Elvis Tarkang

Assessing the ownership, usage and knowledge of Insecticide Treated Nets (ITNS) in malaria prevention in the Hohoe Municipality, Ghana

Introduction Malaria remains one of the top five killer diseases in sub-Saharan Africa (SSA) and its burden is skewed towards pregnant women and children under five. Insecticide Treated Bed-Net (ITN) usage is considered one of the most cost-effective, preventive interventions against malaria. This study sought to assess ownership, usage, effectiveness, knowledge, access and availability of ITNs among mothers with children under five in the Hohoe municipality. Methods In August 2010 a cross-sectional survey was carried out in 30 communities, selected using the WHO 30 cluster sampling technique. In the selected communities, mothers/caregivers with children under five years were selected using the snowball method. Data were collected through questionnaires and direct observation of ITN. Descriptive statistics was used to analyse the data collected. Results A total of 450 mothers/caregivers were interviewed and their mean age was 30 ± 7 years. ITN ownership was 81.3%, and usage was 66.4%. The majority (97.8%) of the mothers/caregivers said ITNs were effective for malaria prevention. Awareness about ITNs was high (98.7%) and the majority (52.9%) had heard about ITNs from Reproductive and Child Health (RCH) Clinic and antenatal care ANC clinic (33.6%). Over 60% of the ITNs were acquired through free distribution at RCH clinics, clinic and home distribution during mass immunization sessions. The majority of the mothers/caregivers (78.6%) knew the signs and symptoms of malaria, what causes malaria (82.2%) and who is most at risk (90%). Conclusion Behaviour change communication strategies on ITN use may need to be further targeted to ensure full use of available ITNs.

Publication practices and responsible authorship: a review article

Dissemination of research findings through the publication of one’s work or a group of contributors is an important part of the research process, as this allows the passing on of benefits to a much wider community. In whatever evocative form this dissemination may take, the onus lies on the author(s) to ensure adherence to the code of ethics as it pertains to the integrity of the information being put out. We publish because we want our findings to be adapted into practice and application, or in some cases may be relevant to policy makers in decision-making. To a large extent in the field of academia, successful publication improves opportunities for academic funding and promotion whilst enhancing scientific and scholarly achievement and repute. A situation may be compromised where intellectual contributions to a scientific investigation do not adhere to the four key guidelines of scholarship, authorship, approval and agreement as well as the protocols of ensuring good publication ethics. The objective of this review is to lay emphasis on universal standards for manuscript authorship and to fostering good practices. This in our view will bring authorship credit and accountability to the attention of our colleagues and readers at large. To achieve this, a systematic and critical review of the literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to responsible authorship, common authorship malpractices, conflict of interest, universal publication guidelines and other authorship related issues, were used. Only references deemed useful from relevant texts and journal articles were included. In this paper, the authors have sought to highlight the pitfalls researchers sometimes entangle themselves within an act of compromise thereby impinging on the ethical and professional responsibilities for the content of a paper under consideration. This article presents the case that authorship has a strong currency that brings not only personal satisfaction but also career rewards based on publication counting. In all cases described here, a universal standard for manuscript authorship will be critical in fostering good practices. As you write and review manuscripts, keep these good practices in mind, and consider ways to bring authorship credit and accountability to the attention of your colleagues and readers.

Perceptions of factors associated with condom use to prevent HIV/AIDS among persons with physical disability in an urban town of Cameroon: a qualitative study

Persons with disabilities have been identified as one of the groups vulnerable to HIV, due to several challenges posed by their disabilities. They also suffer external stigma from their able bodied peers. However, they have largely been ignored as part of HIV prevention programs, largely due to the perceptions that they are not at risk, and information is not being accessible. About 5.4% of the Cameroon population lives with a disability. In Cameroon, no official statistics exist on perception of factors associated with condom use to prevent HIV among persons with disabilities, which creates a challenge for understanding the extent of the pandemic in this population. The objective of this study was therefore to investigate perceptions of factors associated with condom use among persons with physical disability in an urban town of Cameroon. The qualitative study from which this paper is based, used semi-structured in-depth interviews, conducted with a purposive sample of ten (5 male and 5 female) persons with physical disability, aged 18 years and above, in April 2015. The findings of this study as interpreted according to the components of the Health Belief Model, indicated that perceived susceptibility to HIV, perceived severity of HIV, perceived benefit of condom use, perceived barriers to condom use and perceived self-efficacy for condom use were the factors perceived by persons with physical disability, to be associated with condom use. It is therefore recommended that there should be educational programs in HIV/AIDS targeted specifically at persons with physical disability. These programs should pertinently promote the understanding and perceptions of persons with physical disability of the real threat of HIV/AIDS, and also equip them with condom negotiation skills and strategies to overcome barriers to condom use.

Implementation and challenges of test, treat and track (T3) strategy for malaria case management in children under five years in the Bongo District, Ghana

Background: Malaria is a very deadly vector borne disease, which causes high morbidity and mortality, especially among children less than five years. In 2010, Ghana subscribed to the World Health Organization’s recommendation and developed guidelines for implementing the test, treat and track (T3) strategy. This study examined the extent to which the T3 strategy was being adhered to by clinicians and the challenges with its implementation at various levels of the health system in the Bongo district of Ghana. Method: This was a descriptive cross-sectional study carried out in March 2016 in 28 public health facilities comprising one (1) District Hospital, 6 Health Centres and 21 Community-based Health Planning and Services (CHPS) compounds. Semi-structured questionnaires were used to collect information from parents/ guardians of children under five years who visited the outpatient department (OPD). Information collected included whether the children reported with fever, were tested for malaria, treated with an antimalarial and asked to return to the health facility for review. The clinicians were asked if they were trained on the T3 strategy and the challenges they had with the implementation. Results: Overall, 322 (91.2%) out of the 353 children with fever were tested and 318 (98.8%) of them were positive for malaria parasites. All (353) children including those 31 (8.8%) not tested were treated with antimalarial drugs. Majority 351 (99.4%) of the children were treated with ACTs and only 2 (0.6%) were treated with Quinine. Less than half 167 (48.3%) were asked to return for review. Only 150(42.5%) of the children completed the T3 protocol. Completing T3 at facility level was highest at the CHPS compound 72 (60.5%), followed by the District Hospital 32 (39.5%) and the least was the Health Centre 46 (30.1%). Completing T3 by clinicians was highest among Doctors 4 (80.0%), followed by Health Assistants 24 (51.1%), Nurses 92 (47.2%) and the least was Medical/Physician Assistants (MA/ PA) 30(28.3%). Overall, the main challenges confronting clinicians were frequent malaria rapid diagnostic test (RDT) kits stock-outs 11(39.3%), lack of diagnostic facilities 10 (35.7%), ACTs stock-outs 1 (3.6%) and RDTs not giving accurate or valid results 3 (10.7%). These challenges were mainly with clinicians at the CHPS compounds and the health centres. The District hospital had no challenges with logistics. Conclusion: Testing fever cases for malaria parasitaemia was very high and ACTs were the main drugs for treating malaria at all levels. The main determinant of completing T3 was asking clients to return for review. Compliance with the T3 strategy was better at the CHPS compounds than Hospitals and Health Centres. Doctors and Health Assistants were more likely to complete T3 than nurses and MA/PA. Recommendations: The National Malaria Control Programme (NMCP) should ensure that CHPS compounds and Health Centres are regularly stocked with RDTs and ACTs. More training and monitoring support for clinicians are required to improve patient tracking and management of non-malaria fever cases at the lower levels of the health system. Correspondence to: Elvis Tarkang, Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Ho, Ghana, Tel: +233 505754478; E-mail: ebeyang1@yahoo.com

Highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon

Introduction Cameroon has a high prevalence of out-of-school youths. Therefore, research relating to out-of-school youths and HIV/AIDS is imperative, since they might engage in high risk sexual behaviours. The current study investigated the highly prevalent at-risk sexual behaviours among out-of-school youths in urban Cameroon. Methods A cross-sectional design was adopted using a self-administered questionnaire to collect data from a cluster sample of 405 out-of-school youths, aged 15-24 years. Statistics was calculated using SPSS version 20 at the level 0.05. Results By age less than 16 years, more females, 90.2% than males, 71.8% had experienced sex (p < 0.001); more females, 40.4% than males, 23.2% used condoms during first sex (p < 0.01); more males, 70.8% than females, 46.0% had multiple sequential sexual partners during the last one year prior to this study (p < 0.001); more males, 42.6% than females, 18.0% had multiple concurrent sexual partners during the study period (p < 0.01); more youths who did not belong to a well-defined social network, 80.8% had experienced sex than those who belonged, 55.8% (p < 0.001); more youths who did not belong to a well-defined social network had multiple sequential sexual partners, 46.7% than those who belonged, 32.3% (p < 0.01); more youths who belonged to a well-defined social network, 24.3% used condoms consistently than those who did not belong, 15.4% (p < 0.01). Conclusion Sexual risk behaviours exist among out-of-school youths in urban Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change especially among those with low socioeconomic status. Youths should be encouraged to join well-defined social networks.

Psychosocial predictors of consistent condom use among migrant road construction workers in the Southwest Region of Cameroon using the Health Belief Model

Introduction A significant proportion of road construction workers are migrants and prone to HIV infection. This study investigated the psychosocial predictors of consistent condom use among migrant road construction workers in the South-west region of Cameroon using the Health Belief Model (HBM) as the theoretical framework. Methods A cross-sectional survey of a stratified sample of 254 road construction workers was conducted at construction sites along the Kumba-Mamfe road in the South-west region of Cameroon in December 2015. Data were collected using a pretested structured questionnaire and binomial logistic regression was performed to test the strength of association between the independent and the dependent variables using SPSS version 20 at the level 0.05. Results Only 67 (43.5%) reported consistent condom use. Perception of risk of contracting HIV was also low, 109 (42.9%). None of the constructs of the HBM was significantly associated with consistent condom use. However, perception that road construction workers are prone to HIV (perceived susceptibility) was associated with an increased likelihood of using condom consistently, OR = 2.1 (95% CI 0.72-6.12, p = 0.17); perception that consistent condom use could prevent HIV transmission (perceived benefit) was associated with an increased likelihood of using it consistently, OR = 1.9 (95% CI 0.74-4.80, p = 0.18); perception by workers that they can refuse sex with their partners if they refuse to use condoms (perceived self-efficacy) was associated with an increased likelihood of using condoms consistently, OR = 1.5 (95% CI 0.62-3.53, p = 0.38). However, the perception that condom reduces sexual pleasure (perceived barriers) was associated with a reduced likelihood of using it consistently, OR = 0.84 (95% CI 0.35-2.01, p = 0.698) Conclusion There were no significant associations between the psycho-social constructs of the HBM and consistent condom use. Therefore, interventions to increase the perception of risk of contracting HIV, which is assumed to be the immediate antecedent of consistent condom use is highly recommended.

The Ubuntu concept, sexual behaviours and stigmatisation of persons living with HIV in Africa: A review article

Stigma and discrimination and risky sexual behaviours have been major stumbling blocks to the efforts by implementers to mitigate the effects of HIV amongst communities in Africa. A key cultural resource, based on evolving South African cultural traditions, is the notion of Ubuntu, which is grounded in respect, ethics, humanity and the interconnectedness of beings. This concept can be a useful resource in upholding confidentiality, a central requirement in research ethics and the deliverance of health promotion interventions regarding HIV/AIDS. This article explored the applicability of the Ubuntu concept in enhancing safe sexual practices and positive attitudes towards persons living with HIV, with the view of achieving Zero new infections, Zero discrimination against persons living with HIV (PLHIV), and Zero AIDS-related deaths. A review of literature was undertaken. Electronic databases, academic journals and books from various sources were accessed. Several key search terms relating to the tenets of Ubuntu, stigma and discrimination towards PLHIV, and sexual behaviours were used. Only references deemed useful from relevant texts and journal articles were included. Going therefore by the Ubuntu tradition of basic respect and compassion for others, one will expect positive attitudes towards PLHIV. This review therefore advocates positive attitudes towards PLHIV. Also, according to the Ubuntu tradition that prescribes a rule of conduct and social ethics, one would expect the sexual behaviours of youths in Africa to be good. This review article also advocates safe sexual behaviours of adolescents in Africa. With this in mind, from a critical Ubuntu-centric philosophical perspective, this article breaks new ground by advocating the use of the Ubuntu concepts in enhancing safe sexual practices and positive attitudes towards PLHIV in Africa. This could in turn bring about safe sexual practices among youths, and curb the discrimination and stigmatization against PLHIV in Africa.

Predictors of Perception of Risk of Contracting HIV among Migrant RoadConstruction Workers in Rural Cameroon

Background: Migration, mobility, and HIV/AIDS are well-documented interlinked phenomena. While the Cameroon AIDS Strategic Plan 2014-2017 focuses on the key populations, little was mentioned on migrant workers. Nevertheless, the inclusion of migrant workers in the road construction sector in the national strategic plan offers a critical opportunity to design and deliver HIV services that meet their needs. Risk perception of HIV/AIDS should accompany risky sexual behaviour change. This study investigated the predictors of perception of risk of contracting HIV among migrant road construction workers in the Southwest region of Cameroon using the Health Belief Model (HBM) as the theoretical framework. Methods: A cross-sectional survey of a stratified sample of 254 road construction workers was conducted at construction sites along the Kumba-Mamfe road in December 2015. Data were collected using a pretested structured questionnaire and analysed using binomial logistic regression using SPSS version 20 at the level 0.05. Results: Only 109 (42.9%) perceived that they are at risk of contracting HIV. Apart from perceived susceptibility to HIV which was found to be a significant predictor of the perception of risk of contracting HIV: OR=5.12 (95% CI 0.667- 15.604, p=0.004), none of the other constructs of the HBM was a significant predictor of perception of risk of contracting HIV. However, the perception that HIV is deadly (perceived severity) was associated with an increased likelihood of perception of risk of contracting HIV: OR=1.23 (95% CI 0.523-2.893, p=0.635); the perception that consistent condom use could prevent HIV transmission (perceived benefit) was associated with an increased likelihood of perception of risk of contracting HIV: OR=1.25 (95% CI 0.518-3.008, p=0.621); the perception by workers that they could refuse sex with their partners if they refused to use condoms (perceived self-efficacy) was associated with an increased likelihood of perception of risk of contracting HIV: OR=2.04 (95% CI 0.888-4.693, p=0.093). Conclusion: There is the need for sensitization programmes and interventions to increase the perception of susceptibility to HIV/AIDS among migrant road construction workers, which will, in turn, increase their perception of risk of contracting HIV and consequently bring about sexual behaviour change.