For effective treatments and preventive measures against severe COVID-19, it is essential to determine early markers of disease severity in different populations. We analysed the cytokine kinetics of 129 COVID-19 patients with mild symptoms, 68 severe cases, and 20 healthy controls for the first time in Rwanda. Pro-inflammatory (IFNγ, IL-6, TNFα), Treg (IL-10, TGFβ1, TGFβ3), Th9 (IL-9), Th17 (IL-17), and Th2 (IL-4, IL-13) cytokines, total IgM and IgG, as well as gene expressions of FoxP3, STAT5+, IFNγ-R1, and ROR alpha+, were measured at day 1, day 7, day 14, day 21, and day 28 post-infection. Severe cases showed a significantly stronger increase than mild patients in levels of all cytokines (except IL-9) and all gene expression on day 1 of infection. Some cytokine levels dropped to levels comparable to mild cases at later time points. Further analysis identified IFNγ as a marker of severity throughout the disease course, while TGFβ1, IL-6, and IL-17 were markers of severity only at an early phase. Importantly, this study revealed a striking low IL-9 level and high IFNγ/IL-9 ratio in the plasma of patients who later died compared to mild and severe cases who recovered, suggesting that this could be an important biomarker for predicting the severity of COVID-19 and post-COVID-19 syndrome.
Background
Diarrhoeal disease is a worldwide public health issue and remains a major cause of mortality and morbidity in children under five years old. Low and middle income countries (LMIC) of Africa and part of Asia are more affected by diarrhoeal diseases.
Objectives
To measure the prevalence of Diarrhoeal Diseases and to assess Socio-demographic determinants among Under Five Years Old Children in Rwanda.
Methods
A cross-sectional design was used. Secondary data analysis was carried out on a sample of 7474 drawn from Rwanda Demographic and Health Survey (RDHS). RDHS used multistage sampling technique.
Results
After running multiple logistic regression, Sociodemographic determinants associated with diarrhoeal included age of children, wealth index category, mother education, husband/partner education, types of place of residence (P-Value<0.05).
Conclusion
The results of the study showed that diarrhoeal remains an important health issue in Rwanda. Occurrence of diarrhoeal was statistically associated with child age, wealth index, education of parents, types of place of residence.
Rwanda J Med Health Sci 2020;3(3):328-341
AbstractBackground: In Rwanda, despite significant political achievements in women's empowerment and efforts to eliminate child sexual abuse, the rate of teenage pregnancy remains high. Increased access to and use of contraceptive methods could reduce the rates of teenage pregnancy and HIV infection. Objectives: This study aims to assess the determinants, needs, and barriers to the use of contraceptive methods and HIV/AIDS preventive services by adolescents in Rwamagana District, Rwanda. Methods: A cross-sectional design was used in this study. A multistage sampling strategy with a simple random technique was employed to select 376 female students as participants. Data were collected using a pretested questionnaire composed of closed-ended questions with Likert scale constructs based on the Theory of Planned Behavior. Descriptive statistics, bivariate analysis, and multivariable logistic regression were conducted. Results: A multiple logistic regression analysis shows that participants aged 18–20 are more than twice as likely to use contraceptive methods or HIV preventive measures compared to those aged 13–15 (OR=2.876, P=0.041, 95% CI=1.974–4.052). Urban participants are also more than twice as likely to use contraceptives or HIV preventive methods compared to those whose schools are in rural areas (OR=2.333, P=0.037, 95% CI=1.261–4.316). Female students in Senior 6 are more than three times as likely to use contraceptive methods or HIV preventive measures compared to those in Senior 1 (OR=3.444, P=0.032, 95% CI=2.544–6.884). Participants who intend to have sex at an older age had a 24.9% reduction in the odds of using a contraceptive method or HIV preventive measures (OR=0.751, P=0.033, 95% CI=0.352–0.977). Friends of respondents also influence contraceptive use (OR=0.611, P=0.043, 95% CI=0.252–0.917). Participants with contraceptive knowledge are three times more likely to use contraceptives or HIV preventive methods compared to those with less contraceptive knowledge (OR=3.096, P=0.011, 95% CI=1.150–6.803). Conclusion: Area of residence, age, friendships, and knowledge of contraceptive methods and HIV preventive measures are the determinants underlying early sexual activity among teenagers. One of the biggest challenges is the level of sex education, which remains a taboo topic in Rwandan culture. It is still difficult for parents to discuss sex directly with their children. We recommend further studies to focus on teenage non-scholars while conducting similar research.
The Internet of Things (IoT) is changing the way people work, behave, interact, study and believe through the interconnectivity and interoperability of human beings, digital devices and various systems. Nevertheless, the perception of IoT and its impact on the society, remains unexploited to some countries which are reluctant to adapt the technology. This paper investigates the viewpoints of master's program students from East African Community, in Japan, towards the awareness and potential contributions of IoT in their countries. The paper aims at contributing to the inspiration of further researches and studies from the region in the field of IoT technologies.
BackgroundAdolescent pregnancy is a global health concern. Many adolescent deaths occur due to early marriage and pregnancy. This study assessed knowledge and utilization of contraception among secondary school female adolescents at selected secondary schools in Rwamagana district.MethodsCross-sectional design using a self-administered questionnaire was conducted on 117 participants selected by simple random. Analysis used descriptive and inferential statistics at 95% confidence interval, employing SPSS Version 23. Dependent variable was the use of contraceptive and independent variables were socio-demographics and knowledge variables. Bivariate analysis assessed the association between independent and dependent variables. Multivariate analysis assessed the strength of association between dependent and independent variables by computing Odds Ratio. Results are presented in tables and figures. ResultsThe majority (88%) had heard of contraception, though knowledge about contraception was inadequate (61.54%). Level of contraceptive use was low (17%). The significant independent predictors of contraceptive use were the level of education, having heard of contraception, knowledge of source of contraception, and knowledge of specific contraception methods. ConclusionHearing about contraception, was not proportionately associated with knowledge or practicing contraception among the sexually active female adolescents. There is a need to enhance sex education, youth-friendly health services, and research.
Rwanda J Med Health Sci 2022;5(1):71-84
Pressure injuries are costly and can lead to mortality and psychosocial consequences if not managed effectively. Proper management of pressure injuries is crucial for quality nursing care. However, there is limited research on nurses' knowledge and practices in preventing and managing pressure injuries among critically ill patients in Rwanda. In addition, barriers affecting nurses' practices in this area also need further investigation in order to inform the interventions to improve nursing care of patients with pressure injuries in Rwandan hospitals. A cross-sectional study involving 129 health nurses was conducted to determine their knowledge and practice levels regarding the prevention of pressure injuries in critically ill patients, and barriers impeding practice in this area. The research modified the Pieper-Zulkowski Pressure Ulcer Knowledge Test to evaluate the knowledge of nurses concerning the prevention of pressure injuries. A 33-item instrument drawn from pressure ulcer risk assessment and prevention toolkits established by the Agency for Healthcare Research and Quality was used to assess nurses' practices. Additionally, barriers influencing nurses' knowledge and practices related to the prevention of pressure injuries were evaluated through questions derived from a comparable study conducted in Ethiopia. Descriptive statistics were computed for each variable. Mean scores were computed to categorize nurses' level of knowledge and practice. Logistic regression analysis was employed to examine the influence of sociodemographic factors and training on the nurses' knowledge and practice, with a statistical significance set at a p-value less than 0.05. The study found that 40.0% of nurses had inadequate knowledge towards pressure injury prevention, and 60.0% reported that they inadequately practiced pressure injury prevention among critically ill patients. Nurses who have not been trained in pressure injury prevention have a 52.4% reduction in the odd of having adequate practice compared to those who have been trained (OR 0.476; 95% CI 0.211–0.996). Heavy workload, inadequate staff, shortage of equipments, presence of other priorities than pressure injury prevention, inadequate training coverage of pressure injury prevention were the most prevalent barriers reported. The evaluation of nurses' knowledge and practices on pressure injury prevention in critically ill patients at the study setting found that while nurses have satisfactory knowledge, their practical application is lacking due to factors like high workloads and insufficient staffing. The study recommends caution in interpreting the results due to a limited sample size, suggesting further research to guide improvements in nursing practices.
In Rwanda, despite significant political achievements in women's empowerment and efforts to eliminate child sexual abuse, the rate of teenage pregnancy remains high. Increased access to and use of contraceptive methods could reduce the rates of teenage pregnancy and HIV infection. The study aimed to identify sociodemographic characteristics of secondary school teenagers, factors influencing their access to contraceptive methods and HIV preventive services, the components of the theory of planned behaviour that underlie teenagers' access to these services, and propose strategies for improvement. A cross-sectional design was used in this study. A multistage sampling strategy with a simple random technique was employed to select 374 female students as participants. Data were collected using a pretested questionnaire composed of closed-ended questions with Likert scale constructs based on the Theory of Planned Behavior. Descriptive statistics, bivariate analysis, and multivariable logistic regression were conducted. A multiple logistic regression analysis shows that participants aged 18-20 are more than twice as likely to use contraceptive methods or HIV preventive measures compared to those aged 13-15 (OR = 2.876, P = 0.041, 95% CI = 1.974-4.052). Urban participants are also more than twice as likely to use contraceptives or HIV preventive methods compared to those whose schools are in rural areas (OR = 2.333, P = 0.037, 95% CI = 1.261-4.316). Female students in Senior 6 are more than three times as likely to use contraceptive methods or HIV preventive measures compared to those in Senior 1 (OR = 3.444, P = 0.032, 95% CI = 2.544-6.884). Participants who intend to have sex at an older age had a 24.9% reduction in the odds of using a contraceptive method or HIV preventive measures (OR = 0.751, P = 0.033, 95% CI = 0.352-0.977). Friends of respondents also influence contraceptive use (OR = 0.611, P = 0.043, 95% CI = 0.252-0.917). Participants with contraceptive knowledge are three times more likely to use contraceptives or HIV preventive methods compared to those with less contraceptive knowledge (OR = 3.096, P = 0.011, 95% CI = 1.150-6.803) CONCLUSION: Area of residence, age, friendships, and knowledge of contraceptive methods and HIV preventive measures are the determinants underlying early sexual activity among teenagers. One of the biggest challenges is the level of sex education, which remains a taboo topic in Rwandan culture. It is still difficult for parents to discuss sex directly with their children. We recommend further studies to focus on teenage non-scholars while conducting similar research.
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