Factors associated with childhood diarrhea in Rwanda: a secondary data analysis of the Rwanda demographic and health survey 2014-15

Background: Diarrheal diseases remain an important cause of morbidity among children, particularly in children under five years old, in low- and middle-income countries where it causes nearly 1.7 billion cases every year.Methods: We used a quantitative cross-sectional design. This study aimed to explore the determinants of child diarrhea among under five-year children in Rwanda. A deep analysis of the 2014- 2015 Rwanda Demographic and Health Survey (RDHS), with multivariate logistic regression, using stata13 was performed. The 2014-2015 Survey was the fifth standard national survey, implemented by the National Institute of Statistics of Rwanda (NISR) in a period of six months from November 2014 to April 2015.Results: A sample of 2841 children under five years old were included. Chi-square test and logistic regression were performed. A significance level of 0.05 at 95% CI was considered. Child age and wealth index showed a strong association with diarrhea. Children in the age groups of 6-11, 12-23, 24-35 months were at higher risk of diarrhea than children aged 48-59 months, OR: 5.0 [3.1-8.2], P-value: 0.001; OR: 7.6, CI [4.7-12.2], P-value: 0.001; OR:3.8 [2.3-6.2], P-value: 0.001 respectively. Moreover, children from poorest and poorer families were twice more at risk of diarrhea than children from richest families. OR: 2, CI [1.3-2.9], P-value: 0.001.Conclusion: The study concluded that low wealth index, and child age less than 35 months were important risks for under-five child diarrhea.Keywords: determinants, under five years children, diarrhe

Socio-Demographic Determinants of Diarrhoeal Diseases among Under Five Years Old Children in Rwanda

Background Diarrhoeal disease is a worldwide public health issue and remains a major cause of mortality and morbidity in children under five years old. Low and middle income countries (LMIC) of Africa and part of Asia are more affected by diarrhoeal diseases. Objectives To measure the prevalence of Diarrhoeal Diseases and to assess Socio-demographic determinants among Under Five Years Old Children in Rwanda. Methods A cross-sectional design was used. Secondary data analysis was carried out on a sample of 7474 drawn from Rwanda Demographic and Health Survey (RDHS). RDHS used multistage sampling technique. Results After running multiple logistic regression, Sociodemographic determinants associated with diarrhoeal included age of children, wealth index category, mother education, husband/partner education, types of place of residence (P-Value<0.05). Conclusion The results of the study showed that diarrhoeal remains an important health issue in Rwanda. Occurrence of diarrhoeal was statistically associated with child age, wealth index, education of parents, types of place of residence. Rwanda J Med Health Sci 2020;3(3):328-34

Clinical learning environment and supervision: satisfaction levels of University of Rwanda Students

Background: Nursing and midwifery students need to learn theoretical knowledge and practical skills. Students are satisfied with a clinical education program when the environment is conducive to acquiring the knowledge, skills and professional attitude essential for their career.Objective: To assess the level of satisfaction with the clinical learning environment among nursing and midwifery students at the University of Rwanda.Methods: A descriptive cross-sectional study design was used to assess 280 undergraduate nursing and midwifery students. The study used the instrument entitled, the ‘Clinical Learning Environment Supervision and Nurse Teacher Tool’ (CLES+T). Data analysis used descriptive statistics.Results: The majority of participants were highly satisfied with the clinical learning environment (58%), ward atmosphere (54%), the leadership of ward manager (58%) and supervisory relationship (62%). Chi-square results showed a significant association between class level (p=0.001) and last clinical placement (p=0.000). Some students (7%) were dissatisfied with the supervisory relationship.Conclusion: Most nursing and midwifery students were satisfied with the clinical learning environment. However, the reported levels of dissatisfaction showed that improvements are needed to attain a quality education and meet the Sustainable Development Goal (SDG) Four: to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.Keywords: Clinical placement, learning,student, satisfaction, nursing, midwifer

Malaria rapid diagnostic tests in community pharmacies in Rwanda: availability, knowledge of community pharmacists, advantages, and disadvantages of licensing their use

Abstract Background Presumptive treatment of malaria is often practiced in community pharmacies across sub-Saharan Africa (SSA).To address this issue, the World Health Organization (WHO) recommends that malaria Rapid Diagnostic Tests (m-RDTs) be used in these settings, as they are used in the public sector. However, their use remains unlicensed in the community pharmacies in Rwanda. This can lessen their availability and foster presumptive treatment. Therefore, this study investigated the availability of m-RDTs, knowledge of community pharmacists on the use of m-RDTs, and explored Pharmacists’ perceptions of the advantages and disadvantages of licensing the use of m-RDTs in community pharmacies. Methods This was a cross-sectional study among 200 licensed community pharmacists who were purposefully sampled nationwide from 11th February to 12th April 2022. Data was collected using an online data collection instrument composed of open-ended and closed-ended questions. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 25.0. The chi-square test was used to evaluate the association between the availability of m-RDTs and independent variables of interest. Content analysis was used for qualitative data. Results Although 59% were consulted by clients requesting to purchase m-RDTs, only 27% of the participants had m-RDTs in stock, 66.5% had no training on the use of m-RDTs, and 18.5% were not at all familiar with using the m-RDTs. Most of the participants (91.5%) agreed that licensing the use of m-RDTs in community pharmacies could promote the rational use of antimalarials. The chi-square test indicated that being requested to sell m-RDTs (x2 = 6.95, p = 0.008), being requested to perform m-RDTs (x2 = 5.39, p  = 0.02),familiarity using m-RDTs (x2 = 17.24, p = 0.002), availability of a nurse in the Pharmacy (x2 = 11.68, p < 0.001), and location of the pharmacy (x2 = 9.13, p = 0.048) were all significantly associated with the availability of m-RDTs in the pharmacy. Conclusions The availability of m-RDTs remains low in community pharmacies in Rwanda, and less training is provided to community pharmacists regarding the use of m-RDTs. Nevertheless, community pharmacists had positive perceptions of the advantages of licensing the use of m-RDTs. Thus, licensing the use of m-RDTs is believed to be the first step toward promoting the rational use of antimalarial medicines in Rwanda