Public health challenges最新文献

{"title":"Indoor and outdoor NO2 and SO2 levels in 13 randomly selected preschools from 7 districts in Mpumalanga Province, South Africa","authors":"Mudau Rodney, Voyi Kuku, Shirinde Joyce","doi":"10.1002/puh2.175","DOIUrl":"https://doi.org/10.1002/puh2.175","url":null,"abstract":"Air pollution is a serious worldwide issue, where both outdoor and indoor air quality have a substantial impact on the health of children. Children are more vulnerable to the effects of air pollution due to their developing respiratory systems and higher respiration rates than adults. These children dedicate a substantial amount of time to the preschool setting. The study sought to evaluate the concentration of NO2 and SO2 in both outdoor and indoor environments of preschool facilities.Concurrently, the levels of NO2 and SO2 were measured indoors and outdoors at 13 randomly selected preschools in 7 districts in Mpumalanga Province, South Africa. Radiello passive air samplers were employed to collect gaseous samples.The mean levels of NO2 indoors and outdoors were within the recommended criteria outlined by the World Health Organization (WHO), specifically target levels 1–3. Additionally, these values were also below the air quality guides outlined by South Africa, both for yearly and 1‐h mean measurements. Nevertheless, both levels remained above the suitable threshold of 10 µg m−3 outlined by the WHO air quality guidelines.It is important to implement proactive measures such as enhancing airflow systems, employing air filters and reducing potential sources of air pollution in preschools, to aid in reducing exposure to indoor and outdoor NO2 and SO2.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":" 33","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140999638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new era for African health systems: Market shaping and the African Continental Free Trade Area (AfCFTA)","authors":"Jonta Kamara, Ukeme Essien, Alain B. Labrique","doi":"10.1002/puh2.172","DOIUrl":"https://doi.org/10.1002/puh2.172","url":null,"abstract":"The COVID‐19 pandemic has forced a reflection on the origins of supplies in African healthcare market and underscored the need for an increase in local manufacturing of medical supplies. Several African countries’ health markets have been heavily reliant on imports. First, this article demonstrates how the African healthcare market has had a high import dependency and the role that the African Continental Free Trade Area (AfCFTA) could play to reverse this. It is estimated that African countries import between 80% and 94% of medical supplies, 75% of testing kits, between 70% and 95% of pharmaceuticals, and 99% of vaccines. Second, during the COVID‐19 pandemic, countries imposed export restrictions which impacted the flow of medical supplies to African countries. This finding highlighted the limited production capabilities on the African continent and reiterated the need to strengthen continental value chains and local manufacturing capacity to establish the continent's New Public Health Order. Third, there was the emergence of local innovations seeking to minimize the impact of these supply chain disruptions. Using case studies on the local production of COVID‐19 testing kits and personal protective equipment, the article highlights progress made toward health market reform. It calls attention to the implementation of the AfCFTA to strengthen the supply, manufacturing, and trade of medical resources. Fourth, this article highlights countries that have African‐made pharmaceuticals and vaccinations and the importance of regional hubs to expand these products in African healthcare markets. It concludes by discussing investments made to expand local manufacturing of health products.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"67 s271","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141002359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health intervention trials involving transgender, transabled and transracial persons in Africa: A scoping review","authors":"J. Amzat, K. Kanmodi, K. Aminu, Abbas Ismail, A. Salami","doi":"10.1002/puh2.182","DOIUrl":"https://doi.org/10.1002/puh2.182","url":null,"abstract":"Health intervention trials constitute important research efforts to find appropriate solutions to health issues affecting different populations. In many cases, it involves high‐risk groups such as the trans‐communities. This scoping review aims to review the existing health intervention trials involving transgender, transabled and transracial persons in Africa.This scoping review adopted the research design by Arskey and O'Malley. Using the Population–Concept–Context framework, a robust systematic search of four research databases, including APA PsycINFO, SCOPUS, CINAHL Complete and PubMed, was conducted to retrieve literature relevant to the review's question. Duplicate copies in the retrieved literature were removed using the Rayyan web‐based application. The residual literature was screened for relevance based on the review's inclusion and exclusion criteria, and only those eligible articles were included in this review. From the included literature, data were charted, collated, summarized and presented as results.The scoping review included and reviewed only four articles, which reported studies involving transgender persons. No peer‐reviewed original research article on transabled and transracial persons in Africa was found eligible for inclusion in this review. All the reviewed articles focused on at‐risk, healthy and human immunodeficiency virus (HIV)‐uninfected adult participants ranging between the ages of 18 and 65 years. The domains investigated in those articles were on sexual health, HIV preventive drugs and vaccine trials. The reviewed findings showed the use of HIV‐inhibiting medications and HIV screening or testing as vital preventive interventions among transgender persons in Africa. The available research evidence shows sexuality reductionism about trans behaviour by neglecting other health domains.Health trial research on transracial, transgender and transabled persons is a largely underexplored research domain in Africa. More health intervention trials, beyond the domain of sexual health, are required to improve the health and well‐being of this highly marginalized population group in Africa.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The School Suicide Policy Evaluation Tool (SSPET): A proof‐of‐concept for assessing school suicide prevention policies","authors":"Douglas Wirthlin, Zeke Richards, Cody Crandall, Shad Mortensen, Jackson R. Richards, Amanda Bakian","doi":"10.1002/puh2.178","DOIUrl":"https://doi.org/10.1002/puh2.178","url":null,"abstract":"As adolescent suicide rates have increased, there has been a nationwide increase in legislation requiring schools to create suicide prevention policies. In Utah, school districts must implement a youth suicide program for grades 7–12. Currently, there have been no systematic analyses of Utah school district suicide prevention policies. Thus, we developed a new evaluation instrument, the School Suicide Policy Evaluation Tool (SSPET).The SSPET was derived from the “Model School District Policy” and evaluates criteria on prevention, intervention, re‐entry, and postvention. Four raters used the SSPET in a systematic analysis of suicide prevention policies for all school districts in the state of Utah.Analysis revealed a right‐skewed distribution of policy scores, and a median total score was 2.25/36. The mean percentage of inclusion of the four subsections in policies was less than 20% for most criteria. Median scores were totaled for the four subsections as follows: Prevention score was 1/9, intervention score was 1/14, re‐entry score was 0/4, and postvention score was 0/9.This proof‐of‐concept study demonstrates the utility of the SSPET in identifying shortcomings of school district policies on suicide while generating specific recommendations for improvement. With further validity testing, we expect this tool to be useful to school district administrators, education policymakers, and those studying suicide interventions and outcomes in school‐aged children and adolescents.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"107 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141022016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing cervical cancer prevention in Bhutan: A study on the use of loop electrosurgical excision procedures at the primary health care level","authors":"Sangay Tshering, N. Dorji, Zimba Letho, Nishal Chhetri","doi":"10.1002/puh2.180","DOIUrl":"https://doi.org/10.1002/puh2.180","url":null,"abstract":"Cervical cancer is the top and fourth leading cause of death among women in Bhutan and worldwide, respectively. The cervical cancer elimination flagship program initiated by the Ministry of Health aims to achieve the 90–70–90 goals by 2030. To achieve this, detection and treatment of pre‐cancerous lesions of the cervix through colposcopy and loop electrosurgical excision procedure (LEEP) are being carried out through the outreach health camps.This descriptive study aimed to assess the safety and tolerability of LEEP under local anesthesia and assess the margin status of high‐grade lesion (HGL). We analyzed 193 records of clients who underwent LEEP at Wangdue Phodrang Hospital from 26 September to 5 October 2022. The sociodemographic profile, intraoperative pain, complications, and histopathological reports were described using structured pro forma.The mean age of clients was 40.9 ± 8.5 years (range 25–66 years). There were 3.1% who had intraoperative and 2.6% who had postoperative bleeding. There were 18.6% who had foul‐smelling vaginal discharge, and 8.3% had moderate‐to‐severe intraoperative pain. Histopathological assessment revealed 29.5% with chronic cervicitis, 34.2% with HGL, and 1.6% with microinvasive cervical carcinoma. The margin positivity for HGL was 36.4%.Given the safety profile of LEEP under local anesthesia in our setting, the scope of providing a complete cervical cancer screening and treatment package at the primary health care level looks promising. Based on the higher rate of overtreatment and margin positivity, we recommend the practical implementation of standard colposcopy guidelines.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"116 S149","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141040861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using eLearning to improve and retain the knowledge of community health workers in maternal and neonatal health in Rwanda: A cohort study.","authors":"Yves Sangwa, Victor Ndaruhutse, Samson Radeny, Dieudonne Ndatimana, François Niragire, Erigene Rutayisire, Beatrice Mukamana, Josee Uwamariya, Clovis Kabanda, Angelique Nyirafaranga, Marie Chantal Uzayisenga, Chris Adrien Kanakuze, Jean Claude Gasamagera, Jacqueline Umunyana, Christian Mazimpaka","doi":"10.1002/puh2.174","DOIUrl":"10.1002/puh2.174","url":null,"abstract":"<p><strong>Background: </strong>In Rwanda, community health workers (CHWs) serve a crucial function in providing community-based maternal and neonatal health (CBMNH) services. However, limited access to continuous training affects their confidence and ability to execute their roles effectively. This study aimed at evaluating the impact of eLearning on enhancing and maintaining CHWs' knowledge of CBMNH.</p><p><strong>Methods: </strong>This cohort study, conducted from April to October 2021 in two Rwandan districts, evaluated knowledge acquisition and retention among 36 CHWs participating in an eLearning course. Knowledge scores were measured using a structured questionnaire administered pre-training, post-training and at a 6-month follow-up. Descriptive analysis and paired <i>t</i>-tests were used to assess mean score differences.</p><p><strong>Results: </strong>There was improvement in CHWs' performance scores following eLearning training, with an average increase from 86.5% to 98.2%. The improvement was sustained at a 6-month follow-up. Statistical significance was found between age category and CHWs' pre- and post-test performance (<i>p</i> = 0.01, <i>p</i> = 0.04 respectively), and between years of experience and pre-test scores (<i>p</i> = 0.02).</p><p><strong>Conclusions: </strong>The results of this study suggest that eLearning is an effective method for enhancing and retaining CHWs' knowledge of CBMNH. The findings support the use of eLearning as a valuable strategy for strengthening the capacity of CHWs in Rwanda and other countries with similar contexts.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"3 2","pages":"e174"},"PeriodicalIF":0.0,"publicationDate":"2024-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268068","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":"Overcoming barriers to COVID-19 herd immunity in Afghanistan.","authors":"Mohammad Faisal Wardak, Ali Rahimi, Don Eliseo Lucero-Prisno, Adriana Viola Miranda","doi":"10.1002/puh2.161","DOIUrl":"10.1002/puh2.161","url":null,"abstract":"<p><p>Afghanistan faces numerous obstacles in its endeavor to achieve herd immunity against COVID-19. Inadequate resources, vaccine hesitancy, and the new government's lack of international recognition have impeded the country and harmed vaccine procurement and distribution. Although the recent power shift has led to a more secure situation, the country's vaccination coverage remains at 44.05% as of November 26, 2023. The main hurdles to herd immunity include limited vaccine accessibility, extensive vaccine hesitancy, an inefficient cold chain system causing high vaccine wastage rates, substandard service delivery, recent restrictions on women's healthcare access, low health literacy, and a weakened economy owing to decades of conflict and international sanctions. This article assesses vaccination progress, and herd immunity barriers, and provides solutions to overcome them in Afghanistan. A comprehensive approach is required, which involves enhancing public awareness of the benefits of vaccination, debunking vaccine-related misconceptions through the media, expanding vaccine accessibility especially in remote areas, increasing vaccination personnel, promoting the cold chain and delivery system, reversing the ban on women's education and employment, boosting the economy, and increasing the inflow of humanitarian aid by lifting international sanctions. Successfully implementing these measures can help Afghanistan overcome obstacles to herd immunity, leading the country toward a safer and healthier future.</p>","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"3 1","pages":"e161"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268069","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":"Prevalence and risk factors for childhood anemia in Rwanda: Using Rwandan demographic and health survey 2019–2020","authors":"Henriette Usanzineza, E. Nsereko, Jean Pierre Niyitegeka, Aline Uwase, Jean de Dieu H. Tuyishime, Francois Xavier Sunday, Christian Mazimpaka, J. Ahishakiye","doi":"10.1002/puh2.159","DOIUrl":"https://doi.org/10.1002/puh2.159","url":null,"abstract":"Anemia in children is a significant health issue globally, with developing countries, notably Africa, being disproportionately affected. This condition can result in detrimental and irreversible impacts on a child's neurological development. Despite its relevance, research on anemia prevalence and risk factors in Rwandan children aged 6–23 months is limited. Our study aimed to ascertain the prevalence and potential risk factors associated with anemia in this defined population.This is a cross‐sectional study that used secondary data analysis on a weighed sample of 1247 children aged 6–23 months, sourced from the 2019–2020 Rwanda Demographic Health Survey. We used descriptive statistics and binary logistic regression to identify the links between anemia and various factors.The study revealed a high prevalence of anemia at 52.79%. Among anemic children aged 6–23 months, most (52.82%) had mild anemia, 46.12% had moderate anemia, and 1.06% had severe anemia. Key contributors to childhood anemia included maternal anemia (adjusted odds ratio [AOR] = 1.62, 95% confidence intervals (95% CI): [1.11, 2.33]) and history of coughing in the 2 weeks before the survey (AOR = 1.42, 95% CI: [1.12, 1.81]). Vitamin A supplementation and antiparasitic medication were identified as protective factors (AOR = 0.70, 95% CI: [0.50, 0.97]) and (AOR = 0.59, 95% CI: [0.45, 0.77]), respectively.Given the high anemia prevalence among Rwandan children aged 6–23 months, targeted public health interventions are critically needed. A comprehensive strategy throughout the health system is essential for reducing childhood anemia, involving measures such as addressing maternal anemia, managing childhood illnesses, and enhancing existing interventions like vitamin A supplementation and deworming.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"391 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extrapulmonary tuberculosis in Africa: Molecular analysis of clinical specimens of suspected cases in Northern Ghana","authors":"Yaa Nyarko Addai, Samuel E. K. Acquah, H. Ganu, E. K. Vicar, David Zeyeh, Abass Abdul Karim, Walana Williams, Israel Mensah Attipoe, Lawrence Quaye","doi":"10.1002/puh2.160","DOIUrl":"https://doi.org/10.1002/puh2.160","url":null,"abstract":"Extrapulmonary tuberculosis (EPTB) is a major component of the total tuberculosis cases reported by the World Health Organization. This is a study conducted to compare microscopy and molecular techniques to determine the prevalence of Mycobacterium tuberculosis complex (MTBC) in EPTB patients.Smear microscopy and genotype MTBDRplus line probe assay (LiPA) were applied to concentrated extrapulmonary clinical specimens from different anatomic sites to determine the presence of M. tuberculosis and their susceptibility to isoniazid (INH) and/or rifampin (RIF).A total of 251 specimens comprising 108 (43%) ascitic fluid, 54 (21.5%) pleural aspirate, 24 (9.6%) gastric lavage, 15 (6.0%) pus, 9 (3.6%) synovial fluid, 5 (2%) cerebrospinal fluid, 2 (0.8%) breast aspirate and 34 (13.5%) aspirates from unindicated sites obtained from patients with suspected EPTB attending the Tamale Teaching Hospital were analysed. Microscopically, acid fast bacilli (AFB) were detected in one ascitic fluid and a pus specimen. Using the LiPA, MTBC was observed in four (2.6%) samples; three (3) ascitic fluid and one aspirate.M. tuberculosis complex was confirmed in four (2.6%) patients. The most common specimens suspected of EPTB were ascitic fluid, pleural aspirate and gastric lavage. However, MTBC was predominantly detected in ascitic fluid. This result indicates that the LiPA can improve the detection of EPTB in the region and similar settings globally.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"137 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139838872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for childhood anemia in Rwanda: Using Rwandan demographic and health survey 2019–2020","authors":"Henriette Usanzineza, E. Nsereko, Jean Pierre Niyitegeka, Aline Uwase, Jean de Dieu H. Tuyishime, Francois Xavier Sunday, Christian Mazimpaka, J. Ahishakiye","doi":"10.1002/puh2.159","DOIUrl":"https://doi.org/10.1002/puh2.159","url":null,"abstract":"Anemia in children is a significant health issue globally, with developing countries, notably Africa, being disproportionately affected. This condition can result in detrimental and irreversible impacts on a child's neurological development. Despite its relevance, research on anemia prevalence and risk factors in Rwandan children aged 6–23 months is limited. Our study aimed to ascertain the prevalence and potential risk factors associated with anemia in this defined population.This is a cross‐sectional study that used secondary data analysis on a weighed sample of 1247 children aged 6–23 months, sourced from the 2019–2020 Rwanda Demographic Health Survey. We used descriptive statistics and binary logistic regression to identify the links between anemia and various factors.The study revealed a high prevalence of anemia at 52.79%. Among anemic children aged 6–23 months, most (52.82%) had mild anemia, 46.12% had moderate anemia, and 1.06% had severe anemia. Key contributors to childhood anemia included maternal anemia (adjusted odds ratio [AOR] = 1.62, 95% confidence intervals (95% CI): [1.11, 2.33]) and history of coughing in the 2 weeks before the survey (AOR = 1.42, 95% CI: [1.12, 1.81]). Vitamin A supplementation and antiparasitic medication were identified as protective factors (AOR = 0.70, 95% CI: [0.50, 0.97]) and (AOR = 0.59, 95% CI: [0.45, 0.77]), respectively.Given the high anemia prevalence among Rwandan children aged 6–23 months, targeted public health interventions are critically needed. A comprehensive strategy throughout the health system is essential for reducing childhood anemia, involving measures such as addressing maternal anemia, managing childhood illnesses, and enhancing existing interventions like vitamin A supplementation and deworming.","PeriodicalId":74613,"journal":{"name":"Public health challenges","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}