Birth Outcome and Maternal Risk Factors Associated with Childhood Leukemia in Rwanda: A case - Control Study

BackgroundLeukemia is the most common cancer affecting children and remains the top cause of death among children.ObjectiveThis study aimed at determining birth outcomes and maternal risk factors associated with childhood leukemia in Rwanda.MethodsA case control study was conducted at Butaro Cancer Referral hospital. The sample of 103 cases and 103 controls was recruited using the records for children diagnosed with Acute lymphocytic leukemia (ALL) and Acute myelogenous leukemia (AML) and those who were hospitalized for non-cancer treatment as controls. Semi-structured questionnaire and phone calls were used to gather information. SPSS version 21.0 was used to analyze the data. Logistic regression analysis was used to assess the risk factors.ResultsThe majority (56.8%) of children who participated in the study were aged 10-14 years. Overall 41.3% were born via C-Section. It was revealed that children who had had birth asphyxia had about three (3) times increased risk of childhood leukemia [AoR= 2.47, 95%CI: 1.167-5.262, P=0.018] compared to children that had not experienced birth asphyxia. Children who had suffered Neonatal Jaundice, had five (5) times increased risk of getting leukemia [AOR= 5.05, 95%CI: 1.738-14.664, P=0.003].ConclusionIt is important that public and private stakeholders invest more in childhood oncology researches to enable the health system deliver effective management of the cases more efficiently. Rwanda J Med Health Sci 2022;5(2):158-16

Contribution of Complementary Elementary Education towards Transition of Nomadic Pupils from Non-Formal to Middle School Education in Habero Sub-Zone, Eritrea

Background: Education in Eritrea is a fundamental right of every person. Therefore, ensuring equal and equitable educational opportunities for every citizen is essential for upward mobility. However, enrolment in areas inhabited by the nomadic groups is far less from the national average. To boost enrolment among the nomads and to meet the Millennium Development Goals (MDGs) the government of Eritrea along with donor partners in 2007 introduced non-formal Complementary Elementary Education (CEE) targeted at out-of-school children aged 9-14 years. Nevertheless, no study was conducted since the program has started whether the children are mainstreamed to formal middle school primary education. Objective: The study was aimed to assess the enrollment and transition rate of CEE, examine challenges of transition and to identify possible alternatives to facilitate transition of pupils to formal middle school education in Habero Sub-Zone. Materials and methods: Mixed method design along with the use of both qualitative and quantitative approaches was employed. Semi-structured questionnaire was used to collect information on socio-demographic characteristics of pupils and CEE teachers, challenges and alternatives of transition to middle school. Moreover, key informant interview was carried out from the middle school director and sub-zone education officer. The sample size included were 150 pupils, 18 teachers, 1 middle school director and 1 sub-zone education officer. The data was analyzed using frequencies and percentages. Qualitative data were transcribed and coded and then analyzed thematically. Results: The study findings indicate that the transition rate of pupils from the CEE centers to formal middle school education was high (83%). However, the enrollment of pupils transited from CEE centers in the available middle schools of the sub-zone was low (35%). Conclusion: The low enrollment in middle school was contributed by distance of middle school, early marriage and economic status of the community. Finally, based on these findings, it is recommended that CEE centers at the very distance should develop to formal middle school. Establishment of at least one boarding school in Habero sub-zone to accommodate the most disadvantaged nomadic children would ease economic burden of the pupils. Furtherer, government authorities, national unions and religious bodies should play important role in sensitizing the community about benefits of education.   Keywords: Complementary Elementary Education, Nomadic Pupils, Transition to Middle Schoo

Risk of HIV Infection among Men Aged 50 to 75 Years using Erectile Dysfunction Drugs Attending at Kenyatta National Hospital: A Case Control Study, Kenya

Background: Erectile dysfunction drug (EDD) use has gained popularity among older men for enhancement and treatment of erectile dysfunction in recent years. Increased number of sexual partners and sexual activity due to EDD use concerns about the rising rate of HIV infection among older men. Men who use EDD for erectile dysfunction are found to be two to three times more likely to have sexually transmitted diseases (STDs), particularly human immunodeficiency virus (HIV) or chlamydia, than those who did not use the drugs. In Kenya, the prevalence of HIV among men of age 50 to 54 years has increased from 5.7% in 2003 to 9.1% in 2008. Objectives: This study was aimed at determining the association between EDD use and risk of HIV infection among men aged 50 to 75 years. Patients and Methods: A hospital based case-control study was conducted among men aged 50 to 75 years. A total of 274 men (137 cases confirmed as HIV positive and same number of controls confirmed as HIV negative), consented to participate in the study. Pearson’s chi-square test and odds ratio with corresponding 95% confidence interval were computed to establish the association between the dependent variable (HIV status) and independent variables (Key independent variable being EDD use). The level of statistical significance was set at p-value <0.05. Binary logistic regression analyses were performed to adjust for confounding factors in the relationship between HIV status and EDD use. Results: Out of 137 cases, 18(13.1%) used EDD before they found out that they were HIV +ve compared to 8(5.8%) of the controls. Even though the use of erectile dysfunction drugs was found to be significantly associated with serum HIV positivity in bivariate analysis (OR= 2.44; 95%CI: 1.04-5.93; p=0.039), it was not significant after adjustment for other factors at the multivariate analysis (AOR= 1.52; 95%CI: 0.43- 5.34; p=0.519). Multiple logistic regression revealed the following factors as independent predictors of HIV: having had sexually transmitted diseases (AOR=5.96; 95%CI: 2.43 – 14.63; p<0.001), taking alcohol/drunkenness (AOR=6.84; 95%CI: 3.22 – 14.56; p<0.001) and having multiple sexual partners (AOR=21.69; 95%CI: 8.82 – 53.33; p<0.001).Conclusion: This study shows that there is an increased risk of HIV infection among older men using EDD. However, this observation is not sustained after controlling for other associated factors. It is therefore recommended that a more robust study design (prospective cohort) with a large sample size to be undertaken to shed more light on this pressing topic. Keywords: Erectile Dysfunction Drugs, HIV infection, Older Men, Ris

Characterization of malaria vectors in Huye District, Southern Rwanda

Background: Effective control of malaria requires knowledge of vector species, their feeding and resting behaviour as well as breeding habitats. The objective of this study was to determine malaria vector species abundance and identify their larval habitats in Huye district, southern Rwanda.Methods: Adult mosquitoes were collected indoors using light trap and pyrethrum spray catch techniques, and outdoors using light traps. Female Anopheles mosquitoes were identified to species level by morphological characteristics. Enzyme-linked Immunosorbent Assay (ELISA) was used to screen for Plasmodium falciparum circumsporozoite protein and host blood meal sources. Anopheles larvae were sampled using dippers and raised into adult mosquitoes which were identified morphologically.Results: Anopheles gambiae sensu lato comprised of 70% of the 567 Anopheles collected. Other Anopheles species identified were An. funestus 4%, An. squamosus 16.5%, An. maculipalpis 6.5%, An. ziemanni 1.7%, An. pharoensis 1.2 % and An. coustani 0.1%. The majority, 63.5% of the collected mosquitoes were from indoors collections. The overall human blood index was 0.509. The P. falciparum circumsporozoite protein was found in 11 mosquitos including 8 Anopheles gambiae s.l. and 3 secondary vectors out of the 567 tested. The overall sporozoite rate was 1.9%. A total of 661 Anopheline larvae from 22 larval habitats were collected. They comprised of An. gambiae s.l. (89%) and An. ziemanni (11%). The absolute breeding index was 86.4%. The most common larval habitats were in full sunlight with still water like rice paddies and pools of stagnant water.Conclusion: These findings show that Anopheles gambiae s.l. is the dominant malaria vector in the area with other vectors playing a secondary role in malaria transmission. Malaria interventions need to be strengthened to reduce even further the malaria transmission in the area.

Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors

Abstract Background All over the globe shisha smoking is fast growing among different age brackets. Shisha use has been reported to be increasing among youths in African major cities. Its use is documented to result in health effects such as lung cancer, cardiovascular and respiratory conditions, periodontal diseases, keratoacanthoma which are also associated with cigarette smoking. In Kigali, Rwanda’s capital, reports indicate that shisha use is increasing among the youths, particularly the university students. The study aimed at determining the prevalence, and establishing factors associated with shisha use among students in a university in Kigali Rwanda, which will be a significant step in stemming shisha fame among youths in Rwanda as there was no previously documented evidence-based study. Methods A total of 427 students were selected for this cross-sectional study using stratified sampling method. A questionnaire was used to collect data on shisha use, knowledge about shisha, attitude towards shisha, and factors associated with use of shisha. The association between the independent variables and shisha use was assessed using chi-square p value < 0.05. Binary logistic regression was used to determine variables that were independently associated with shisha smoking. Results Prevalence of ever smoking shisha among the university students was 26.1% and that of those that smoked in the last month (30 days) was 20.8%. About 40 % (39.9%) of the participants that had heard about shisha before demonstrated low level of knowledge, and 41.6% of these reported shisha use in the last 30 days. Logistic regression revealed that the followings were independently associated with shisha smoking: always drink alcohol (p = 0.003); drink alcohol occasionally (p = 0.045); having friend(s) who smoke shisha (p = 0.001); being aware of shisha’s availability in cafes, bars and restaurants in Kigali (p = 0.022); positive attitude towards shisha smoking (p < 0.001) and participants with age < 20 years (p = 0.039). Conclusions There is a relative high prevalence of shisha smoking and a poor knowledge about its impact on health among these university students. Regular medical education and health promotion targeting the youths could improve knowledge and practices about shisha use. Shisha laws and regulations should be enacted, and fines imposed on individuals or group who flout them

Awareness, attitudes towards genetic diseases and acceptability of genetic interventions among pregnant women in Burera district, Rwanda

Abstract Approximately 3% of all pregnancies are associated with conditions linked with disability, either mild or severe congenital diseases. This is a consequence of environmental and genetic exposures. Complications and poor management of these diseases arise due to limited knowledge, awareness about the disease, and limited resource settings. The current study assessed awareness, attitudes towards genetic diseases, and acceptability of genetic interventions among pregnant women. This was a cross-sectional study that was conducted among 664 pregnant women in six selected health centers in Burera district using a detailed questionnaire. The data were analysed using STATA Version 15 and entailed univariate, bivariate, and multivariable analyses. The level of significance was set at p < 0.05. The mean age of the study participants was 28, and most of them were in the age range of 21 to 30 (50%). Most of the participants were married (91.1%), Christians (98.4%), farmers (92.7%), used public health coverage (96.6%), and attained primary studies (66.1%). The findings from this study showed that among participants, adequate awareness was at 29.5%, inadequate awareness at 70.5%, positive attitudes at 87.1%, negative attitudes at 12.9%, high acceptability at 97.1%, and low acceptability at 2.9%. While there was no significant difference between awareness and acceptability, there was a statistical significance between attitudes towards genetic diseases and acceptability towards the use of genetic services (p < 0.01). There was no statistical significance between sociodemographic or obstetric characteristics and the acceptability of genetic interventions. Participants with positive attitudes towards genetic diseases were more likely to develop a high level of acceptability and willingness towards the use of genetic interventions (OR: 5.3 [2.1–13.5]). Improving awareness about genetic diseases and establishing genetic interventions in healthcare facilities are needed

Additional file 2: of Shisha use among students in a private university in Kigali city, Rwanda: prevalence and associated factors

Knowledge of shisha and its health effects. (DOCX 17 kb