Knowledge, beliefs and attitude towards malaria control and prevention among students in tertiary institutions in the Gambia

BACKGROUNDEven though Malaria caused by five parasite species, two of which – Plasmodium falciparum and Plasmodium vivax is preventable, curable and treatable, it continues to pose a significant health threat to many communities around the world. Particularly in Sub-Saharan Africa, The Gambia is one of the African countries that has seen a significant reduction in malaria cases. Malaria cases in The Gambia had decreased gradually from 346.9 per 100,000 persons in 2004 to 66 per 100,000 people in 2018. The fight against malaria is great progress for the future. AIMThis study aimed at assessing the knowledge, attitude and practice of students attending tertiary institutions in The Gambia in regard to Malaria prevention and control. METHODOLOGYFrom May to June 2021, a standardized pre-tested semi-structured questionnaire was used to obtain information from 431 students in four public institutions in The Gambia. The University of The Gambia (UTG) Brikama Campus, The Gambia College-Brikama Campus, Management Development Institution (MDI) and The Gambia Technical Training Institution (GTTI. Respondents were chosen using a random sampling approach of students who were found on campuses and consented to participate. Sample size was determined using the formula described by Thrusfield (2007) based on a 95% confidence interval. It was first entered into excel and then exported to SPSS version 22 (SPSS Inc., Chicago, Ill., USA) for data analyses. RESULTThe aetiology, symptoms and therapy of malaria were all well-understood by the respondents. Age (P-value=0.005) and program of study (P-value=0.014) were highly significant with students’ knowledge on the mode of transmission of malaria as for students belief of the disease. Institution of learning Odd ratio (1.385, P value=0.003) was the only factor which affected students perception of malaria. Gender (Odd ratio=2.491, P-value=0.005) and the institution of learning (Odd ratio=1.506, P-value=0.003) were factors which had a high statistical significance with students practice of sleep under an ITNs. CONCLUSIONThis study reported a high level of knowledge, poor attitude and practice towards malaria control interventions among students attending tertiary institutions in The Gambia. Students from the UTG and GTTI showed a better positive knowledge than those from the other participants. Their curriculum studies and social activities (individual students’ unions) exposed them to a higher level of awareness. RECOMMENDATIONSHealth-related programs on malaria prevention and control should be organized to raise awareness in through television and radio or any other media. Health education should be a compulsory topic or module in institutions

Circulation of respiratory viruses during the COVID-19 pandemic in The Gambia

Background: In many countries, non-pharmaceutical interventions to limit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission resulted in significant reductions in other respiratory viruses. However, similar data from Africa are limited. We explored the extent to which viruses such as influenza and rhinovirus co-circulated with SARS-CoV-2 in The Gambia during the COVID-19 pandemic.  Methods: Between April 2020 and March 2022, respiratory viruses were detected using RT-PCR in nasopharyngeal swabs from 1397 participants with influenza-like illness. An assay to detect SARS-CoV-2 and a viral multiplex RT-PCR assay was used as previously described  to detect influenza A and B, respiratory syncytial virus (RSV) A and B, parainfluenza viruses 1-4, human metapneumovirus (HMPV), adenovirus, seasonal coronaviruses (229E, OC43, NL63) and human rhinovirus. Results: Overall virus positivity was 44.2%, with prevalence higher in children 50 years (39.9%), p50 years (24.3%), p50 years (6.3%), p<0.0001. Four SARS-CoV-2 waves occurred, with 36.1%-52.4% SARS-CoV-2 positivity during peak months. Influenza infections were observed in both 2020 and 2021 during the rainy season as expected (peak positivity 16.4%-23.5%). Peaks of rhinovirus were asynchronous to the months when SARS-CoV-2 and influenza peaked. Conclusion: Our data show that many respiratory viruses continued to circulate during the COVID-19 pandemic in The Gambia, including human rhinoviruses, despite the presence of NPIs during the early stages of the pandemic, and influenza peaks during expected months

Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs), where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB), depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51%) of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4%) were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2%) had body area surface burned (BSAB) of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62), those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57), or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23) had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively) were less likely to have BSAB ≥ 20% than adults. Those burned in a rural location (aOR = 9.23, 95% CI = 2.30–37.12) or by fire or flames (aOR = 6.09, 95% CI = 1.55–23.97) were more likely to die. Children 0–5 years or 5–18 years (aOR = 0.2, 95% CI = 0.03–1.18; aOR = 0.38; 95% CI = 0.11–1.570, respectively) were less likely to die. Children constitute a significant proportion of admitted burn patients, and most of them were supervised at the time of the burn event. Supervised children (compared to unsupervised children) had less severe burns. Programs that focus on burn prevention at all levels including child supervision could increase awareness and reduce burns or their severity. Programs need to be designed and evaluated with focus on the child development stage and the leading causes of burns by age group

Knowledge of Infection Prevention and Control and Practice Behaviors among Career and Volunteer Firefighters in Rural Communities

Due to the emerging threat conditions in the work environment, firefighters are at a high risk of exposure to not only toxic substances but also biological agents in the dayroom and during emergency runs. The aim of this study is to evaluate firefighter (career and volunteer) knowledge and practice behaviors on infection control. This study surveyed 444 firefighters (210 career, 234 volunteer) in rural Northwestern Kentucky. The self-reported survey focused on individual characteristics, knowledge on exposure incident control, precautionary actions, and personal protections. We evaluated the descriptive characteristics of knowledge and practice scores stratified by firefighter groups (career and volunteers). The associations between infection control training received (yes/no) and firefighter knowledge and practice scores were also examined. Firefighters who were trained on infection control prevention had significantly higher knowledge scores (M = 63.7, SD = 13.4 vs. M = 59.7, SD = 15.9; p = 0.012). Volunteer firefighters exhibited better infection control practice behaviors than career firefighters (M = 70.6, SD = 13.0 vs. M = 67.4, SD = 11.1; p = 0.05). Firefighters who followed infection control guidelines (M = 69.5, SD = 11.9 vs. M = 58.1, SD = 9.9; p = 0.012) and expressed need for a comprehensive training on personal protective equipment (PPE) selection (β = 3.41, SE = 1.54, aOR = 30.22, 95% CI: 1.47–620.87; p = 0.028) had significantly higher practice scores compared to those who did not. The study results have policy implications for infection prevention and control (IPC) in rural fire departments, both career and volunteer. A review of infection control policies is needed, especially as it relates to training and practice behaviors during emergency calls and in the dayroom. Results also suggest the need to develop strategies to improve the culture of PPE use and training on the selection of PPEs appropriate to the emergency response type

Risk Factors for Recurrent Violent Injuries Among African Women in The Gambia

Introduction: Violence against women remains a major public health concern in African countries. We conducted a matched case-control study to identify risk factors for recurrent violent injuries among African women in The Gambia, a small West African country.Methods: During the 12-month study period, we recruited study participants from eight emergency departments in the metropolitan areas of the municipality of Kanifing and the West Coast region. We selected women aged ≥15 years who sought medical treatment for an injury due to physical violence at least twice over the study period. Two control groups were used: violence controls (VC), which included those who had experienced a single violence-related injury in the prior 12 months; and nonviolence controls (NVC), which included those who had experienced a nonviolent injury. Control patients were matched based on gender, health facility, injury date, and age (±2 years).Results: In total, 116 case patients and 232 control patients participated in the study. Results of the conditional logistic regression analyses of the VC and NVC control groups individually showed that women with recurrent violent injuries had a significantly higher likelihood of having a secondary education (odds ratio [OR]VC 6.47; ORNVC 4.22), coming from a polygamous family (ORVC 3.81; ORNVC 3.53), and had been raised by a single parent (ORVC 5.25; ORNVC 5.04). Furthermore, compared with the VC group, women with recurrent violent injuries had a significantly higher likelihood of living in a rented house (ORVC 4.74), living with in-laws (ORVC 5.98), and of having experienced childhood abuse (ORVC 2.48). Compared with the NVC group, women with recurrent violent injuries had a significantly higher likelihood of living in an extended family compound (ORVC 4.77), having more than two female siblings (ORVC 4.07), and having been raised by a relative (ORVC 3.52).Conclusion: We identified risk factors for recurrent injuries from physical violence among African women in The Gambia. Intervention strategies targeting these risk factors could be effective in preventing recurrent violence against African women

Rice growers, hunters and fishermen perception of hippopotamus activities across Central River Region (CRR) of the Gambia: implication for their conservation

The aim of the study is to investigate the types of damages caused by hippopotamus and control methods adapted by farmers in order to facilitate co-existence between hippopotamus and humans. A cross-sectional survey was conducted in March 2021 to assess the activities of Hippopotami across CRR of The Gambia using 252 standardized questionnaire and two Focal Group Discussions (FGDs). About 96% of respondents reported that they have seen hippos before in their communities and 98% of them also said that hippos have been raiding their communities for food for the past 10 years. Majority of the respondents reported that hippos have affected them before and 93% of them said that there was no help from the government when these animals attacked or destroyed their crops/fishing nets. However, 11% of the respondents reported that, hippos are not important to be conserved. The multinomial logistic regression result shows that, the young active, adult active and respondents from Janjanbureh had a positive belief about the importance of conserving hippos

Risk Factors for Road Traffic Injuries among Different Road Users in the Gambia

We identified risk factors for road traffic injuries among road users who received treatment at two major trauma hospitals in urban Gambia. The study includes pedestrians, bicyclists, motorcyclists, and drivers/passengers of cars and trucks. We examined distributions of injury by age, gender, collision vehicle types and vehicle category, and driver and environment factors. Two hundred and fifty-four patients were included in the study. Two-thirds were male and one-third female. Two-thirds (67%) of road traffic injuries involved pedestrians, bicyclists, and motorcyclists; and these were more common during weekdays (74%) than weekends. Nearly half (47%) of road traffic injuries involved pedestrians. One-third (34%) of injured patients were students (mean age of students was less than 14 years), more than half (51%) of whom were injured on the roadway as pedestrians. Head/skull injuries were common. Concussion/brain injuries were 3.5 times higher among pedestrians, bicyclists, and motorcyclists than vehicle occupants. Crashes involving pedestrians were more likely to involve young people (<25 years; aOR 6.36, 95% CI: 3.32–12.17) and involve being struck by a motor car (aOR 3.95, 95% CI: 2.09–7.47). Pedestrians contribute the largest proportion of hospitalizations in the Gambia. Young pedestrians are at particularly high risk. Prevention efforts should focus on not only vehicle and driver factors, but also protecting pedestrians, bicyclists, and motorcyclists

A Commodity Flow Study to Identify the Hazardous Materials Transported through Northern Kentucky, the Human Health Risks, and Needs for Hazardous Materials Transport Emergency Preparedness in Kentucky

The purpose of this study was to assess the transport of hazardous materials, the risks to human health from transported hazardous commodities, and the emergency management and preparedness needs related to hazardous materials transport in Northern Kentucky. Components of this study included a placard survey, a fixed-facility survey, and an analysis of hazardous material transportation incidents. Hazardous materials placard surveys were conducted in the summer of 2022 to determine the types and frequency of specific hazardous commodities transported on the major interstates and highways throughout the Northern Kentucky region. Additionally, a fixed-facility survey consisting of 35 response items designed to collect data on the types, frequency, and routes of hazardous materials shipments and receipts was sent to local Tier II facilities. An analysis of hazardous materials incidents was also conducted in this study to determine locations of historical accidents that could pose a continued risk to human health, as well as determine locations of “hot spots” that require emergency preparedness planning and exercise development. Results of the study were used to document the hazardous materials identified during the study, the timing and frequency of transport, and the major hazardous materials risks observed during the study period. A major conclusion of the study is the need for a statewide database for hazardous materials transport that is accessible to emergency managers, first responders, and communities in preparation for hazardous materials emergencies. This system would enhance emergency preparedness, training, and response across Kentucky