Journal of Public Health in Africa最新文献

{"title":"Africa's unpaid outbreak frontline workers: The political economy of community health worker neglect.","authors":"Eric N Ikoona, Lucy Namulemo","doi":"10.4102/jphia.v17i1.1920","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1920","url":null,"abstract":"<p><p>Community health workers (CHWs) in Africa perform indispensable functions across the outbreak response cycle. These include early case detection, contact tracing, risk communication and zoonotic interface monitoring. They depend on community embeddedness, an asset the formal health system cannot replicate in emergencies. Yet despite a substantial evidence base, more than 80% of Africa's 1.4 million CHWs operate under volunteerism frameworks, without formal employment, salaries or enforceable protections. This is not a consequence of resource scarcity. It is a deliberate programme design choice, endorsed by governments and development partners that extracts community labour from the most precarious workers in the system without commensurate investment. We write from national public health institutions in West and East Africa, sub-regions where outbreak frequency, CHW volunteerism prevalence and weak Joint External Evaluation (JEE) surveillance scores converge. We argue that the evidence for CHW effectiveness is settled and that the policy frameworks for professionalism are in place. The principal remaining barrier is the political economy of global health security financing. The 2023 Monrovia Call to Action and 2023 Lusaka Agenda provide an actionable roadmap. The most tractable path to binding accountability is the formal incorporation of CHW surveillance capacity as a scored metric in the World Health Organization (WHO) JEE process.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1920"},"PeriodicalIF":1.3,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension and blood lead levels among battery technicians and office workers in western Nigeria.","authors":"Ebenezer A Ozomata, Blossom A Maduafokwa, Ugonnaya U Igwilo, Emmanuel F Osagiede, Uzoamaka A Igwilo, Opeyemi Giwa","doi":"10.4102/jphia.v17i1.1825","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1825","url":null,"abstract":"<p><strong>Background: </strong>Occupational exposure to lead remains a significant public health concern because of its association with hypertension and cardiovascular disease. Battery technicians are particularly at risk because of prolonged exposure to lead-containing materials.</p><p><strong>Aim: </strong>This study assessed and compared blood lead levels (BLL), blood pressure (BP) profiles and associated risk factors among battery technicians and office workers in Western Nigeria.</p><p><strong>Setting: </strong>The study was conducted in Lagos State, Nigeria.</p><p><strong>Methods: </strong>A cross-sectional study design was employed using multistage sampling. Data were collected with a structured interviewer-administered questionnaire, and BP measurements were obtained. Data analysis was performed using the Statistical Package for Social Sciences version 20. Chi-square, Mann-Whitney U, Fisher's exact and Student's <i>t</i>-tests were applied at a significance level of <i>p</i> ≤ 0.05.</p><p><strong>Results: </strong>Median systolic blood pressure (SBP) was statistically significantly higher among battery technicians (124 mmHg) compared to office workers (119.33 mmHg) (<i>p</i> = 0.029). However, the prevalence of elevated SBP (> 140 mmHg) was 22% in technicians and 18% in office workers. Among technicians, age and years of work were significantly associated with both SBP and diastolic blood pressure. While 30% of technicians had BLL ≥ 5.00 µg/dL, all office workers had levels below this threshold (<i>p</i> < 0.001). Multivariable logistic regression demonstrated that elevated BP was independently driven by advancing age (adjusted odds ratio [aOR]: 3.92; 95% confidence interval [CI]: 1.52-10.12; <i>p</i> = 0.005), occupational longevity exceeding 10 years (aOR: 2.54; 95% CI: 1.18-5.46; <i>p</i> = 0.017) and work intensity over 8 h daily (aOR: 2.12; 95% CI: 1.09-4.13; <i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>Battery technicians exhibited higher SBP levels than office workers. Improved workplace safety practices, regular use of protective devices, personal hygiene and routine biological monitoring may reduce elevated lead and hypertension among battery technicians in Nigeria.</p><p><strong>Contribution: </strong>Improved workplace safety and practices, regular use of PPEs and personal hygiene, and routine biological monitoring among battery technicians in Nigeria may reduce elevated lead and hypertension among battery technicians.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1825"},"PeriodicalIF":1.3,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extreme weather events and mental health impacts in West Africa: A systematic review of evidence gaps.","authors":"Jamaji C Nwanaji-Enwerem, Joshua M Perez-Cruet, Nadav Sprague, Stephen Uong, Caroline Obi, Shenita Peterson, Adetoun Mustapha, Max Jordan Nguemeni Tiako, Saria Hassan, Yun Hang, Temilola Oluseyi, Lisa Reyes Mason, Christine Ekenga","doi":"10.4102/jphia.v17i1.1760","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1760","url":null,"abstract":"<p><strong>Background: </strong>A growing body of evidence, primarily from high-income nations, suggests that extreme weather events can have a profound impact on mental health.</p><p><strong>Aim: </strong>To contribute to a more inclusive understanding of this public health threat, we reviewed the literature to understand the impact of climate-related extreme weather events on mental health in the West African context.</p><p><strong>Setting: </strong>This study is a systematic review of studies based in West Africa.</p><p><strong>Methods: </strong>Our literature search of six databases (PubMed/MEDLINE, Index to Nursing and Allied Health Literature [CINAHL], EMBASE, PsycINFO, Cochrane and Web of Science) from January 2007 to December 2024 identified 2968 articles of which 13 met study inclusion criteria.</p><p><strong>Results: </strong>These 13 studies were predominantly cross-sectional and qualitative. The studies took place in four West African countries (Burkina Faso, Ghana, Nigeria and Sierra Leone) and reported direct and indirect relationships between climate-related weather events and poor mental health. The articles also highlighted that certain groups like women and persons of low socioeconomic status are likely to experience more adverse mental health impacts due to gender roles and factors associated with a lower social standing. The studies further suggest bolstering population climate health education, reforming building and development mechanisms, and targeting social programmes to women and other vulnerable groups as potential strategies to address the negative impact of climate on mental well-being.</p><p><strong>Conclusion: </strong>Findings from this study as well as continued investments in mental health clinical capacity will be important for meeting existing shortfalls in mitigating the impact of climate change on mental health.</p><p><strong>Contribution: </strong>There is a need for greater research investment in larger studies, in more West African countries, and including substantial proportions of the population like children.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1760"},"PeriodicalIF":1.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Integrated Epidemiological Surveillance System in Chad according to the CDC method.","authors":"Kallah Boukar Ousmane, Moussiliou Noël Paraïso, Harold Dossou Yovo, Oloumane Dyvail Junior, Patrice Zekeng","doi":"10.4102/jphia.v17i1.1762","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.1762","url":null,"abstract":"<p><strong>Background: </strong>The Integrated Epidemiological Surveillance System (IESS) is an essential pillar of public health, in the detection and rapid response to priority diseases. In Chad, despite its existence, the persistence of structural weaknesses influences its functioning, which justifies this study.</p><p><strong>Aim: </strong>This article aims to determine the current performance of the IESS in Chad, with a view to identifying possible shortcomings and proposing corrective measures.</p><p><strong>Setting: </strong>An evaluative cross-sectional study was conducted from 16 September 2024 to 15 January 2025, in eight provincial health delegations in Chad.</p><p><strong>Methods: </strong>The collected primary and secondary data were analysed according to the five pillars of the Centres for Disease Control and Prevention (CDC) evaluation methodology: operation, usefulness, importance, cost and quality of the IESS.</p><p><strong>Results: </strong>The quality of IESS in Chad - evaluated by the CDC method - is considered low with an overall score of 44% (other pillars have been evaluated otherwise). The acceptability (87%) and simplicity (72%) of this system are its strengths. Although acceptable, the flexibility (56%) and responsiveness (55%) of the system need to be improved. The weak points that justify this low quality overall are its low sensitivity (29%) and positive predictive value (29%), as well as its very low representativeness (27%). This overall assessment seems obvious given the weaknesses identified in terms of operation, usefulness, importance and cost of IESS in Chad.</p><p><strong>Conclusion: </strong>The IESS in Chad remains generally functional but is of low quality.</p><p><strong>Contribution: </strong>This study innovates mainly because of its rigorous application of the five pillars of the CDC method for assessing the current performance of Chad's IESS in 2024.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1762"},"PeriodicalIF":1.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health facility-related barriers associated with cervical cancer screenings in the health districts of Dakar and Kédougou (2023, Senegal).","authors":"Fatoumata B Diongue, Ibrahima Ndiaye, Ndeye M Sougou, Oumar Bassoum, Caryn E Peterson, Omar Gassama, Sarah Abboud, Fatou B Seck, Malick Anne, Ndeye M Dieng, Hilaire Sarr, Assane Sall, Adja M Diaw, Aliath Salami, Aida Fall, Aida Barro, J Andrew Dykens, Adama Faye","doi":"10.4102/jphia.v17i1.1879","DOIUrl":"10.4102/jphia.v17i1.1879","url":null,"abstract":"<p><strong>Background: </strong>Because of low utilisation of cervical cancer screening (CCS) services, Senegal ranks 17th in the world for cervical cancer incidence.</p><p><strong>Aim: </strong>The aim was to investigate health facility factors associated with CCS.</p><p><strong>Setting: </strong>The study was conducted in six Senegalese health districts (Keur Massar, Yeumbeul, Diamniadio, Kédougou, Saraya and Salémata).</p><p><strong>Methods: </strong>This was a descriptive and analytical cross-sectional study of women aged 25-69 years. A two-stage cluster survey was carried out, with a selection of census districts (CDs) followed by households. The data were collected with collection tools during individual interviews. Data were analysed using R 4.2.3 software. Univariate, bivariate analysis and logistic regression were performed.</p><p><strong>Results: </strong>The study involved 360 women. The average age was 40.2 (± 11.5) years. A proportion of 46.5% (334 individuals) regularly went to the health facility for treatment. 18.8% of women had been screened for cervical cancer. Factors associated with screening were hearing about a CCS or the human papillomavirus vaccine, regular attendance at a traditional healer for care, regular attendance at a healthcare facility to receive care and professionalism of healthcare facility workers. Other significantly related factors were age, marital status and level of education.</p><p><strong>Conclusion: </strong>Improving the uptake of CCS services requires a multifactorial approach, including taking into account obstacles linked to health facilities. It will involve improving attendance at health facilities through information, education and communication strategies aimed at women and health workers to contribute to maternal health.</p><p><strong>Contribution: </strong>This study will help remove the barriers faced by healthcare facilities that limit screening, including a lack of information, reliance on traditional medicine, irregular visits to healthcare facilities, and a lack of professionalism among healthcare workers. As a result, an improvement will be observed in the utilisation of cervical cancer screening services. Policy makers will be able to use the results to implement appropriate strategies that will increase screening rates and ensure adequate care for women who test positive. This study makes a positive contribution to science and opens up avenues for further research, such as on the implementation of cervical cancer screening services.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1879"},"PeriodicalIF":1.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health maturity models for Human Resources for Health Information Systems in low- and middle-income countries in Africa: A scoping review.","authors":"Agbonkhese I Oaiya, Christmal D Christmals, Hillary K Kipruto","doi":"10.4102/jphia.v17i1.2010","DOIUrl":"https://doi.org/10.4102/jphia.v17i1.2010","url":null,"abstract":"<p><strong>Background: </strong>Health workforce challenges in Africa are exacerbated by fragmented and underdeveloped Human Resources for Health Information Systems (HRH-IS). While digital health maturity models exist, their applicability to HRH-IS in low- and middle-income countries (LMICs) remains unclear, with limited evidence of context-specific frameworks.</p><p><strong>Aim: </strong>This scoping review aimed to (1) map digital health and health information system (HIS) maturity models, frameworks, tools and guidelines relevant to HRH-IS, and (2) synthesise key domains to inform the development of a context-appropriate HRH-IS maturity model for African LMICs.</p><p><strong>Setting: </strong>The study was conducted in low- and middle-income countries in Africa.</p><p><strong>Methods: </strong>A scoping review was conducted following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. PubMed, EBSCO-hosted databases, Google Scholar and grey literature sources, including institutional repositories and global health agency publications were searched. Data were extracted using a structured form and analysed descriptively, with thematic synthesis used to identify transferable domains.</p><p><strong>Results: </strong>A total of 3128 records were screened, and 41 were included. Only one tool targeted HRH-IS. Most identified frameworks addressed broader digital health or HIS. Six cross-cutting domains were synthesised: (1) governance and leadership; (2) workforce and organisational capacity; (3) financing and sustainability; (4) data architecture and interoperability; (5) data quality and analytics; and (6) equity, trust and system adoption.</p><p><strong>Conclusion: </strong>There is limited evidence of dedicated HRH-IS maturity models in African LMICs. However, existing digital health and HIS frameworks provide a strong foundation for adaptation.</p><p><strong>Contribution: </strong>The six synthesised domains offer a preliminary basis for developing and validating a context-specific HRH-IS maturity model to strengthen workforce data systems and support evidence-informed policy.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"2010"},"PeriodicalIF":1.3,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13636403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission haemoglobin and albumin as correlates of central nervous system inflammation in <i>rhodesiense human African trypanosomiasis</i> at Rumphi District Hospital, Malawi.","authors":"Westain T Nyirenda, Lovemore Mapahla, Bonheur Dounebaine, Nebiyu Dereje, Peter S Nyasulu","doi":"10.4102/jphia.v17i1.1775","DOIUrl":"10.4102/jphia.v17i1.1775","url":null,"abstract":"<p><strong>Background: </strong><i>Rhodesiense human African trypanosomiasis</i> (<i>rHAT</i>) is an acute zoonotic infection that can rapidly progress to central nervous system (CNS) disease. As lumbar puncture is no longer routinely required for treatment selection, district hospitals need accessible measures associated with CNS inflammatory burden.</p><p><strong>Aim: </strong>This study aimed to evaluate routine admission clinical and laboratory measures as correlates of cerebrospinal-fluid white-cell count and to describe changes in this count during early hospital care.</p><p><strong>Setting: </strong>The study was conducted at Rumphi District Hospital, a public secondary-level treatment facility serving rural communities in the Vwaza Marsh focus of northern Malawi.</p><p><strong>Methods: </strong>We retrospectively studied patients aged ≥ 6 years with parasitological confirmed <i>rHAT</i> from 2012-2024. Cerebrospinal-fluid white-cell counts at admission and Day 11 were analysed using mixed-effects negative binomial regression, reporting adjusted incidence rate ratios (aIRRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Forty-three patients met the eligibility criteria; 43 contributed admission counts, and 42 contributed Day-11 counts. Day-11 cerebrospinal-fluid white-cell counts were 75% lower than admission counts (aIRR = 0.25, 95% CI: 0.14-0.45; <i>p</i> < 0.001). Stage 2 disease was associated with a higher count than Stage 1 disease (aIRR = 4.23, 95% CI: 1.35-13.30; <i>p</i> = 0.013). Each 1 g/dL increase in haemoglobin and albumin was associated with lower expected counts (haemoglobin aIRR = 0.83, 95% CI: 0.78-0.89; <i>p</i> < 0.001; albumin aIRR = 0.70, 95% CI: 0.54-0.92; <i>p</i> = 0. 009).</p><p><strong>Conclusion: </strong>Lower haemoglobin and albumin were associated with greater cerebrospinal-fluid inflammation, which declined during early care. As accessible admission measures, they may support recognition, triage and monitoring of CNS burden in <i>rHAT</i>, pending prospective diagnostic-accuracy validation before implementation.</p><p><strong>Contribution: </strong>This study links routine blood measures to cerebrospinal-fluid inflammation in <i>rHAT</i>, informing prospective validation priorities.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1775"},"PeriodicalIF":1.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Signal integration challenges in African epidemic intelligence: Lessons from the 2026 Bundibugyo virus disease outbreak and application of the PREIS framework.","authors":"Hyacinthe R Zabré","doi":"10.4102/jphia.v17i1.2079","DOIUrl":"10.4102/jphia.v17i1.2079","url":null,"abstract":"<p><p>On 17 May 2026, the Director-General of the World Health Organization determined that Ebola disease caused by Bundibugyo virus in the Democratic Republic of the Congo (DRC) and Uganda constituted a Public Health Emergency of International Concern. Ten days separated the initial alert (05 May) from laboratory confirmation (15 May) although multiple non-laboratory signals were already active. Using this outbreak, we argue that Africa's principal detection challenge is often not signal availability but the timely interpretive integration of concurrent multi-source signals, and we outline how a reproducible analytical layer - the Pan-African Real-time Epidemiological Intelligence System (PREIS) framework - might support it.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"2079"},"PeriodicalIF":1.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of health promotion practitioners during disease outbreaks in the OR Tambo District, South Africa.","authors":"Mzwanele Toni, Nongiwe L Mhlanga, Sibusiso C Nomatshila","doi":"10.4102/jphia.v17i1.1650","DOIUrl":"10.4102/jphia.v17i1.1650","url":null,"abstract":"<p><strong>Background: </strong>In South Africa, infectious disease outbreaks are common and pose severe public health threats. To mitigate outbreaks, health promotion plays a significant role. However, the role of health promotion practitioners remains obscure.</p><p><strong>Aim: </strong>To describe the role of health promotion practitioners during outbreaks in the OR Tambo District.</p><p><strong>Setting: </strong>The study was conducted in the Oliver Reginald (OR) Tambo District, a predominantly rural area in the Eastern Cape province of South Africa.</p><p><strong>Methods: </strong>The study used a qualitative descriptive-phenomenological design. The population comprised health promotion practitioners with a tertiary qualification. These were selected using snowball sampling until data saturation. Data were collected using individual face-to-face and telephonic interviews. Thematic analysis was used to analyse data.</p><p><strong>Results: </strong>The sample consisted of 14 participants, with the majority (57.1%, <i>n</i> = 8) being female. Three themes were identified. Firstly, the implementation role in planning and health education. This was supported by three subthemes: (1) planning and organising, (2) health education collaboration with government departments and (3) multidisciplinary collaborative health education. Secondly, the theme was research, monitoring and evaluation, supported by two subthemes: (1) surveillance and assessment and (2) monitoring and evaluation. Thirdly, the theme, advocacy, was supported by the subtheme advocacy for health services.</p><p><strong>Conclusion: </strong>The roles of health promotion practitioners during outbreaks were aligned with the national strategy and could be optimised by inclusion in training and planning activities.</p><p><strong>Contribution: </strong>The study contributes to the efficient management of infectious disease outbreaks by clarifying the role of health promotion practitioners.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1650"},"PeriodicalIF":1.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cholera outbreak investigation in Adamawa state, Nigeria, June 2021 - December 2021: An unmatched case-control study.","authors":"Aisha A Abba, Celestine Ameh, Aisha Sadauki, Muhammad S Balogun, Muntari Hassan, Oladipo Ogunbode, Suleiman I Ahmad, Lukman Ismaila, Peace Umar, Azuka Adeke","doi":"10.4102/jphia.v17i1.1559","DOIUrl":"10.4102/jphia.v17i1.1559","url":null,"abstract":"<p><strong>Background: </strong>Cholera is a major public health challenge in Nigeria. On 09 September 2021, the Adamawa State Ministry of Health confirmed an outbreak affecting 12 local government areas (LGAs).</p><p><strong>Aim: </strong>To describe the outbreak and identify risk factors.</p><p><strong>Setting: </strong>Community-based in Adamawa State, Nigeria (30 June 2021 - 01 December 2021).</p><p><strong>Methods: </strong>We described the State cholera line list (30 June 2021 - 01 December 2021) and estimated case fatality and attack rates. We conducted an unmatched case-control study in seven LGAs, involving 66 laboratory-confirmed cases and 120 asymptomatic neighbourhood controls. We collected data on demographics, clinical history, practices and risk factors using interviewer-administered questionnaires. We executed univariate, bivariate and multivariate analyses to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Of 1332 cases reported across 12 LGAs, we recorded an overall case fatality rate (CFR) of 3.6%. We recorded the highest CFR (16.7%) in Song and the attack rate (<i>N</i> = 239.6/100 000) in Numan. Children aged 5-14 years were most affected. The median age was 24 years for cases (range: 1-76) and 32 years for controls (range: 5-70). Males accounted for 54.5% (cases) and 53.3% (controls). Independent risk factors were age < 10 years (aOR = 9.7; 95% CI: 2.6-34.9) and consumption of street-vended noodles (aOR = 7.0; 95% CI: 1.4-34.8).</p><p><strong>Conclusion: </strong>The outbreak disproportionately affected children with unregulated food sources, contributing significantly. Public health interventions included hygiene education and chlorine distribution. Strengthening food safety regulations and sustaining hygiene promotion were recommended to mitigate future outbreaks.</p><p><strong>Contribution: </strong>The study supports Nigeria's Cholera Control Programme in refining hygiene strategies, regulating street food safety and targeting high-risk groups, such as young children.</p>","PeriodicalId":44723,"journal":{"name":"Journal of Public Health in Africa","volume":"17 1","pages":"1559"},"PeriodicalIF":1.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}