Evaluation of the HIV Case-Based Surveillance System: A Pilot of the Electronic Health Record System in Mutare District, Zimbabwe, 2021

Background: Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. Methods: We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. Results: The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). Conclusion: The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.

Is There a Correlation between Body Weight and Awareness of Healthy Life Style Components in Children?

Background: Incidence of obesity in children is increasing worldwide. Healthy eating and exercise are the major components of a healthy life style in the community. Objective: we aim to assess the knowledge of healthy eating and exercise in children?of varying weight?and to explore the correlation between knowledge and bodyweight. Method: School children are invited to fill in a 2 questions quiz about healthy life style.?BMI is calculated and children are classified into obese, overweight, normal and underweight. Answers are scored and results compared for different categories of the BMI. Results: 445 children participated. Age range (mean) was 7 - 13 (10) years. 67 were obese, 59 overweight, 237 normal weight and 34 were underweight. In the food question, 22%, 20%, 23% 15% of obese, overweight, underweight and normal weight children respectively gave wrong answers compared to 17.5%, 15% and 14.7%, 13.3% for the exercise question. Neither of the results was statistically significant. Boys are more knowledgeable about exercise than girls (P = 0.03). Conclusion: There is no difference in the level of knowledge about healthy eating and exercise among children with varying body weights. Tackling children behavior and attitude towards food and exercise is as important as improving their knowledge.

Is metaphyseal ulnar shortening osteotomy superior to diaphyseal ulnar shortening osteotomy in the treatment of ulnar impaction syndrome?A meta-analysis

BACKGROUND Although metaphyseal ulnar shortening osteotomy(MUSO)is safer for the treatment of ulnar impaction syndrome(UIS)than diaphyseal ulnar shortening osteotomy(DUSO),DUSO is widely used for UIS treatment.AIM To evaluate the effectiveness of DUSO and MUSO for UIS treatment and determine the factors that should be considered when choosing surgical treatment for UIS.METHODS Articles comparing the effectiveness of DUSO and MUSO for UIS treatment were systematically retrieved from MEDLINE(Ovid),PubMed,EMBASE,and Cochrane Library.The demography,incidence of complications,secondary operation rate,postoperative DASH score,wrist pain on the visual analogue scale,and grip strength improvement were also evaluated.In addition,the correlation between the improvement of grip strength and the shortening of osteotomy length of ulna was analyzed.The outcome of the patient was discontinuous,and the odds ratio,risk ratio(RR),and 95%CI were calculated and analyzed via RevMan5.3 software.RESULTS Six studies,including 83 patients receiving MUSO(experimental group)and 112 patients receiving DUSO(control group),were included in the meta-analysis.The second operation rate was significantly higher after DUSO than after MUSO.The DASH scores were slightly lower in the MUSO group than in the DUSO group.The patients receiving MUSO had slightly better pain relief effect than patients receiving DUSO.However,the incidence of complications and improvement of grip strength were not significantly different between the two groups.CONCLUSION Although DUSO and MUSO provide similar effects for UIS,MUSO is associated with a lower secondary operation rate,slightly lower postoperative DASH scores and slightly better pain relief effect than DUSO,indicating that MUSO can effectively be used for UIS treatment.

Molecular Genotyping of Human Papillomavirus (HPV) in Hypopharyngeal Cancer

Background: In recent years, head and neck cancers have become common worldwide, ranking sixth in incidence. In 2007, in France the incidence increased by 14,697 including 11,158 among men, which places them in fourth place. The same year, 32,268 patients were hospitalized for this pathology, but 95% are associated with alcohol and tobacco poisoning. Few data exist on these cancers in Africa and Senegal. In recent years, many studies have hypothesized that about 25% of head and neck cancers are associated with high-risk oncogenic human papillomaviruses (HPV) whose role in cervical cancer was already widely established. Objective: To know the prevalence and genotypes of HPV in head and neck cancers, particularly hypopharyngeal cancer. Material and method: This study was carried out on samples of biopsies of hypopharynx cancerous tissue (ulcerative-budding lesion) and healthy oropharyngeal tissue obtained from the ENT department of the Fann hospital, then sent to the Molecular Biology Unit of the Ouakam military hospital (HMO). The nucleic acids extraction was carried out using the standard method of the Zymo research kit “Quick-DNATM Miniprep Plus kit” https://www.zymoresearch.com/. Molecular HPV detection and genotyping were performed by multiplex RT-PCR with the Seegene AnyplexTM II HPV28 kit Detection on a Biorad CFX96 automaton according to the manufacturer’s protocol for the simultaneous genotyping of 28 types of HPV including 19 at High Risk (HR) and 9 low risk (LR). Results: 156 patients were sampled, 61 Hypopharynx cancer biopsies and 95 healthy tissues. The median age of the general population was 36.5 years [12, 73];the median age of the population with hypopharyngeal cancer of 40 years. Of the general study population 24.36% (38/156) was infected with HPV. In populations with hypopharyngeal cancer, HPV prevalence was 19.67% (12/61), 17.84% (5/28) in men and 21.21% (7/33) in women. HPV6 was the most frequently encountered genotype in the cancer population. Multiple infections have also been noted in cancer patients: HPV6+HPV18, HPV6+HPV56. For patients without hypopharyngeal cancer, the HPV prevalence was 27.36% (26/95), 9.59% (7/73) in women and 89.36% (19/22) in men. Several types of HPV-HR genotypes (HPV18, HPV26, HPV69), and HPV-LR genotypes (HPV42, HPV43, HPV70, HPV6) have been detected in healthy patients but also cases of co-infections (HPV6+HPV69;HPV56+HPV44;HPV58+HPV18). Conclusion: Our results showed a higher prevalence of HPV in non-cancer patients compared to hypopharyngeal cancer patients. The genotypes (HPV 6, 18 and 56) were observed in the study population. Molecular genotyping does not show a significant involvement of HPV in hypopharyngeal cancer.

Prevalence and Factors Associated with HIV Serodiscordance among Infected Couples in the City of Parakou (Benin)

Introduction: Achieving the goal of “zero new human immunodeficiency virus (HIV) infections by 2030” requires the elimination of HIV transmission within serodiscordant couples. In Benin, the phenomenon of HIV serodiscordance remains poorly documented. Objective: the aim of this study was to determine the prevalence of HIV serodiscordance and its associated factors among infected couples in the city of Parakou. Study Framework and Method: This was a descriptive cross-sectional study with an analytical focusing on qualitative and quantitative plans. It was carried out on thirty approved sites in the city of Parakou between July and December 2022. We used a non-exhaustive convenience sample of people living with HIV (PLHIV) whose partner’s status was known. Data collection took place in two phases: an interview phase during which sociodemographic, economic, behavioral and marital/social data were collected. The second phase focused on clinical and therapeutic data which were collected from the patients’ personal records. Results: A total of 417 study subjects were recruited. The average age (SD) of the subjects was 38.17 (±10.25) years [37.19 - 39.16]. Females accounted for the largest proportion (79.62%). Most respondents (74.11%) were married. Monogamous unions were the most frequent, involving 67.87% of participants, most of whom (44.60%) had been infected for between 1 and 5 years. Couples in union for less than 10 years were the most numerous (218 people or 52.28%). The respondent was head of household among only 140 respondents (33.57%) of which 84 men (60.00%) and 56 women (40.00%). Female heads of household were mainly divorcees and widows. Around 75% of PLHIV had monthly incomes of less than 50,000F CFA (81.16 USD). Prevalence of HIV serodiscordance was 71.70%. It was 70.91% [65.54% - 76.28%] at care sites and 73.24% [65.95% - 80.52%] at sites involved in preventing mother-to-child transmission (PMTCT sites). Potential predictors of HIV serodiscordance were: household head status;serostatus of last child;duration of relationship;multiple and occasional sexual partners;sharing serostatus with spouse;duration of couple relationship;spouse’s extramarital relationships and strained relations with children. Conclusion: Response strategies against the HIV pandemic need to be reshaped to better supervise the follow-up of HIV serodiscordant couples in the city of Parakou specifically and in Benin in general.

pregnane X receptor and constitutive androstane receptor modulate differently CYp3A-mediated metabolism in earlyand late-stage cholestasis

AIM To ascertain whether cholestasis affects the expression of two CYP3 A isoforms(CYP3 A1 and CYP3 A2) and of pregnane X receptor(PXR) and constitutive androstane receptor(CAR).METHODS Cholestasis was induced by bile duct ligation in 16 male Wistar rats; whereas 8 sham-operated rats were used as controls. Severity of cholestasis was assessed on histological examination of liver sections, and serum concentrations of albumin, AST, ALT, GGT, ALPK and bilirubin. Gene and protein expressions of PXR, CAR, CYP3 A1 and CYP3 A2 were assessed by means of q RT-PCR and Western blot, respectively. Alterations in CYP3 A activity were measured by calculating the kinetic parameters of 4-OH and 1'-OH-midazolam hydroxylation, marker reactions for CYP3 A enzymes.RESULTS The m RNA and protein expression of CYP3 A1 increased significantly in mild cholestasis(P < 0.01). At variance, m RNA and protein expression of CYP3 A2 didn't change in mild cholestasis, whereas the expression and activity of both CYP3 A1 and CYP3 A2 decreased dramatically when cholestasis became severe. Consistently with these observations, the nuclear expression of both PXR and CAR, which was measured because they both translocate into the cell nucleus after their activation, virtually disappeared in the late stage of cholestatic injury, after an initial increase. These results indicate that early-and late-stage cholestasis affects CYP3 Amediated drug metabolism differently, probably as consequence of the different activation of PXR and CAR.CONCLUSION Early-and late-stage cholestasis affects CYP3 Amediated drug metabolism differently. PXR and CAR might be targeted therapeutically to promote CYP3 Amediated liver detoxification.

Women’s Motivation and Associated Factors for Herbal Medicine Use during Pregnancy and Childbirth: A Systematic Review

Background: Herbal medicines use has prevailed over the past decades in both low-middle-income and high-income countries over the years. The use among women has increased with increased risks of ill-health. There is extensive literature on herbal medicine use among women in pre/pregnancy, labour, and the postpartum periods. Therefore, this study aimed to understand women’s purposes, experiences, and motivation for using herbal medicines during pregnancy, childbirth and postpartum, and the experiences associated with the use. Methods: Four critical databases were predetermined and searched: CINAHL, Medline, Web of Science, and EMBASE. These databases were chosen for their comprehensiveness and relevance to the review aims. We considered peer-reviewed published articles from January 2000 to December 2018. We chose these databases because we found that they are dominant in the medical and healthcare-related literature. All references were pooled to Endnote reference management software for screening. Quality appraisal of articles was conducted using the Mixed-Method Assessment Tool (MMAT). Content analysis approach was used to extra the data from the articles. Globally, twenty-one articles met the inclusion criteria, and thus, formed the dataset for this review. Results: Most articles (n = 10, 47.6%) reported solely HM uses on only pregnancy whiles the rest evaluated HM uses in labour, pre-pregnancy, and the postpartum periods. The results have shown that the majority of women received information about HM from friends, family, the “black markets,” and drug outlets. Overall, the results were presented in seven broad themes: 1) sociodemographic characteristics of HM users, 2) perceived threat of health problem, 3) sources and quality of the information received, 4) susceptibility to health complications, 5) potential limitations to the use of HM, 6) the motivation for HM utilization, 7) concerns on the combined use of herbal and allopathic medicines. Conclusion: The study recommends the further research into the toxicity of herbal products, to ensure that accurate information can be provided to women before use.

Anopheles gambiae larvicidal and adulticidal potential of Phyllanthus amarus(Schumach and Thonn,1827)obtained from different localities of Nigeria

Objective:To screen phytochemicals in ethanolic leaf extracts of Phyllanthus amarus collected from three different geographical zones in Nigeria and evaluate their effects on larva and adult of Anopheles gambiae.Methods:The sample extracts of Phyllanthus amarus prepared with ethanol solvent were tested against Anopheles gambiae at two important developmental stages of its life cycle using slightly modified WHO protocols.Results:Alkaloids,saponins,tannins,flavonoids,glycosides,phenols,and terpenes were detected in each extract.Among these samples,the extract from northwest exhibited the highest larvicidal activity(LC50=263.02 ppm),followed by southeast and southwest extracts(LC50=288.40 and 295.12 ppm,respectively after 48 h),while the extract from southwest exhibited the highest adulticidal activity(LC50=275.42 ppm),followed by northwest and southeast extract(LC50=301.99 and 316.22 ppm,respectively after 24 h).A 50%larva mortality was almost attained at 600 ppm after 48 h duration of exposure to the northwest extract.Conclusions:The tested samples possess strong larvicidal and adulticidal property against Anopheles gambiae which depends on their chemical composition and localities of collection.Further studies are needed to explore the insecticidal activity against a wider range of mosquito species,and to identify active ingredient(s)of the extract responsible for such activity.

Exercise-induced anaphylaxis with an Ayurvedic drug as cofactor:A case report

BACKGROUND The practice of Indian Ayurvedic medicine is spreading in Western countries and Shilajit is one of the most used drugs, for its antioxidant activities and immunomodulatory effects. Albeit Shilajit has showed a high degree of safety, it can act as cofactor of anaphylaxis, especially in condition at high risk, such as mast cell activation syndrome(MCAS). We reported this case to sensitize practitioners to investigate to the use of complementary and alternative medicine,in case of exercise-induced anaphylaxis(EIAn).CASE SUMMARY A 43-year-old woman, working as a dance teacher, developed urticaria after ingestion of rice, tuna and Shilajit, which did not respond to intramuscular corticosteroids. Subsequently, she developed dyspnoea and hypotension with loss of consciousness that arose 1 h after sexual activity. The patient did not refer personal history of atopy. Specific IgE for main food allergens resulted negative,with total IgE levels of 14 IU/L. Oral provocation test with Shilajit was not perfomed because the patient refused, but we performed prick-by-prick and patch test that resulted negative. Serum tryptase at the time of anaphylaxis was 20.6 μg/L that fell down to of 10.6 μg/L after therapy, but has remained at the high value after two days and during the follow-up. We performed an analysis of the c-KIT gene in peripheral blood, which was negative. We felt the diagnosis consistent with EIAn in a patient with a possible MCAS.CONCLUSION In Western countries the use of drugs from Ayurvedic medicine is more common than in the past. These substances can be cofactors of anaphylaxis in patients with risk factors.

Prevalence of latent eosinophilia among occupational gardeners at Babcock University,Nigeria

Objective: To determine the level of eosinophils present in the blood and sputum samples, presumably as a result of continual occupational exposure to allergens while on duty, as gardeners at Babcock University, Nigeria.Methods: Haemocytometer and Olympus microscope were utilized to estimate eosinophils population in 44 blood samples and 21 sputum samples respectively.Results: Relationship between the occurrence of eosinophil in blood and the exposure period among Babcock University gardeners had a positive correlation(r = + 0.08,t = 4.55, P < 0.05). It was found that blood eosinophil count in these workers correlated with the length of exposure period.Conclusions: The nature and the gardening activities are not a risk factor that significantly affect eosinophil level but duration of exposure to allergens. However, all safety precautionary kits and wears should be enforced and embraced by the concerned occupational gardeners so as to avert and subvert its pre-disposing deleterious effect on them.

Molecular Genotyping of Human Papillomaviruses (HPV) in HIV+ and HIV−Women in Senegal

Background: Different studies have demonstrated high prevalence of HPV infection and dysplastic lesions of the cervix in immunocompromised patient such as women living with HIV. Is this high prevalence due to a greater susceptibility to HPV infection, which is known to be frequent in its latent form in women? Objective: This study aims to identify HPV genotypes in HIV+ and HIV&minus;women to understand HPV molecular epidemiology in Senegal. Material and Method: Endocervical samples from 331 HIV+ and HIV&minus;women, sexually active, were collected. The molecular identification of the 28 genotypes studied (19 HPV-HR and 9 HPV-LR) was carried out after DNA extraction, by multiplex PCR with the Anyplex&trade;II HPV28 detection kit from Seegene on CFX96&trade;Bio-Rad machine. The comparisons were made by calculating the p-value and odds ratio with R Studio software (version 4.1.0). The results were considered significant if p Results: The general prevalence of HPV was significantly higher in HIV+ women with 78.95% vs 64.65% for HPV;72.18% vs 57.07% for HPV-HR;57.14% vs 34.34% for HPV-BR (p &minus;women. Conclusion: Our results showed that the prevalence of HPV, HPV-HR and HPV-BR was significantly higher in HIV+ women. Non-vaccine genotypes were among the most found genotypes. Groups of HIV+ women aged between 35 and 50, married and using contraception were significantly more infected with HPV than the same groups of HIV-women.

High fecal calprotectin levels are associated with SARS-CoV-2 intestinal shedding in COVID-19 patients:A proof-of-concept study

BACKGROUND One third of coronavirus disease 2019(COVID-19)patients have gastrointestinal symptoms.Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)RNA has been detected in stool samples of approximately 50%of COVID-19 individuals.Fecal calprotectin is a marker of gastrointestinal inflammation in the general population.AIM To investigate if fecal calprotectin correlates with SARS-CoV-2 intestinal shedding in COVID-19 patients with pneumonia.METHODS Patients with SARS-CoV-2 pneumonia admitted to the Infectious Disease Unit(University Hospital of Trieste,Italy)from September to November 2020 were consecutively enrolled in the study.Fecal samples were collected and analyzed for quantification of fecal calprotectin(normal value<50 mg/kg)and SARS-CoV-2 RNA presence by polymerase chain reaction(PCR).Inter-group differences were determined between patients with and without diarrhea and patients with and without detection of fecal SARS-CoV-2.RESULTS We enrolled 51 adults(40 males)with SARS-CoV-2 pneumonia.Ten patients(20%)presented with diarrhea.Real-time-PCR of SARS-CoV-2 in stools was positive in 39 patients(76%),in all patients with diarrhea(100%)and in more than two thirds(29/41,71%)of patients without diarrhea.Obesity was one of the most common comorbidities(13 patients,25%);all obese patients(100%)(P=0.021)tested positive for fecal SARS-CoV-2.Median fecal calprotectin levels were 60 mg/kg[interquartile range(IQR)21;108];higher fecal calprotectin levels were found in the group with SARS-CoV-2 in stools(74 mg/kg,IQR 29;132.5)compared to the group without SARS-CoV-2(39 mg/kg,IQR 14;71)(P<0.001).CONCLUSION High fecal calprotectin levels among COVID-19 patients correlate with SARSCoV-2 detection in stools supporting the hypothesis that this virus can lead to bowel inflammation and potentially to the‘leaky gut’syndrome.

Designing a Need Based Social Protection Intervention Package for Children and Adolescents Living with HIV and AIDS in Ghana—An Eclectic Perspective on Desired Social Protection Intervention Package/Framework

Background: Designing a need-based social protection intervention for children comes as comprehensive tool for addressing the overall quality of life of HIV positive children. Not much has been examined on what constitute the desired social protection framework for HIV positive children. Methods: This study was informed by a qualitative descriptive exploratory design approach. The study drew insights from the shared perspectives of 27 participants sampled from positive HIV status disclosed children—10 - 17 years, healthcare workers, Social and Development worker, HIV positive caregivers and parents from 7 ART clinics in rural and urban Brong Ahafo and Ashanti regions of Ghana. Data was collected through interviews and two focus group discussions with study participants. Drawing on the emerged themes from the transcripts, thematic content analysis was used to analyze the data using comparative thematic framework approach. Findings: The eclectic perspectives on the type of social protection policy/intervention preferred demonstrated the need for an interrelated and integrated social protection policy. This should not be designed in isolation towards addressing the child vulnerability. The study found that social protection policies aimed at addressing vulnerability levels of children should consider the dual vulnerability situation within which HIV positive children and adolescents are located. A set of unique specific tailored approach and package reflecting minimum combination social protection package to HIV positive children was considered essential for inclusion. The themes that emerged covered social policy/intervention package inclusive of a disease ending/eradication intervention package, cash transfer for children and their caregivers, free comprehensive health insurance integrating all consultancy and laboratory services charges, direct food supplements supply and nutritional support, research, target specified with evidenced-based monitoring. Counseling support and preferential treatment for children visiting ART for treatment were to be included. Conclusion: Combination social protection intervention packages remain the pathway to yielding maximum dividends on any social intervention that seeks to address the vulnerability levels of HIV positive children in Ghana. This should be designed taking into consideration the preference of the main target beneficiaries (HIV positive children) while accounting for the inclusion of the technical expertise of implementing stakeholders in the policy design from conceptualization to evaluation.

Parental Disclosure of Own HIV Status to Children in Two Ghanaian Regions;Examining the Determinants within a Child Vulnerability Context

Purpose: Parent informing children and adolescents about their own HIV infection status is crucial for harmonious and interfamilial relationship despite the associated dilemma. This study assessed the factors associated with parental disclosure of own HIV status to their biological children. Methods: The facility based cross-sectional design approach informed the recruitment of 192 HIV positive parents. This was done through a two-stage stratified (rural/urban) and random sampling technique across 7 ART clinics and hospitals in the Ashanti and Brong Ahafo regions in Ghana between June 2018 and June 2019. Data was collected through interviewer-administered structured questionnaires. Parental disclosure to children was defined as parent own verbal statement of having mentioned HIV or AIDS as the name of his/her illness to at least one of his or her biological children. The study compared weighted proportions for variables measured categorically by the use of chi-square (χ2) significant at P Results: Of the 192 HIV positive parents aged 20 to 64 years (M, SD = 38.56, 8.34), 89.1% were females, averagely having 3 children with 89.5% having only one child being HIV positive, out of which one in every four parent was without formal education. Parental disclosure to biological children was 11% while parental own status disclosure to any child under the parent’s care was 14.6%. Parental disclosure was associated with being married or living with a sexual partner (OR = 3.4;95% CI: 1.08 - 10.66, P Conclusions: Only a tenth of all HIV positive parents had told their children about their own (parents) HIV status. Parental disclosure should be encouraged and interventions designed to improve it particularly as they contribute to shaping the vulnerability context of HIV and AIDS positive children.

Active Case Finding of Pulmonary Tuberculosis among Prison Inmates in Aba Federal Prison, Abia State, Nigeria

Background: Conditions in prisons favour rapid transmission of Mycobacterium tuberculosis and progression to tuberculosis (TB) disease, resulting in higher prevalence rates of TB in prisons than in the corresponding general population. However, in many developing countries with high TB burden, passive case-finding remains the usual approach to case detection of TB in prisons. On this premise, the Abia State TB Control Programme conducted a pilot study to assess the contribution of active case finding to tuberculosis control in Aba Federal Prison. Methods: The inmates were clinically screened and those with symptoms suggestive of TB cases were tested by sputum smear microscopy. Results: Out of the total number of 477 prison inmates present in the prison at the time of study, 449 (94.1%) were clinically screened for history of cough of 2 weeks’ duration;52 (10.42%) met the inclusion criteria for sputum smear microscopy. Eleven of the 52 (21.15%) tested for acid fast bacilli (AFB) by direct smear light microscopy were positive for AFB. One inmate was on anti-tuberculosis therapy;this with the 11 cases detected in the course of this study gave a total of 12 inmates of Aba prison with active pulmonary tuberculosis at the time of this study. This gives a minimum point prevalence rate of 2405 cases per 100,000 prison inmates. Four of the 11 prison cells had at least one smear positive case with 7 of the 11 cases concentrated in two cells. The age group of 25 - 34 years had the highest number of sputum positive cases. Conclusion: Active case-finding resulted in detection of 11 new cases of sputum positive tuberculosis (an increase in detection rate of 1100%) and the prevalence of sputum positive TB is very high (2405 cases per 100,000 prison inmates) in Aba prison. There is an urgent need to institute more effective TB case-finding and control in the prison.

Males as Partners in Family Planning Service Uptake in Ghana: A Descriptive Cross-Sectional Survey

Background: Family planning is an efficient and effective intervention that results in quick benefits for the whole family socio-economically. Differences exist in the rate of contraceptive use between male and female and male involvement of service uptake in Ghana. The objective of this study was to explore male direct involvement and or support to their partners in family planning service uptake. Methods: The study used a descriptive cross-sectional survey to sample 384 men of reproductive age (18 - 45 year) using cluster sampling to enlist participants from within the Suame Magazine light Industrial area in the Ashanti Region of Ghana. Data was analyzed descriptively using SPSS version 16. Results: Men showed very high knowledge (90%) about what constitutes Family Planning, with moderate level of involvement both active and passive involvement (56%) though only a few (38.9%) were presently adopting or using modern contraceptive. The study rather found only 14% (55) males were willing to be solely responsible and actively involved in Family Planning service. Family Planning services did not adequately meet the needs of men with the services centers remaining unavailable in the study area. Conclusion: The extent of male involvement in family planning programmes is marginally above average. Males showed appreciable knowledge of family planning options though misconceptions continued to exist. A more couple-oriented approach to family planning is needed including recruiting males as family planning providers, offering more family planning counseling for couples, and promoting female-oriented methods with men and vice versa.

Prevalence and predictors of smoking in a mining town in Kitwe, Zambia: A 2011 population-based survey

Smoking is one of the major preventable causes of death and non-communicable diseases which include hypertension, cardiovascular diseases and cancers. The aim of the study is to establish prevalence and predictors of smoking so that interventions specific to these communities can be executed to prevent smoking. A cross sectional study was conducted using a modified World Health Organizations Global Non Communicable Diseases (NCD) Surveillance Initiative NCD-STEPs 1 and 2. Multivariate logistic regression was used to examine the determinants of tobacco smoking. A total of 1627 individuals participated in the survey, of which 42.3% were males. About half of the participants were of age 25-34 years (56.0%), and 41.7% had attained secondary level of education. Overall, 8.7% of the participants (18.1% among males and 1.8% among females) currently smoked any tobacco product. Female respondents were 71% (AOR = 0.29, 95%CI [0.21, 0.39]) less likely to smoke cigarettes compared to male respondents. Compared to respondents who had no formal education, respondents who had attained primary level of education were 45% (AOR = 1.45, 95%CI [1.02, 2.08]) more likely to smoke, and those who attained college or university level of education were 57% (AOR = 0.43, 95%CI [0.28, 0.65]) less likely to smoke. Respondents who did not consume alcohol were 50% (AOR = 0.50, 95%CI [0.41, 0.61]) less likely to smoke compared to those who consumed alcohol. The study showed that sex, education, and alcohol consumption were independently associated with Smoking. These are the key determinants which should be considered when designing a health education and awareness campaign to the residents.

An Evaluation of the Adverse Events Following Voluntary Medical Male Circumcision Surveillance System in Zvimba District, Zimbabwe, 2020

Background: The Adverse Events following Voluntary Medical Male Circumcision Surveillance System (VMMC AESS) serves to identify adverse events (AEs) for safe provision of VMMC. In 2019, Zvimba District reported two adverse events out of 542 circumcisions translating to a 0.4% AE rate against an acceptable threshold of 2% and this is suggestive of underreporting. We evaluated the system to verify existence of underreporting of AEs, assess the surveillance system attributes and evaluate data quality. Methods: A descriptive cross-sectional study was conducted using the updated Center for Disease Control (CDC) guidelines for surveillance system evaluation. We proportionately sampled VMMC client intake records and purposively selected health workers involved in the VMMC programme into the study. An interviewer-administered questionnaire was used to collect data from 14 - 30 December 2020 on knowledge of the VMMC AESS among health care workers and surveillance system attributes. We used a checklist to check for data quality. Data were analysed using Epi Info 7 statistical software. Results: Of the 31 health workers that participated in the study, 21 (68%) had fair knowledge of the surveillance system. Out of 384 records reviewed, 104 had missing data on AE monitoring days 7 and 42. Sixteen (52%) of participants regarded filling AE reporting forms as difficult and the process as time-consuming. The surveillance system was not representative as only two out of eight facilities were conducting outreaches in hard-to-reach areas. Conclusion: There was possible underreporting of adverse events as about a quarter of reviewed records had missing data on AE monitoring days and the system’s performance was threatened by poor data quality and unavailability of reporting forms. The system was rendered acceptable though unstable, not representative and not simple and the health workers were not making use of the surveillance system. We recommended retraining on the surveillance system for all health care workers involved in VMMC in Zvimba District.

Antiretroviral Therapy Discontinuation among Adults Receiving HIV Care in Kadoma City in 2015-2019

Background: Discontinuation remains a legitimate threat to the long-term success of antiretroviral therapy (ART) scale-up in Zimbabwe. Furthermore, the characteristics associated with ART discontinuation and trends are poorly understood in developing countries like Zimbabwe. We analysed the HIV/AIDS data to describe the characteristics associated with ART discontinuation and the trends from 2015 to 2019. Methods: We conducted an analytical cross- sectional study using secondary data from Electronic Patient Management System (ePMS) in Kadoma City. We interviewed eighteen health care workers to find the reasons for ART discontinuation. Data were analysed using Microsoft Office Excel 2016 and Epi info 7 version 7.2.2.6. Microsoft office excel was used to generate linear graphs to demonstrate the trends in ART discontinuation in Kadoma City in 2015-2019. Epi info 7 was used to generate frequencies, means, prevalence odds ratios p-values, and 95% confidence intervals (CI) and significance testing. Backward stepwise logistic regression analysis was done to determine the independent factors associated with discontinuation. Results: A total number of 2833 patients were enrolled on ART from 2015 to 2019. One hundred and seventy-three 173/2833 (6.1%) discontinued ART, 415/2833 (14.7%) transferred out, 69/2833 (2.4%) died and 2176/2833 (76.8%) were retained on ART. Out of those who discontinued ART, sixty-five percent (112/173) were females. Approximately two-thirds had immunological failure 110/173 (64%). The trend in ART discontinuation decreased over the years but was not statistically significant (R2 = 0.57, p > 0.05). ART discontinuation was independently associated with being Conclusion: We concluded that the characteristics associated with ART discontinuation were having never attended school, being less than forty years of age and having immunological failure. The reasons why patients discontinue ART were health state not improving, participating in artisanal mining activities, change in marital status, medical side effects of ART, living far from health facilities, and relocating to neighbouring countries. We recommended continuous provision of health education, enhanced adherence counselling sessions to those with unsuppressed viral loads and investigating the cause of virologic failure.

HIV Self-Testing Kits Uptake in Mashonaland West Province, Zimbabwe, 2019-2020: A Secondary Data Analysis

Background: Human Immuno-Deficiency Virus Self-Testing (HIVST) is a process where an individual who wants to know their HIV status collects a specimen, performs a test and interprets the result by themselves. HIVST data from the Zimbabwe AIDS and TB Program (ATP) directorate showed that between 2019-2020, only 31% of the target HIVST kits were distributed in the country. Mashonaland West Province was one of the least performing provinces in meeting targets for HIVST kits distribution. Gaps in the implementation of the HIVST in the province ultimately affect the nationwide scaleup of targeted testing, a key enabler in achieving HIV epidemic control. We analyzed HIVST trends in Mashonaland West Province to inform HIV testing services programming. Methods: We conducted a cross-sectional study using HIVST secondary data obtained from the District Health Information Software 2 (DHIS2) electronic database. We conducted regression analysis for trends using Epi Info 7.2 and tables, bar graphs, pie charts and linear graphs were used for data presentation. Results: A total of 31,070 clients accessed HIVST kits in Mashonaland West Province from 2019-2020. A slightly higher proportion (50.4% and 51.7%) of females as compared to males accessed HIVST kits in 2019 and 2020 respectively. Overall, an increase in the trend of HIVST kits uptake was recorded (males R2 = 0.3945, p-value = 0.003 and females R2 = 0.4739, p-value = 0.001). There was generally a decline in the trend of community-based distribution of HIVST kits from the third quarter of 2019 throughout 2020 (R2 = 0.2441, p-value = 0.006). Primary distribution of HIVST kits remained the dominant method of distribution, constituting more than half of the kits distributed in both 2019 (67%) and 2020 (86%). Conclusion: Mashonaland West Province was mainly utilising facility-based distribution model for HIVST over the community-based distribution model. We recommended training more community-based distribution agents to increase community distribution of HIVST kits.