Factors Influencing Neonatal Practice in a Rural Community in Kano (Northern), Nigeria

Prevalence of traditional uvulectomy and its associated factors among parents who had less than 6 months of infants in Gondar City, north-west Ethiopia: Mixed study design

BACKGROUND

Traditional uvulectomy is widely practiced in Africa especially in sub-Saharan countries including Ethiopia. Limited Studies conducted in different times and areas of the world have shown that the prevalence of uvulectomy and its associated factors are varied from country to country. There is limited evidence to determine the prevalence and reasons of malpractice in Ethiopia. Therefore, this study aimed to assess the prevalence of traditional uvulectomy, and its associated factors among parents who had children aged less than 6 months.

METHODS

A community-based cross-sectional mixed study design was conducted among 630 participants selected by a systematic sampling technique. Data were collected using a pretested interviewer-administered questionnaire. The collected data were entered into Epi-data, and analyzed by using STATA version 14software. Descriptive statistics were computed and presented using tables, figures and texts. Factors associated with the prevalence of uvulectomy were selected for multiple logistic regressions at the probability value (p-value) of less than 0.2 in the X2- analysis. Statistically significant associated factors were identified at the probability value (p-value) less than 0.05 and adjusted OR (AOR) with a 95% CI. A total of 10 individual depth interviewees and 5 key informants were included using purposive sampling techniques. For the qualitative study, and thematic content analysis was employed to analyze the data, which were transcribed, translated, coded, screened, thematized, analyzed, synthesized, and finally supplemented the quantitative finding.

RESULTS

The prevalence of traditional uvulectomy was 84.60% (CI: 81.77%n-87.42%). Being rural residence (adjusted OR = 2.08, CI = 1.06-4.12), mothers aged 30 to 34 years (adjusted OR = 2.9, CI = 1.28-6.60), having no antenatal care visit (adjusted OR = 3.91, CI = 1.33-11.47), having no bad obstetric history (adjusted OR = 2.11, CI = 1.12-3.98), having no postnatal care visit (adjusted OR = 3.88, CI = 1.36-11.12) and mothers' poor attitude (adjusted OR = 3.32, CI = 2.01-5.47) were statistically significant associated factors of traditional uvulectomy. Seeking traditional uvulectomy, lack of information and third-party pressure were the main themes of the qualitative study that support the findings of the quantitative study.

CONCLUSION

The prevalence of traditional uvulectomy was high. Being rural residents, mothers aged 30 to 34 years, having no antenatal care visit, having no complications of obstetric history, having no postnatal care visit and mothers with poor attitude were statistically significant associated factors of traditional uvulectomy. Lack of information about uvulectomy and third-party pressure was the reason for seeking traditional uvulectomy.

Intergenerational exploration of traditional practices affecting child health: A phenomenological study

BACKGROUND

All over the world, various traditional practices affect child health. The aim of our research was to explore the changes in traditional practices that affect child health between generations and to investigate the life experiences of generations in depth.

METHODS

Using a phenomenological design, this study was conducted with semi-structured interviews with families of both generations (mothers and daughters). The study was written based on the COREQ checklist.

FINDINGS

Four themes (traditional practices and intergenerational differences, beliefs/emotions related to traditional practices, influence factors in traditional practices, traditional methods in child care) and fourteen sub-themes (change in practices between generations, intergenerational transmission of traditional practices, beliefs in perceived benefits, skepticism and disbelief attitude, emotional reactions and perceiving as unnecessary, mother/mother in-law, traditional knowledge from mothers and grandmothers, family elders, the role of the internet and social media, spiritual practices, use of herbal products, alternative applications to medicines, relaxing applications, health consequences of traditional practices) were generated from the data.

DISCUSSION

According to the findings, some harmless traditional practices are still relevant across generations, while harmful practices are mostly abandoned by new generations. The level of education and access to information has led the new generation to question traditional practices and show more interest in scientific knowledge-based methods.

APPLICATION TO PRACTICE

This research can contribute to advances in child health by helping us understand beliefs, feelings, and influencing factors related to traditional practices. Maternal education and community awareness-raising campaigns can be used to reduce harmful traditional practices.

COVID-19 vaccine hesitancy in Latin America and Africa: a scoping review

Vaccination has played an important role in the containment of COVID-19 pandemic advances. However, SARS-CoV-2 vaccine hesitancy has caused a global concern. This scoping review aims to map the scientific literature on COVID-19 vaccine hesitancy in Latin America and Africa from a Global Health perspective, observing the particularities of the Global South and using parameters validated by the World Health Organization (WHO). The review reporting observes the recommendations of the PRISMA for Scoping Reviews (PRISMA-ScR) model. Search was conducted in PubMed, Scopus, Web of Science, and Virtual Health Library (VHL) databases, selecting studies published from January 1, 2020 to January 22, 2022. Selected studies indicate that COVID-19 vaccine hesitancy involves factors such as political scenario, spread of misinformation, regional differences in each territory regarding Internet access, lack of access to information, history of vaccination resistance, lack of information about the disease and the vaccine, concern about adverse events, and vaccine efficacy and safety. Regarding the use of conceptual and methodology references from the WHO for vaccine hesitancy, few studies (6/94) use research instruments based on these references. Then, the replication in Global South of conceptual and methodological parameters developed by experts from the Global North contexts has been criticized from the perspective of Global Health because of it may not consider political and sociocultural particularities, the different nuances of vaccine hesitancy, and issues of access to vaccines.

The folk illness kimeo and "traditional" uvulectomy: an ethnomedical study of care seeking for children with cough and weakness in Dar es Salaam

BACKGROUND

Amputation of the uvula by lay providers, so-called "traditional uvulectomy", is common in parts of Sub-Saharan Africa. In Tanzania, the procedure is a treatment of persistent cough, and in some areas of the country, one in three children have been cut. Previous research from Sub-Saharan Africa suggest that uvulectomy by lay providers can increase morbidity and mortality in children, but few studies have examined the cultural ideas and practices that are linked to this form of lay surgery.

METHODS

This ethnomedical study took place in Dar es Salaam. Ten focus group discussions with a total of 43 caregivers in three different administrative districts were carried out, focusing on their perceptions of uvulectomy, the folk illness kimeo, and their experiences with taking a child for cutting. Four folk practitioners who carry out uvulectomies were interviewed individually, with a special focus on their background, and their perceptions of kimeo and uvulectomy.

RESULTS

Caregivers in Dar es Salaam typically take children who suffer from cough, vomiting and weakness to a professional health provider as a first recourse. If the child does not get well relatively quickly, some start fearing that their child may suffer from the folk illness kimeo. Kimeo is perceived by some to be an acute, life-threatening illness that professional health providers are incapable of treating. Folk practitioners treat kimeo by amputating the uvula using forceps. The four interviewed practitioners had learned their skill in apprenticeship, and two of them were third generation uvula cutters. Caregivers regard the folk practitioners as experts who offer a service that is perceived as both efficient and safe.

CONCLUSIONS

Efforts should be made to improve the quality of professional health services for children presenting with cough, including more open communication with caregivers about the folk illness kimeo. More research is needed to establish the clinical conditions that children who are taken for uvulectomy suffer from, to what degree the practice delays professional health care for underlying illnesses like pneumonia, and the negative effects of the cutting itself.

Vaccine hesitancy in the global south: Towards a critical perspective on global health

The complex phenomenon of vaccine hesitancy has been causing increasing global concern. This systematic review aims at analysing the state of art of scientific literature concerning vaccine hesitancy in Latin America and Africa, observing if: (i) they use the same research trends as the global North; and (ii) the parameters recommended by the World Health Organization (WHO) and taken from the experience of the global North are adequate to the Global South's context. This review analyses empirical, qualitative, quantitative, or mixed-study publications, from 2015 to 2020, available at five different databases. The studies produced in the Global South bring up important context-specific issues, such as issues of access (that are not included in the WHO's definition of vaccine hesitancy), cultural and religious issues, reactions to governments, reactions to recent episodes of vaccine tests on populations, and reactions to past of colonial violence. Initiatives to understand the phenomenon based on methodological and conceptual frameworks from the global North alone can cause wrongful conclusions.

Traditional African remedies induce hemolysis in a glucose-6-phopshate dehydrogenase deficient zebrafish model

Traditional remedies are widely used throughout Africa in routine care for infants. However, such remedies could have detrimental effects. Acute bilirubin encephalopathy (ABE) and kernicterus spectrum disorder (KSD) are common newborn health conditions in the developing world, contributing to substantial neonatal mortality and morbidity. They frequently occur in children with glucose-6-phopshate dehydrogenase (G6PD) deficiency. Using our established zebrafish model of G6PD deficiency, we tested the effects of three traditional compounds used in the care of the newborn umbilical cord: eucalyptus oil, methylated spirits, and Yoruba herbal tea. We found that eucalyptus oil induced a 13.4% increase in a hemolytic phenotype versus control, while methylated spirits showed a 39.7% increase in affected phenotype. Yoruba herbal tea exposure showed no effect. While methylated spirits are already a known pro-oxidant, these data indicate that eucalyptus oil may also be a hemolytic trigger in those with G6PD deficiency. Discovering which agents may contribute to the pathophysiology of G6PD deficiency is critical to eliminate ABE and KSD, especially in countries with a high prevalence of G6PD deficiency. The next step in elucidating the role of these agents is to determine the clinical correlation between the use of these agents and ABE/KSD.