Pan African Medical Journal最新文献

{"title":"The effectiveness of Afrislum's expert client-delivered group brief cognitive behavioural therapy model in reducing HIV self-stigma among pregnant adolescent girls and young women living in urban informal settlements of Kampala, Uganda: a quasi-experimental difference-in-difference analysis.","authors":"Susan Babirye, Shafiq Kawooya, Jennipher Florence Namuli, Christopher Oundo, Cecilia Kihara","doi":"10.11604/pamj.2026.53.148.43474","DOIUrl":"10.11604/pamj.2026.53.148.43474","url":null,"abstract":"<p><strong>Introduction: </strong>cognitive behavioural therapy (CBT), a psychotherapeutic treatment, has been reported to effectively reduce self-stigma among people living with HIV; however, to date, there are barely any studies that have tested its effectiveness when delivered by lay counsellors. This study assessed the effectiveness of the expert client-delivered group CBT in reducing self-stigma among HIV positive pregnant adolescent girls and young mothers (AGYM) living in urban informal settlements of Kampala, Uganda.</p><p><strong>Methods: </strong>this was a quasi-experimental pre-post-test study of 253 pregnant AGYM attending Elimination of Mother-to-Child Transmission of HIV (EMTCT) and Early Infant Diagnosis (EID) clinics at four public health facilities serving the urban poor in Kampala, Uganda. In total, 142 participants in the treatment group were assigned to a 10-session CBT group, while 111 participants in the control group continued receiving treatment as usual. A difference-in-differences (DiD) analysis was conducted.</p><p><strong>Results: </strong>the DiD analysis demonstrated that the expert client delivered group CBT intervention showed a significant change/reduction of -1.121 percentage points (pp) in HIV self-stigma between baseline and endline, with P<0.001, after controlling for differences in various demographic variables and confounders between the intervention and control groups.</p><p><strong>Conclusion: </strong>this study provides evidence for the effectiveness of the expert-client-delivered group CBT HIV self-stigma reduction model among AGYM in Uganda. The use of peer-to-peer group CBT may be a promising approach for increasing access to psychosocial services in resource-limited settings like Uganda, where trained psychologists and mental health counsellors are few and psychosocial services are expensive.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"148"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139433","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":"Demographic predictors of hepatitis C virus viremia among seropositive individuals in Ethiopia: retrospective analysis and implications for testing algorithms.","authors":"Mesfin Nigussie, Kifle Tilahun","doi":"10.11604/pamj.2026.53.147.50389","DOIUrl":"10.11604/pamj.2026.53.147.50389","url":null,"abstract":"<p><strong>Introduction: </strong>hepatitis C virus (HCV) screening efficiency in resource-limited settings is compromised by variable ribonucleic acid (RNA) detectability among seropositive individuals. Understanding the demographic predictors of RNA positivity is crucial for optimizing testing algorithms in high-burden populations such as Ethiopia.</p><p><strong>Methods: </strong>we conducted a retrospective analysis of 792 anti-HCV seropositive treatment-naive individuals in Ethiopia. Multivariate logistic regression with comprehensive diagnostics was used to assess the independent associations of age and sex with HCV RNA status. Assay specificity was enhanced through duplicate testing and elevated signal-to-cutoff thresholds (S/CO ≥5.0).</p><p><strong>Results: </strong>the overall RNA positivity rate was 69.7% (552/792). Multivariate analysis revealed that each additional year of age increased the odds of RNA positivity by 3.1% (aOR = 1.031, 95% CI: 1.019-1.042, P <0.001), whereas female sex was independently associated with 44.6% greater odds (aOR = 1.446, 95% CI: 1.060-1.973, P = 0.020). Subgroup analysis revealed that young males (<30 years) had lower RNA positivity (37.8%, 95% CI: 24.1-53.9%) than young females did (50.0%, 95% CI: 36.6-63.4%). RNA positivity was 1.6-fold greater in adults ≥30 years (72.8%) than in younger individuals <30 years (44.8%). Genotype 4 predominated (49.6%) among the RNA-positive cases.</p><p><strong>Conclusion: </strong>both age and sex independently predict HCV RNA detectability in Ethiopia. The substantially lower RNA positivity among young males suggests that this subgroup may benefit from differentiated testing approaches. Demographic-informed algorithms could optimize resource allocation in HCV elimination programs in low- and middle-income countries (LMICs).</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"147"},"PeriodicalIF":0.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139430","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":"Clinical pattern and outcomes of acute cholangitis among patients at a tertiary health care facility in Kenya: a cross-sectional study.","authors":"Caleb Karani, Ashley Odiado, Njoroge Maina, Mohamed Onyango, Daniel Ojuka","doi":"10.11604/pamj.2026.53.146.52075","DOIUrl":"10.11604/pamj.2026.53.146.52075","url":null,"abstract":"<p><strong>Introduction: </strong>acute cholangitis (AC) is a life-threatening condition associated with high mortality and lethal complications, with limited data from sub-Saharan Africa. This study determines the clinical pattern and outcomes of acute cholangitis among patients admitted to Kenyatta National Hospital.</p><p><strong>Methods: </strong>this cross-sectional study retrieved records from the Health Records Department for patients with a discharge diagnosis of AC between 2018 and September 2025. Ethical approval was obtained from the institutional body. We performed consecutive data sampling of all available records. Demographic and clinical data were collected and analyzed using means and proportions. Associations were analyzed using Chi-square, and P-values of <0.05 were considered statistically significant.</p><p><strong>Results: </strong>among 111 acute cholangitis patients, the male-to-female ratio was 2:3, and the median age was 61 years. Median length of hospital stay was 12 days, with a 39.6% mortality rate. Malignant obstruction was the predominant etiology (67.6%), followed by benign stricture (11.7%); stent obstruction and stones each accounted for 6.3%. Malignant etiology was associated with worse outcomes (p<0.001) while ERCP drainage was protective (p<0.001). Independent predictors of in-hospital mortality were mental status changes (OR 23.034; 95% CI: 5.356-99.054) and sepsis with multiorgan dysfunction (OR 26.381; 95% CI: 4.028-172.765).</p><p><strong>Conclusion: </strong>acute cholangitis in our setting is primarily due to malignant biliary obstruction and has high mortality. The strongest predictors of mortality are mental status changes and sepsis. Early diagnosis using Tokyo Guidelines 2018 (TG18) criteria, prompt biliary drainage, and critical care reduce mortality.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"146"},"PeriodicalIF":0.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139479","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 impact of smoking on serum zinc levels among Sudanese adults: a case-control study.","authors":"Sara Sami Yousif, Tarig Hakim Merghani, Azza Osman Alawad, Shahenaz Seifaldeen Satti, Nadia Osman Yousif","doi":"10.11604/pamj.2026.53.145.47865","DOIUrl":"10.11604/pamj.2026.53.145.47865","url":null,"abstract":"<p><strong>Introduction: </strong>smoking increases oxidative stress and may impair zinc status by reducing absorption, increasing excretion, or disrupting enzyme function. Zinc is vital for antioxidant defence, and its deficiency could exacerbate smoking-related damage. This study assessed serum zinc levels in smokers and non-smokers to explore the association between smoking and zinc status.</p><p><strong>Methods: </strong>a hospital-based case-control study was conducted at Ibrahim Malik Teaching Hospital in Khartoum, Sudan. The study included 80 healthy adult males aged 18-39 years (mean age 25.56 ± 3.42 years), comprising 40 smokers as the case group and 40 non-smokers as the control group. Participants with known chronic illnesses or those on mineral supplementation were excluded. Serum zinc concentrations were measured using atomic absorption spectrophotometry. Descriptive statistics were calculated, and group comparisons were performed using the independent samples t-test. A p-value < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>the mean serum zinc level was significantly lower in smokers (66.83 ± 21.13 µg/dL) compared to non-smokers (90.08 ± 14.93 µg/dL) (p < 0.05). No significant associations were observed between serum zinc levels and the number of cigarettes smoked (p = 0.683) or duration of smoking (p = 0.596).</p><p><strong>Conclusion: </strong>smokers exhibited significantly lower serum zinc levels compared to non-smokers, indicating a potential impact of smoking on zinc status. However, zinc levels did not correlate with smoking intensity or duration, suggesting the effect may occur regardless of exposure level.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"145"},"PeriodicalIF":0.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139495","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":"[Associated factors with vaccine hesitancy in sub-Saharan Africa: a literature review].","authors":"Amadou Tila Kebe, Bakary Diarra, Issa Kalossi, Bocar Mahamane Traore, Léon Savadogo, Hamadoun Sangho","doi":"10.11604/pamj.2026.53.143.49923","DOIUrl":"10.11604/pamj.2026.53.143.49923","url":null,"abstract":"<p><p>Vaccination is a key intervention for reducing infant and child morbidity and mortality. Its success depends largely on public acceptance. This study aims to understand the determinants of vaccine hesitancy in sub-Saharan Africa. The methodological approach consisted of a systematic review of the literature, conducted through consultation of PubMed and grey literature, according to Population/Patient, Intervention, Comparison, and Outcome (PICO) criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Of the 32 studies included, 28 were peer-reviewed, while the others were taken from dissertations and theses by master's and doctoral students in health sciences. The main factors contributing to hesitancy include young age, rural location, low educational attainment, doubts about the safety and efficacy of vaccines, and fear of possible side effects. Mistrust of governments and the influence of social media also play a role. This review identifies these barriers and proposes solutions to improve vaccine uptake, particularly for the Expanded Programme on Immunisation and COVID-19 vaccines.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"143"},"PeriodicalIF":0.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139438","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":"[Expression of NF-κB, EGFR, and HER3 in castration-resistant prostate adenocarcinoma: a clinical and molecular study of 88 Moroccan patients].","authors":"Ilham Sadaoui, Imane Sadaoui, Hanaa Amrani Hassani Joutei, Hakima Benomar, Sellama Nadifi","doi":"10.11604/pamj.2026.53.144.51276","DOIUrl":"10.11604/pamj.2026.53.144.51276","url":null,"abstract":"<p><p>The progression of prostate adenocarcinoma (PCa) toward castration resistance involves complex molecular pathways. This study evaluates the role of NF-κB and EGF receptors (EGFR, HER3) in tumor aggressiveness among Moroccan patients. A retrospective study with immunohistochemical analysis of NF-κB subunits (p65, p50, RelB), EGFR, and HER3 was performed on tissue samples from 88 PCa patients. Results were correlated with castration resistance status and Gleason scores (using Chi-square tests and logistic regression). Strong nuclear localization of NF-κB was detected in castration-resistant cancer cells (p = 0.0005), serving as a predictive marker for progression. Simultaneously, high EGFR expression was identified in hormone-refractory patients (OR = 5.37; p = 0.0010). Nuclear HER3 expression significantly correlated with high Gleason grades (≥ 7) in resistant tumors (p = 0.0064). Nuclear activation of NF-κB and HER3, along with EGFR overexpression, plays a critical role in hormonal escape. These molecules represent promising therapeutic targets and prognostic biomarkers for high-risk PCa management in Morocco.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"144"},"PeriodicalIF":0.9,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139428","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":"Well-differentiated endometrial adenocarcinoma demonstrating morphological spectrum: a clinical image.","authors":"Shubham Kalode, Punam Sawarkar","doi":"10.11604/pamj.2026.53.142.50774","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.142.50774","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"142"},"PeriodicalIF":1.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139486","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":"Papillary thyroid carcinoma with Hashimoto's thyroiditis: a clinical image.","authors":"Shubham Kalode, Punam Sawarkar","doi":"10.11604/pamj.2026.53.139.51381","DOIUrl":"https://doi.org/10.11604/pamj.2026.53.139.51381","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"139"},"PeriodicalIF":0.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621936","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":"Family planning utilization among people living with HIV: a cross-sectional study at the Kumasi South Hospital, Ghana.","authors":"John Jude Kweku Annan, Boniface Mensah, Betty Roberta Norman, Rachel Agyeman Boateng, Anthony Enimil, Christiana Asiedu-Neizer, Martin Agyei, Tracey Afoley Laryea","doi":"10.11604/pamj.2026.53.137.43954","DOIUrl":"10.11604/pamj.2026.53.137.43954","url":null,"abstract":"<p><strong>Introduction: </strong>prevention of unintended pregnancies among Women Living with Human Immunodeficiency Virus (WLWHIV) through family planning is a highly cost-effective vertical transmission prevention strategy. This study evaluated the family planning utilization and fertility needs among adults Persons Living with HIV (PLWHIV) in a regional hospital in Ghana.</p><p><strong>Methods: </strong>this was a cross-sectional study conducted at the HIV clinic of Kumasi South Hospital, a regional hospital in Ghana. Study participants (n=602) were sampled and interviewed using questionnaires to determine the consistent use of contraception. A descriptive analysis was done to determine the rate of consistent contraceptive use. A multivariable analysis was used to assess factors affecting the consistent use of contraception among PLWHIV at a statistical significance of 0.05.</p><p><strong>Results: </strong>barrier contraception is the most well-known and widely used among study participants (>98%). Factors associated with increased odds of consistent use of contraception included marital status, HIV infection, duration of 4 or more years, and receipt of family planning assistance. However, having a seropositive sexual partner was associated with less consistent use of contraception.</p><p><strong>Conclusion: </strong>barrier contraception, the most popular method among PLHIV, is less effective in reducing unintended pregnancies. Efforts to meet the contraception needs of PLHIV should be focused on dual contraception (barrier and long-term reversible methods) to reduce HIV transmission, dual HIV infections, and unintended pregnancies.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"137"},"PeriodicalIF":0.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621955","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":"Immune and non-immune hydrops fetalis in a resource-limited setting: a report of two cases.","authors":"Willis Okumu Ochieng, Rosa Ndiema Chemwey, Moses Kipchumba Lagat, Elijah Kagondu Thagana","doi":"10.11604/pamj.2026.53.141.52080","DOIUrl":"10.11604/pamj.2026.53.141.52080","url":null,"abstract":"<p><p>Hydrops fetalis is a fetal condition characterized by abnormal fluid accumulation in multiple fetal compartments and is associated with high perinatal mortality. Unlike high-income settings, both immune and non-immune hydrops fetalis (IHF and NIHF) remain relevant in low- and middle-income countries (LMICs), where evaluation and specialized care are often delayed or inaccessible. We report two cases of hydrops fetalis diagnosed antenatally at a tertiary referral hospital in Kenya, followed through delivery and outcome. Case one involved immune hydrops fetalis due to suspected non-Rhesus alloimmunization, presenting with fetal ascites and cardiac dysfunction. Management included paracentesis and intrauterine transfusions, which temporarily stabilized the fetus, but the neonate died on day two of life. Case two involved non-immune hydrops fetalis initially presenting with isolated pleural effusion, which progressed to generalized hydrops. Amniotic fluid testing showed Rubella IgM positivity. Management included thoracocentesis and conservative management till 34+0 weeks´ gestation. Unfortunately, the pregnancy resulted in an intrauterine fetal demise. These cases illustrate the wide spectrum of hydrops fetalis and the diagnostic and therapeutic challenges in resource-limited settings. While antenatal interventions may prolong gestation, outcomes are largely determined by the underlying cause and disease severity.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"53 ","pages":"141"},"PeriodicalIF":0.9,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13221780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148139436","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}