Prévalence de l’hypertension artérielle dans la population des meuniers de la ville de Lubumbashi, République Démocratique du Congo

Introduction: L'objectif était de comparer la prévalence de l'hypertension artérielle chez les meuniers dans la ville de Lubumbashi qui sont exposés d'une manière permanente aux bruits des machines de  transformation des céréales à la prévalence de l'hypertension artérielle chez un groupe des gardiens. Méthodes: Quic'est une étude descriptive transversale qui a concerné 286 meuniers et 115 agents d'une entreprise de gardiennage. Apres un consentement éclairé, un auto questionnaire a été administré aux enquêtés et des mesures de poids, taille, et tension artérielle ont été prises. Résultats: La prévalence de l'HTA chez les meuniers était 49.3% et celle des gardes était 20.9%, pour un ratio de prévalence de 2.4.significativement élevée par rapport aux contrôles (49.3% vs 20.9%) et le ratio de prévalence était de 2.4 . Les facteurs de risque tels que: l'âge, l'indice de masse corporelle,  l'ancienneté, la durée de travail ont été significativement élevés chez les meuniers par rapport aux  gardiens. Conclusion: Nous avons trouvé une prévalence élevée de l'HTA chez les meuniers. Nos  résultats suggèrent que cette prévalence est probablement due à l'environnement du milieu de travail des meuniers (bruits, vibration des machines) et ce dernier constitue un facteur de risque de l'hypertension artérielle.Key words: Hypertension artérielle, meuniers, bruits, environnement du milieu de travai

Human Resources for Health-Related Challenges to Ensuring Quality Newborn Care in Low- and Middle-Income Countries: A Scoping Review.

BACKGROUND: A critical shortage of health workers with needed maternal and newborn competencies remains a major challenge for the provision of quality care for mothers and newborns, particularly in low- and middle-income countries. Supply-side challenges related to human resources for health (HRH) worsen shortages and can negatively affect health worker performance and quality of care. This review scoped country-focused sources to identify and map evidence on HRH-related challenges to quality facility-based newborn care provision by nurses and midwives. METHODS: Evidence for this review was collected iteratively, beginning with pertinent World Health Organization documents and extending to articles identified via database and manual reference searches and country reports. Evidence from country-focused sources from 2000 onward was extracted using a data extraction tool that was designed iteratively; thematic analysis was used to map the 10 categories of HRH challenges. FINDINGS: A total of 332 peer-reviewed articles were screened, of which 22 met inclusion criteria. Fourteen additional sources were added from manual reference search and gray literature sources. Evidence has been mapped into 10 categories of HRH-related challenges: (1) lack of health worker data and monitoring; (2) poor health worker preservice education; (3) lack of HW access to evidence-based practice guidelines, continuing education, and continuing professional development; (4) insufficient and inequitable distribution of health workers and heavy workload; (5) poor retention, absenteeism, and rotation of experienced staff; (6) poor work environment, including low salary; (7) limited and poor supervision; (8) low morale, motivation, and attitude, and job dissatisfaction; (9) weaknesses of policy, regulations, management, leadership, governance, and funding; and (10) structural and contextual barriers. CONCLUSION: The mapping provides needed insight that informed new World Health Organization strategies and supporting efforts to address the challenges identified and strengthen human resources for neonatal care, with the ultimate goal of improving newborn care and outcomes

Immunization coverage and risk factors for failure to immunize within the Expanded Programme on Immunization in Kenya after introduction of new Haemophilus influenzae type b and hepatitis b virus antigens

Background: Kenya introduced a pentavalent vaccine including the DTP, Haemophilus influenzae type b and hepatitis b virus antigens in Nov 2001 and strengthened immunization services. We estimated immunization coverage before and after introduction, timeliness of vaccination and risk factors for failure to immunize in Kilifi district, Kenya. Methods: In Nov 2002 we performed WHO cluster-sample surveys of > 200 children scheduled for vaccination before or after introduction of pentavalent vaccine. In Mar 2004 we conducted a simple random sample (SRS) survey of 204 children aged 9 - 23 months. Coverage was estimated by inverse Kaplan-Meier survival analysis of vaccine- card and mothers' recall data and corroborated by reviewing administrative records from national and provincial vaccine stores. The contribution to timely immunization of distance from clinic, seasonal rainfall, mother's age, and family size was estimated by a proportional hazards model. Results: Immunization coverage for three DTP and pentavalent doses was 100% before and 91% after pentavalent vaccine introduction, respectively. By SRS survey, coverage was 88% for three pentavalent doses. The median age at first, second and third vaccine dose was 8, 13 and 18 weeks. Vials dispatched to Kilifi District during 2001 - 2003 would provide three immunizations for 92% of the birth cohort. Immunization rate ratios were reduced with every kilometre of distance from home to vaccine clinic (HR 0.95, CI 0.91 - 1.00), rainy seasons ( HR 0.73, 95% CI 0.61 - 0.89) and family size, increasing progressively up to 4 children ( HR 0.55, 95% CI 0.41 - 0.73). Conclusion: Vaccine coverage was high before and after introduction of pentavalent vaccine, but most doses were given late. Coverage is limited by seasonal factors and family siz

Hospital Detention of Mothers and Their Infants at a Large Provincial Hospital: A Mixed-Methods Descriptive Case Study, Lubumbashi, Democratic Republic of the Congo

The practice of detaining people who are unable to pay for health care services they have received is widespread in many parts of the world. We aimed to determine the proportion of women and their infants detained for inability to pay for services received at a provincial hospital in the Democratic Republic of the Congo during a 6-week period in 2016. A secondary objective was to determine clinical and administrative staff attitudes and practices about payment for services and detention