Development of guidelines to reduce road accidents amongst community members in Botswana: a public health issue

Bibliography: leaves 124-147BACKGROUND The leading and increasing contributor to the regional and global disease burden that leads to death and disability is represented by road accidents. An enormous toll on individuals together with communities and national economies has been observed because of the occurrence of road accidents. AIM The study developed guidelines to reduce road accidents amongst automobile drivers in Botswana. METHODS Study design The study was conceptualised using Haddon's theory and the mixed-method sequential explanatory design was utilized to conduct the study. Collection of data for this study was done over a period of time in two consecutive phases. v Study setting The study took place in Gaborone, and the study was conducted at Broadhurst Police Headquarters, Directorate of transport station, and the University of Botswana. Data Collection methods: The data for this study were collected through the usage of focus group interviews and document analysis using a checklist. The first phase involved collecting quantitative data through document analysis of 400 police records using a checklist. The second phase took place in Gaborone at the University of Botswana. It involved collecting qualitative data using two focus group interviews with various stakeholders like traffic police, third party claim officers, and emergency nurses/doctors who have been in contact with people involved in road traffic accidents. Study Population: The study population included traffic accident victims' documents at the police headquarters for Gaborone and Francistown, police and traffic officers, lawyers/third party claims officers, and emergency department staff such as nurses and doctors working in Gaborone and Francistown. Data analysis: A checklist was used in transforming observations of found categories into quantitative statistical data. Data generated from the content analysis were transformed into quantitative statistical data using a checklist. Quantitative data were entered and analysed principally using the Statistical Package for Social Sciences (SPSS 27) software to generate graphs and tables. Inconsistencies of the data set was managed by cleaning and editing the data. The data that were missing were not statistically imputed. The relationships of independent variables based on Haddon Matrix-like, drunk driving, unlicensed drivers, over speeding, deaths, and injuries were analysed against the dependent variable of having a road traffic accident using logistic regression. Qualitative vi data from focus group interviews was transcribed verbatim using a transcription protocol. Using transcription protocol ensured that transcription is done consistently and is of the appropriate type for analytic aims. Tesch’s framework for qualitative data analysis was used. UNISA, Botswana Ministry of Health and Wellness, and The Ministry of Defence, Justice, and Security granted the researcher the permission to conduct the study. Results The study found that most accidents are caused by the drivers’ carelessness followed by animals, both domestic and wild. The accidents had an impact on the health of drivers, passengers, and pedestrians. The accidents resulted in fatalities and lower limb fractures, upper limb fractures, and brain injuries. Over the past five years, Gaborone and Serowe recorded the highest cases of road traffic accidents. Most of the accidents occurred where there were no junction. Conclusion It is envisioned that the guidelines informed by research and literature will ensure a decrease in road traffic accidents and consequently fatalities and injuries among Botswana communities.Health StudiesD. Phil. (Public Health

The status of health promotion in Botswana

Health education and promotion remains an integral part of public health. This paper details health promotion activities in Botswana since the establishment of the profession in 1988. It further describes health promotion infrastructure, investment in health promotion, human resource training and collaborations within the country. Infrastructure and services for health promotion in the country are mainly provided by government through educational institutions, faith based organizations, non-governmental organizations, general medical practitioners and mining companies complementing the Ministry’s efforts. More than 1000 health promotion cadres have been trained at certificate, diploma and degree levels by Boitekanelo College and the Ministry of Health through Serowe Institute of Health Sciences

Addressing the Challenge of P-Value and Sample Size when the Significance is Borderline: The Test of Random Duplication of Participants as a New Approach

The issue of borderline p-value seems to divide health scientists into two schools of thought. One school of thought argues that when the p-value is greater than or equal to the statistical significance cut-off level of 0.05, it should not be considered statistically significant and the null hypothesis should be accepted no matter how close the p-value is to the 0.05. The other school of thought believes that by doing so one might be committing a Type 2 error and possibly missing valuable information. In this paper, we discuss an approach to address this issue and suggest the test of random duplication of participants as a way to interpret study outcomes when the statistical significance is borderline. This discussion shows the irrefutability of the concept of borderline statistical significance, however, it is important that one demonstrates whether a borderline statistical significance is truly borderline or not. Since the absence of statistical significance is not necessarily evidence of absence of effect, one needs to double check if a borderline statistical significance is indeed borderline or not. The p-value should not be looked at as a rule of thumb for accepting or rejecting the null hypothesis but rather as a guide for further action or analysis that leads to correct conclusions

SD Bioline malaria antigen Pf (HRP-2/pLHD) for assessing efficacy of artemisinin combination therapy against Plasmodium falciparum in pediatric patients in the Democratic Republic of the Congo

Introduction: The emergence of Plasmodium falciparum resistance to artemisinin combination therapy (ACT) is a worrying development. It calls for close surveillance to monitor the efficacy of the drugs. The objectives of this study were to determine the performance of SD Bioline malaria AgPf(HRP-2/pLDH) 3  band Rapid Diagnostic Test (RDT) against Giemsa-stained blood smear and evaluate the suitability of this test in assessing the therapeutic efficacy of ACT in pediatric malaria patients in the Democratic Republic of the Congo (DRC). Methods: Five hundred and one patients with malaria symptoms were screened for P. falciparum in  Kinshasa, DRC. Of the 166 patients who tested positive for P. falciparum at recruitment (day 0), 103 consented to participate in this study and were followed up and retested for P. falciparum on day 3, day 7, day 14, day 21 and day 28. Results: Sensitivity and specificity of the test were significantly high on day 0 and so were their positive and negative predictive values. Higher proportions of false positive cases were observed on the HRP-2 band irrespective of patient parasite densities during the follow up but these were barely seen on the pLDH band. Some patients turned positive during follow up but pLDH readings remained consistent with bloodsmear readings. Conclusion: SD Bioline malaria AgPf(HRP-2/pLDH) RDT demonstrated high performance in DRC. Thus, the test can be employed to assess the efficacy of ACT in pediatric malaria patients and prioritize areas that require the deployment of advanced testing like polymerase chain reaction (PCR).Key words: Malaria, AgPf(HRP-2/pLDH) RDT, artemisinin combination therapy, Democratic Republic of the Cong

Nature and sources of poisoning in patients admitted to a referral hospital in Gaborone, Botswana : findings and implications

Background: Intentional poisoning is becoming an important public health concern particularly among young women globally. Consequently, there is a need to analyse this further within countries to establish pertinent policies to reduce current incidence rates. This includes sub-Saharan African countries where there has been a scarcity of information. Consequently, we sought to establish the nature and sources of poisoning in patients admitted to a leading hospital in Botswana to help develop pertinent future policies for Botswana and surrounding countries. Methods: Retrospectively reviewing the medical records of all patients admitted to Princess Marina Hospital (PMH), which is a leading tertiary hospital in the capital city of Botswana, due to acute poisoning over a six-year period. Results: The records for 408 patients were reviewed. The majority of admissions (58%) were females, and the mean age of patients was 21(±14) years. Most poisoning cases (53%) were intentional. The 15-45 years age group was most likely to intentionally poison themselves compared to other age groups, with females four and half times more likely to intentionally poison themselves compared to males (AOR 4.53, 95% CI: 2.68- 7.89, p < 0.001). Half of the patients were poisoned by medicines followed by household chemicals (22%), with females overall four times more likely to be poisoned by medicines compared to males. The medicine mostly ingested was paracetamol (30%). Failing relationships (57%) were the principal reason for intentional poisoning. Six patients died from poisoning representing a 1.5% mortality rate. Conclusions: The findings suggest in-depth and urgent investigations on intentional poisoning are needed among young women across countries including sub-Saharan African countries to inform future policies on prevention strategies. Further, strategies for poisoning prevention should target social and family relationship problems. We will be following this up in the future

Occurrences of Cadmium, Arsenic, Lead, and Mercury in Potable Water in Greater Gaborone, Botswana: Implications for Public Health

Heavy metals, such as cadmium (Cd), arsenic (As), lead (Pb), and mercury (Hg), are often detected in water, causing detrimental effects to human health. This study assessed Cd, As, Pb, and Hg concentrations in drinking water from the greater Gaborone water distribution system supply area. The Inductively Coupled Plasma—Mass spectrometry was used to analyze 200 water samples from water treatment reservoirs, the distribution line, households, and bottled water. Heavy metal pollution was calculated using the heavy metal pollution index (HPI). Average heavy metal concentrations were in the order of Pb > Hg > As > Cd in the overall study, with lead exceeding the permissible limit set by the United States Environmental Protection Agency (US-EPA) in all the samples. Average lead concentrations from indoor taps were 15 times more than untreated raw water. HPI values were respectively 33.2 and 0.74 for the World Health Organization (WHO) and Botswana Bureau of Standards (BOBS). An increase in heavy metal concentrations post-water treatment suggests inadequate system maintenance and possible contamination of water during the distribution system from copper and lead soldered pipes. Further research on the treatment infrastructure and plumbing activities is suggested

How well does the process of screening and diagnosis work for HIV-infected persons identified with presumptive tuberculosis who are attending HIV care and treatment clinics in Harare city, Zimbabwe?

Background: Intensified TB case finding is recommended for all HIV-infected persons regularly attending HIV care and treatment clinics. The authors aimed to determine how well this system worked among HIV-infected patients diagnosed with presumptive TB in 14 health facilities of Harare province, Zimbabwe, between January and December 2016. Methods: Retrospective review using routine programme records. Results: Of 47 659 HIV-infected persons enrolled in HIV care, 102 were identified with presumptive TB through the programmatic electronic database. Of these, 23% (23/102) were recorded in presumptive TB registers and, of these 65% (15/23) were traced to laboratory registers. Of 79 patients not recorded in presumptive TB registers, 9% (7/79) were traced to laboratory registers. Of 22 patients in the laboratory register, all had negative sputum smears for acid-fast bacilli and 45% (10/22) had Xpert MTB/RIF assays with one positive result. Six patients altogether started anti-tuberculosis treatment, the median time from presumptive tuberculosis diagnosis to treatment being 12 days. The only significant risk factor for loss-to-follow-up between presumptive TB diagnosis and laboratory registration was not being recorded in presumptive TB registers. Conclusions: Follow-up mechanisms for presumptive TB cases diagnosed in HIV care clinics in Harare city need strengthening, particularly through improved documentation in presumptive TB registers and better Xpert MTB/RIF use

SD Bioline malaria antigen Pf (HRP-2/pLHD) for assessing efficacy of artemisinin combination therapy against Plasmodium falciparum in pediatric patients in the Democratic Republic of the Congo

Abstract Introduction: The emergence of Plasmodium falciparum resistance to artemisinin combination therapy (ACT) is a worrying development. It call

A bibliometric analysis of medical informatics and telemedicine in sub-Saharan Africa and BRICS nations

The advances in eHealth have dramatically changed the face of healthcare delivery around the world, with Sub-Saharan Africa being no exception. It is essential to identify the prominent, emerging researchers, successful areas of research within the field of Health Informatics (H.I.) and Telemedicine (T.M.) to be duplicated where there is a need. This study gives a bibliometric overview of original research articles on medical informatics and telemedicine indexed in Scopus, PubMed, and Science Direct over the last 20 years in sub-Saharan Africa. Keywords related to health informatics and Telemedicine were used to retrieve relevant literature. We specifically analyzed the evolution, standard metrics, domains of MI and T.M. in sub-Saharan Africa (S.S.A.) and Brazil, Russia, India, China, and South Africa (BRIC) nations. Our results identified mhealth as the main field of research in telemedicine that has seen significant growth in both BRIC and S.S.A nations and is poised to be the focus of research activity in the near future. Research production in mhealth and telemedicine showed a considerable increase from 1999–2018. The production was dominated by articles from South Africa in Africa and China from the BRIC nations. Most prolific authors have resources and are leaders of health informatics projects. The production came from 26 sub-Saharan African countries, denoting this field's devotion in different areas around sub-Sahara. Research in mhealth needs to be encouraged, mostly in the fight against infectious and non-infectious diseases in sub-Saharan Africa, where technology can improve health services and decrease disease burden

The prevalence of oral conditions and tobacco use among dental patients at princess Marina Mental Clinic, Botswana

Background Several studies have associated smoking with oral conditions such as tooth staining and bad breath, periodontal diseases, impaired healing of wounds, precancer and oral cancer. These effects are often visible and potentially reversible after cessation of smoking. Dentists are frequently in contact with the general population and therefore provide an opportunity for early intervention in smoking cessation counseling compared to other health professionals. This study profiled patients with oral conditions, to assess their knowledge on oral conditions and tobacco use. Methods A cross-sectional survey was carried out at Princess Marina Dental Clinic in Gaborone. The study population included all dental patients visiting the clinic. Only dental patients from the age of 18 years old and above participated in the study. Patients were interviewed using a structured questionnaire and investigated clinically for the presence of oral conditions by a qualified dentist. Results The prevalence of Tobacco use was 21% among the patients. The prevalence was significantly higher among patients aged 25 and 36 (p< 0.05). Dental carries was the most common condition affecting 45% of patients followed by periodontal disease affecting 21% of patients. The age group 25-36 years was the most affected by oral conditions (p< 0.05). Current smokers had a higher prevalence of tooth staining (26%) compared with never smokers (11%). Periodontal disease was prevalent in 32% of tobacco users and 20% of past tobacco users. Overall, 25%(n=68) of patients were not aware of the relationship between smoking and oral health. Conclusions Tobacco use prevalence is high among dental patients in this study. The lack of awareness on tobacco use and effects on oral health is also concerning. On account of their frequent contact with the general population, dentists could provide a window of opportunity for early detection of oral conditions associated with smoking, provide patient education, counseling and smoking cessation advice