FACTORS INFLUENCING ATTRITION OF NURSES IN ROYAL VICTORIA TEACHNG HOSPITAL, THE GAMBIA

Background: Human resources are the foundation of a health system and a key prerequisite for improving health outcomes. In recent years, there is a crisis in human resources for health in The Gambia due to high attrition rate of trained health care professionals. As employees leave an organization, they take with them much-needed skills and qualifications that they developed during their tenure. However, understanding the factors that satisfyor dissatisfy nurses can guide the development of interventions that can improve the working conditions and discourage attrition among them. Therefore, the purpose of this study was to determine the factors influencing the attrition of nurses in the Royal Victoria Teaching Hospital (RVTH).Methods: A descriptive study design was used and information was obtained through self –administered questionnaire from a simple randomly selected sample of 75 nurses. Data was analyzed with SPSS version 15 using descriptive and inferential statistics and the significant level was set at 0.05.Results: Findings from the study indicate that 24% of the respondents already left the hospital and 67% of those working with RVTH during the time of data collection reported that they had the intention to leave. Among those who left the hospital, most of them were trained midwives and had working experience of 10 years or more. The study respondents rated the hospital low in meeting their basic human needs. The main factors reported to be contributing to their attritions were low opportunity for promotion, management and financial problems, lack of self-esteem and self-actualization and low sense of love and belonging.Conclusion: The high rate of attrition among nurses in RVTH calls for urgent interventions that will include reviewing the remuneration of nurses and management reform that targets their human needs

Declining Trends of Pneumococcal Meningitis in Gambian Children After the Introduction of Pneumococcal Conjugate Vaccines.

BACKGROUND: Acute bacterial meningitis remains a major cause of childhood mortality in sub-Saharan Africa. We document findings from hospital-based sentinel surveillance of bacterial meningitis among children <5 years of age in The Gambia, from 2010 to 2016. METHODS: Cerebrospinal fluid (CSF) was collected from children admitted to the Edward Francis Small Teaching Hospital with suspected meningitis. Identification of Streptococcus pneumoniae (pneumococcus), Neisseria meningitidis (meningococcus), and Haemophilus influenzae was performed by microbiological culture and/or polymerase chain reaction where possible. Whole genome sequencing was performed on pneumococcal isolates. RESULTS: A total of 438 children were admitted with suspected meningitis during the surveillance period. The median age of the patients was 13 (interquartile range, 3-30) months. Bacterial meningitis was confirmed in 21.4% (69/323) of all CSF samples analyzed. Pneumococcus, meningococcus, and H. influenzae accounted for 52.2%, 31.9%, and 16.0% of confirmed cases, respectively. There was a significant reduction of pneumococcal conjugate vaccine (PCV) serotypes, from 44.4% in 2011 to 0.0% in 2014, 5 years after PCV implementation. The majority of serotyped meningococcus and H. influenzae belonged to meningococcus serogroup W (45.5%) and H. influenzae type b (54.5%), respectively. Meningitis pathogens were more frequently isolated during the dry dusty season of the year. Reduced susceptibility to tetracycline, trimethoprim-sulfamethoxazole, and chloramphenicol was observed. No resistance to penicillin was found. CONCLUSIONS: The proportion of meningitis cases due to pneumococcus declined in the post-PCV era. However, the persistence of vaccine-preventable meningitis in children aged <5 years is a major concern and demonstrates the need for sustained high-quality surveillance

African women in science and development, bridging the gender gap

Science and technology play a fundamental role in driving social progress and economic growth in today's rapidly evolving world. Yet, despite considerable advancements, the gender gap in science remains a harsh reality, particularly for African women. This inequality directly impedes their invaluable perspectives and contributions to scientific advancements and innovations. Africa's development requires significant investment in science, technology, engineering, and mathematics (STEM) fields and leadership. This opinion piece delves into the gender disparity prevailing in STEM, emphasizes the challenges that African women experience, highlights the immense potential that African women possess, and finally advocates for immediate efforts to bridge this gap

Protein profiling in hepatocellular carcinoma by label-free quantitative proteomics in two west african populations

Background: Hepatocellular Carcinoma is the third most common cause of cancer related death worldwide, often diagnosed by measuring serum AFP; a poor performance stand-alone biomarker. With the aim of improving on this, our study focuses on plasma proteins identified by Mass Spectrometry in order to investigate and validate differences seen in the respective proteomes of controls and subjects with LC and HCC. Methods: Mass Spectrometry analysis using liquid chromatography electro spray ionization quadrupole time-of-flight was conducted on 339 subjects using a pooled expression profiling approach. ELISA assays were performed on four significantly differentially expressed proteins to validate their expression profiles in subjects from the Gambia and a pilot group from Nigeria. Results from this were collated for statistical multiplexing using logistic regression analysis. Results: Twenty-six proteins were identified as differentially expressed between the three subject groups. Direct measurements of four; hemopexin, alpha-1-antitrypsin, apolipoprotein A1 and complement component 3 confirmed their change in abundance in LC and HCC versus control patients. These trends were independently replicated in the pilot validation subjects from Nigeria. The statistical multiplexing of these proteins demonstrated performance comparable to or greater than ALT in identifying liver cirrhosis or carcinogenesis. This exercise also proposed preliminary cut offs with achievable sensitivity, specificity and AUC statistics greater than reported AFP averages. Conclusions: The validated changes of expression in these proteins have the potential for development into highperformance tests usable in the diagnosis and or monitoring of HCC and LC patients. The identification of sustained expression trends strengthens the suggestion of these four proteins as worthy candidates for further investigation in the context of liver disease. The statistical combinations also provide a novel inroad of analyses able to propose definitive cutoffs and combinations for evaluation of performance

Impact of routine vaccination against Haemophilus influenzae type b in The Gambia: 20 years after its introduction.

BACKGROUND: In 1997, The Gambia introduced three primary doses of Haemophilus influenzae type b (Hib) conjugate vaccine without a booster in its infant immunisation programme along with establishment of a population-based surveillance on Hib meningitis in the West Coast Region (WCR). This surveillance was stopped in 2002 with reported elimination of Hib disease. This was re-established in 2008 but stopped again in 2010. We aimed to re-establish the surveillance in WCR and to continue surveillance in Basse Health and Demographic Surveillance System (BHDSS) in the east of the country to assess any shifts in the epidemiology of Hib disease in The Gambia. METHODS: In WCR, population-based surveillance for Hib meningitis was re-established in children aged under-10 years from 24 December 2014 to 31 March 2017, using conventional microbiology and Real Time Polymerase Chain Reaction (RT-PCR). In BHDSS, population-based surveillance for Hib disease was conducted in children aged 2-59 months from 12 May 2008 to 31 December 2017 using conventional microbiology only. Hib carriage survey was carried out in pre-school and school children from July 2015 to November 2016. RESULTS: In WCR, five Hib meningitis cases were detected using conventional microbiology while another 14 were detected by RT-PCR. Of the 19 cases, two (11%) were too young to be protected by vaccination while seven (37%) were unvaccinated. Using conventional microbiology, the incidence of Hib meningitis per 100?000-child-year (CY) in children aged 1-59 months was 0.7 in 2015 (95% confidence interval (CI)?=?0.0-3.7) and 2.7 (95% CI?=?0.7-7.0) in 2016. In BHDSS, 25 Hib cases were reported. Nine (36%) were too young to be protected by vaccination and five (20%) were under-vaccinated for age. Disease incidence peaked in 2012-2013 at 15 per 100?000 CY and fell to 5-8 per 100?000 CY over the subsequent four years. The prevalence of Hib carriage was 0.12% in WCR and 0.38% in BHDSS. CONCLUSIONS: After 20 years of using three primary doses of Hib vaccine without a booster Hib transmission continues in The Gambia, albeit at low rates. Improved coverage and timeliness of vaccination are of high priority for Hib disease in settings like Gambia, and there are currently no clear indications of a need for a booster dose

Protein profiling in hepatocellular carcinoma by label-free quantitative proteomics in two west african populations.

Background Hepatocellular Carcinoma is the third most common cause of cancer related death worldwide, often diagnosed by measuring serum AFP; a poor performance stand-alone biomarker. With the aim of improving on this, our study focuses on plasma proteins identified by Mass Spectrometry in order to investigate and validate differences seen in the respective proteomes of controls and subjects with LC and HCC. Methods Mass Spectrometry analysis using liquid chromatography electro spray ionization quadrupole time-of-flight was conducted on 339 subjects using a pooled expression profiling approach. ELISA assays were performed on four significantly differentially expressed proteins to validate their expression profiles in subjects from the Gambia and a pilot group from Nigeria. Results from this were collated for statistical multiplexing using logistic regression analysis. Results Twenty-six proteins were identified as differentially expressed between the three subject groups. Direct measurements of four; hemopexin, alpha-1-antitrypsin, apolipoprotein A1 and complement component 3 confirmed their change in abundance in LC and HCC versus control patients. These trends were independently replicated in the pilot validation subjects from Nigeria. The statistical multiplexing of these proteins demonstrated performance comparable to or greater than ALT in identifying liver cirrhosis or carcinogenesis. This exercise also proposed preliminary cut offs with achievable sensitivity, specificity and AUC statistics greater than reported AFP averages. Conclusions The validated changes of expression in these proteins have the potential for development into high-performance tests usable in the diagnosis and or monitoring of HCC and LC patients. The identification of sustained expression trends strengthens the suggestion of these four proteins as worthy candidates for further investigation in the context of liver disease. The statistical combinations also provide a novel inroad of analyses able to propose definitive cut-offs and combinations for evaluation of performance

Teaching and practicing nursing code of ethics and values in the Gambia

Nursing has a professional autonomy which goes along with responsibility and accountability of nursing actions. Nursing practice should always be guided by a code of ethics and values. However, the concepts of nursing ethics and values are contained only in the introductory courses of the nursing curriculum in the Gambia. Many nurse educators and clinicians are not knowledgeable about the code of ethics of nursing in this country. Lectures on nursing ethics and values are mostly taught by invited guest lecturers in only one or two lecture sessions of the entire nurse training programme. Teaching nursing ethics and values at clinical level is poor due to the limited number of trained senior nurses to serve as mentors and supervisors for students and junior nurses. Most of the Gambian public health facilities do not have standard guidelines on various nursing procedures. Low status of nurses and conformist style of training nurses hinder the effective implementation of the code of nursing ethics and values among professional nurses in this country. There is, therefore, inadequate teaching and implementation of the code of nursing ethics and values which calls for urgent reforms in nursing education and practice to improve the standard and image of the Nursing Profession in the Gambia. Keywords: Teaching, Implementing, Nursing, Ethics, Values, The Gambi

Jadelle implant acceptance amongst women in Western Health Region 1, The Gambia

The reproductive health hazards of unwanted pregnancies and unsafe abortions have been reduced with modern contraceptive use. The study aimed to highlight the Jadelle Implant acceptance rate amongst women in The Gambia. A descriptive correlational (retrospective) study design was employed. Family planning records were reviewed from January 2015 to December 2015. Data was analyzed using SPSS version 21. Ethical approval was granted by the Regional Health Office, Ministry of Health & Social Welfare, and the Bundung Maternal & Child Health Hospital. Results indicated that out of 3439 acceptors of family planning methods for the year 2015, 660 women went in for the Jadelle implant representing an overall acceptance rate of 19.19%. The mean age was 29.5 years (SD ± 6.3). Mean parity was 4.5 (SD ± 2.4), the average number of alive children was 4.2 years (SD ± 2.1) and most acceptors were housewives 638 (96.7%). A positive relationship existed between age of the last child delivered and Jadelle uptake (p < 0.05). The age of last child delivered was able to predict about 26.1% of Jadelle uptake (p < 0.05). Therefore, the Jadelle implant is a highly accepted contraceptive amongst women attending these health facilities, thus, reducing unintended pregnancies, unsafe abortion, and short birth intervals amongst women in Western Health Region1, The Gambia. Keywords: Jadelle implant, Acceptance, Contraceptives, Women, The Gambi

Protein profiling in hepatocellular carcinoma by label-free quantitative proteomics in two west african populations

Background: Hepatocellular Carcinoma is the third most common cause of cancer related death worldwide, often diagnosed by measuring serum AFP; a poor performance stand-alone biomarker. With the aim of improving on this, our study focuses on plasma proteins identified by Mass Spectrometry in order to investigate and validate differences seen in the respective proteomes of controls and subjects with LC and HCC. Methods: Mass Spectrometry analysis using liquid chromatography electro spray ionization quadrupole time-of-flight was conducted on 339 subjects using a pooled expression profiling approach. ELISA assays were performed on four significantly differentially expressed proteins to validate their expression profiles in subjects from the Gambia and a pilot group from Nigeria. Results from this were collated for statistical multiplexing using logistic regression analysis. Results: Twenty-six proteins were identified as differentially expressed between the three subject groups. Direct measurements of four; hemopexin, alpha-1-antitrypsin, apolipoprotein A1 and complement component 3 confirmed their change in abundance in LC and HCC versus control patients. These trends were independently replicated in the pilot validation subjects from Nigeria. The statistical multiplexing of these proteins demonstrated performance comparable to or greater than ALT in identifying liver cirrhosis or carcinogenesis. This exercise also proposed preliminary cut offs with achievable sensitivity, specificity and AUC statistics greater than reported AFP averages. Conclusions: The validated changes of expression in these proteins have the potential for development into highperformance tests usable in the diagnosis and or monitoring of HCC and LC patients. The identification of sustained expression trends strengthens the suggestion of these four proteins as worthy candidates for further investigation in the context of liver disease. The statistical combinations also provide a novel inroad of analyses able to propose definitive cutoffs and combinations for evaluation of performance