South Sudan Medical Journal

Climate change, oil pollution, and birth defects in South Sudan: A growing crisis

Edward Eremugo Kenyi — Tue, 03 Dec 2024 00:00:00 +0000

No abstract.

An introduction to quantitative and qualitative approaches for researchers

Stephen Hyer — Tue, 03 Dec 2024 00:00:00 +0000

Research is important. It adds to our knowledge base, improves practice, shows which practices are effective and which are not, provides evidence to inform policy debates, and helps us as health professionals become better practitioners. Findings from research are shared at scientific meetings, conferences, and in medical journals such as this one.

To be useful, research must be carried out ethically, with full disclosure of how the data were collected. The researchers must have used appropriate statistical methods to analyse their data. This is vital if we are to draw valid conclusions and potentially change practice.

This paper will discuss quantitative and qualitative approaches used in research studies. By the end of this paper, you should understand the differences between the two approaches, and which is best suited for your planned research.

Basic statistical methods in research and their interpretation

Stephen Hyer, Jyoti Balani — Tue, 03 Dec 2024 00:00:00 +0000

Whether quantitative or qualitative, research generates data that requires analysis and interpretation to derive insights. Statistical tests allow researchers to calculate how much the relationship between the variables they have investigated differs from that which might be expected by chance alone. In statistical terms, whether the null hypothesis of no significant relationship is accepted or rejected. This article will consider the common types of statistical tests applied to quantitative research data and their interpretation. By the end of this paper, readers should be better informed about the choice of statistical test for their research study and how to interpret the results.

Simple sample size calculations for crosssectional studies

James Beard — Tue, 03 Dec 2024 00:00:00 +0000

No abstract.

How to author a research proposal for a dissertation or thesis: A guide for South Sudanese medical postgraduates

John Adwok — Tue, 03 Dec 2024 00:00:00 +0000

A research proposal is a three-chapter document that outlines a study to be conducted for a dissertation or thesis. The three chapters of a proposal include the Introduction, a literature review on the chosen topic, and the research methodology proposed for the study. After successfully navigating the proposal process and receiving approval from the academic research team and the Research Ethics Committee, one can proceed with the actual research project. In South Sudan, all healthcare-related research proposals must be approved by the South Sudan Research Ethics Committee (SSREC) based at the Ministry of Health, as institutional committees still need to be established. Authoring a research proposal as a postgraduate medical professional in a resource-poor country like South Sudan poses challenges related to inadequate healthcare infrastructure and research facilities and limited access to the internet and medical libraries. Therefore, it is important to consider the scope of the proposed research carefully and select a clear topic that addresses a significant medical topic relevant to the population’s healthcare. This overview aims to guide medical postgraduate students in South Sudan and other resource-limited regions on their dissertation and thesis projects.

Modern contraceptives use among women in Terekeka County, Central Equatoria State, South Sudan

Imba Alex David, Ambayo Peter Otte, Mawa Ratib, Lou Eluzai Loponi — Tue, 03 Dec 2024 00:00:00 +0000

Introduction: The South Sudan health sector strategic plan indicates that only 1.2% of women aged 15-49 years have their need for family planning met, and the contraceptive prevalence rate of 6% is lower than the rate of 17% in the whole of sub-Saharan Africa. The use of modern contraceptives contributes to women’s health and reduces maternal mortality related to pregnancy and childbirth complications globally. The study investigated the utilization of modern contraceptives among women of reproductive age (WRA) in Terekeka County of South Sudan.

Method: We employed cross-sectional, qualitative, and quantitative research involving in-depth interviews with key informants. Respondents were selected purposively and through a multistage random sampling technique. Data were analysed using thematic content analysis.

Results: There were 384 respondents. The results indicate that 21.4% of the women use modern contraceptives. Demographic factors such as education, religion, marital status, knowledge, access to contraceptive information, and partner support are positively associated with the use of modern contraceptives in Terekeka County.

Conclusion: We conclude that if all WRA had access to education and family planning information, many would use modern contraceptives. The study recommends more studies to explore the use of modern contraceptives in the whole country.

Validity of semi-structured questionnaire for prevalence and risk factors of hepatitis B virus infections among women of reproductive age

Ezbon WApary, Akway M. Cham, Oromo F Seriano — Tue, 03 Dec 2024 00:00:00 +0000

Introduction: Hepatitis B is a viral disease caused by the hepatitis B virus (HBV). This virus increasingly infects the population each year. The evidence focusing on the validity of a research tool in the South Sudan context is scant. This study examined the validity of the questionnaire for prevalence and risk factors of HBV infection among women of reproductive age in South Sudan.

Method: The study adapted a quantitative cross-sectional research design. Nine panelists were selected. Twenty-nine items of two key constructs, demographic characteristics and health behaviours, were assessed and analysed using formula 1 (Lawshe’s Content Validity Ratio) and formula 2 (Lawshe’s Content Validity Index) built-in Power Pivot of Microsoft Office 365.

Results: Twenty-nine questions of the constructs surpassed the content validity ratio threshold value of 0.78. Thus, we maintained these questions in the final semi-structured questionnaire. The demographic characteristic construct’s overall content validity index (CVI) was 0.926, and the health behaviour construct was 0.928.

Conclusion: This study validated the semi-structured questionnaire for assessing the prevalence and risk factors of HBV infection among women of reproductive age in South Sudan. This tool identified the essential items in this health domain. Therefore, it should assist researchers in collecting data related to hepatitis B.

A five-year epidemiological study of tuberculosis and its related risk factors in northwestern Algeria

Walid Hassene Hamri, Mustapha Diaf, Fatima Zohra Hamadouche — Tue, 03 Dec 2024 00:00:00 +0000

Introduction: Tuberculosis (TB) is a worldwide emergency and a leading cause of death. Algeria reported an incidence rate between 53 and 88 per 100,000 in 2017. This study aimed to highlight TB’s clinical and therapeutic characteristics at the Pulmonology Unit in Sidi Bel Abbes, Algeria.

Method: This retrospective and descriptive study analysed patient records from 2015 to 2020. Data collected included sociodemographic data, clinical characteristics, type of TB, and therapeutic evolution after each patient’s treatment period. Data were processed using SPSS.

Results: Of the 649 TB patients, 57.3% had extra-pulmonary TB, with a higher proportion of females affected. Pulmonary TB cases were predominantly male, and bi-therapy with isoniazid and rifampicin was the most common treatment. Just over half of cases (55.2%) achieved treatment success.

Conclusion: Although TB incidence gradually declined over the study period, increased attention to extra-pulmonary TB and adherence to treatment protocols are recommended.

Improvised explosive device injuries to the maxillofacial region: Diagnostic findings and treatment approaches in north-eastern Nigeria

Tue, 03 Dec 2024 00:00:00 +0000

Introduction: The use of improvised explosive devices (IED) poses a significant threat, particularly in low- and middle-income countries. These homemade explosives incorporate certain objects that create unique injury patterns that present diagnostic and therapeutic challenges. This study examines the maxillofacial wounds and patterns of Boko Haram IED victims treated at the University of Maiduguri Teaching Hospital (UMTH). Understanding the different wounding patterns these injuries cause and management options will help with proper planning and management.

Method: This retrospective study was carried out over five years at UMTH, Nigeria. The clinical records and treatment approaches of IED injuries to the maxillofacial region were obtained from patient case notes. Data were analyzed using the statistical software SPSS version 20.

Results: The study involved 14 patients, 14–43 years old. There were three (21.4%) females, M:F ratio of 4.7:1. Primary blast injuries were seen in six (42.9%). Lacerations were the most common facial injury at 31.7%%. The most common facial fractures recorded were naso-orbitoethmoidal at 21.9%, maxillary at 18.8%, and frontal bone fractures at 15.6%. Globe rupture occurred in six (42.9%). The most common treatment was closed reduction with intermaxillary fixation (57.4%).

Conclusion: Intermaxillary fixation emerged as the predominant treatment modality, reflecting the pragmatic use of available resources. Prevention is critical to reducing IED injuries.

Attitudes of university students in Sudan towards digital mental health

Tue, 03 Dec 2024 00:00:00 +0000

Introduction: University students are particularly vulnerable to mental health illnesses. Access to mental health services in Sudan is limited. Digital mental health presents a promising approach that young people widely accept. The study aimed to assess the attitude of university students in Sudan toward digital mental health.

Method: A cross-sectional survey was conducted among university students in Khartoum using a self-administered electronic questionnaire. Data were collected between June 19 and July 30, 2022.

Results: Four hundred and thirty-two responses to the questionnaire were received, with a mean age of 20.37 years. Overall, 95.1% of respondents were willing to search online for mental health information, and 71.1% were willing to try a mental health teleconsultation. The perceived barriers to digital mental health included a preference for traditional consultations (35.6%) and a lack of trust in online providers (18.8%).

Conclusion: Digital mental health has the potential to play a significant role in increasing access to mental health care for university students in Sudan.

Liver fibrosis and its associations among people with hepatitis B in rural Uganda: A retrospective records review

Tue, 03 Dec 2024 00:00:00 +0000

Introduction: Chronic hepatitis B affects about 240 million people worldwide, with significant complications including liver fibrosis and hepatocellular carcinoma. We aimed to study the prevalence of liver fibrosis and its associations among people with hepatitis B at Mbarara Regional Referral Hospital (MRRH).

Method: This study was a retrospective review of cross-sectionally collected data in an integrated hospital management system from July 2018 to August 2021 at MRRH. Socio-demographics, co-morbidities, and laboratory parameters were retrieved. Liver fibrosis was defined by an aspartate aminotransferase-to-platelet index score of >2. A bivariable and multivariable logistic regression analysis was used to identify factors associated with liver fibrosis. Associations in the multivariate model with a p-value ≤0.05 were considered statistically significant.

Results: Five hundred and thirty-seven records of hepatitis B patients were retrieved. The median age was 34 (Interquartile Range (IQR), 28-43) years, and 334 (62.2%) were males. One hundred and two (18.99 %) were alcohol consumers, and 189 (35.20 %) were cigarette smokers at the data collection time. The prevalence of liver fibrosis was 10.8% (CI: 8.4–13.7). Hepatitis B viral load ≥ 20,000 IU/ml (AOR: 3.58; 95% CI:1.2-1.1; p<0.016) and cigarette smokers (AOR: 5.33; 95% CI:1.4-19.9; p<0.013) were independently associated with liver fibrosis.

Conclusion: At our clinic, one in ten people with hepatitis B infection has liver fibrosis. We recommend regular screening of liver fibrosis in all people with hepatitis B, especially those with a viral load ≥20,000 IU/ml and cigarette smokers. Liver screening by a FibroScan in the hepatitis B prevalent areas of resource-limited settings may improve the detection rate.

From affection to infection: Understanding the risks of kissing infants: A review

Husam Hussein Lazim — Tue, 03 Dec 2024 00:00:00 +0000

Although it’s a typical and loving gesture, kissing newborns carries a considerable danger because it could spread infections. Due to immature immune systems and incomplete vaccination histories, newborns are especially susceptible to respiratory viruses like influenza and respiratory syncytial virus (RSV), bacterial pathogens like Streptococcus pneumoniae and Group A Streptococcus, and cytomegalovirus (CMV). Despite the risks, many parents and other caretakers are ignorant of them and frequently permit intimate contact with guests who might be unintentionally carriers of infectious pathogens. This overview looks at the several infections that can spread by kissing, the possible effects on a newborn’s health, and the precautions experts advise taking to reduce the dangers.

A review of one year malaria blood film data from a hospital in Yei, South Sudan

Kennedy Obonyoh, Agnes James, J. Clarke McIntosh — Tue, 03 Dec 2024 00:00:00 +0000

Although Rapid Diagnostic Tests (RDTs) are utilized more frequently today, blood films are still the gold standard for diagnosing malaria. This is an observational study, looking at the experience of His House of Hope and Faith Hospital (HHHF) in Yei, South Sudan, in one calendar year (January to December in 2023) tracking Plasmodium falciparum (PF) and other plasmodium species. We report some simultaneous data using RDT for malaria and data regarding co-infection with Salmonella typhi (Typhoid fever).