Awareness of and attitudes towards heat waves within the context of climate change among a cohort of residents in Adelaide, Australia

Heat waves are a public health concern in Australia and unprecedented heat waves have been recorded in Adelaide over recent years. The aim of this study was to examine the perception and attitudes towards heat waves in the context of climate change among a group of residents in Adelaide, an Australian city with a temperate climate. A cross-sectional study was conducted in the summer of 2012 among a sample of 267 residents. The results of the survey found that television (89.9%), radio (71.2%), newspapers (45.3%) were the main sources from which respondents received information about heat waves. The majority of the respondents (73.0%) followed news about heat waves very or somewhat closely. About 26.6% of the respondents were extremely or very concerned about the effects of heat waves on them personally. The main issues that were of personal concern for respondents during a heat wave were their personal comfort (60.7%), their garden (48.7%), and sleeping well (47.6%). Overall, respondents were more concerned about the impacts of heat waves to the society than on themselves. There was a significant association between gender (χ² = 21.2, df = 3, p = 0.000), gross annual household income (p = 0.03) and concern for the societal effects of heat waves. Less than half (43.2%) of the respondents believed that heat waves will extremely or very likely increase in Adelaide according to climate projections. Nearly half (49.3%) believed that the effects of heat waves were already being felt in Adelaide. These findings may inform the reframing and communication strategies for heat waves in Adelaide in the context of climate change.Derick A. Akompab, Peng Bi, Susan Williams, Janet Grant, Iain A. Walker and Martha Augoustino

Population health and climate change: public perceptions, attitudes and adaptation to heat waves in Adelaide, Australia

Background and objectives: There is compelling scientific evidence that climate change will increase the frequency of heat waves which have an impact on population health. In Adelaide, unprecedented heat waves have been experienced in recent years which had significant impact on human health. The objectives of this research project were to: (1) explore public opinion (views and attitudes) about heat waves in relation to climate change, (2) explore public understanding of the consequences and the emotional and psychological responses associated with heat waves, (3) identify the predictors of risk perception using a heat wave scenario and adaptive behaviours during heat waves; and (4) explore the concept of multi-stakeholder processes during the development of an adaptation strategy for heat waves. Methods: In the first study, interviews were conducted among fourteen residents to explore their views about heat waves, their understanding of its consequences and the emotional and psychological responses associated with heat waves. The second study was a cross-sectional study that examined the attitudes towards heat waves, risk perception and adaptive behaviours during heat waves among 267 participants with the health belief model used as the theoretical framework. The third study explored the concept of multi-stakeholder processes during the development of an adaptation strategy for heat waves. Data were gathered through a review of policy documents and interviews with eighteen stakeholders involved in the strategy development process. Qualitative data were analysed according to themes while descriptive and inferential statistical techniques were used to analyse quantitative data. Results: In the first study, most participants didn’t associate recent heat waves in Adelaide with climate change, although they acknowledged a considerable change in weather patterns over recent years. Although there were differences in the level of understanding among the participants, they modified their behaviours during a heat wave. Fear, worry, anxiety and concern were the main emotional responses associated with heat waves. Participants were concerned about low agricultural productivity, the costs of running an air-conditioner, sleeping well, and the threat of bush fires during a heat wave. In the second study, there was a significant association between gender, annual household income and concern for the societal effects of heat waves. About 43.2% of the participants believed that heat waves will extremely or very likely increase in Adelaide according to climate projections; 49.3% believed that the effects of heat waves were already being felt. The significant predictors of risk perception included age, marital status, annual household income, fan ownership and living arrangements. Participants’ perceived benefit, cues to action, educational level, and annual household income were associated with adaptive behaviours during a heat wave. In the third study, there was high level governance, leadership, collaboration, coordination and good institutional arrangements during the adaptation strategy development process in South Australia. The process benefited from the Emergency Management Act 2004, which facilitated an enabling environment. Although the process was not entirely inclusive and the fact that it experienced a few challenges, the strategy development process was overall successful. Conclusions: These findings suggest that there are variations in public opinion about heat waves in the context of climate change. Heat waves affect the emotional and psychological wellbeing of certain individuals. Using the health belief model as the theoretical framework, perceived benefit and cues to action predicted good adaptive behaviours. There were some demographic factors that were associated with risk perception in relation to heat waves. These factors would inform risk communication and behaviour change strategies for heat waves. An adaptation policy process for heat waves indicates that the process can be successful through a participatory process characterised by good leadership, excellent coordination, governance and institutional framework.Thesis (Ph.D.) -- University of Adelaide, School of Population Health, 2014

Knowledge, Attitude, and Practice on Pediatric Tuberculosis Management among Healthcare Workers in the Centre Region of Cameroon: A Cross-Sectional Study

Background. This study was designed to assess the level of knowledge, attitude, and practice (KAP) of healthcare workers (HCWs) on pediatric TB management and its associated factors in the Centre Region of Cameroon. Methods. A cross-sectional study was conducted between January and March 2022. HCWs, selected through a multistage sampling technique in 21 health facilities, were interviewed using a KAP questionnaire on pediatric TB management. Logistic regression analyses were used to test associations between HCWs’ characteristics and knowledge, attitudes, and practice levels at a 0.05 level of significance. Results. The median age of the participants was 35 years (IQR = 30–42), and the majority (73.2%) were females. About half (50.9%) of the participants (173/340) had good knowledge, 55.6% (189/340) had a good attitude, and 57.1% (194/340) had good practice scores on pediatric TB management. Having a bachelor’s degree and above, working in the TB unit, and having received training on pediatric TB in the last five years were significantly associated with good knowledge of pediatric TB management. Similarly, having a bachelor’s degree or higher and more than five years of experience providing TB services were significantly associated with a good attitude towards pediatric TB management. Being a general practitioner, nurse, and lab technician was significantly associated with good practice in pediatric TB management. Conclusion. The level of knowledge, attitude, and practice on pediatric TB management among HCWs was suboptimal, as substantial gaps were identified. The Ministry of Health and other international organizations need to prioritize training, coaching, and mentoring support to help HCWs improve their knowledge, attitude, and practice to detect, diagnose, and treat pediatric TB

Oral contraceptive use and premenstrual syndrome among sexually active female university students in Cameroon

Introduction: premenstrual syndrome (PMS) is a prevalent health problem affecting women of reproductive age and some young women use oral contraceptive pills (OCPs) to prevent unwanted pregnancy. However, the association between OCP use and the experience of symptoms of PMS has not been studied in Cameroon. We examined the association between the use of OCPs and PMS among female university students in Cameroon. Methods: we used data extracted from a larger study on sexual and reproductive health that was conducted between July and August 2018 among female university students at the University of Yaoundé 1, Cameroon. A pre-tested, validated and paper-based self-administered questionnaire was used to collect data. We extracted data (demographic and health characteristics, contraceptive use and experience of PMS) for the 424 sexually active students who participated in the larger study. We used Poisson regression analysis to examine the association between OCP use and PMS and conducted stratified analysis to determine effect modification. The level of statistical significance was set at p≤0.05. Results: the median age of the 424 sexually active female university students was 23 years (IQR=21-25). About 77.8% of participants self-reported to have experienced symptoms of PMS prior to their last menstrual period. The most commonly reported symptoms of PMS were breast tenderness (55.7%), acne/pimples (39.2%) and abdominal pain (31.1%). After adjusting for confounders in multivariate analysis, we found a statistically significant relationship between the use of OCPs and experience of symptoms of PMS. Current OCP users had a slightly increased risk (PR=1.21; 95% CI, 1.09-1.32, p<0.001) of developing symptoms of PMS compared to non-pill users. We found that age modified the effect of this association. Among older students (≥25 years), the direction of the effect was strongly positive and statistically significant (APR=1.32; 95% CI, 1.12-1.56, p=0.001). Conclusion: the proportion of female university students who reported to have experienced symptoms of PMS prior to their last menstrual period was high. The use of OCPs was positively associated with the risk of developing symptoms of PMS and this relationship was modified by age. Further studies in Cameroon and other sub-Saharan African countries are required to understand this relationship

Research Questions and Priorities for Pediatric Tuberculosis: A Survey of Published Systematic Reviews and Meta-Analyses

Background. Advancing a research agenda designed to meet the specific needs of children is critical to ending pediatric TB epidemic. Systematic reviews are increasingly informing policies in pediatric tuberculosis (TB) care and control. However, there is a paucity of information on pediatric TB research priorities. Methodology. We searched MEDLINE, EMBASE, Web of Science, and the Cochrane Library for systematic reviews and meta-analyses on any aspect related to pediatric TB published between 2015 and 2021. We used the UK Health Research Classification System (HRCS) to help us classify the research questions and priorities. Findings. In total, 29 systematic reviews, with 84 research questions, were included in this review. The four most common research topics in the area of detection were 43.33% screening and diagnosis of TB, 23.33% evaluation of treatments and therapeutic interventions, 13.34% TB etiology and risk factors, and 13.34% prevention of disease and conditions and promotion of well-being. The research priorities focused mainly on evaluating TB diagnosis by improving yield through enhanced in specimen collection or preparation and evaluating of bacteriological TB diagnostic tests. Other topics of future research were developing a treatment for TB in children, assessing the use of IPT in reducing TB-associated morbidity, evaluating the prioritization of an IPT-friendly healthcare environment, and providing additional guidance for the use of isoniazid in the prevention of TB in HIV-infected children. Conclusion. There is a need for more systematic reviews on pediatric TB. The review identified several key priorities for future pediatric TB research mainly in the domain of (1) “Detection, screening and diagnosis,” “Development of Treatments and Therapeutic Interventions,” and “Prevention of Disease and Conditions, and Promotion of Well-Being.” These domains are very relevant in the research component of the roadmap towards ending TB in children. It also will serve as an additional action in the WHO End TB strategy.</jats:p

Uptake of HIV testing and counseling among tertiary institution students in the Hohoe Municipality, Ghana

HIV Testing and Counselling (HTC) is a critical strategy to reduce the rate of new HIV infections and the key entry point to HIV treatment, care and support services. This study aimed to determine the uptake of HTC among students of tertiary institutions in the Hohoe Municipality of Ghana. This was a quantitative cross-sectional study. A structured questionnaire was used to collect data among a proportionate stratified sample of students from tertiary institutions. Chi-square and Logistic regression analyses were performed using Stata version 12.0 at the 0.05 level of significance. Only 30.6% of the total respondents had ever tested for HIV/AIDS of which, only 22.9% tested less than 6 months before the current study. Students above twenty-four years of age were 3 times more likely to go for HTC than those below 20 years [OR=2.56 (95% CI: 1.07-6.11; p=0.034)]; those in the fourth year of study were 3 times more likely get HTC than those in the first year [OR=3.05 (95%CI: 1.10-8.49; p=0.033)]; and those attending THERESCO, the Midwifery training college and UHAS were more than 2 times more likely to get tested for HIV than those attending FRANCO [OR =2.67 (95% CI: 1.14-6.15; p=0.024)], [OR=2.40 (95% CI: 1.04-5.54; p=0.040)] and [OR=2.63 (95% CI: 1.13-6.13; p=0.026)] respectively. The uptake of HTC among tertiary institution students in Hohoe municipality was considerably low. Policymakers should design programs and interventions that would increase uptake of HTC among tertiary students, with focus on those aged less than 20 years, those at the lower level of study and those in the non-health related institutions.</jats:p

Epidemiology of Pediatric Tuberculosis and Factors Associated with Unsuccessful Treatment Outcomes in the Centre Region of Cameroon: A Three-Year Retrospective Cohort Study

Background. In Cameroon, there are limited data on treatment outcomes of pediatric tuberculosis (TB). We sought to identify the factors associated with unsuccessful treatment outcomes and the risk factors for mortality among children receiving TB treatment in the Centre Region of Cameroon. Methods. This was a multicentre facility-based retrospective cohort study using routinely collected programmatic data. All children <15 years old treated for TB between 2018 and 2020 in 21 health facilities were included. We assessed risk factors for experiencing an unsuccessful treatment outcome and mortality through multivariable logistic regression analysis. Results. Of the 610 children with TB, 307 (50.3%) were females and the median age was 6 years (IQR = 2–12). One hundred and fifty-three (25.1%) of the children were TB/HIV co-infected patients. TB treatment success (cases categorized as cured and completed treatment) was observed in 488 (80.0%) of the patients. Unsuccessful treatment outcomes were experienced by 122 (20.0%) children. Of these, 73 (12.0%) died, 4 (0.6%) had treatment failure, 25 (4.1%) were lost to follow-up, and the outcomes of 20 (3.3%) children were not evaluated. In multivariable analysis, HIV-positive status (adjusted odds ratio [AOR] = 2.43; 95% CI, 1.55–3.80, p<0.001) and clinical method of TB diagnosis (AOR = 2.46; 95% CI, 1.55–3.91, p<0.001] were associated with unsuccessful treatment outcomes. HIV-positive status (AOR = 4.23; 95% CI, 2.44–7.33, p<0.001) and clinical method of TB diagnosis (AOR = 2.22; 95% CI, 1.25–3.91, p=0.006) were the risk factors for mortality among children on TB treatment. Conclusion. The study found that HIV-TB co-infected children and those clinically diagnosed with TB were significantly more likely to have had unsuccessful TB treatment outcomes and mortality. Our findings underscore the need for healthcare workers to closely monitor and support HIV-TB co-infected children on TB treatment. TB/HIV collaborative activities should be strengthened by implementing TB preventive interventions among HIV-infected children