Joyce Mahlako Tsoka-Gwegweni

Skin lightening practices: an epidemiological study of South African women of African and Indian ancestries

Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in sub‐Saharan Africa where such products are widely used, with a prevalence of 25–67%.

The spectrum of skin diseases in a black population in Durban, KwaZulu‐Natal, South Africa

Precise knowledge of the prevalence and spectrum of skin diseases in a population allows for effective planning for provision of dermatology services and distribution of resources. There are no published data on the epidemiology of skin disorders in Durban, KwaZulu‐Natal.

Women's perceptions of the benefits and risks of skin-lightening creams in two South African communities

Skin‐lightening products are commonly used by black communities in South Africa and worldwide. This practice has deep historical and cultural roots and is associated with adverse cutaneous effects.

Chemical analysis and in vitro UV-protection characteristics of clays traditionally used for sun protection in South Africa.

Clays have been used in southern Africa as photoprotectants by the indigenous people. Typically, two types of clay are used: one white in colour and the other red. In this work, the two clays were identified and characterized, and their in vitro SPF values measured. The clays afford a low SPF but offer broad‐spectrum protection. No cutaneous side effects from the use of these clays are known. Further consideration should be given to the potential use of clays in sunscreen preparations.

Prevalence of and associated risk factors for high risk human papillomavirus among sexually active women, Swaziland

Background High risk human papillomavirus (hr-HPV) infection and the dual burden of HIV remains a huge challenge in some low-income countries (LICs) such as Swaziland with limited or no data. We estimated the prevalence and investigated determinants of hr-HPV, including HIV infection among sexually active women in Swaziland. Methods A total of 655 women aged between 15 and 49 years from five health facilities were randomly enrolled using a cross-sectional study design. Cervical cells were tested for hr-HPV types using GeneXpert HPV Assays. Results The overall weighted hr-HPV prevalence was 46.2% (95%CI: 42.8–49.5). Of hr-HPV infected women, 12.4% (95%CI: 8.6–17.5) were HPV16-positive, 13.8% (95%CI:12.0–15.8) were positive for HPV18/45, 26.7% (95%CI: 24.2–29.3) for HPV31/33/35/52/58, 7.6% (95%CI: 7.6–11.9) for HPV51/59 and 11.0%, (95%CI: 7.9–15.3) for HPV39/56/66/68. Prevalence of hr-HPV decreased with increasing age. Overall HIV prevalence remained high (42.7%; 95%CI: 35.7–46.2). HIV infection was associated with hr-HPV infection (Adjusted OR = 4.9, 95%CI: 3.043–7.8, p<0.001). Overall hr-HPV/HIV co-infection was 24.4% (95%CI: 20.3–29.1) which was significantly higher among younger age groups (p<0.001). Prevalence of multiple group hr-HPV infection was significantly higher in HIV-positive versus -negative women (27.7% and 12.7% respectively, p<0.001). The presence, absence or unknown of history of STI with HIV did not appear to modify the relationship with hr-HPV (OR = 4.2, 95%CI: 2.6–7.1, OR = 4.6, 95%CI: 2.8–7.7, p<0.001, p<0.001 and OR = 4.1, 95%CI: 1.3–13.4, p<0.021 respectively). Conclusion The prevalence of hr-HPV infection was high and significantly associated with HIV among sexually active women. Furthermore, the study has provided essential information about the HIV link with hr-HPV infections which may explain the high prevalence among HIV infected women. This can contribute to policy development and planning of prevention strategies incorporating HPV infection prevention especially among youth and HIV infected people.

Knowledge and Beliefs of Breast Self-Examination and Breast Cancer among Market Women in Ibadan, South West, Nigeria.

Background In most resource constrained settings like Nigeria, breast self-examination self-breast examination (BSE) is culturally acceptable, religious friendly and attracts no cost. Womens knowledge and beliefs about breast cancer and its management may contribute significantly to medical help-seeking behaviours. This study aimed to assess knowledge and beliefs of BSE among market women. Methods A descriptive cross-sectional study was conducted among 603 market women in Ibadan, Nigeria. Data was collected using semi-structured interviews and analyzed using descriptive and analytic statistical methods. Results The mean age of the respondents was 34.6±9.3 years with 40% of the women aged between 30-39years. The proportion of married women was 339 (68.5%) with 425 (70.8%) respondents reporting that they do not know how to perform BSE. However, 372 (61.7%) women strongly agreed that BSE is a method of screening for breast cancer. Highest proportion 219 (36.3%) reported that the best time for a woman to perform BSE was ‘anytime’. Most of the respondents believed breast cancer is a dangerous disease that kills fast and requires a lot of money for treatment. Conclusion More efforts are needed in creating awareness and advocacy campaigns in the grassroots in order to detect early breast cancer and enhance prevention strategies that would reduce the burden of breast cancer in Nigeria.

The health profile of street children in Africa: a literature review

The United Nations Children’s Fund has labeled street children as children in difficult circumstances, which represent a minority population that has been under-represented for too long in health research. This is a concern because street children are at risk of carrying a greater disease burden. Their homeless lifestyle makes them more vulnerable to health risks and problems than children who live at home; as they roam the streets begging for food and money to obtain basic needs and are found sleeping in half-destroyed houses, abandoned basements, under bridges and in the open air. This paper presents health results from a systematic review of literature from 17 databases and including 16 countries in Africa. The review revealed that there are more boys than girls living on the street in their adolescence and who mainly have left home due to poverty and abuse. These children in these countries are vulnerable to poor health due to factors such as homelessness, risky sexual behavior, substance abuse and violence. Among the health problems identified are growth and nutritional disorders, physical injuries, violence, sexual abuse, communicable diseases including diarrheal diseases, malaria, respiratory diseases, neglected tropical diseases, mental health issues, substance abuse, reproductive health disorders, mortality, sexually transmitted diseases and HIV/AIDS. Primary interventions that could prevent poor health and improve the health status of street children include provision of safe shelter, proper nutrition, access to health care, health education, and sexual reproductive health, protection from any form of abuse, violence and substance abuse. Enforcing state policies and laws in all African countries is required to protect street children from neglect, abuse and to increase their access to education. More research on the health risks and health status of street children is still required, particularly in Sub-Saharan Africa, which carries the greatest disease burden and poverty.

Under Five Malnutrition Crises in the Boko Haram Area of Cameroon

Boko-Haram has increased their attacks along the Cameroon boarder in the Far North region of Cameroon since 2013. The prevalence of malnutrition in the north of Cameroon is high. Regions like the Adamawa, North and Far North regions have a prevalence of malnutrition of 5.2%, 6.7%, 9.0%, respectively; and, in addition to that, 1289 children have been admitted for therapeutic care due to malnutrition from the above regions. This crisis has an impact on access to livelihoods, because insecurity reduces access for farmers to harvest and impacts the upcoming sowing season, which has a direct impact on nutrition. Furthermore, the frequent attacks and displacement of persons in the Far North of Cameroon goes hand-in-hand with other issues, such as water shortage, shelter, food shortages and limitations to other basic needs.

Breast cancer among women in sub-Saharan Africa: prevalence and a situational analysis

Abstract Breast cancer is the most common cause of death in women worldwide. The incidence of breast cancer in sub-Saharan Africa (SSA) has been rising and yet many cases remain undetected. Studies reveal that the prevalence of breast cancer in most SSA countries does not give the true picture as many of these countries lack national cancer registries. A number of risk factors such as alcoholism, age and hormones predispose women to breast cancer and several challenges are currently faced in detecting and managing breast cancer in SSA, especially in the domain of medical imaging technology and finances. The purpose of this review is to document the prevalence of breast cancer among women in SSA.

Ethical issues associated with medical tourism in Africa

ABSTRACT Global disparities in medical technologies, laws, economic inequities, and social–cultural differences drive medical tourism (MT), the practice of travelling to consume healthcare that is either too delayed, unavailable, unaffordable or legally proscribed at home. Africa is simultaneously a source and destination for MT. MT however, presents a new and challenging health ethics frontier, being largely unregulated and characterized by policy contradictions, minority discrimination and conflict of interest among role-players. This article assesses the level of knowledge of MT and its associated ethical issues in Africa; it also identifies critical research gaps on the subject in the region. Exploratory design guided by Arksey and O’Malley’s (2005) framework was used. Key search terms and prior determined exclusion/inclusion criteria were used to identify relevant literature sources. Fifty-seven articles met the inclusion criteria. Distributive justice, healthcare resource allocation, experimental treatments and organ transplant were the most common ethical issues of medical tourism in Africa. The dearth of robust engagement of MT and healthcare ethics, as identified through this review, calls for more rigorous research on this subject. Although the bulk of the medical tourism industry is driven by global legal disparities based on ethical considerations, little attention has been given to this subject.