Rwanda Journal of Medicine and Health Sciences

Association between Identity Dimensions and History Sexual Abuse among Rwandan Adolescents: A Case-Control Study

Sat, 30 Nov 2024 00:00:00 +0000

Background
Adolescent sexual abuse can profoundly impact psychological development, including identity formation, yet there is limited research in African contexts. This study aimed to explore how different levels of identity dimensions (low, moderate, high) are associated with the likelihood of reporting a history of sexual abuse.
Methods
A case-control study design was conducted with 746 girls aged 10-19 years, evenly divided between sexually abused (case group) and non-sexually abused adolescents (control group). Cases were selected from Isange One-Stop Centres, and controls were recruited from secondary schools in Rwanda. Data on socio-demographics and identity dimensions were collected. Group differences were analysed using Chi-Square test; and logistic regression was employed to determine independent association’s predictor variables.
Results
No significant group differences were observed in socio-demographic variables (p>0.05). Teen motherhoods was reported exclusively in the case group (22.9%), with 1.9% of the case group pregnant and 5.4% reporting a history of abortion. Adolescents with a history of sexual abuse were more likely to score high on identity diffusion (AOR =7.55, 95% CI: 5.11–13.92), foreclosure (AOR = 4.81, 95% CI: 2.87–7.95), and moratorium (AOR =2.21, 95%CI: 1.30–3.93). They were also more likely to report moderate or high levels of exploration in depth, commitment making, and identification with commitment.
Conclusion
Sexual abuse is significantly associated with disruptions in identity development, including heightened diffusion, foreclosure, and altered exploration processes. Adolescents with a history of sexual abuse exhibit a premature identity characterized by commitment without sufficient exploration. These findings underscore the need for targeted interventions to support identity development and address the psychological impacts of trauma in adolescents.
Rwanda J Med Health Sci 2024;7(3):392-401

Effect of Myofascial Release and Soft Tissue Mobilization versus Interferential Therapy with Exercises on Neck Musculoskeletal Related Syndromes: A Before and After Study

Sat, 30 Nov 2024 00:00:00 +0000

Background
Neck-related musculoskeletal disorders are classified among the top disabling conditions leading to discomfort, pain and functional restrictions which impact people’s functions and performance. Aim: To assess the effects of soft tissue mobilization versus interferential therapy with exercises among adults with neck musculoskeletal syndromes.
Materials and Methods
Thirty-two (32) participants in this study were randomly allocated to two groups. Experimental (n=16) received myofascial release and soft tissue mobilization. Control (n=16) received interferential therapy with conventional neck exercises for 6 weeks. Numeric Pain Rating Scale (NPRS) Scores and Neck Disability Index (NDI) were used to measure the effect of the treatment interventions.
Results
The findings from this trial showed a significant improvement in pain and disability. Unpaired (independent) t-test on NPRS and NDI scores between groups (NPRS t-test: -3.693 P=0.001) and (NDI t-test: -8.472, P=0.001) thus, favouring Myofascial release and soft tissue mobilization compared to IFT and exercises.
Conclusion
Myofascial release provides greater benefits in terms of reduction of functional limitations and pain. IFT and exercise therapy showed improvement suggesting that a combination of both treatment approaches may yield better results than single treatment modality alone.
Rwanda J Med Health Sci 2024;7(3):403-410

The Development and Validation of an Attitude Scale for Abortion in Turkey

Yusuf Karaşin, Yalçın Karagöz — Sat, 30 Nov 2024 00:00:00 +0000

Background
Abortion is a complex phenomenon studied not only from a health perspective, but also from a legal and social dimensions. Attitudes towards abortion have been varied significantly across different cultures and historical periods. In Turkey, where abortion is legal under specific conditions and timeframes, understanding these attitudes through the development of a standardized measurement tool can contribute meaningfully to the field.
Aim
This study aims to develop a reliable and valid attitude scale to measure perspectives towards abortion in a Turkish sample.
Methods
The study included 303 women aged 18-49 years residing in the Esenyurt district of Istanbul. The scale development process followed a rigorous methodology, including creating a draft scale, obtaining expert input, conducting a pilot application, refining the draft scale, collecting data from the sample group, and performing factor analyses.
Results
A three-factor structure consisting of 23 items was identified (χ2/df: 2.787, Goodness of Fit Index(GFI): 0.853, Incremental Fit Index(IFI):0.913, Comparative Fıt Index(CFI):0.912, Root Mean Square Error of Approximation(RMSEA): 0.077, Standardized Root Mean Square Residual(SRMR): 0.0751). The three factors labeled as stigma, exclusion and hear respect explained the underlying attitudes captured by the scale.
Conclusion
This study successfully developed valid and reliable measurement tool to assess attitudes towards abortion has been developed in a Turkish context. The scale provides an important resource for future research and contributes to the broader understanding of abortion-related attitudes.
Rwanda J Med Health Sci 2024;7(3):411-422

Post-traumatic Stress Disorders among Survivors of Road Traffic Crash injuries aged 18 Years and above, in Kigali City, Rwanda

Aimable Mutayomba, Japheths Ogendi — Sat, 30 Nov 2024 00:00:00 +0000

Background
Post-traumatic Stress Disorder (PTSD) affects approximately 4% of the world’s population and is one of the most prevalent mental illnesses among survivors of road traffic crashes; however, it has received little attention in the clinical setting.
Objective
The objective of this study was to evaluate the prevalence and factors associated with PTSD among survivors of road traffic crash injuries aged not less than 18 years obtaining follow-up care in public hospitals in Kigali, Rwanda.
Methods
This cross-sectional study included 288 survivors of road traffic crash injuries who were obtaining care in three public hospitals in Kigali for two months, from 1st August to 30th September 2023. The PTSD was diagnosed using a clinician-administered PTSD scale described in DSM V. Binary logistic regression was used to identify the factors linked to PTSD. The previous history of traumatic events was assessed using a Life Event Checklist for Diagnostic Statistical Manual-V (DSM-V).
Results
Of the 288 survivors, 50 (17.36%), were diagnosed to experience PTSD. The following were found to be positively associated with PTSD: age bracket of 32 to 38 (p = 0.001) and 39 to 45 years (p=0.001); absence of formal education (p=0.03); a history of family conflict (p=0.001); severe injuries (p=0.001); and; history of previous traumatic event (p=0.02).
Conclusion
Post-traumatic stress disorder is a public health concern among RTC survivors. Screening programs that capture PTSD should be an important intervention strategy.
Rwanda J Med Health Sci 2024;7(3):423-434

Prevalence and Factors Associated With Cesarean Section Delivery among Pregnant Women Attending Rwamagana Level Two Teaching Hospital, Rwanda

Wed, 18 Dec 2024 00:00:00 +0000

Background
Cesarean section (CS) is an essential, life-saving procedure when clinically justified. However, exceeding the World Health Organization's recommended prevalence (10–15%) may lead to adverse outcomes. This study aimed to determine the prevalence of CS at Rwamagana Hospital and to assess the associated factors.
Methods
This cross-sectional study was conducted among 426 postpartum women at Rwamagana Hospital. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics and multivariable logistic regression were employed. Statistical significance was set at a 5% level.
Results
The results showed a 38% prevalence of CS. Women younger than 25 years were 9.51 times more likely to undergo CS compared to those aged 36-45 years (AO:9.51, 95% CI: 3.37-26.83, p < 0.001), Fetal malposition (AOR:106.8, 95% CI: 29.89-382.25, p < 0.001), experiencing no labour (AOR: 4.64, 95%CI: 1.71 - 12.63, p = 0.003), and first-time mothers (Parity=1) (AOR: 19.65, 95%CI: 8.91-43.33, p<0.001) were positively associated with CS. However, Previous vaginal birth reduced the odds of CS by 89% (AOR:0.11, 95% CI: 0.06-0.21, p < 0.001).
Conclusion
The prevalence of CS at Rwamagana Hospital exceeds the WHO recommendation. There is a need for enhanced community education to support safe vaginal deliveries.
Rwanda J Med Health Sci 2024;7(3):435-444

Factors Associated With Minimum Acceptable Diet among Children Aged 6 to 23 Months in Rwanda

Wed, 18 Dec 2024 00:00:00 +0000

Background
Globally, one in two children aged 6 to 23 months fails to meet recommended dietary practices, with 70% fail to meet dietary diversity or meal frequency. This study assessed factors associated with the minimum acceptable diet (MAD) among children aged 6 to 23 months in Rwanda.
Methods
This cross–sectional study utilized secondary data from the 2019–2020 Rwanda Demographic and Health Survey (RDHS), analyzing 1,203 children. Weighted data were analyzed using STATA version 17, employing bivariate and multivariable logistic regression at a 5% significance level.
Results
The prevalence of MAD was 23.9%. Among breastfed children aged 6–8 months, 27.09% achieved the minimum meal frequency (MMF), while only 11.9% of children aged 9–23 months met the MMF. Significant factors associated with MAD included residence in the Eastern Province (AOR: 1.66; 95% CI: 1.02–2.27), access to nutrition–related information (AOR: 1.72; 95% CI: 1.03–2.41), and household wealth, with the richest households showing the highest odds (AOR: 5.93; 95% CI: 3.08–11.42). Delivery in health facilities also increased odds (AOR: 3.42; 95% CI: 1.20–9.77).
Conclusion
The low prevalence of MAD highlights the need for promoting dietary diversity and meal frequency, support low–income households to improve child feeding practices.
Rwanda J Med Health Sci 2024;7(3):445-453

Knowledge, Attitude, and Practices of Antibiotic Usage and Resistance among People Attending Primary Healthcare in Rwanda

Wed, 18 Dec 2024 00:00:00 +0000

Background
Antimicrobial resistance (AMR) poses a global threat to public health with sub-Saharan Africa facing a substantial burden. Our study assessed the knowledge, attitude, and practices of antibiotic usage and resistance among people attending primary healthcare facilities in Rwanda.
Methods
The cross-sectional study was conducted at three health centres in Kigali, and it involved 246 individuals. We used a close-ended questionnaire for data collection. The levels of knowledge, attitudes and practices were calculated as proportions of correct answers, with high, good, or positive being greater or equal to 70%. The chi-square test was used to find the association between demographic characteristics and knowledge, attitudes and practices.
Results
Among 246 participants, 8 (3.2%) and 51 (20.7%) had high knowledge of antibiotic usage and antimicrobial resistance respectively. In addition, 81 (32.9%) had a positive attitude and 97 (39.4%) had good practices. Attitudes were significantly positive in males (p = 0.003) and among individuals with a university education (p = 0.007). Knowledge of antimicrobial resistance was significantly high in males (p-value = 0.047).
Conclusion
Limited levels of knowledge, attitude and practices on antibiotic usage and resistance were found, with women having lower levels in multiple aspects. Strategies to promote rational use of antibiotics ought to address social inequities.
Rwanda J Med Health Sci 2024;7(3): 454-470

Assessment of Dyslipidaemia and Cardiovascular Disease Risk Factors among Type 2 Diabetes Mellitus Patients Attending Kabutare District Hospital, Huye, Rwanda

Fri, 27 Dec 2024 00:00:00 +0000

Background
Dyslipidaemia is a major contributing factor to the development of cardiovascular disease (CVD) in type 2 diabetic mellitus (T2DM) patients. People with T2DM are at a significantly high risk of developing dyslipidaemia which in turn is a risk factor for CVD. The objective of this study was to assess the risk factors for CVD in T2DM patients.
Methodology
A descriptive cross-sectional study was conducted on 100 T2DM patients consecutively presenting at Kabutare District Hospital, Huye District southern Rwanda. Excluded were patients on lipid lowering drugs and those with chronic renal and liver diseases.
Results
The overall prevalence of dyslipidaemia was 79% with hypoalphalipoproteinaemia (47%) being the most common and hypercholesterolaemia (29%) the least frequent. When stratified according to glycaemic control, median diastolic blood pressure was significantly higher (p=0.045) in participants whose median fasting plasma glucose (FPG) was ≥5.6 mmol/L. Median fasting triglycerides (p=0.006) and non-HDL-C (p=0.019) concentrations were significantly lower in euglycaemic participants compared to participants with median FPG ≥5.6 mmol/L. Dysglycaemia was significantly associated with dyslipidaemia status (p=0.001).
Conclusion
Effective management and monitoring of dyslipidaemia, particularly among those with poor glycaemic control, is crucial in mitigating CVD risks in this population.
Rwanda J Med Health Sci 2024;7(3):471-484

Prevalence of Metabolic Syndrome and Its Determinants in Pregnant Women in Auchi, Edo State, Nigeria

Kierian Ikechukwu Uzochukwu, Anthony Moses Ugbenyen, Olulope Olufemi Ajayi — Fri, 27 Dec 2024 00:00:00 +0000

Background
There are limited epidemiological data on metabolic syndrome (MetS) during gestation in many developing nations. Available information on MetS prevalence in pregnancy is of clinical importance as it could aid in identifying pregnant women at risk of adverse perinatal outcomes. This study was designed to determine the prevalence of MetS, and its associated risk factors in pregnant women in Auchi, Edo Stage, Nigeria.
Methods
This hospital-based cross-sectional study involved 223 pregnant women aged 17-45 years recruited from selected hospitals in Auchi and its environs. Information on socio-demography and nutritional habits were obtained using a self-administered questionnaire. Anthropometric indices were determined using appropriate methods for height, weight and BMI. Blood glucose, triglyceride, high-density lipoprotein, low-density lipoprotein and total cholesterol were determined from the serum of the study participants using enzymatic assay. The prevalence of MetS was determined using the HNLBI/AHA and NECP ATP III definitions, modified for pregnant women.
Results
The findings revealed the following prevalences: MetS 10.8% , low HDL 35.7%, obesity 14.4%, high blood pressure 4.5%, hyperglycaemia 21.6% and hypertriglyceridemia 11.8%. There was no significant association between social-demographic and life style parameters with MetS.
Conclusion
The findings emphasize the importance of vigilant monitoring of pregnant women to reduce the risk of metabolic syndrome.
Rwanda J Med Health Sci 2024;7(3):485-494

Awareness of Risk Factors for Type-2 Diabetes Mellitus among Undergraduates at a Private University in Nigeria: A Cross-Sectional Survey

Oluwaseun Oluwafunmilayo Abiodun, Timothy Aghogho Ehwarieme — Fri, 27 Dec 2024 00:00:00 +0000

Background
Diabetes mellitus (DM) is a chronic condition marked by high blood sugar due to issues with insulin production or function, posing a significant global health challenge. Its prevalence is rapidly increasing, with projections rising from 537 million cases in 2021 to 783 million by 2045, particularly in low- and middle-income countries.
Aim
The study evaluated the level of awareness of predictive factors of type 2 diabetes mellitus (T2DM) among undergraduate students of Achievers University Owo, Ondo State, Nigeria.
Methods
A cross-sectional analytical study involving 318 respondents was conducted using a self-administered Google Form questionnaire. Binary and multiple logistic regression analysis were used for data analysis with a significance level set at p<0.05. Analysis were carried out using SPSS version 28.
Results
The study found that 222 (70%) of the respondents have high awareness of predictive factors for the development of T2DM while 96(30%) have low awareness. The study found that age (AOR = 4.883, P<0.001; 95% CI 1.483-2.848), persistent unhealthy diet (AOR = 8.685; 95% CI 1.837-3.285; P<0.006), and heredity (AOR = 6.930; 95% CI 1.294-2.834; P<0.001) are independent predictors of awareness of T2DM.
Conclusion
This study revealed that the participants had a good level of awareness with regard to the predictive factors of T2DM. However, since a significant proportion had a low level of awareness, there is a need for health promotion and educational programs to be run aimed at addressing gaps in knowledge among the undergraduates.
Rwanda J Med Health Sci 2024;7(3):495-505