2026-03-13
Glory T. Mzama, Kruger Kaswaswa, Tobias Chirwa, Juliana Kagura, Latifat Ibisomi
Background: The World Health Organization recommends 6 months of isoniazid preventive therapy (IPT) to children who have been exposed to tuberculosis (TB) patients to prevent active TB. Although IPT is an efficacious intervention, it is underutilised. Aim: The aim of this study was to examine factors associated with the completion of IPT among children under 5 years who have been exposed to TB patients. Setting: This was a secondary data analysis; the primary study was conducted in Blantyre, Malawi. Methods: This study was a secondary analysis of a randomised controlled trial with follow-up at 3 months and 6 months. Univariable and multivariable logistic regression models were used to identify factors associated with the completion of IPT. Results: One hundred and twenty-eight children were included, of whom 58 (45.3%) completed IPT. Index patient human immunodeficiency virus (HIV)-positive status (adjusted odds ratio [aOR] = 0.39, 95% confidence interval [CI]: 0.16–0.94) and longer distance (> 5 km) (aOR = 0.25, 95% CI: 0.07–0.89) were associated with lower IPT completion. Wealth status, household health-seeking decision maker and type of contact tracing were associated with higher IPT completion, with aOR = 3.42 (95% CI: 1.19–9.88) for children coming from households of high wealth status, aOR = 3.17 (95% CI: 1.19–8.42) in which the health-seeking decision maker was the parent compared to other guardians, and aOR = 3.13 (95% CI: 1.25–7.84) for children who were identified through patient-conducted tracing compared to routine contact tracing. Conclusion: Human immunodeficiency virus status, wealth status, household health-seeking decision maker, proximity to health facility and type of contact tracing are key determinants of IPT completion among children. Contribution: This study provides valuable insights into the factors that affect the completion of IPT. By addressing these factors, completion of IPT can be improved, thereby preventing TB among children.
2026-03-09
Sheikh O. Bittaye, Lamin Manneh, Morikebba Danso, Sheriffo Jagne, Amadou W. Jallow, Ya Fatou B.M Jobe, Mary Bobb, Ebrima K. Jallow, Momodou Kalisa, Kebba Jobarteh, Modou L. Sanneh, Haddijatou Allen, Ifeanyi L. Udenweze, Pius Ononigwe, Abdoulie Badjan, Mustapha Bittaye, Momodou T. Nyassi
Mpox is a zoonotic virus that can infect humans and animals. The director general of the World Health Organization (WHO) declared the mpox outbreak a public health emergency of international concern on 14 August 2024, with the greatest burden in Africa. The Gambia registered its first case of mpox on 18 July 2025. This case study, therefore, assesses the weaknesses and strengths in the emergency response and management of the first mpox case in The Gambia. The patient is a 26-year-old female Gambian, who presented with a two-day history of a skin rash which was associated with fever, headache and myalgia. This patient was seen at the health centre, and swab samples were collected for mpox testing before she returned home. The samples were delivered to the National Public Health Laboratories (NPHL) a day later, and the polymerase chain reaction tests were conducted 8 days later, which confirmed the presence of mpox virus infection. The confirmed mpox case initially presented challenges with compliance, as the patient could not be readily located for isolation and treatment. However, through the coordinated efforts of the police, mobile operators, the village health worker (VHW), field investigators, surveillance officers, public health officers, regional health directorate staff, the head of the village or community, and the nurse at the Fajikunda Health Centre (FJKHC), the case was successfully traced. The assessment of the emergency response and management of the first mpox case in The Gambia revealed notable strengths and weaknesses. Surveillance efforts at the primary healthcare level were effective, leading to the detection of the case and a well-coordinated overall response. However, significant challenges emerged in the laboratory analysis of collected samples, including delays in processing as a result of an unreliable electricity supply and gaps in appropriate infection prevention and control measures.
2026-02-27
Eugene M. Makhavhu
Background: For women of childbearing age in South Africa, using different traditional healthcare practices is common. The use is intended for differing reasons, including aiding with conception and care of the baby during the neonatal phase and of the mother during the nursing stages. This is particularly so in underserved communities; however, perceptions of those who use such treatments are not widely explored. Aim: This study explored the perceptions of caregivers in township communities regarding traditional practices in healthcare. Setting: This study was conducted in a township in a metropolitan city in Gauteng. Methods: The study used a qualitative exploratory design, and data were collected using a semi-structured interview guide from 15 participants who were sampled conveniently. Results: Three themes were generated: (1) critical perspectives on traditional healthcare practices use, (2) benefits of using traditional healthcare and (3) the preference and influence on continued traditional healthcare use. Results indicated continued traditional healthcare practice use because of the belief systems and trust enshrined in individual families and communities. Benefits such as the ability to use multiple healthcare modalities were also a strong indication. Conclusion: This study highlights a strong need to understand the traditional healthcare practices to foster safe and comprehensive healthcare delivery and meet the health needs of communities. Contribution: The study contributes to literature on the use of traditional health practices and has captured the perceptions of caregivers in a South African township.
2026-02-26
Michel C. Tommo Tchouaket, Joseph Fokam, Ezéchiel N. Semengue, Yagai Bouba, Collins A. Chenwi, Alex D. Nka, Mirice Mbazo'o, Désiré Takou, Samuel M. Sosso, Grace A. Beloumou, Aude C. Ka’e, Aurelie M. Ngueko, Nadine Fainguem, Laeticia Y. Heunko, Sandrine C. Ndjeyep, Willy L. Pabo, Davy-Hyacinthe G. Anguechia, Naomi-Karell Etame, Evariste Molimbou, Rachel A. Mundo, Aissatou Abba, Gregory-Edie Halle-Ekane, Anne-Cecile Z.K. Bissek, Vittorio Colizzi, Carlo-Federico Perno, Alexis Ndjolo
Background: Nasopharyngeal swabs (NASO) cause discomfort for patients, which can discourage them from getting tested for COVID-19 and limit case detection. It is therefore necessary to consider an alternative, more comfortable swab. Aim: Evaluated the concordance between nasopharyngeal and oropharyngeal sampling for COVID-19 diagnosis in the Cameroonian context. Setting: This study was carried out at “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB) in Yaoundé, Cameroon. Methods: A comparative study was conducted in April 2021 among consenting participants tested for COVID-19 at “Chantal Biya” International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB) in Yaoundé, Cameroon. Sampling began with nasopharyngeal swabs, followed by oropharyngeal swabs, all taken by the same technician, and analysis was carried out using polymerase chain reaction (PCR) tests on the Abbott platform. Statistical analyses were performed using GraphPad version 6.0; p < 0.05 was considered statistically significant. Results: A total of 154 participants were enrolled (59.7% male, median age 38 years, interquartile range [IQR]: 30–49). Following PCR testing, the overall COVID-19 positivity rate was 36.36% (56/154), with 34.41% ( n = 53/154) in nasopharyngeal versus 16.23% ( n = 25/154) in oropharyngeal samples, p < 0.0002. The overall concordance rate was 78% ( n = 120/154), with 39.28% positive concordance and 74.24% negative concordance (kappa = 0.441 [0.289–0.513]). According to severe acute respiratory syndrome coronavirus 2 viral load, the positive concordance was improved with high viral load (cycle threshold [CT]: ≤ 25): 61% ( n = 11/18) versus 31% ( n = 11/35) with low viral load (CT > 25), p = 0.037; odds ratio (OR) = 3.43. According to gender, the positive concordance was higher in men, 55% ( n = 16/29), versus 25% ( n = 6/24) in women, p = 0.021; OR = 0.27. Using nasopharyngeal swab as the gold standard, oropharyngeal swab had a sensitivity of 41.50% ( n = 22/53), specificity 97.02% ( n = 98/101), positive predictive value (PPV) 88% ( n = 22/25) and negative predictive value (NPV) 76% ( n = 98/129). Conclusion: Our evidence suggests a superiority effect of nasopharyngeal in detecting cases of COVID-19. However, the overall high PPV of oropharyngeal swab, and its improved performance with high viral load. Contribution: Therefore, in case of counter-indication to nasopharyngeal swabbing, oropharyngeal can be an acceptable alternative.