Rwanda Public Health Bulletin

Drugs and Substance Abuse Amongst Adolescents - A pilot Study in 7 Districts

Darius Gishoma — 2023-03-31

Introduction: Studies have shown that alcohol and illicit drug abuse are a growing problem in Africa and Rwanda in particular. This study aimed at determining the prevalence of alcohol and drug use by adolescents and young adults in 7 districts in Rwanda.

Methods: This was a cross-sectional study with mixed methods using individual interviews with questions on alcohol and substance abuse, and substance use disorders. We used Mini International Neuropsychiatric Interview (MINI) and other mostly standardized questionnaires to collect data and urine specimens to cross-validate responses.

Results: 3301 adolescents and young adults aged 13 to 24 from 7 selected districts participated in this cross-sectional study. In the past 30 days, 28.5% of adolescents reported to have used alcohol; 4.4% reported to have used cannabis, while the reported prevalence for cigarettes, opiates and cocaine was respectively 2.9%; 0.2%; 0.1%. Urine analysis testing for presence of cannabis and heroin confirmed the reported findings, showing high sensitivity (80%) and specificity (99%). No participant reported the use of amphetamines or methamphetamines. Youth currently using cannabis were more likely to report unprotected sexual practice in the past 12 months (OR=3.4, p<0.001) compared to those who did not use cannabis. Alcohol and cannabis were the main factors for youths to have a protected sex at (OR=3.4, p<0.001) and (OR=3.3, p<0.001).

Conclusions: Alcohol and cannabis are the most used substances among adolescents, and alcohol and drug use are associated with unprotected sexual practice.

Factors Associated with Notification and Testing among Partners of HIV Positive Index Clients in Kigali City

Umutoni Angela — 2024-07-13

Introduction: Notification of sexual partners of persons diagnosed HIV infection is a vital tool in identifying those at risk of infection. This study assessed determinants of being notified and case-finding effectiveness among sexual partners of HIV infected individuals in Rwanda.

Methods: A cross-sectional study was conducted in Kigali city, Rwanda analyzing data of individuals newly diagnosed HIV infection who listed their sexual partners for referral to HIV test services (HTS) through one of three methods of partner notification: passive referral, contract referral, or provider referral. Data were extracted from the national HIV case-based surveillance dataset.

Results: In this study, 2104 index patients named 3791 sexual partners and provided locator information for 2689 partners. Among successfully notified partners, 2402 returned for HIV counseling and testing; among them, 267/2409 were spouses (aOR: 1.43; 95% CI; 1.11–1.82). Index clients with 2-5 partners were 2.53 times more likely (95%CI 1.60-3.99) to successfully notify their sexual partners; also, partners that had been listed as spouses of index clients were 2.1 imes more likely to get notified of their exposure to HIV than any other partners (95%CI; 1.54-2.89) (p=0.000).

Conclusion: This study's findings support the notion that partner notification among index clients is associated with the relation between HIV positive patients and their partners, marital status, number of sexual partners, and referral method used.

Predictors of In-Hospital Mortality of Preterm Newborns at University Teaching Hospital of Butare Neonatology Department

Habimana Samson — 2023-03-31

Introduction: Neonatal mortality in Rwanda is still high, especially among preterm infants, despite the improvements in mortality rate among other neonates attributed to the implemented measures and strategies since the mid-2000s in Rwanda. This study is aimed to determine predictors of mortality at the University Teaching Hospital of Butare (CHUB), Huye, Rwanda

Methods: This retrospective cross-sectional study was conducted on 427 participants from July 2018 to June 2019.

Results: Of all infants enrolled in this study, 51.1% of newborns were female. The mean birth weight, maternal age, and duration of labor were 1.58 ± 0.52 kg, 30.7 ± 6.8 years, and 3.16 ± 6.59 hours, respectively. Most participants had attended antenatal care services (ANC) (95.1%) and had no concerning obstetrical history (83.1%). The most common mode of delivery was spontaneous vaginal delivery (SVD) (51.5%) at the hospital (93.1%).

Receiving Kangaroo mother care (KMC) was a protective factor in in-hospital mortality (OR: 0.63; 95CI: 0.028-0.140, p<0.001). Respiratory distress was associated with a 3-time high risk of mortality (OR: 3.132; 95CI: 1.26-7.745, p=0.013).

Conclusion: This study showed that KMC and respiratory distress were the only studied factors associated with in-hospital mortality of preterm infants at the CHUB.

The National Health Insurance Scheme (NHIS) and the Attainment of Universal Health Coverage in Zambia

Zombe Mazimba — 2024-07-13

Zambia, together with over 133 other members of the World Health Organization (WHO), became a signatory to the historic Alma-Ata Declaration of 1978, which was a WHO blueprint that enabled Primary Health Care (PHC) to become the official health policy for all member countries at the International Conference on PHC which was held in Alma-Ata, USSR, on 6-12 September 1978 [1]. PHC is defined as the essential health care made accessible universally to all families and individuals in a community in ways that are acceptable to them. It involves their full participation and is done at a cost that the community and country can afford [2]. PHC addresses the main health problems faced in communities by providing a wide range of preventive, curative, promotive, and rehabilitative services to the members.