Student's Journal of Health Research Africa
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BARRIERS TO EXCLUSIVE BREASTFEEDING PRACTICES AMONG HIV-POSITIVE MOTHERS ATTENDING POSTNATAL CLINIC AT KAJJANSI HEALTH CENTRE IV, WAKISO DISTRICT. A CROSS-SECTIONAL STUDY.
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Exclusive breastfeeding is critical for infant health, particularly among HIV-positive mothers. This study aimed to assess the barriers to exclusive breastfeeding among HIV-positive mothers attending a postnatal clinic at Kajjansi Health Center IV.
Methodology
A descriptive cross-sectional study design was employed to select 40 mothers. A simple random sampling method was used, and data was collected using a semi-structured researcher-administered questionnaire with both open and close-ended questions. Microsoft Excel was used for data analysis.
Results
40 respondents participated in this study; the majority, 28(70%) of the respondents, were between 18-25 years of age, while only 01(2.5%) was above 35 years. 75% of the respondents knew that exclusive breast milk is important for HIV-positive mothers. However, 37.5% of the mothers were not sure whether taking ARVs during pregnancy and after childbirth reduces the chances of HIV transmission to the born baby, and 37.5% of them also mentioned replacement feeding as the ideal baby feeding method in the first 6 months. 62% of the respondents reported having sufficient breast milk for EBF. However, 65% of them reported sometimes having support from their partners to EBF, and 20% were not sure whether EBF is culturally accepted. Half of the mothers never got breastfeeding counseling during ANC, and 75% were not advised on EBF for the first 6 months at the health facility.
Conclusion
The study found good knowledge among most of the respondents. However, socioeconomic and health facility factors greatly contributed to barriers to EBF among HIV-positive mothers.
Recommendation
The government, through the Ministry of Health, should expand breastfeeding education during antenatal care and postnatal visits, emphasizing the health benefits of EBF beyond HIV transmission alone
A PROSPECTIVE STUDY ON BIPARIETAL DIAMETER AND FEMUR LENGTH UTILISING ULTRASONOGRAPHIC TECHNIQUES, ALONG WITH ITS CORRELATION TO FOETAL GESTATIONAL AGE.
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The prenatal evaluation is crucial during pregnancy for evaluating the growth and development of the fetus. Ultrasonography is an accessible screening method for monitoring prenatal growth using fetal parameters and gestational age (GA). Femur length (FL) and biparietal diameter (BPD) are frequently utilized in the second trimester to evaluate fetal growth and ascertain precise gestational age. Studies indicated discrepancies in the reliability of FL and BPD for determining gestational age and fetal growth by ultrasonography. The purpose of the current study was to compare biparietal diameter and femur length with gestational age.
Materials and Methods
The study included 190 pregnant women in total. The participants ranged in age from 18 to 35 years, and their gestational ages ranged from 20 to 38 weeks.
Results
This investigation examined 79 cases in the second trimester, specifically between 20 and 27 weeks, and 110 instances in the 3rd trimester of pregnancy. The observed means of FL and BPD were 56.19 and 73.09, respectively. The standard error (SE) and the standard deviation (SD) of the mean for BPD and FL were 0.629, 0.569, and 12.79 and 11.59, respectively.
Conclusion
The study demonstrates a significant link between FL and BPD, with FL exhibiting good accuracy in assessing gestational age, while the correlation diminishes from 20 to 38 weeks.
Recommendation
Analyzing the growth patterns of FL and BPD by sonography will lead to better results
ASSESSMENT OF PAIN AND FUNCTIONAL DISABILITY IN PATIENTS WITH KNEE OSTEOARTHRITIS: A CROSS-SECTIONAL STUDY.
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Osteoarthritis (OA) is a degenerative joint disease that leads to pain, stiffness, and functional limitations, significantly affecting quality of life. Knee OA, the most prevalent form, impacts multiple joint structures and causes progressive disability. Understanding the relationship between pain, functional impairment, and quality of life is crucial for effective management. This study assesses the correlation among knee osteoarthritis, pain, functional impairment, and overall quality of life.
Methods
This cross-sectional study was conducted at Hi-tech Medical College and Hospital, Bhubaneswar (2020–2022) with 800 participants aged 50–65 years diagnosed with unilateral knee OA. Pain was assessed using the Visual Analogue Scale (VAS), functional disability with the WOMAC index, and quality of life using the SF-36 survey. Statistical analysis was performed using SPSS version 20, with Pearson correlation applied to assess associations between pain, functional disability, and quality of life (p < 0.05).
Results
Among 800 knee osteoarthritis patients (70% females, mean age 56.82 ± 4.75 years), the mean pain intensity (VAS) was 5.42 ± 1.09, and the total WOMAC score was 56.89 ± 8.47. Pain and functional disability showed a significant correlation (r = 0.285, p = 0.01), and higher disability was associated with lower quality of life (PCS: r = 0.595, MCS: r = 0.415, p < 0.05).
Conclusion
Greater pain and functional disability significantly reduce the quality of life in knee OA patients. Effective pain and disability management strategies are essential for improving patient well-being.
Recommendation
Integrated management approaches focusing on both pain relief and functional rehabilitation are recommended to enhance the quality of life in patients with knee osteoarthritis
Comparison of Modified Mallampati Classification and Acromio-Axillo-Suprasternal Notch Index in Predicting Difficult Laryngoscopy: A Prospective cohort study.
Get PDFBackground:Difficult airway management remains a major concern in anesthesia, with unanticipated intubation failures increasing perioperative morbidity and mortality. Accurate preoperative identification of at-risk patients is essential for safe airway management and reducing complications like hypoxia and failed intubation. Among airway assessment tools, the Modified Mallampati Classification (MMP) and Acromio-Axillo-Suprasternal Notch Index (AASNI) are commonly used. This study compared the predictive accuracy of MMP and AASNI in forecasting difficult visualization of the larynx (DVL) during direct laryngoscopy.
Methods:A prospective cohort study was conducted on 106 adult patients aged between 18 and 60 years, scheduled for elective surgeries requiring general anesthesia and endotracheal intubation. Each patient underwent preoperative airway assessments using MMP and AASNI. During laryngoscopy, the Cormack-Lehane (CL) grading was recorded. Diagnostic parameters—sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), odds ratio, and likelihood ratios—were calculated to evaluate the predictive performance of MMP and AASNI.
Results:Of the 106 participants, 58 (54.7%) were male and 48 (45.3%) were female. The mean age was 38.11 ± 9.88 years, with the majority aged 40–50 years (38.7%). The average BMI was 24.75 ± 2.33 kg/m². AASNI showed higher sensitivity (83.3%) and NPV (93.9%) compared to MMP (41.67% and 83.7%, respectively), while MMP had greater specificity (87.8%). Both tools shared equal PPV (50%) and diagnostic accuracy (77.36%). AASNI demonstrated a higher odds ratio (15.5 vs. 5.14) and lower negative likelihood ratio (0.220 vs. 0.664), confirming superior predictive performance.
Conclusion:AASNI is a more reliable and objective predictor of difficult laryngoscopy than MMP. It enhances preoperative airway assessment and supports better preparedness for airway management.
Recommendations:Routine use of AASNI is recommended in pre-anesthetic evaluations. Future multicentric studies with larger, diverse populations are warranted to further validate its effectiveness and generalizability
A cross-sectional study on knowledge, attitude, and practices towards exclusive breastfeeding among postnatal mothers at Eastern Division Health Center III in Soroti City.
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Exclusive Breastfeeding is one of the practices that can minimize malnutrition in children below 6 months of life. However, undernutrition cases have alarmingly risen from 10% to 19% over the past three years. This study assessed the knowledge, attitudes, and practices toward exclusive breastfeeding among postnatal mothers at Eastern Division Health Center III, Soroti City.
Methodology.
A descriptive cross-sectional study design was carried out among 30 randomly selected postnatal mothers using a simple random procedure. Data was collected through face-to-face interviews using a pretested semi-structured questionnaire. Data was analyzed and presented in tables, graphs, and pie charts using Excel, from which statements were made.
Results.
15/30 (50%) of the respondents were mothers aged between 19 and 35 years, and 11/30 (36.7%) of the respondents had completed secondary education. (46%) Knew the meaning of Exclusive Breastfeeding (40%), knew that EBF was beneficial for infant growth (46.7%), and attended antenatal care (46.7%). (43.3%) Of the respondents who agreed that complementary breastfeeding is good for babies before 6 months, 50% agreed that EBF makes their breasts flat, and 43.3% disagreed that EBF is enough for infant growth in the first 6 months. Low EBF practices were noted as the majority, 60% of the respondents, who complemented breastfeeding their babies.
Conclusion.
Respondents had average knowledge, though attitudes and practices on exclusive breastfeeding were low. Thus, it is important to provide prenatal education to mothers and fathers on breastfeeding.
Recommendation
Post-natal mothers at Eastern Division Health Centre III should actively participate in postnatal activities to enhance and promote exclusive breastfeeding practices
A cross-sectional environmental assessment of the ecological integrity of key driver components (Water Quality, Sediment, and Habitat) in the uMngeni, Thukela, Umvoti, Umdloti, and Umfolozi rivers, KwaZulu-Natal.
Get PDFBackgroundFreshwater ecosystems in KwaZulu-Natal are increasingly threatened by urbanization, agriculture, and industrial activities. These pressures undermine ecological integrity by affecting water quality, sediment characteristics, and habitat structure. The uMngeni, Thukela, Umvoti, Umdloti, and Umfolozi Rivers hold critical ecological and socio-economic value, yet comprehensive assessments of their environmental condition remain limited.
MethodsA cross-sectional environmental assessment was conducted across five major rivers between March 2024 and October 2024, with sampling sites positioned upstream, midstream, and downstream to capture spatial variability. Water quality parameters (pH, dissolved oxygen, turbidity, nitrates, phosphates, and heavy metals) were measured using standard methods. Sediment samples were analysed for particle size distribution, organic content, and contaminants. Habitat integrity was assessed using the South African Scoring System (SASS5) and the Index of Habitat Integrity (IHI). Data were analysed using descriptive statistics and multivariate techniques.
ResultsThe assessment revealed varying levels of ecological degradation. Downstream sections of the uMngeni and Umvoti Rivers showed poor water quality, with elevated nutrient levels and low dissolved oxygen. Sediment contamination by organic matter and heavy metals was prominent near urban and industrial zones. Habitat integrity scores were lowest in areas affected by agricultural runoff and informal settlements. The Umdloti and Umfolozi Rivers showed relatively better ecological conditions, though signs of degradation were still evident.
ConclusionThe study highlights significant ecological stress in KwaZulu-Natal’s rivers, particularly due to declining water quality and habitat degradation. Spatial trends reveal a strong association between land use activities and ecosystem health, emphasizing the need for urgent intervention.
RecommendationTo protect freshwater ecosystems, authorities should enhance river monitoring programs, enforce pollution control measures, and implement habitat rehabilitation. A collaborative, catchment-based management approach involving communities, industries, and conservation stakeholders is essential for sustainable riverine ecosystem protection
Death on the operating table: A 10-year retrospective, observational descriptive case series study at Victoria Mxenge tertiary referral hospital in KwaZulu-Natal.
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Death on the operating table is a rare occurrence and remains under-researched in South Africa. Multiple factors may contribute to this outcome. This study aimed to identify whether the Shock Index (SI) and ASOS (African Surgical Outcomes Study) risk calculator correlates with intraoperative mortality and explored additional contributing factors.
Methods
A ten-year retrospective case series (2013-2022) was conducted at Victoria Mxenge Hospital. This study included adult patients (Age>18years) who died on the operating table after anaesthetic induction for non-obstetric cases. Of 66920 theatre cases, 57 met our inclusion criteria. Descriptive statistics, including means, interquartile ranges (IQR), and percentages, were used for analysis.
Result
SI data were available for 35 patients; 63% had an SI >1, and 91% of these cases were emergencies. Among patients with ASA 5 status (n=18), 16 (89%) had an SI >1. Of those with ASA 4 (n=11), 6 (55%) also had elevated Shock Indices. Emergency surgery accounted for 95% of all cases. Among patients with ASOS scores of 10–18 (n=8), 63% were emergencies; all patients with ASOS scores ≥19 (n=49) were emergencies. ASA 4 and 5 accounted for 53% and 37% of all deaths, respectively. Of the six cases classified as ASA 2 or 3, five had ASOS scores of 10–18, and one had a score ≥19. Hypovolemic shock was the most likely cause of death in 65% of cases, followed by septic shock (19%) and obstructive shock due to pulmonary embolism (9%).
Conclusion
The SI and ASOS risk calculators are useful tools; identifying high-risk surgical patients and guiding escalation of care. Elevated scores correlate with poorer outcomes.
Recommendation
The use of the Shock Index and ASOS risk calculator may facilitate earlier intervention and resource mobilisation, potentially reducing intraoperative mortality
Molecular subtyping of breast carcinomas in urban and rural Indian population – A cross-sectional study.
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Consequently, one crucial aspect for the treatment profile of breast cancer is the classification of breast cancer into pertinent molecular subgroups. Breast cancer is divided into four primary clinical subtypes based on gene expression profiles, receptor status, and proliferative status. There hasn't been much research done on how common these molecular subtypes are among Indian people.
Objectives
The purpose of conducting this analysis was to evaluate the molecular subtyping of breast cancer in Indians living in both urban and rural areas.
Materials and Methods
It was a prospective, observational study. The study was carried out in SCB Medical College & Hospital, Odisha, India. The study was conducted for two years, that is, from January 2023 to April 2025. In all, 150 patients were enrolled. Study participants included all females with breast cancer.
Results
With 83 (55.3%) patients older than 50, the mean age at diagnosis was skewed toward older patients. Metastases from lymph nodes were found in 89 patients, or 59.3%. In 32 (21.3%) of the cases, distant metastases were discovered at the time of initial presentation. Of the population, 24 (16.0%) had luminal A-like tumors.
Conclusion
This study uses immunohistochemistry surrogate markers to show the distribution of subtypes that are molecular in breast cancer in an Indian population living in both urban and rural areas. The majority of patients come with high-grade tumors and substantial nodal involvement, and the results show a preponderance of aggressive subtypes, including TNBC and Luminal B-like cancers.
Recommendation
Routine molecular subtyping using immunohistochemistry should be incorporated into the diagnostic evaluation of all invasive breast cancer cases to guide treatment decisions effectively
Determinants to grand multi parity among women of reproductive age (35-45), at Entebbe regional referral hospital, Wakiso district. A cross-sectional study.
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The study aims to identify the individual and facility-related determinants of grand multiparity among women of reproductive age (35-45 years) attending Entebbe Regional Referral Hospital in Wakiso District.
Methodology
A descriptive cross-sectional study design employing a quantitative research method was used, targeting women of reproductive age (35-45 years) attending Entebbe Regional Referral Hospital. A total of 59 respondents were considered, and a simple random sampling technique was used.
Results
22(37%) were 39-42 years, 22(37%) had 3-4 children. 58(66%) said it was not easy for them to access family planning information in their location.
32(54%) said their spouses decide on the number of children to have in the family. 48(81%) agreed that gender preferences influenced their desire to have more children. 26(44%) were not informed of the health risk of grand multiparity. 39(51%) had ever experienced unintended pregnancies due to stockouts of contraceptives at the health facility.
24(40%) said insufficient or unclear guidance was given to them on family planning by health workers. 28(47%) were living more than 10 km from the nearest health facility.
Conclusion
Individually, financial status, limited access to family planning information, lack of decision-making autonomy, and inadequate knowledge about the health risks associated with multiple pregnancies were all key contributors to grand multiparity. Health facility-related determinants, stockouts of contraceptives, geographic barriers such as long distances to health facilities, and prolonged waiting times discouraged women from seeking reproductive health services, thereby contributing to continued high parity.
Recommendation
The Ministry of Health should ensure consistent availability of contraceptives in all health facilities to prevent unintended pregnancies and support family planning efforts. Health facility administrators should reduce waiting times and improve counseling services to enhance accessibility and effectiveness of reproductive health services
Predictors of Implant Failure in Orthopaedic Infections Due to Coagulase-Negative Staphylococci: The Impact of Biofilm and Proteolytic Enzymes – A Prospective Observational Study.
Get PDFBackground: Coagulase-negative staphylococci (CoNS), long considered low-virulence skin commensals, have emerged as significant pathogens in orthopaedic implant-associated infections. Their ability to form biofilms and produce proteolytic enzymes contributes to chronic infection, antimicrobial resistance, and implant failure.
Objectives: To evaluate the microbiological and biochemical characteristics of CoNS isolates from orthopaedic implant infections, assess antimicrobial susceptibility, and identify predictors of adverse clinical outcomes, including implant removal and delayed bone healing.
Methods: This prospective observational study enrolled 120 patients with suspected implant-associated infections over two years. Sonication fluid and periprosthetic tissue cultures were performed, and isolates underwent species identification, antimicrobial susceptibility testing, and assessment of biofilm formation, exopolysaccharide production, and protease activity. Clinical outcomes were recorded over a six-month follow-up. Statistical analyses included multivariate logistic regression and correlation studies.
Results: CoNS were isolated in 48 cases (40%), predominantly Staphylococcus epidermidis (70.8%). Methicillin resistance was present in 68.7% of isolates, with high rates of multidrug resistance to erythromycin (79.1%), ciprofloxacin (64.5%), and clindamycin (60.4%). Strong biofilm production was observed in 79.1% of isolates and was significantly associated with implant removal (73.6% vs. 30%; p=0.004), prolonged antibiotic therapy (mean 6.4 vs. 4.2 weeks; p=0.001), and delayed union (44.7% vs. 20%; p=0.03). Multivariate analysis identified strong biofilm production (OR 4.25; p=0.015) and higher proteolytic enzyme activity (OR 1.92; p=0.040) as independent predictors of implant removal.
Conclusions: CoNS are major contributors to orthopaedic implant failure, primarily driven by biofilm-related virulence and proteolytic activity rather than methicillin resistance alone. These findings highlight the need for early microbiological diagnosis and biofilm-targeted interventions.
Recommendations: Clinicians should incorporate implant sonication and biofilm assessment into routine diagnostic protocols and consider prolonged antimicrobial therapy and early surgical intervention in cases with strong biofilm-producing CoNS. Future research should focus on molecular characterization of virulence factors and anti-biofilm therapies to improve treatment outcome