Does community-based health insurance affect lifestyle and timing of treatment seeking behavior?Evidence from Ethiopia

Objectives This paper aims to investigate the effects of enrollment in the Ethiopian community-based health insurance(CBHI)scheme on household preventive care activities and the timing of treatment-seeking behavior for illness symptoms.There is growing concern about the financial sustainability of CBHI schemes in developing countries.However,few empirical studies have identified potential contributors,including ex-ante and ex-post moral hazards.Methods We implement a household fixed-effect panel data regression model,drawing on three rounds of household survey data collected face to face in districts where CBHI scheme is operational and in districts where it is not operational in Ethiopia.Results The findings show that enrolment in CBHI does not significantly influence household behaviour regarding preventive care activities such as water treatment before drinking and handwashing before meals.However,CBHI significantly increases delay in treatment-seeking behaviour for diseases symptoms.Particularly,on average,we estimate about 4-6 h delay for malaria symptoms,a little above 4 h for tetanus,and 10-11 h for tuberculosis among the insured households.Conclusions While there is evidence that CBHI improve the utilization of outpatient or primary care services,our study suggests that insured members may wait longer before visiting health facilities.This delay could be partly due to moral hazard problems,as insured households,particularly those from rural areas,may consider the opportunity costs associated with visiting health facilities for minor symptoms.Overall,it is essential to identify the primary causes of delays in seeking medical services and implement appropriate interventions to encourage insured individuals to seek early medical attention.

Understanding the concept of health literacy: A strategy to improve nursing practice

Health literacy(HL)is an effective approach for improved health status and measures the capacity of individuals to engage in health promotion and disease prevention activities as low HL constitutes a global problem in health-care delivery.Nurses play a significant role in providing adequate information to the client and as such it becomes imperative for them to understand the concept of HL.Clinical approach of HL refers to ability to utilize literacy skills in relation to appointments,prescriptions,and instructions for self-management.Public health approach presents HL as means of empowering individuals to take control of their health and factors that influences health.HL is a hierarchy of skills that can be assessed and managed through health education and effective communication.Nurses’understanding of the concept of HL and strategies to reduce HL demands is crucial to delivery of effective nursing practice.This review will provide a clear understanding of the concept of HL which is essential for nurses to effectively educate patients and provide holistic care.More so,nurses will be able to assess literacy level of the patients,plan and develop better educational program tailored to patients’level of literacy.This could invariably improve patients’comprehension and adherence to treatment plans and overall health outcomes.

The Oral Health Status of Person with Special Needs in Kumasi

Background: The most prevalent non-communicable disease worldwide is oral health-related disease, with dental caries and periodontal conditions being common. Oral health status significantly impacts overall health and quality of life. Barriers to dental care affect children with special needs. This study evaluates the oral health status and treatment requirements of people with special needs. Methodology: This descriptive cross-sectional study in Kumasi, Ghana examined oral health status among people, 121 children with special needs over two months, in June-July 2022. Dental caries, periodontal changes, malocclusion, and trauma were assessed. The data was analyzed using SPSS 20.0. Results: The oral health status among people with special needs in this study was generally moderate, with a range from very good to very poor. The prevalence of dental caries was 37%, with a mean DMFT score of 2.82. Periodontal health showed unsatisfactory indicators such as mobile teeth, poor gingival health, high plaque scores, and the presence of halitosis. Conclusion: This descriptive study aimed to provide baseline data on the oral health status of special needs students in Kumasi, addressing the lack of knowledge in this area. It highlighted the importance of dental care in maintaining good oral health and overall well-being in individuals with special needs. Coordinated efforts by dental professionals are needed to provide dental health education and preventive interventions for these children.

Impact of phytoconstituents on oral health practices:a post COVID-19 observation

Appropriate oral hygiene significantly reduces the possibility of oral infections.However,dental caries and periodontal diseases are major oral health issues causing chronic diseases due to poor oral health.Recently,herbal compounds have gained interest in maintaining oral health.Extracts of burdock root(Arctium),noni fruit(Morinda citrifolia),and neem leaf(Azadirachta indica)are now used as intracanal medicaments in endodontics and periodontics.Plectranthus amboinicus species and other plants produces essential oil likeβ-caryophyllene,p-cymene,andγ-terpinene can exhibit antibacterial activity;highlighting phytoconstituents plays a vital role in oral health.The COVID-19 pandemic highlighted the importance of hygiene and sanitization,to curb SARS-CoV-2.Oral cavity is among the gateways for virus entry into saliva.Saliva is a potential reservoir of SARS-CoV-2,and there is an increased risk of infection if there is any fissure in the mouth.This enables entry of virus into the vascular system through gingival or periodontal pocket,possibly reaching lung periphery then to lung vessels by interacting with endothelial surface receptors triggering pulmonary vasoconstriction and lung damage due to endothelial dysfunction.This review aims to draw attention to the possible route of SARS-CoV-2 infection via the oral cavity and the importance of oral hygiene against COVID-19.

Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China

High-resolution ultrasonography was used to analyze the nerve cross-sectional area （CSA） of the median nerve at 7 sites： the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm （where the nerve enters the pronator teres muscle）, 4 cm proximal to the tip of the medial epicondyle, and mid-humerus （mid-point between elbow crease and axilla） in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

Protective effects of physical activity against health risks associated with type 1 diabetes: “Health benefits outweigh the risks”

The magnitude of diabetes mellitus(DM)has increased in recent decades,where the number of cases and the proportion of the disease have been gradually increasing over the past few decades.The chronic complications of DM affect many organ systems and account for the majority of morbidity and mortality associated with the disease.The prevalence of type 1 DM(T1DM)is increasing globally,and it has a very significant burden on countries and at an individual level.T1DM is a chronic illness that requires ongoing medical care and patient self-management to prevent complications.This study aims to discuss the health benefits of physical activity(PA)in T1DM patients.The present review article was performed following a comprehensive literature search.The search was conducted using the following electronic databases:“Cochrane Library”,Web of Science,PubMed,HINARI,EMBASE,Google for grey literature,Scopus,African journals Online,and Google Scholar for articles published up to June 21,2021.The present review focused on the effects of PA on many outcomes such as blood glucose(BG)control,physical fitness,endothelial function,insulin sensitivity,well-being,the body defense system,blood lipid profile,insulin resistance,cardiovascular diseases(CVDs),insulin requirements,blood pressure(BP),and mortality.It was found that many studies recommended the use of PA for the effective management of T1DM.PA is a component of comprehensive lifestyle modifications,which is a significant approach for the management of T1DM.It provides several health benefits,such as improving BG control,physical fitness,endothelial function,insulin sensitivity,well-being,and the body defense system.Besides this,it reduces the blood lipid profile,insulin resistance,CVDs,insulin requirements,BP,and mortality.Overall,PA has significant and essential protective effects against the health risks associated with T1DM.Even though PA has several health benefits for patients with T1DM,these patients are not well engaged in PA due to barriers such as a fear of exercise-induced hypoglycemia in particular.However,several effective strategies have been identified to control exercise-induced hypoglycemia in these patients.Finally,the present review concludes that PA should be recommended for the management of patients with T1DM due to its significant health benefits and protective effects against associated health risks. Italso provides suggestions for the future direction of research in this field.

Knowledge and awareness of human mpox infection among healthcare workers:A cross-sectional study in southwestern Nigeria

Objective:To identify the knowledge and awareness level of human mpox viral infection among healthcare workers in southwestern Nigeria.Methods:A cross-sectional study was conducted in Ekiti State,southwest Nigeria among 316 healthcare workers that were selected through a systematic random sampling.Data were collected with the aid of a semi-structured,self-administered questionnaire.The Chi-square test and binary logistic regression were used to find the association between the independent and dependent variables.The significance level was set at P-value<0.05.Results:Two hundred and twenty-two(70.3%)of the respondents were aged≤40 years,mean age(36±9)years,189(59.8%)were female,306(96.8%)were Christians,and 203(64.2%)were married.Three hundred and fourteen(99.4%)of the respondents were aware of mpox infection.Main sources of information about mpox were medical education(44.0%),radio/television(32.0%)and newspaper(21.0%).However,among those aware of the disease,209(67.0%)demonstrated poor knowledge levels.Longer than 5 years’experience of medical practice was the only significant predictor of higher knowledge level of the disease(OR 1.76,95%CI 1.01-3.06;P=0.046).Conclusions:Despite the high awareness level of mpox infection among healthcare workers,there still exists a huge knowledge gap.It is recommended that targeted intervention could be directed towards continuous medical education and simulation exercises on re-emerging infectious diseases like mpox to improve the knowledge of the healthcare workers.

Seroprevalence of Brucellosis among Clinically Suspected Human Cases Presenting at Health Facilities in Namibia from 2012 to 2017

Brucellosis is a zoonosis global importance.Brucella abortus and Brucella melitensis are the main species responsible for this disease in humans and production losses in domestic ruminants.Unpasteurized milk,home-made cheese and ice cream,and meat present a risk for human infection[1].

Caring Behaviour of Nurses in Orthopaedic Wards of Selected Health Institutions as Perceived by Patients

Nurses are trained to provide hands-on care to patients in a variety of settings, which include physical care which can range from total care to helping a patient prevent illness. The health of a patient can significantly improve when they (patients) perceive caring nursing behaviours and are satisfied with the quality of care been received from their care giver. The aim of this study was to determine the caring behaviour of nurses as perceived by patients admitted to orthopaedic ward in some selected hospitals in Osogbo, Osun state, Nigeria. A descriptive comparative design was used. Convenient sample technique was used to select 616 respondents consisting of male and female patients admitted to orthopaedic wards of selected hospitals. The questionnaire on Caring Behaviour Assessment scale was adapted from CBI. The most highly ranked perceived nurses’ behaviour by patients rated “satisfactory” was the general perception of the patients and rendering of basic needs. The findings also revealed that patients rated nurses behaviour (care-giving) with respect to human needs assistance, the provision of safe environment, assisting in psychological care and giving physical comfort as average. Lastly, findings also revealed that patients rated perceived nurses behaviour (care-giving) as “not satisfactory” with regards to meeting their communication needs, nutritional needs and individualized care. In conclusion, care giving is an important branch of nursing and it depicts the quality of care received by a patient which in turn is capable of aiding speedy recovery.

Characterization of mycobacterium isolates from pulmomary tuberculosis suspected cases visiting Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,Addis Ababa Ethiopia:a cross sectional study

Objective:To characterize mycobaclerium isolates from pulmomary tuberculosis suspected cases visiting National Tuberculosis Reference Laboratory at Ethiopian Health and Nutrition Research Institute,for diagnosis of pulmonary tuberculosis from January 4 to February 22.2010 with total samples of 263.Methods:Sputum specimens were collected and processed:the deposits were cultured.Por culturing Lowenstein Jensen medium(LJ) and Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) were used.Capilia Neo was used for detecting NTM isolates from isolates of BACTEC MGIT960.In Armauer Hansen Research Institute,Addis Ababa Ethiopia,Deletion typing PCR method for species identification(from confirmed Mycobacterium tuberculosis complex(MTBC) isolates by Capilia Neo) uas done.Results:Out of 263 enrolled in the study.124 and 117 ol them were positive for mycobaeterium growth by BACTEC MGIT 960 and 1.1 culture method,respectively.From BACTEC MGIT 960 positive media of 124 isolates.117 were randomly taken to perform Capilia TB Neo lest.From these 7(6%) of them were found to be NTM and 110(94%) were MTBC.From these 110 MTBC isolates,81 of them were randomly taken and run by the deletion typing RD9 PCR method of molecular technique.Out of these 78(96.3%) were found to be species of Mycobacterium tuberculosis and 3(3.7%) were found to be not in the MTBC.Regarding the types of methods of culture media.Mycobacteria Growth Indicator Tube(BACTEC MGIT 960) method was found to have excellent agreement(with kappa value ol 0.78) with the routine method of LJ.Conclusions:Pulmonary tuberculosis suspected cases visiting the National Tuberculosis Reference Laboratory at EHNR1 that were confirmed to be pulmonary tuberculosis are caused by the species of Mycobacterium tuberculosis.hence treatment regimen including pyrazinamide can be applied to the patients as the first choice in the study area in Addis Ababa.Ethiopia.There is indication of the presence of NTM in patients visiting the tuberculosis reference laboratory and this is important because NTM is known lo cause pulmonary disease similar with sign and symptom ol pulmonary tuberculosis but different in treatment.BACTEC MGIT 960 has excellent agreement with LJ media but it has high tendency of having high contamination rale unless a better decontamination method is designed.

Imaging, pathology, and diagnosis of solitary fibrous tumor of the pancreas: A case report and review of literature

BACKGROUND A solitary fibrous tumor(SFT)is often located in the pleura,while SFT of the pancreas is extremely rare.Here,we report a case of SFT of the pancreas and discuss imaging,histopathology,and immunohistochemistry for accurate diagnosis and treatment.CASE SUMMARY A 54-year-old man presented to our hospital with pancreatic occupancy for over a month.There were no previous complaints of discomfort.His blood pressure was normal.Blood glucose,tumor markers,and enhanced computed tomography(CT)suggested a malignant tumor.Because the CT appearance of pancreatic cancer varies,we could not confirm the diagnosis;therefore,we performed endoscopic ultrasound-guided fine-needle biopsy(EUS-FNB).Pathology and immunohistochemistry were consistent with SFT of the pancreas.The posto-perative pathology and immunohistochemistry were consistent with the puncture results.The patient presented for a follow-up examination one month after discharge with no adverse effects.CONCLUSION Other diseases must be excluded in patients with a pancreatic mass that cannot be diagnosed.CT and pathological histology have diagnostic value for pancreatic tumors.Endoscopic puncture biopsy under ultrasound can help diagnose pancreatic masses that cannot be diagnosed preoperatively.Surgery is an effective treatment for SFT of the pancreas;however,long-term follow-up is strongly recommended because of the possibility of malignant transformation of the tumor.

Utilization of Malaria Diagnostic Tests and Receipt of Anti-Malarial Drugs by Febrile Patients Attending Outpatient Clinics of Health Centre IV Facilities in Mukono District, Uganda

Background: Failure to demonstrate the presence of malaria parasites prior to treatment with anti-malarial drugs remains a challenge in Uganda, often resulting into over-prescription of anti-malarial drugs to febrile patients suspected of malaria. The aim of this study was to describe the role of utilization of malaria diagnostic tests and associated factors in the receipt of anti-malarial drugs among febrile patients suspected of malaria. Methods: In a cross-sectional study design, client-exit interviews with febrile patients and key-informant interviews with purposively selected health workers were conducted at outpatient clinics of health centre IV facilities in Mukono district. Data entry and analysis were done using EpiData 3.2 and STATA 10 respectively. Data were described using frequency distributions and proportions. Chi square was used in two by two tables, odds ratios as the measure of association and an alpha level of 0.05 was used in all significance tests. Results: Out of 408 respondents, the majority were female (252, 61.8%) and a third of the samples were aged five years and below. The mean age in years was 3.3 with a standard deviation of 2.1. More than half of the respondents (359, 88%) utilized malaria diagnostic tests and about half (241, 59%) received anti-malarial drugs. There were no statistically significant differences between utilizers and non-utilizers in most characteristics except age, history of indoor residual spraying and perceived satisfaction with services at outpatient clinics. Utilizers were 75% less likely to receive anti-malarial drugs than non-utilizers after controlling for age, sex and residence (OR: 0.25, 95%CI: 0.09, 0.66). Frequent power cut-offs as well as limited knowledge on malaria treatment guidelines amongst laboratory personnel were some of the major limitations to microscopic diagnosis of malaria. Conclusion: Utilizers were 75% less likely to receive anti-malarial drugs as opposed to non-utilizers. This implies that increasing utilization of malaria diagnostic tests can reduce the problem of over-prescription of anti-malarial drugs by 75% among those tested for malaria, since anti-malarial drugs would be received by only those with a parasi- tologically-confirmed diagnosis of malaria. Policy implications: To overcome the problem of over-prescription of anti-malarial drugs, there must be a policy that ensures a consistent power supply in all public health laboratories. Training of health workers should encompass all cadres and work-shifts for laboratory personnel should be established to enhance utilization of malaria diagnostic tests especially at night.

Association between Occupational Change Trajectories and Mental Health: Results from the Korean Longitudinal Study of Aging

Objectives:This study was to longitudinally investigate the association between occupational change trajectories and mental health in the Korean population aged 45 years and older from the Korean Longitudinal Study of Aging(KLo-SA).Methods:After excluding missing values,the data of 6,224 participants from thefirst to eighth waves of the KLo-SA were analyzed using t-test,Analysis of variance(ANOVA),Group-based Trajectory Model(GBTM)from 1–5th KLoSA and Time-Lagged Generalized estimating equation(GEE)model from 5–8th KLoSA to analyze the association between occupational change trajectories and mental health in the Korean population aged 45 years and older.Results:An analysis of the association between occupational change trajectories and mental health demonstrated that,among all age group,the“sustained in unemployment”group had a worse MMSE and CESD score compared to“sustained WC”group.unlike the under-54 age group,those aged≥55 years demonstrated reductions in the MMSE and CESD scores in the sustained unemployment and the changed working condition from Standard BC to Unemployment groups,whereas those who underwent a change from the Standard WC to unemployment group only demonstrated a reduction in MMSE scores.Conclusions:There was a close relationship between occupational change trajectories and mental health.Therefore,this study can serve as the foundation for policies and institutional measures to manage the deteriorate mental health in the late middle-aged and older population.

Determinants of Male Coital Difficulties among Attendees of the Gynae Clinic at a Tertiary Health Center in North-Central Nigeria

Background: Male sexual or coital difficulties are among the factors contributing to infertility in couples seeking fertility as this may result in low coital frequency. Aims/Objectives: To evaluate the causes of male sexual or coital difficulties among couples attending the infertility clinic at BSUTH, Makurdi over a 2 year period. Methodology: This was a cross-sectional study involving all males attending the infertility clinic at Benue State University Teaching Hospital (BSUTH) who consent to participate in the study. A pretested structured questionnaire was administered and analyzed with statistical package for social sciences (version 23.0) and the results were presented in simple proportions. Results: There were several factors responsible for male coital difficulties. The most common was male erectile dysfunction 33 (32.4%), vaginismus 11 (10.8%), penile pain 14 (13.7%), poor response from the female partner 8 (7.8%) and severe dyspareunia 18 (17.1%). Conclusion: Coital difficulties resulting to low frequency of sexual exposure constitutes a major cause of infertility among males attending the infertility clinic at BSUTH, Makurdi. Therefore efforts should be made to evaluate these factors while assessing infertility couples in order to mitigate the effect.

Expanding public health professionals’ roles in promoting and supporting breastfeeding as optimal infant feeding: A pilot study with online tutorial implications

Background: Their knowledge of preventive health, coupled with their dynamic roles in the community, puts public health professionals in a key position to expand their roles in the health promotion and support of breastfeeding as optimal infant feeding. This online tutorial was created to increase public health professionals’ knowledge about breastfeeding and to assess their attitudes in supporting healthy behaviors related to infant feeding as a health promotion strategy. Method: The study utilized an online breastfeeding tutorial based on the US Breast-feeding Committee recommendations for minimum breastfeeding knowledge for health professionals. Pre- and post-tutorial questionnaires assessed breastfeeding knowledge, and an attitudinal survey evaluated attitudes of public health professionals after the tutorial. Exposing public health students to this information can facilitate the early shaping of their attitudes and understanding about the importance of breastfeeding. Results: Fifty-two Northeastern University MPH students and alumni (62% response rate) completed the study. There was an overall gain in participants’ fundamental knowledge regarding breastfeeding as assessed by pre- (77%) to post-tutorial (97%) correct responses (p = 0.00001). The post-tutorial attitudinal survey showed that 92% of participants were comfortable in answering questions about breastfeeding as part of their professional responsibilities. Conclusion: This pilot study highlights the important role that a short online tutorial can play in expanding public health professionals’ knowledge about breastfeeding. Greater use of online methods can enhance awareness of critical health behaviors, such as breastfeeding, that have not received adequate attention in public health curricula. This pilot study provides the foundation for a larger study. Integration of breastfeeding into public health professionals’ core training could support broader social change.

Survival and Its Predictors among Tuberculosis Patients on Treatment in Selected Health Centers of Addis Ababa, Ethiopia: A Retrospective Cohort Study

Tuberculosis is one of the leading causes of morbidity and mortality globally. Although different strategies have been designed and implemented to combat it, it has continuously increased in the past five years, resulting in 10 million new cases and 1.6 million deaths. This study aims to estimate survival and predictors among tuberculosis patients on treatment in selected health centers in Addis Ababa, Ethiopia. The study employed a retrospective cohort design where data were collected by reviewing medical records of tuberculosis patients who were registered from May 2016 to May 2017 on treatment in 20 selected health centers in Addis Ababa. Independent predictors were identified, and the strength of association between dependent and independent predictors was determined using the Weibull regression model. Before computing Weibull regression analysis, Cox proportional assumption, model diagnosis, and fitness were checked. The hazard ratio was calculated to indicate the strength of association. Of 371 TB patients, about 136 (36.7%) died during the treatment period. Most TB deaths occurred during the intensive phase, and the overall estimated median survival time was 157 days. In the multivariable Weibull model, age (HR = 0.98), baseline weight (HR = 0.96, P = 0.03), tuberculosis treatment phase (continuation phase, HR = 0.48), and tuberculosis type (pulmonary negative TB, HR = 19.92) were found to be independent predictors of time to death of tuberculosis patients. Finally, the study concluded that the survival time to death of the patients is high. The health care providers should give special attention and follow up for pulmonary negative and underweight TB patients.

The Sustainable Development Goals (SDGs) and Its Promises for the Sexual and Reproductive Health of Girls and Women in Africa

The United Nations Sustainable Development Goals take into account the economic, social and environmental challenges of our world. In relation to the sexual and reproductive health and rights (SRHR) of girls and women, the Sustainable Development Goals provide a platform for the enhancement of the SRHR of adolescents and women, especially in Africa. The promises of SDGs are to eliminate gender disparities in the education sector and to ensure equal access at all levels particularly for the vulnerable girls and women in Africa. The SDGs promise to ensure healthy lives and promote well-being for all at all ages through universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes. Predictably, few years down the line, most African countries have not demonstrated sufficient commitment and political will towards the realisation of these noble goals. The reproductive and sexual health of concerned girls and women in Africa that have been deliberately relegated for several decades can no doubt be redeemed by the SDGs. We advocate to Governments, non-governmental organisations and stakeholders in Africa to work towards the realisation of the SDGs and for more sensitization to enable African women live a happy and fulfilled life devoid of discrimination, sexual abuses or exploitations, injustice as well as unequal access to economic, political and reproductive health services.

Characterization of Tuberculosis Cases Presenting in a Tertiary Healthcare Facility in South-Eastern Nigeria

Background: Tuberculosis is second only to HIV/AIDS as the greatest killer worldwide, due to a single infectious agent. Directly Observed Treatment Short-Course (DOTS) is presently the WHO recommended programme to fight tuberculosis worldwide. There is need to understand the characteristics of patients who receive treatment for tuberculosis. This will help modify the strategies to fight the scourge of tuberculosis. Methods: This was a retrospective study conducted at the DOTS clinic at Nnamdi Azikiwe University Teaching Hospital Nnewi, Anambra State, Nigeria. The records of patients who received treatment from the clinic from 1st January 2012 to 31st December 2012 were reviewed. Three hundred and fifteen patients were included in the study. Important characteristics of the patients were retrieved. Associations between patients’ characteristics were determined using relevant tests of significance. Results: Three hundred and fifteen patients were included in the study. There were more male patients (59%). The reproductive age group (37.5%) was more than the other age groups. Mean age was 33.1 (±18.5) years. There were more rural patients (50.2%) than urban patients (49.8%). There were more pulmonary TB patients (87.3%) than extrapulmonary TB patients (12.7%). There were more sputum AFB negative patients (45.4%) than positive patients (41.3%). There were more HIV negative patients (59.4%) than positive patients (40.6%). Conclusion: This study demonstrated some important characteristics of tuberculosis patients. Such knowledge if taken into consideration in the tuberculosis control programme will definitely improve the outcome of the programme.

Barriers and Facilitators of Adherence to Anti-Diabetic Therapy in Pregnant Women with Diabetes: Health Care Workers’ Perspectives

Global prevalence of hyperglycaemia in pregnancy in women of 20 - 49 years was estimated to be 16.9% and affecting 21.4 million live births, in 2013, 90% of which occurred in developing countries. The cornerstone of anti-diabetic therapy is diet, physical activity and medications. The study utilized a qualitative descriptive design using key informant interviews from August 2016 to November 2016 to explore challenges of adherence to anti-diabetic therapy in pregnant women with diabetes at a central hospital in Harare, Zimbabwe. Permission to conduct the study was obtained from the respective local and national ethical review boards. All participants gave verbal and written informed consent. A sample of eight key informants directly involved in the care of pregnant women with diabetes was purposively selected for key informant interviews. Key informants should have worked with diabetic pregnant women for at least one year. Sample size was determined by data saturation. Interviews followed a semi structured questionnaire that had sections on the burden of diabetes in pregnancy, challenges of adherence, challenges in management and possible solutions to challenges faced. All interviews were conducted in a private room. Detailed notes were taken during the interviews which were also being audiotaped. Trustworthiness was achieved by observing credibility, dependability, transferability and confirmability. Thematic analysis was done. Thematic analysis was done manually. The stages of data analysis followed were data organization, familiarization, transcription, coding, developing a thematic framework, indexing, displaying and reporting. Major themes identified were barriers and facilitators of adherence to anti-diabetic therapy. Categories under barriers were financial barriers, lack of health education, lack of trained personnel, shortage of staff and lack of collaboration among practitioners. Categories under facilitators of adherence were subsidization of care, formal training of professionals, promoting collaboration and establishment of a unit dedicated to the care of pregnant women with diabetes. Barriers and solutions identified should be utilized to develop frameworks to promote adherence to anti-diabetic therapy incidence of adverse perinatal outcomes.

Beyond Nutrition Recommendations: What Healthcare Professionals Should Know about Dietary Supplements to Best Serve Their Patients

Although whole food nutrition will likely influence physical health more than any other lifestyle component besides exercise, the use of dietary supplements among men and women continues to be high. Due to this fact, it is imperative that healthcare professionals understand how supplements may impact overall health and wellness of their patients. With the majority of adults taking some form of dietary supplements and many concomitantly taking prescription medications, healthcare providers should be conscientious of adverse effects and interactions that may occur between dietary supplements and prescription drugs. As many consumers are misled by false marketing, healthcare providers should encourage them to be wary of exaggerated claims and direct them to products that are scientifically supported and safe. Continuing education for healthcare providers on dietary supplements is crucial, with new dietary supplement products constantly reaching the markets, in addition to new findings being made through clinical research and case studies. While some dietary supplements provide no meaningful benefit, many dietary supplements have been identified that can be used to ameliorate nutritional deficiencies and reduce the risk of some common health conditions. Others can serve to improve mental and physical performance, while truly enhancing health. This article presents relevant information on dietary supplements that will be useful to the healthcare professional.