primers. Only very few revealed bands from 75 Egyptian strains were detected by bands. The study revealed that Anopheles pharoensis species collected from Egypt have X- chromosome inversions. Inversions were absent in the Sudanese strains. The study also reacted to the fact that Anopheles phronesis could be a sibling species or a species complex, but further studies are needed to prove this. From the results and observations of this investigation, it was recommended to undergo further genetic studies on Anopheles species in Sudan and use of PCR technique in the classification.

INFECTION PREVENTION PRACTICE AND ASSOCIATED FACTORS AMONG HEALTH CARE WORKERS IN PUBLIC HEALTH FACILITIES OF MOGADISHU, SOMALIA, 2022

Background: Infection prevention is essential for providing safe and quality facility-level services. Worldwide, morbidity and mortality are primarily due to preventable infectious diseases which account for 62% of all deaths in Africa and 31% in Southeast Asia. Therefore, infection prevention and control measures enhance the protection of vulnerable people. Objective: The objective of this study is to determine infection prevention practice and associated factors among healthcare workers working in government health facilities of Mogadishu, Somalia, 2022 Methods: A quantitative cross-sectional study was conducted from March 01, 2022, to May 30, 2022 on 562 healthcare workers of public health facilities in Mogadishu town. After obtaining consent from the study participants, data was collected using pretested, self-administered, and standardized questionnaires adapted from other studies. After the data was collected, it was processed, cleaned, and analyzed using SPSS version 26. A logistic regression model was computed to measure the association between the predictor and outcome variables. A P-value of.05 with a 95% CI was used as the cut-off point to declare the level of statistical significance. Results: The study found that 236 (42.4%) (95%CI: 1.38-1.47) of the 556 respondents had a good practice of infection prevention. In the multivariate logistic regression analysis, attitudes of health care workers toward infection prevention (AOR=0.478, 95 percent CI: 0.316, 0.723), occupational training (AOR:0.177, 95%CI:0.177,0.591), work experience of health care workers (AOR:3.215,95%CI:1.712,6.038), availability of infection prevention guidelines (AOR: 0.489,95%CI:0.284,0.842), budget availability for infection prevention (AOR: 0.421, 95%CI: 0.245,0.723) were among factors significantly associated with infection prevention practice. Conclusion: The magnitude of infection prevention practice was low (42.4%) compared to other studies. The results of the study showed that attitude, knowledge work experience, training, needlestick injury, vaccination against HepB and other infectious diseases, availability of infection prevention guidelines, availability of hand rub in the room, and availability of budget for infection prevention were among factors associated with infection prevention practice.

Community Health of Children and Adolescents in Sub-Saharan Africa

Health is central to the development of any country. Despite the efforts and goodwill of the United Nations, the goals established have not been successfully achieved and people in Sub-Saharan Africa (SSA) continue to strive with the same burdens of poverty, employment, malnutrition or hunger, inequality, environmental crisis, access to energy, conflicts and injustice. All these determinants drawback factors may be cause or consequence of a never-ending cycle with enormous impact on individual and community health. In SSA, policy makers, donors, healthcare providers, and academics have paid less attention to chronic diseases than to acute, communicable diseases. Despite severe dysfunctions, Public Health in this region, distinct from immediate medical services, is now engaged in endless struggles, against pathogens, modelling human behaviors, and searching for financing. Parental education, health and welfare, substandard literacy and language communication, access to material assets and other factors may all affect their ability to interpret hazards and risks in key areas of health and nutrition. While some 70% of deaths in Africa result from infectious and parasitic diseases, mortality rates from chronic diseases are higher in SSA than in other parts of the world. Children and adolescents in SSA in their livelihoods experience slow physical growing, inadequate observation and physical development, and a series of biological impairments that amplifies their risk of non-communicable diseases as they mature. Integrated strategies of sound health leadership and community-adapted initiatives are needed and probably engaged constructively with the private sector. Some ambitious new health goals take longer to achieve, but progress can be achieved in stages.