Pan African Medical Journal最新文献

{"title":"Scoping review protocol: a mobile health solution for the management of stress among health science students at rural universities in South Africa.","authors":"Bhekithemba Vellem, Nozuko Glenrose Mangi","doi":"10.11604/pamj.2026.53.156.48724","DOIUrl":"10.11604/pamj.2026.53.156.48724","url":null,"abstract":"<p><p>Stress is prevalent among health science students, particularly in rural settings where access to mental health resources is limited. Mobile health (mHealth) interventions offer a promising avenue for providing accessible support for stress management. This scoping review aims to identify existing mHealth interventions, evaluate their feasibility and acceptability, and explore the specific needs of students within these contexts. This scoping review will be conducted using the Arksey and O'Malley framework, a structured approach that consists of six stages: identifying the research question, searching for relevant studies, selecting studies, charting the data, collating and summarising the results, and consulting stakeholders. The search will include a comprehensive range of electronic databases and grey literature sources to ensure broad coverage of relevant studies. The Joanna Briggs Institute (JBI) guidelines will be used to enhance the methodology, ensuring rigour and transparency throughout the review process. A systematic search strategy will be employed across multiple databases to gather relevant literature on mHealth interventions targeting stress management among health science students. The findings of this review, which will be disseminated through academic journals and conferences, are crucial in informing policymakers, researchers, and educators about effective mHealth strategies tailored for health science students. By highlighting gaps in current research and practice, this review will contribute valuable insights that can guide future intervention development and implementation in rural settings. The findings from this review will help shape a contextually appropriate mHealth program designed to support stress management for health science students studying in rural university settings.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"156"},"PeriodicalIF":0.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761965","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":"A rare sequela of snake bite: latent calcific myonecrosis of the tibialis anterior.","authors":"Najeebuddin Patel, Priyanka Nagaonkar","doi":"10.11604/pamj.2026.53.158.51991","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.158.51991","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"158"},"PeriodicalIF":0.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762434","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":"A systematic review on health systems integrated approach towards elimination of HIV, syphilis and viral hepatitis as public health threats in sub-Saharan Africa.","authors":"Newten Handireketi, Pisirai Ndarukwa, Tafadzwa Mindu, Moses John Chimbari","doi":"10.11604/pamj.2026.53.159.49740","DOIUrl":"10.11604/pamj.2026.53.159.49740","url":null,"abstract":"<p><p>Health systems (HSs) in sub-Saharan Africa (SSA) face significant challenges. Integrated HSs approach has been considered a feasible option for eliminating HIV, syphilis and hepatitis B (triple elimination). We performed a systematic review to determine the extent of utilisation of the integrated HSs approach towards triple elimination in SSA countries. We registered the systematic review protocol on PROSPERO (ID: CRD420251011221). We adopted Arksey and O'Malley's review methodology framework for article searching on databases: Medline (using PubMed interface), EMBASE and EBSCOHOST. Studies published from March 2015 to March 2025 were assessed by two reviewers independently. Joanna Briggs' checklist was used to assess the quality of included studies. Thematic analysis was performed, and results were reported according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. A total of 533 studies were identified from databases. Eighteen studies were fully reviewed. Five themes were developed: Effectiveness of HSs integration, Barriers to HSs integration, Facilitators for HSs integrated approach on triple elimination, Improved case detection, and Recommendations to HSs integration. All themes but one were developed from sub-themes that were built around six blocks of the health systems, according to the World Health Organization. Progress in the integrated approach exists. A fully integrated HSs approach for triple elimination remains unmet in SSA. Facilitators and barriers within the WHO's HSs building blocks can work for or against an integrated approach towards triple elimination, offering a roadmap for future efforts to strengthen HSs. Further enquiry into HSs integrated approach needs to be considered towards triple elimination.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"159"},"PeriodicalIF":0.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760687","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":"Preputial cyst in the newborn: a case report.","authors":"Kamal El Haissoufi, Amine El Wardi","doi":"10.11604/pamj.2026.53.155.50885","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.155.50885","url":null,"abstract":"<p><p>Preputial cysts are rarely seen in the pediatric population, with most reported cases from Asia. This condition falls within the category of median raphe cysts, which encompasses various possible locations from urethral meatus to the anus. The diagnosis remains clinical and must be confirmed by histology. Surgical excision is still the treatment of choice with a negligible risk of complications and recurrence. Here, we report the case of a newborn who was successfully treated by circumcision for a preputial cyst diagnosed immediately after birth. Given that the lesion can occur many years after birth, the universal practice of circumcision early in life in most countries of Africa may explain its rarity in our settings.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"155"},"PeriodicalIF":0.9,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760834","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":"[Determinants of modern contraceptive non-use among women of reproductive age living in a post-conflict zone: a study conducted in the Ibanda Health Zone, Bukavu City, eastern Democratic Republic of Congo].","authors":"Sylvie Nabintu Mwambali, Théophile Mitima Kashosi, Jean Paul Cikwanine, Mukanire Ntakwinja, Olivier Nyakio, Denis Mukwege","doi":"10.11604/pamj.2026.53.153.21571","DOIUrl":"10.11604/pamj.2026.53.153.21571","url":null,"abstract":"<p><strong>Introduction: </strong>the purpose of this study was to determine predominant factors for modern contraceptive non-use in women of childbearing age living in the Ibanda Health Zone.</p><p><strong>Methods: </strong>we conducted a descriptive cross-sectional study from May 1 to May 31, 2019. All women aged 13-45 who were not pregnant and had been living in the Ibanda Health Zone for two years, were enrolled. Data collection was carried out by free interview. Modern contraceptive prevalence referred to women using modern contraceptives at the time of the survey. Data were analyzed using IBM SPSS 20 software. Proportions were compared setting significance threshold at 5%, with an odds ratio greater than 1 and a confidence interval excluding 1 at its lower bound.</p><p><strong>Results: </strong>the prevalence of modern contraceptive utilization was 23,9%, several women (67,2%) refused to use modern contraceptive methods, despite the information they had, because of their desire for maternity and the loss of a baby during delivery (OR: 0.07; CI95%: 0.03-0.18; p=0.000).</p><p><strong>Conclusion: </strong>improving the survival rate for children in each household, a key indicator for the quality of obstetric and pediatric care in a country and increasing awareness on disinformation about the risks of infertility by contraceptive use are prerequisites to increase the use of modern contraceptive methods in the Ibanda Health Zone.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"153"},"PeriodicalIF":0.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148841831","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":"Apparent \"double wall sign\" in emphysematous bullae of the lung.","authors":"Lokesh Devalla","doi":"10.11604/pamj.2026.53.154.43815","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.154.43815","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"154"},"PeriodicalIF":0.9,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762197","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 economics and financing for health systems transformation: lessons from five African epistemological frameworks.","authors":"Alex Olateju Adjagba, Aboubakar Kampo, George Laryea-Adjei","doi":"10.11604/pamj.2026.53.152.51164","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.152.51164","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Persistent financing challenges in African health systems are often attributed to resource scarcity or weak implementation. This paper argues that a deeper structural issue lies in the continued reliance on inherited vertical health architectures and economic evaluation frameworks that remain epistemically misaligned with local social realities. Many contemporary financing models, shaped by colonial and postcolonial donor interventions and operationalized through tools such as disability-adjusted life years (DALYs) and cost-effectiveness thresholds, prioritize externally defined metrics of value. As external funding declines and fiscal pressures intensify, sustaining these imported models exposes tensions between technical efficiency and social legitimacy. This study examines whether reorienting health economics through African epistemological frameworks can improve the sustainability, legitimacy, and governance of health financing. The paper employs a decolonial analytical framework drawing on the work of Ngũgĩ wa Thiong'o, Felwine Sarr, Samir Amin, Valentin Mudimbe, and Paulin Hountondji. It combines historical analysis of colonial health system design, conceptual synthesis of African epistemic frameworks, and applied examination of contemporary financing domains, including insurance uptake, community health worker compensation, and decentralised budgeting. Secondary literature from health policy, political economy, and governance studies is used to assess how epistemic assumptions shape institutional outcomes and financing sustainability. The analysis demonstrates that financing challenges are not solely fiscal but epistemic. Imported models often fail where they conflict with social understandings of care, reciprocity, and collective responsibility, contributing to enrollment gaps, workforce tensions, and performative participation in budgeting. African intellectual frameworks converge in identifying language, valuation systems, and institutional design as sites where power and legitimacy are negotiated. Evidence from insurance reform, workforce governance, and participatory budgeting shows that when financing mechanisms are adapted to locally grounded priorities, they are more likely to generate trust, accountability, and durable engagement. However, risks persist, including elite capture and the symbolic adoption of decolonial language without structural change. Decolonizing health economics and financing requires more than redistributing resources; it demands epistemic and institutional transformation. Aligning financing models with community-defined priorities, plural valuation frameworks, and participatory governance can reduce structural friction and improve legitimacy, even within globally interconnected economies. While such reform will not resolve all fiscal constraints, it offers a pathway toward more socially grounded and sustainable health systems. This reframing, described as a \"structural adjustment of the soul\", calls for","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"152"},"PeriodicalIF":0.9,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763669","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":"Tested but unprotected? Uncovering missed opportunities in hepatitis B prevention among health professionals in Sierra Leone.","authors":"Prince Tamba Lamin-Boima, Alhaji Brima Gogra","doi":"10.11604/pamj.2026.53.151.49695","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.151.49695","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Hepatitis B virus (HBV) remains a major occupational hazard for healthcare workers (HCWs), particularly in low-resource settings like Sierra Leone, where systemic challenges hinder effective prevention efforts. Despite the availability of an effective vaccine since 1982 and widespread screening initiatives, HBV vaccination uptake among HCWs remains alarmingly low. This study investigates the disconnect between HBV screening and subsequent vaccination among HCWs in Sierra Leone, examining individual, institutional, and systemic factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;we employed a mixed-methods cross-sectional design. A total of 432 HCWs were sampled across public, private, NGO, and faith-based hospitals using multi-stage techniques to assess screening uptake, vaccination coverage, and influencing factors. Additionally, 12 in-depth interviews were conducted with senior staff and health administrators. Quantitative data were analysed using SPSS, while the qualitative data were thematically analysed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;quantitative findings revealed suboptimal levels of HBV vaccination and screening among HCWs. Overall, - 65% of HCWs were screened for HBV, while 52% received at least one vaccine dose, and only 34% completed the full three-dose series. Nearly half of those screened were not vaccinated, exposing critical failures in follow-up care. Screening and vaccination rates varied by cadre. Higher uptake was observed among administrators (100.0%), doctors (88.2%), community health officers (68.8%), other clinical staff (68.8%), and laboratory technicians (54.2%). In contrast, nurses (43.4%), pharmacists (34.9%), and other essential staff (13.2%) reported lower coverage levels. Differences were also noted across facility types. Private facilities recorded the highest screening (77.3%) and vaccination (62.5%) rates, followed by NGOs (70.8% and 66.7%). Faith-based facilities recorded moderate levels (56.4% screening and 54.5% vaccination), while public facilities had 64.4% screening but relatively the lowest 44.7% vaccination coverage. Screening and vaccination uptake were significantly associated (Χ&lt;sup&gt;2&lt;/sup&gt; = 317.27, p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;the findings underscore critical missed opportunities in HBV prevention among HCWs in Sierra Leone. Despite moderate screening rates, vaccine coverage remains low, primarily due to institutional weaknesses such as inadequate follow-up systems, limited vaccine access, and weak policy enforcement - rather than individual neglect. These gaps place frontline health professionals at continued risk of HBV infection. Strengthening HBV prevention requires integrated screening-vaccination programs, mandatory occupational health policies, and sustainable vaccine supply systems. Targeted education, consistent advocacy, and inclusive strategies that engage all healthcare worker cadres are also vital. Such interventions are essential not only for prot","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"151"},"PeriodicalIF":0.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765419","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":"Male breast cancer: experience from a quaternary hospital in Tanzania.","authors":"Nashivai Kivuyo, Mungeni Misidai, Daniel Kitua, Alfred Chibwae, Rajabu Bakari, Larry Akoko","doi":"10.11604/pamj.2026.53.149.47743","DOIUrl":"10.11604/pamj.2026.53.149.47743","url":null,"abstract":"<p><strong>Introduction: </strong>male breast cancer (MBC) is rare, but its incidence is increasing globally. In sub-Saharan Africa, breast cancer care has primarily focused on women, creating a gap in understanding MBC outcomes. This study aimed to examine the clinical characteristics and treatment outcomes of MBC patients at Tanzania´s National Hospital.</p><p><strong>Methods: </strong>this retrospective cohort study, conducted at Muhimbili National Hospital, included male patients aged 18 years and above with histologically confirmed breast cancer diagnosed between January 2018 and December 2024. Demographic and clinical data were extracted from treatment records and presented as frequencies, proportions, and means. Survival status, obtained from case notes or patient/next-of-kin interviews, was analyzed using the Kaplan-Meier method.</p><p><strong>Results: </strong>fifty-six MBC patients were identified, with a mean age of 60.6 ± 12.9 years. Most patients (71.1%) had T4 disease, and 26.8% had metastasis, primarily pulmonary (73%). Invasive ductal carcinoma accounted for 83.9% of cases. The most common molecular subtype was Luminal A (61.8%), followed by triple negative (20%). Nearly all patients (97%) underwent surgery, with modified radical mastectomy and simple mastectomy performed in 48% and 45%, respectively. Over 60% of patients treated with curative intent had recurrence within 15 months. The 5-year overall survival rate was 11.2%.</p><p><strong>Conclusion: </strong>advanced disease presentation was common among MBC patients, corresponding to poor overall survival. Additionally, early disease progression was noted among those treated with curative intent. These findings underscore gaps in healthcare-seeking behavior, screening, and referral systems. Addressing these challenges and optimizing treatment protocols are crucial for improving outcomes.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"149"},"PeriodicalIF":0.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139492","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":"Right paraduodenal hernia complicated with small bowel obstruction and midgut rotation: a case report.","authors":"Mohammed Ba Gunaid, Nada Mohsen Salama, Augustin Prochotsky","doi":"10.11604/pamj.2026.53.150.52218","DOIUrl":"10.11604/pamj.2026.53.150.52218","url":null,"abstract":"<p><p>Right paraduodenal hernia is a rare congenital internal hernia resulting from abnormal midgut rotation. Although paraduodenal hernias represent the most common type of congenital internal hernia, the right-sided variant is an uncommon cause of small bowel obstruction and is often challenging to diagnose preoperatively. We report the case of a 46-year-old woman who presented with a 48-hour history of acute abdominal pain, nausea, and vomiting, without any prior history of abdominal surgery. Physical examination revealed tenderness in the epigastric and mesogastric regions without signs of peritonitis, while laboratory findings showed leukocytosis. Plain abdominal radiography demonstrated small bowel air-fluid levels, and contrast-enhanced computed tomography suggested small bowel obstruction secondary to an internal hernia. Urgent exploratory laparotomy revealed a right paraduodenal hernia through Waldeyer´s fossa with viable entrapped small bowel loops. The herniated bowel was successfully reduced, and the mesenteric defect was closed without the need for bowel resection. Right paraduodenal hernia should be considered in patients presenting with small bowel obstruction in the absence of prior abdominal surgery. Early diagnosis using computed tomography and prompt surgical intervention are crucial to prevent strangulation and ischemic complications.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"150"},"PeriodicalIF":0.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139506","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}