Assessment of prevalence and risk factors associated with Hepatitis B virus infection among blood donors in Mogadishu Somalia

Abstract Background The Hepatitis B virus (HBV) is transmitted through contaminated blood or bodily fluids. Globally, over 81 million blood units are donated annually, a crucial therapeutic procedure without alternatives. However, blood-borne infections, including HBV, pose a significant hurdle to safe transfusions, especially in HBV-endemic regions like Somalia with limited screening. Therefore, this study aims to estimate the prevalence of Hepatitis B virus infection and identify risk factors associated with it among blood donors in Mogadishu, Somalia. Method A hospital-based cross-sectional study was conducted between February and April 2023. Research tools included a 5-ml blood sample and a structured questionnaire. The presence or absence of HB markers was determined using a multi-HB rapid test and CDC’s HB marker interpretation guideline. Logistic regression was used in univariate and multivariate models to identify risk factors associated with HBV infection, with significance set at a p-value < 0.05 in the final model. Result A total of 494 blood donors were recruited for this study; 93.9% were male, with a mean age of 31.5 (SD = 8.11). The prevalence of Hepatitis B virus (HBV) infection among blood donors was 9.7%, with a 95% CI of 7.1–12.3. In multivariable logistic regression, those with a monthly income of less than 200 USD (AOR = 5.20, 95% CI = 1.61–16.79), those with an income between 200 and 400 (AOR = 3.59, 95% CI = 1.38–9.34), Jobless blood donors (AOR = 3.78, 95% CI = 1.17–12.20), those in business occupations (AOR = 3.35, 95% CI = 1.24–9.08), those with a history of STDs (AOR = 4.83, 95% CI = 2.03–11.50), those without a history of HB vaccine (AOR = 13.81, 95% CI = 2.46–77.41), those with a history of tooth extraction (AOR = 6.90, 95% CI = 2.66–17.88), and those who shared sharp equipment (AOR = 2.90, 95% CI = 1.07–7.82) were more likely to become infected with the Hepatitis B virus (HBV) compared to their counterparts. Conclusion This study highlights a high prevalence of Hepatitis B virus (HBV) infection. Implementation efforts against HBV infection should specifically focus on low-income individuals, the jobless, and donors with a history of STD to mitigate the burden of HBV infection and promote safer blood donation. In addition, discouraging the sharing of sharp equipment, improving infection control practices during tooth extraction procedures, and enhancing HB vaccination uptake, particularly among individuals lacking a history of HB vaccine, is highly recommended

Prevalence of and factors associated with depression among adult patients living with HIV/AIDs undergoing ART unit in Banadir hospital, Mogadishu Somalia

Abstract Background Depression is the most common psychiatric disorder in HIV/AIDs patients, and its prevalence is three times higher in HIV/AIDs patients. Globally, over 35 million people were living with HIV/AIDs, 24.7 million were in Sub-Saharan Africa. The study aims to estimate the prevalence and determine factors associated with depression among HIV/AIDs adult patients in the ART unit at Banadir Hospital Mogadishu, Somalia. Method A hospital-based cross-sectional study was conducted between 1 May and 1 July 2022. Samples were recruited from the HIV/AIDs adult patients attending in ART unit at Banadir Hospital, Mogadishu, Somalia. A validated research tool, including sociodemographic, behavioral, clinical, and psycho-social characteristics, three items social support scale, an 11-item HIV stigma scale, and patient health questions-9 (PHQ-9) were used. The interview was conducted privet room in the ART unit. Logistic regression was used to determine factors associated with depression at the significance level a = 0.050. Result The overall prevalence of depression among HIV/AIDs patients was 33.5% (95%CI = 28.1–39.0). In the multivariable logistic regression, three factors were associated with depression; the odds of depression were 3.415 times (95%CI=1.465–7.960) greater for those with poor social support than those with moderate-strong social support. Those with moderate and poor treatment adherence had 14.307 times (95%CI=5.361–38.182) greater odds of depression than those with good treatment adherence. Those who use substances had 3.422 times (95%CI=1.727–6.781) greater odds of having depression than those who did not. Conclusion People living with HIV in Mogadishu, Somalia, suffer from depression. The implementation to reduce depression should be focused on empowering social support, developing an appropriate approach to increase treatment adherence, and reducing or eliminating substance use

Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey

Abstract Background In September 2022, a new Ebola outbreak was reported in Uganda, East Africa, and 142 confirmed cases, including 19 Healthcare workers (HCWs) reported. Ebola is not endemic in Somalia, but the country is at a reasonable risk of the virus being introduced due to the direct connection with daily flights from Uganda without border health control and prevention activities. Therefore, evaluating HCWs' Knowledge and attitude is crucial since this is the first time being evaluated in Somalia. The study's objective is to evaluate the HCWs' Knowledge and attitude toward the Ebola virus disease in Somalia. Method An online self-administrated cross-sectional survey was conducted among HCWs (n = 1103) in all six federal member states of Somalia using a validated, reliable, well-structured questionnaire. Data we analyzed using descriptive statistics and Logistic regression were used to determine sociodemographic characteristics associated with poor Knowledge and negative attitude. Result Over one-third (37.3%) of HCWs had poor Knowledge; the mean knowledge score was 7.97 SD ± 2.15. Almost 40.1% of the HCWs had a negative attitude; the mean attitude was 27.81 SD ± 8.06. Low-income HCWs (AOR = 2.06, 95%CI:1.01–4.19), Married HCWs (AOR = 1.39, 95%CI: 1.110–1.963), Midwives (AOR = 2.76, 95%CI: 1.74–4.39), Lab technicians (AOR = 2.43, 95%CI: 1.43–4.14), HCWs work in Jubaland state of Somalia (AOR = 3.69, 95%CI: 2.39–5.70), Galmudug state (AOR = 8.50, 95%CI: 4.59–15.77), Hirshabelle state (AOR = 3.18, 95%CI: 2.15–4.71) were more likely to have poor Knowledge compared to their counterparts. HCWs who work in Hirshabelle state (AOR = 5.44,95%CI: 3.58–8.27), Jubaland state (AOR = 8.47, 95%CI: 4.69–15.29), and Galmudug state (AOR = 4.43, 95%CI: 3.03–6.48) was more likely to have a negative attitude than those working in the Banadir region administration. Conclusion Most Somali healthcare workers showed good Knowledge and a positive attitude toward the Ebola virus. The implementation to enhance Knowledge and attitude must specifically focus on low-income HCWs, Midwives, Lab technicalities, and those who work in Hirshabelle, Jubaland, and Galmudug states of Somalia

Seroprevalence of Anti-SARS-CoV-2 Antibodies in Benadir Region, Somalia

Only little is known about the true extent of COVID-19 in Somalia. The study aims to assess the seroprevalence of the COVID-19 pandemics in the Benadir region using SARS-CoV-2 antibodies and estimate the number of inhabitants infected with SARS-CoV-2. Population-based cross-sectional survey was conducted to measure the seroprevalence of antibodies against SARS-CoV-2 in the Benadir region (Mogadishu city). In the study, we enrolled 2500 Mogadishu city residents aged &ge;18 years who did not receive the SARS-CoV-2 vaccine. The overall seroprevalence of IgG/IgM anti-SARS-CoV-2 antibodies was 44.8%. The seropositivity in females (56.6%) was higher than in males (46.2%). The trend in seropositivity increased with age; however, the variation was only significant in the age group 38&ndash;57 with an odds ratio and p-value of 4.11 (1.475&ndash;11.47), p = 0.007. Families with &gt;5 members (47.2%) were more likely to test positive than those with &lt;5 members (37%). Participants who reported COVID-19 symptoms during the pandemics or who had contact with COVID-19 patients had significantly increased IgG prevalence. Participants with larger families, individuals working in the public sector, and students showed significant seropositive results. Therefore, precautionary measures should be heightened for individuals working in the public sector

Is Retzius-sparing robot-assisted radical prostatectomy associated with better functional and oncological outcomes? Literature review and meta-analysis

Objective: To evaluate the efficiency, safety and clinical outcomes of Retzius-sparing robot-assisted radical prostatectomy (RS-RARP) in comparison with the standard RARP. Methods: A systematic search from Web of Science, PubMed, EMBase, Cochrane Library and Google Scholar was performed using the terms “Retzius-sparing”, “Bocciardi approach” and “robot-assisted radical prostatectomy”. Video articles and abstract papers for academic conferences were excluded. Meta-analysis of interested outcomes such as positive surgical margins (PSMs) and continence recovery was undertaken. A comprehensive literature review of all studies regarding Retzius-sparing (RS) approach was conducted and summarized. Results: From 2010 to 2017, 11 original articles about RS-RARP approach were retrieved. Of that, only four studies comparing the RS-RARP approach to the conventional RARP were comparable for meta-analysis. Faster overall continence recovery within 1 month after the surgery was noted in the RS group (61% vs. 43%; p = 0.004). PSMs of pT2 and pT3 stages were not significantly different between the groups (10.0% vs. 7.4%; p = 0.39 and 13.1% vs. 9.5%, p = 0.56, respectively). Of all the studies, only one reported sexual recovery outcomes after RS treatment in which 40% of the participants achieved sexual intercourse within the first month. Conclusion: Though more technically demanding than the conventional RARP, the RS technique is a safe and feasible approach. This meta-analysis and literature review indicates that RS technique, as opposed to the conventional approach, is associated with a faster continence recovery while PSMs were comparable between the two groups. The limitations of observational studies and the small data in our meta-analysis may prevent an ultimate conclusion. Future well-designed RCTs are needed to validate and confirm our findings. Keywords: Retzius-sparing, Radical prostatectomy, Robotics, Functional recovery, Positive surgical margin

Management of recurrent ureteral stricture: a retrospectively comparative study with robot-assisted laparoscopic surgery versus open approach

Background Management of recurrent ureteral stricture is challenging. Consensus on the best surgical choice has not been demonstrated. In this study, we aim to report our experience in treating recurrent ureteral stricture and demonstrate whether robot-assisted procedure for redo ureteral surgery is as effective as open procedure while remaining less invasive. Methods We retrospectively assessed 41 patients (22 robot-assisted surgeries and 19 open surgeries) who underwent consecutive robot-assisted and open procedures for redo ureteral surgery from January 2014 to 2018 in our institution. Perioperative outcomes, including demographics, operative time, estimated blood loss, complications, pain scores, success rate and cost, were compared between two groups. Results There was no significant intergroup difference in terms of age, body mass index, gender composition and American Society of Anesthesiologists scores. A total of 31 patients underwent redo pyeloplasty and ten underwent redo uretero-ureterostomy. Compared with open group, robot-assisted group showed shorter operative time (124.55 min vs. 185.11 min, p < 0.0001), less estimated blood loss (100.00 mL vs. 182.60 mL, p = 0.008) and higher cost (61161.77¥ vs. 39470.79¥, p < 0.0001). Complication rate and pain scores were similar between two groups. Median follow-up periods were 30 and 48 months for robot-assisted and open group respectively. Success rate in the robot-assisted (85.71%) and the open group (82.35%) was not significantly different. Conclusions Robot-assisted surgery for recurrent stricture after previous ureteral reconstruction is as effective as open procedure and is associated with shorter operative time and less estimated blood loss

COVID-19 Vaccine Coverage and Potential Drivers of Vaccine Uptake among Healthcare Workers in SOMALIA: A Cross-Sectional Study

Healthcare workers (HCWs) are one of the most vulnerable groups for contracting COVID-19 and dying as a result of it. Over 10,000 HCWs in Africa have been infected with COVID-19, according to the World Health Organization, making it a substantial occupational health threat for HCWs. To that end, Somalia&rsquo;s Ministry of Health has ordered that all healthcare personnel obtain the COVID-19 vaccination to safeguard themselves and the community they serve. In this investigation, we aimed to assess the COVID-19 vaccination coverage and its associated factors among healthcare workers in Somalia. A cross-sectional study was employed to examine COVID-19 vaccination coverage among healthcare personnel in Somalia. The data were obtained via an online questionnaire supplied by Google forms between December 2021 and February 2022, where a total of 1281 healthcare workers from the various federal states of Somalia were recruited. A multinomial regression analysis was used to analyse the factors associated with COVID-19 vaccine uptake. Overall, 1281 HCWs participated (630 females, 651 males) with a mean age and standard deviation of 27.7 years &plusmn; 7.1. The overall vaccine coverage was 37.4%. Sex, age, the state of residency, education level, specialization, hospital COVID-19 policy, vaccine availability at the centre, COVID-19 treatment centre, and health facility level were the factors that influenced the COVID-19 vaccine uptake among health professionals in Somalia. Male healthcare employees were 2.2 times (odds ratio-OR = 2.2; confidence interval-CI: 1.70, 2.75, p &lt; 0.001) more likely than female healthcare workers to be fully vaccinated. The survey discovered that the COVID-19 vaccine coverage among health professionals was quite low, with the major contributing factors being accessibility, security challenges and literary prowess. Additional efforts to enhance vaccination uptake are needed to improve the COVID-19 vaccination coverage

BACKSLIDING ON CHILDHOOD IMMUNIZATIONS DUE TO ONGOING COVID-19 PANDEMIC: A RETROSPECTIVE STUDY IN BANADIR REGION, SOMALIA

Background: SARS-CoV-2 has resulted in a global public health crisis. During the pandemic, considerable delay was observed making it impossible for some children to receive their due vaccines on time. Like most resource-poor countries, COVID-19 pandemic is thought to have a negative impact on Somalia’s immunization coverage. Materials and methods: This study aimed to assess the impact of the COVID-19 pandemic on routine childhood immunization coverage in Somalia. A retrospective comparative cross-sectional approach was employed to investigate the number of under-5-year children who got their immunization from the two major mother and child hospital, (Banadir and SOS in Mogadishu, Somalia from October 2019 to December 2020. To do this, a total of 112, 060 data relating to the routine childhood immunization (measles, polio, whooping cough, hepatitis B, pneumonia, and tuberculosis) were collected from the monthly immunization report-data from the two hospitals. Results: The results showed that all the vaccines except birth vaccines have remarkably dropped with Penta-3 (27%), Penta-2 (11%), measles (10%) and Penta-1 (8%) respectively. However, the birth vaccines (BCG and Polio 0) were not affected as observed in this study. The reduction in children immunization rate in Somalia may be a combination of many other factors, we however recognize that the COVID-19 pandemic may have contributed significantly to this outcome. Conclusion: The government needed to take proactive measures to encourage parents to present their children for immunizations, including increasing community concerning the importance of these routine childhood immunizations despite the ongoing COVID-19 pandemics