Journal articles: 'Health care in Gambia'

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Touray, Sunkaru, Baboucarr Sanyang, Gregory Zandrow, and Isatou Touray. "Incidence and Outcomes after Out-of-Hospital Medical Emergencies in Gambia: A Case for the Integration of Prehospital Care and Emergency Medical Services in Primary Health Care." Prehospital and Disaster Medicine 33, no. 6 (November 15, 2018): 650–57. http://dx.doi.org/10.1017/s1049023x1800105x.

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AbstractBackgroundThe Gambia is going through a rapid epidemiologic transition with a dual disease burden of infections and non-communicable diseases occurring at the same time. Acute, time-sensitive, medical emergencies such as trauma, obstetric emergencies, respiratory failure, and stroke are leading causes of morbidity and mortality among adults in the country.ProblemData on medical emergency care and outcomes are lacking in The Gambia. Data on self-reported medical emergencies among adults in a selection of Gambian communities are presented in this report.MethodsA total of 320 individuals were surveyed from 34 communities in the greater Banjul area of The Gambia using a survey instrument estimating the incidence of acute medical emergencies in an adult population. Self-reported travel time to a health facility during medical emergencies and patterns of health-seeking behavior with regard to type of facility visited and barriers to accessing emergency care, including cost and medical insurance coverage, are presented in this report.ResultsOf the 320 individuals surveyed, 262 agreed to participate resulting in a response rate of 82%. Fifty-two percent of respondents reported an acute medical emergency in the preceding year that required urgent evaluation at a health facility. The most common facility visited during such emergencies was a health center. Eighty-seven percent of respondents reported a travel time of less than one hour during medical emergencies. Out-of-pocket cost of medications accounted for the highest expenditure during emergencies. There was a low awareness and willingness to subscribe to health insurance among individuals surveyed.Conclusion: There is a high incidence of acute medical emergencies among adults in The Gambia which are associated with adverse outcomes due to a combination of poor health literacy, high out-of-pocket expenditures on medications, and poor access to timely prehospital emergency care. There is an urgent need to develop prehospital acute care and Emergency Medical Services (EMS) in the primary health sector as part of a strategy to reduce mortality and morbidity in the country.TourayS, SanyangB, ZandrowG, TourayI. Incidence and outcomes after out-of-hospital medical emergencies in Gambia: a case for the integration of prehospital care and Emergency Medical Services in primary health care. Prehosp Disaster Med. 2018;33(6):650–657.

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Sundby, Johanne, Reuben Mboge, and Sheriff Sonko. "Infertility in the Gambia: frequency and health care seeking." Social Science & Medicine 46, no. 7 (April 1998): 891–99. http://dx.doi.org/10.1016/s0277-9536(97)00215-3.

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Sundby, Johanne. "Infertility in the Gambia: traditional and modern health care." Patient Education and Counseling 31, no. 1 (May 1997): 29–37. http://dx.doi.org/10.1016/s0738-3991(97)01006-9.

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Saha, Debasish, Adebayo Akinsola, Katrina Sharples, Mitchell O. Adeyemi, Martin Antonio, Sayeed Imran, Momodou Jasseh, et al. "Health Care Utilization and Attitudes Survey: Understanding Diarrheal Disease in Rural Gambia." American Journal of Tropical Medicine and Hygiene 89, no. 1_Suppl (July 10, 2013): 13–20. http://dx.doi.org/10.4269/ajtmh.12-0751.

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Jordan, Rainer A., Ljubisa Markovic, and Peter Gaengler. "Fluoride availability from natural resources in The Gambia - implications for oral health care." International Dental Journal 58, no. 5 (October 2008): 237–42. http://dx.doi.org/10.1111/j.1875-595x.2008.tb00194.x.

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Jatta, Joseph W., Ararso Baru, Olufunmilayo I. Fawole, and Oladosu A. Ojengbede. "Intimate partner violence among pregnant women attending antenatal care services in the rural Gambia." PLOS ONE 16, no. 8 (August 5, 2021): e0255723. http://dx.doi.org/10.1371/journal.pone.0255723.

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Background Intimate partner violence (IPV) refers to any behavior by either a current or ex-intimate partner or would-be rejected lover that causes physical, sexual, or psychological harm. It is the most common form of violence in women’s lives. According to a World Health Organization report, about 1 in 3 women worldwide experience at least one form of IPV from an intimate partner at some point in her life. In the Gambia, about 62% of pregnant women experience at least one form of violence from an intimate partner. IPV has severe physical and mental health consequences on a woman ranging from minor bodily injury to death. It also increases the risk of low birth weight, premature delivery, and neonatal death. Methods A health facility-based cross-sectional study design was carried out to assess the magnitude and factors associated with intimate partner violence among pregnant women seeking antenatal care in the rural Gambia. The study enrolled 373 pregnant women, and a multi-stage sampling technique was used to select the respondents. An interviewer-administered structured questionnaire was used to obtain information from the study participants. The collected data were analyzed using SPSS Ver.22. Bivariate and multivariate logistic regression were used to determine the association between dependent and independent variables. Odds ratio with 95% confidence interval (CI) was computed to determine the presence and strength of associated factors with IPV. Result The study reveals that the prevalence of IPV in The Gambia is 67%, with psychological violence (43%) being the most common form of IPV reported by the respondents. The multivariate logistic regression result reveals that being aged 35 years or older [AOR 5.1(95% CI 1.5–17.8)], the experience of parents quarreling during childhood [AOR 1.7(95% CI 1.0–2.75)], and having cigarette smoking partners [AOR 2.3 (95% CI 1.10–4.6)] were significantly associated with IPV during pregnancy. Conclusion This study has demonstrated that all forms of IPV in rural Gambia are frequent. Women older than 35 years, had experienced parents quarreling, had a partner who smoked, and a partner who fight with others were more likely report IPV compared to other pregnant women in the study. We recommend that IPV screening should be included as an integral part of routine antenatal care services in The Gambia. Community-based interventions that include indigenous leaders, religious leaders, and other key stakeholders are crucial to create awareness on all forms of IPV and address the risk factors found to influence the occurrence of IPV in rural Gambia.

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Bickler, Stephen W., Michelle L. Telfer, and Boto Sanno-Duanda. "Need for Paediatric Surgery Care in an Urban Area of the Gambia." Tropical Doctor 33, no. 2 (April 2003): 91–94. http://dx.doi.org/10.1177/004947550303300212.

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The report evaluates the need for paediatric surgical care in an urban area of sub-Saharan Africa. Seven hundred and forty-one children were treated for surgical problems from January through December 1997. The most common surgical problems were injuries (67.1%), congenital anomalies (15.0%) and surgical infections (6.7%). Forty-six per cent of children presenting with a surgical problem required a surgical procedure, 68.2% of which were classified as minor. The annual presentation rate for all surgical conditions was 543 per 10 000 children aged 0–14 years. The estimated cumulative risk for all surgical conditions is 85.4% by age 15 years. Our data suggest surgical diseases commonly affect children living in Banjul. Surgical care should be an essential component of child health programmes in developing countries.

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Williams, P. J. "Effect of measles immunization on child mortality in rural Gambia." Journal of Biosocial Science 21, S10 (1989): 95–104. http://dx.doi.org/10.1017/s002193200002530x.

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The Gambia provides an unusual opportunity for the application of cost analysis to health due to a relatively long history of immunization and recent empirical research. The results should apply not only to immunization programmes but also to a variety of types of primary health care in developing countries. In particular, well-based estimates of the cost per case averted and the cost per death prevented by alternative health interventions should prove to be of widespread interest and usefulness.

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Belford, Christopher, Momodou Mustapha Fanneh, Lang Sanyang, Bumi Camara, and Yusupha Dibba. "An Assessment of the Level of Affordability of Eye Health Care Services and Products in the Gambia – Case Study Onesight." International Journal of Innovative Science and Research Technology 5, no. 6 (July 1, 2020): 551–59. http://dx.doi.org/10.38124/ijisrt20jun153.

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Health care services and in particular eye care in The Gambia is plagued by exorbitant costs both direct (consultation fee, cost of medication/glasses, etc.) and indirect (cost of transportation to and from eye clinic, cost of food/sustenance during eye treatment etc.) making it luxury and barrier for the poor and vulnerable of our societies. It is for those reasons that OneSight decided to commission a survey in The Gambia. The sampling of the study was a multistage stratified cluster sampling. At each stage Probability Proportional to Size and random procedures were applied to arrive at the actual sample population of 3300 households. The study employed both quantitative and qualitative research design techniques to collect and analyze data. The finding of the study illustrated that nearly 70% of the household’s heads are willing to be the one to pay for corrective glasses should the need arise for any member of their household. 80% of the respondents reported in affirmative that there are costs required in making eyesight better. It was also disclosed that respondents are willing to pay for a pair of eye glasses GMD 0 (free eyeglasses) to GMD 20,000. The Focus Group Discussion conducted across The Gambia almost all participants unanimously recommended that the affordable cost for a pair of glasses should be GMD50.

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Greenwood, B. M. "Malaria chemoprophylaxis in the Gambia. Comparison of two strategies for control of malaria within a primary health care programme in the Gambia." Biomedicine & Pharmacotherapy 43, no. 3 (January 1989): 223. http://dx.doi.org/10.1016/0753-3322(89)90220-5.

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Telfer, Michelle L., Jane T. Rowley, and Gijs E. L. Walraven. "Experiences of Mothers with Antenatal, Delivery and Postpartum Care in Rural Gambia." African Journal of Reproductive Health 6, no. 1 (April 2002): 74. http://dx.doi.org/10.2307/3583148.

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Isara, Alphonsus, and Aru-Kumba Baldeh. "Prevalence of sexually transmitted infections among pregnant women attending antenatal clinics in West Coast Region of The Gambia." African Health Sciences 21, no. 2 (August 2, 2021): 585–92. http://dx.doi.org/10.4314/ahs.v21i2.13.

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Background: Sexually Transmitted Infections (STI) are the second most common cause of healthy life years lost by women in the 15 – 44 years age group in Africa. Aim/Objective: To determine the prevalence of STIs among pregnant women attending antenatal care (ANC) clinics in the West Coast Region of The Gambia. Materials and Methods: Blood, urine, and high vaginal swabs samples from 280 pregnant women attending ANC in Brika- ma District Hospital, Brikama, and Bandung Maternity and Child Health Hospital, Bandung were examined. Serum samples were tested for HIV using western blot technique and for syphilis using the Venereal Disease Research Laboratory (VDRL) test, and rapid plasma regimen. Candida albicans, Group B Streptococcus and Neisseria gonorrhoea were identified using Analytical Profile Index (API). Direct urine microscopy was used to identify C. albicans and Trichomonas vaginalis while Chlamydia trachomatis was identified using Direct Fluorescent Antibody (DFA) test. Results: The overall prevalence of STIs was 53.6%. The pathogenic agents isolated were Candida albicans (31.8%), Strep- tococcus agalactiae (15.0%), Treponema pallidum (6.8%), HIV (5.7%), Trichomonas vaginalis (3.9%), Neisseria gonorrhoea (1.8%) and Chlamydia trachomatis (0.7%). STIs were more prevalent among women in the younger age group of 15 – 24 years (54.7%), unemployed (54.0%), Primipara (62.3%), and in the third trimester of pregnancy (72.7%). Conclusion: A high prevalence of STIs was found among pregnant women attending ANC in the West Coast region of The Gambia. Public health intervention programmes should be strengthened to promote the sexual and reproductive health of pregnant women in The Gambia. Keywords: Sexually transmitted infections; pregnant women; antenatal clinics; The Gambia.

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Bakary Sanneh, Haruna S. Jallow, Yankuba Singhateh, Babanding Sabally, Alhagie Papa Sey, Amadou Woury Jallow, Tijan Jallow, Ignatius Baldeh, Sana M. Sambou, and Sharmila Lareef Jah. "Knowledge, attitude and practice of health care workers on antibiotic resistance and usage in the Gambia." GSC Biological and Pharmaceutical Sciences 13, no. 2 (November 30, 2020): 007–15. http://dx.doi.org/10.30574/gscbps.2020.13.2.0177.

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Introduction: Irrational prescription and use of antibiotics are found to be risk factors to the spread of antibiotic resistance. Studies have shown that more than half of the admitted patients at the Paediatric Department of the Edward Francis Small Teaching Hospital (EFSTH) in The Gambia have been treated with antibiotics in the year 2015 alone. It was also evident that 74.5% of clinical isolates were resistant to ampicillin which was the most prescribed antibiotic among these patients. Therefore, the need to assess health care workers’ knowledge, attitude and practices on the phenomenon of anti-microbial resistance (AMR) and antibiotic usage in the Gambia. Materials and Methods: This cross-sectional study was conducted using self-administered questionnaires which were adopted from related studies. The questionnaires were administered at 60 randomly selected health facilities (both public and private) from around the country with a sample size of 225 respondents in 2016. Descriptive analyses were performed for each study variable and rates were reported as percentages. The results are presented in the form of contingency tables with their respective related Chi-squared (χ2) statistics values. The interpretations of the P-values are based on the less than or equal to 0.05 (5%) significance level. Result: The study revealed that 63.27% of the respondents were nurses, 41.7% of them had a work experience between 0-4 years of service and most of the respondents work in the urban areas. Most of health care workers have knowledge on the right usage of antibiotics and understood that frequent usage of antibiotic could compromise the effectiveness of antibiotics. The study found 94.14% of the health care workers agreed there exists antibiotic abuse in both hospital and community settings. However, 23.08% of the respondents are not aware those antibiotics are not effective against viral infections such as common cold. Conclusion: Therefore, majority of the health care workers had knowledge about antibiotic resistance and are aware of the frequent and abuse of antibiotic use could contribute to the development of antibiotic resistance in the country. However, they were less informed of the cost involved in the treatment and management of multidrug resistance patients using fewer and expensive antibiotics. Moreover, some of the health care workers had misconception on the treatment of viral infections with antibiotics (such as antibacterial) and there also exists disproportionate distribution of trained health workers in the country. Therefore, refresher training on prudent usage of antibiotics for health care workers especially doctors and nurses must be strengthened.

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Hill, A. G., W. B. MacLeod, D. Joof, P. Gomez, and G. Walraven. "Decline of mortality in children in rural Gambia: the influence of village-level Primary Health Care." Tropical Medicine and International Health 5, no. 2 (February 2000): 107–18. http://dx.doi.org/10.1046/j.1365-3156.2000.00528.x.

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Puchalski Ritchie, Lisa M., Stephen R. C. Howie, and Pamela Collier Njai. "Development of a Pain Management Protocol for a Paediatric Ward in the Gambia, West Africa." International Journal of Pediatrics 2010 (2010): 1–4. http://dx.doi.org/10.1155/2010/975313.

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Despite recent advances in our understanding of paediatric pain and its management, pain continues to be undertreated globally, particularly in children and in low income countries. This article describes the development of a paediatric analgesia and sedation protocol, tailored to the specific setting of the Medical Research Council (MRC) paediatric ward in the Gambia, West Africa. An iterative process was used throughout development, with inputs from the medical literature, local providers, and pain experts, incorporated to ensure a safe, effective, and locally appropriate protocol. We demonstrate that evidence-based published guidelines, can and should be adapted to allow for optimal pain management given the resources and capabilities of specific health care settings. It is hoped that the process and protocol described here, will not only help to improve care on the MRC ward, but serve as an example to others working toward improving pain management in similar health care settings.

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Djourdebbé, Franklin Bouba. "Do urban areas still have advantages over rural areas in antenatal care discontinuity in Sub-Saharan Africa?" Net Journal of Social Sciences 9, no. 2 (May 2021): 27–35. http://dx.doi.org/10.30918/njss.92.21.011.

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In sub-Saharan Africa, among the small proportion of women who had at least one antenatal visit, many of them no longer return to ensure continuity of antenatal care. This antenatal care discontinuity is a matter of serious concern for maternal health. Using Demographic and Health Survey data collected between 2000 and 2016 in 26 sub-Saharan countries, this study aims to analyse urban/rural differences in antenatal care discontinuity. Although in the majority of countries, urban areas have considerable advantages in terms of antenatal care continuity, there are countries where urban/rural differences are not significant, as well as atypical countries (Rwanda, Gambia and Zambia) where antenatal care discontinuity is higher in urban areas compared to rural areas. This study is a contribution to tackle the complex disparities in the discontinuity of care during pregnancy in maternal health policies in sub-Saharan Africa. Keywords: Maternal health, antenatal care, urban, rural, sub-Saharan Africa.

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GREENWOOD, B. "COMPARISON OF TWO STRATEGIES FOR CONTROL OF MALARIA WITHIN A PRIMARY HEALTH CARE PROGRAMME IN THE GAMBIA." Lancet 331, no. 8595 (May 1988): 1121–27. http://dx.doi.org/10.1016/s0140-6736(88)91949-6.

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Wariri, Oghenebrume, Uduak Okomo, Carla Cerami, Emmanuel Okoh, Francis Oko, Hawanatu Jah, Kalifa Bojang, et al. "Establishing and operating a ‘virtual ward’ system to provide care for patients with COVID-19 at home: experience from The Gambia." BMJ Global Health 6, no. 6 (June 2021): e005883. http://dx.doi.org/10.1136/bmjgh-2021-005883.

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Health systems in sub-Saharan Africa have remained overstretched from dealing with endemic diseases, which limit their capacity to absorb additional stress from new and emerging infectious diseases. Against this backdrop, the rapidly evolving COVID-19 pandemic presented an additional challenge of insufficient hospital beds and human resource for health needed to deliver hospital-based COVID-19 care. Emerging evidence from high-income countries suggests that a ‘virtual ward’ (VW) system can provide adequate home-based care for selected patients with COVID-19, thereby reducing the need for admissions and mitigate additional stress on hospital beds. We established a VW at the Medical Research Council Unit, The Gambia at the London School of Hygiene and Tropical Medicine, a biomedical research institution located in The Gambia, a low-income west African country, to care for members of staff and their families infected with COVID-19. In this practice paper, we share our experience focusing on the key components of the system, how it was set up and successfully operated to support patients with COVID-19 in non-hospital settings. We describe the composition of the multidisciplinary team operating the VW, how we developed clinical standard operating procedures, how clinical oversight is provided and the use of teleconsultation and data capture systems to successfully drive the process. We demonstrate that using a VW to provide an additional level of support for patients with COVID-19 at home is feasible in a low-income country in sub-Saharan Africa. We believe that other low-income or resource-constrained settings can adopt and contextualise the processes described in this practice paper to provide additional support for patients with COVID-19 in non-hospital settings.

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Jammeh, Abdou, Siri Vangen, and Johanne Sundby. "Stillbirths in Rural Hospitals in The Gambia: A Cross-Sectional Retrospective Study." Obstetrics and Gynecology International 2010 (2010): 1–8. http://dx.doi.org/10.1155/2010/186867.

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Objective. We determined the stillbirth rate and associated factors among women who delivered in rural hospitals in The Gambia.Method. A cross-sectional retrospective case review of all deliveries between July and December 2008 was undertaken. Maternity records were reviewed and abstracted of the mother’s demographic characteristics, obstetric complications and foetal outcome.Main Outcome Measure: The stillbirth rate was calculated as deaths per 1000 births.Results. The hospital-based stillbirth rate was high, 156 (95% CI 138–174) per 1000 births. Of the 1,519 deliveries, there were 237 stillbirths of which 137 (57.8%) were fresh. Severe obstetric complication, birth weight<2500 g, caesarean section delivery, and referral from a peripheral health facility were highly significantly associated with higher stillbirth rates, OR = 6.68 (95% CI 3.84–11.62), 4.47 (95% CI 3.04–6.59), 4.35 (95% CI 2.46–7.69), and 3.82 (95% CI 2.24–6.51), respectively. Half (50%) of the women with stillbirths had no antenatal care OR = 4. 46(95% CI 0.84–23.43).Conclusion. We observed an unacceptably high stillbirth rate in this study. As most of the stillbirths were fresh, improved intrapartum care supported by emergency transport services and skilled personnel could positively impact on perinatal outcomes in rural hospitals in The Gambia.

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Sanneh, Edward Saja, Allen H. Hu, Modou Njai, Omar Malleh Ceesay, and Buba Manjang. "Making Basic Health Care Accessible to Rural Communities: A Case Study of Kiang West District in Rural Gambia." Public Health Nursing 31, no. 2 (September 4, 2013): 126–33. http://dx.doi.org/10.1111/phn.12057.

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Fox-Rushby, Julia A., and Frances Foord. "Costs, effects and cost-effectiveness analysis of a mobile maternal health care service in West Kiang, The Gambia." Health Policy 35, no. 2 (February 1996): 123–43. http://dx.doi.org/10.1016/0168-8510(95)00774-1.

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Conteh, Lesong, Warren Stevens, and Virginia Wiseman. "The role of communication between clients and health care providers: implications for adherence to malaria treatment in rural Gambia." Tropical Medicine & International Health 12, no. 3 (January 25, 2007): 382–91. http://dx.doi.org/10.1111/j.1365-3156.2006.01806.x.

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Mason, K., S. Ketende, S. Peitzmeier, N. Ceesay, C. Logie, D. Diouf, J. Loum, et al. "Stigma, Human Rights Violations, Health Care Access, and Disclosure among Men who have Sex with Men in the Gambia." Journal of Human Rights Practice 7, no. 1 (January 13, 2015): 139–52. http://dx.doi.org/10.1093/jhuman/huu026.

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Année-van Bavel, J., M. Bosman, I. Bouchier, and K. Manneh. "240-PA12 Intermittent short-course chemotherapy on ambulatory basis integrated in the primary health care system of the Gambia." Tubercle and Lung Disease 76 (October 1995): 118. http://dx.doi.org/10.1016/0962-8479(95)90437-9.

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Johnson, J. G., V. Goode Sen, and H. Faal. "Barriers to the Uptake of Cataract Surgery." Tropical Doctor 28, no. 4 (October 1998): 218–20. http://dx.doi.org/10.1177/004947559802800410.

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In The Gambia many patients identified as blind or as having low vision are not attending for surgery. The aim of this study was to investigate the reasons for non-attendance. Three methods were used: semi-structured interviews; focus group discussions; and written questionnaires completed by staff. The most frequently identified barrier by all three methods was cost, closely followed by lack of information about services, fear, transport difficulties, and the lack of an escort. In addition to the existing measures taken by the National Eye Care Programme (NECP) to reduce these barriers, further research into both the public's knowledge and attitudes regarding surgery for cataract is needed. More contact between members of the eye care programme and the communities would aid the transfer of information about the surgery.

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Bendiksen, Bothild, Trond Heir, Fabakary Minteh, Mai Mahgoub Ziyada, Rex A. Kuye, and Inger-Lise Lien. "The association between physical complications following female genital cutting and the mental health of 12-year-old Gambian girls: A community-based cross-sectional study." PLOS ONE 16, no. 1 (January 22, 2021): e0245723. http://dx.doi.org/10.1371/journal.pone.0245723.

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Background Female genital cutting (FGC) involve an acute physical trauma that hold a potential risk for immediate and long-term complications and mental health problems. The aim of this study was to examine the prediction of depressive symptoms and psychological distress by the immediate and current physical complications following FGC. Further, to examine whether the age at which 12-year-old Gambian girls had undergone the procedure affected mental health outcomes. Method This cross-sectional study recruited 134 12-year-old girls from 23 public primary schools in The Gambia. We used a structured clinical interview to assess mental health and life satisfaction, including the Short Mood and Feeling Questionnaire (SMFQ), the Symptom check list (SCL-5) and Cantril’s Ladder of Life Satisfaction. Each interview included questions about the cutting procedure, immediate- and current physical complications and the kind of help and care girls received following FGC. Results Depressive symptoms were associated with immediate physical health complications in a multivariate regression model [RR = 1.08 (1.03, 1.12), p = .001], and with present urogenital problems [RR = 1.19 (1.09, 1.31), p < .001]. The girls that received medical help following immediate complications had a lower risk for depressive symptoms [RR = .73 (.55, .98), p = .04]. Psychological distress was only associated with immediate complications [RR = 1.04 (1.01, 1.07), p = .004]. No significant differences in mental health outcomes were found between girls who underwent FGC before the age of four in comparison to girls who underwent FGC after the age of four. Conclusion Our findings indicate that the immediate and long-term complications following FGC have implications for psychological health. Only a minimal number of girls received medical care when needed, and the dissemination of health education seems crucial in order to prevent adverse long-term physical and psychological health consequences.

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Rutherford, Merrin. "Access to health care and mortality of children under 5 years of age in the Gambia: a case-control study." Bulletin of the World Health Organization 87, no. 3 (March 1, 2009): 216–25. http://dx.doi.org/10.2471/blt.08.052175.

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Mulholland, E. K., S. Hilton, G. Fegan, G. Inskip, O. Yuuni, J. E. Bangali, B. M. Greenwood, and G. P. Lahai. "Data Management for an Efficacy Trial of a Vaccine in the Gambia." Methods of Information in Medicine 36, no. 03 (July 1997): 214–20. http://dx.doi.org/10.1055/s-0038-1636828.

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An individually randomised double-blind trial of PRP-T Hib conjugate vaccine was conducted in the Gambia between 1993 and 1995, in which 42,848 children were randomised into one of 10 groups, five corresponding to vaccine and five to placebo. Basic demographic data were collected on all children, and administration details of all doses of EPI vaccines were recorded. In addition, details on all doses of vaccines were recorded on each child’s home-based health card; 2,681 episodes of possible Hib disease were investigated and for each episode detailed clinical data were collected. These investigations yielded 50 cases of confirmed Hib disease, which formed the basis of the final efficacy results. In all 50 cases, the data on the children’s health card, describing the doses of study vaccine received exactly, matched the vaccination database which was filled with data returned from the clinics. The data-management procedures are described in detail in this paper.

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Kanteh, Abdoulie, Jarra Manneh, Sona Jabang, Mariama A. Kujabi, Bakary Sanyang, Mary A. Oboh, Abdoulie Bojang, et al. "Origin of imported SARS-CoV-2 strains in The Gambia identified from whole genome sequences." PLOS ONE 16, no. 8 (August 31, 2021): e0241942. http://dx.doi.org/10.1371/journal.pone.0241942.

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The SARS-CoV-2 disease, first detected in Wuhan, China, in December 2019 has become a global pandemic and is causing an unprecedented burden on health care systems and the economy globally. While the travel history of index cases may suggest the origin of infection, phylogenetic analysis of isolated strains from these cases and contacts will increase the understanding and link between local transmission and other global populations. The objective of this analysis was to provide genomic data on the first six cases of SARS-CoV-2 in The Gambia and to determine the source of infection. This ultimately provide baseline data for subsequent local transmission and contribute genomic diversity information towards local and global data. Our analysis has shown that the SARS-CoV-2 virus identified in The Gambia are of European and Asian origin and sequenced data matched patients’ travel history. In addition, we were able to show that two COVID-19 positive cases travelling in the same flight had different strains of SARS-CoV-2. Although whole genome sequencing (WGS) data is still limited in sub-Saharan Africa, this approach has proven to be a highly sensitive, specific and confirmatory tool for SARS-CoV-2 detection.

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Saso, Anja, Benjamin Dowsing, Karen Forrest, and Mary Glover. "Recognition and management of congenital ichthyosis in a low-income setting." BMJ Case Reports 12, no. 8 (August 2019): e228313. http://dx.doi.org/10.1136/bcr-2018-228313.

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We report the case of a 3-week old girl in The Gambia who presented to hospital with an undiagnosed skin disorder evolving since birth. Using telemedicine to seek specialist dermatology advice abroad, she was diagnosed with and managed for suspected congenital lamellar ichthyosis. Poor early recognition and limited resources, for both acute and chronic care, created significant challenges to optimal management; these were overcome, in part, by adopting a common sense, back-to-basics approach to treatment and by empowering the parents to take ownership of their infant’s daily skin and eye care. This case highlights key global health issues associated with managing chronic, often debilitating, paediatric dermatological conditions in a low-income setting; namely, poor access to important diagnostic tools and medications, lack of experience and expertise in the management of severe skin disease and its associated complications, absence of long-term community support, alternative health beliefs and risk of sociocultural stigma.

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Harding-Esch, Emma M., Martin J. Holland, Jean-François Schémann, Sandra Molina, Isatou Sarr, Aura A. Andreasen, Chrissy h. Roberts, et al. "Diagnostic Accuracy of a Prototype Point-of-Care Test for Ocular Chlamydia trachomatis under Field Conditions in The Gambia and Senegal." PLoS Neglected Tropical Diseases 5, no. 8 (August 2, 2011): e1234. http://dx.doi.org/10.1371/journal.pntd.0001234.

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Sreenivasan, Gopal. "Health care and human rights: against the split duty gambit." Theoretical Medicine and Bioethics 37, no. 4 (August 2016): 343–64. http://dx.doi.org/10.1007/s11017-016-9375-7.

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Vekemans, Johan, Martin O. C. Ota, Jackson Sillah, Katherine Fielding, Mark R. Alderson, Yasir A. W. Skeiky, Wilfried Dalemans, Keith P. W. J. McAdam, Christian Lienhardt, and Arnaud Marchant. "Immune Responses to Mycobacterial Antigens in the Gambian Population: Implications for Vaccines and Immunodiagnostic Test Design." Infection and Immunity 72, no. 1 (January 2004): 381–88. http://dx.doi.org/10.1128/iai.72.1.381-388.2004.

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ABSTRACT Recombinant immunodominant mycobacterial antigens are needed for the development of new vaccines and immunodiagnostic tools for use against tuberculosis. Ubiquitous exposure to mycobacteria in tropical countries could influence vaccine-induced immunity and the specificity of tuberculosis immunodiagnosis. For this study conducted in The Gambia, cellular immune responses to recombinant mycobacterial antigens were characterized in Mycobacterium bovis BCG-vaccinated and nonvaccinated infants, adult community controls, household contacts, health care workers, and tuberculosis patients. Neonatal BCG vaccination induced gamma interferon (IFN-γ) responses to Mtb8.4, Mtb32-C, Mtb39A, Mtb9.9A, and Mtb32-N, but not CFP-10 (Mtb11) and α-crystallin (Mtb16). Exposure to Mycobacterium tuberculosis in household contacts and health care workers was associated with high responses to CFP-10 and α-crystallin. Generally, low IFN-γ responses were found in tuberculosis patients. These results suggest that Mtb8.4, Mtb32-C, Mtb39A, Mtb9.9A, and Mtb32-N may be used in a subunit vaccine to boost BCG-induced immunity. While CFP-10 and α-crystallin are promising candidates for the immunodiagnosis of M. tuberculosis infection or for vaccine use, disease-associated immunosuppression may prevent IFN-γ immunodiagnosis of more advanced tuberculosis.

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Hajizadeh, Mohammad. "Socioeconomic inequalities in child vaccination in low/middle-income countries: what accounts for the differences?" Journal of Epidemiology and Community Health 72, no. 8 (March 26, 2018): 719–25. http://dx.doi.org/10.1136/jech-2017-210296.

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BackgroundSocioeconomic inequalities in child vaccination continue to be a global public health concern. This study aimed to measure and identify factors associated with socioeconomic inequalities in full immunisation coverage against the four core vaccine-preventable diseases (ie, bacille Calmette-Guérin, diphtheria-tetanus-pertussis (three doses), polio (three doses) and measles vaccines) in 46 low/middle-income countries.MethodsThe most recent nationally representative samples of children (aged 10–59 months, n=372 499) collected through the Demographic Health Surveys were used to measure vaccination rates. The concentration index (C) was used to quantify socioeconomic inequalities in vaccination coverage. Furthermore, meta-regression analyses were used to determine factors affecting socioeconomic inequalities in vaccination coverage across countries.ResultsResults suggested that immunisation coverage was pro-rich in most countries (median C=0.161, IQR 0.131). Gambia (C=−0.146, 95% CI −0.223 to −0.069), Namibia (C=−0.093, 95% CI −0.145 to −0.041) and Kyrgyz Republic (C=−0.227, 95% CI −0.304 to −0.15) were the only countries where children who belong to higher socioeconomic status group were less likely to receive all the four core vaccines than their lower socioeconomic status counterparts. Meta-regression analyses suggested that, across countries, the concentration of antenatal care visits among wealthier mothers was positively associated with the concentration of vaccination coverage among wealthier children (coefficient=0.606, 95% CI 0.301 to 0.911).ConclusionsPro-rich distribution of child vaccination in most low/middle-income countries remains an important public health policy concern. Policies aimed to improve antenatal care visits among mothers in lower socioeconomic groups may mitigate socioeconomic inequalities in vaccination coverage in low/middle-income countries.

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Solanke, Bola Lukman, Joseph Ayodeji Kupoluyi, John Olugbenga Abe, and Olatunji Taofik Bankole. "Polygyny and Resources for Empowerment and Equality in Anglo-Phone West Africa: Implications for Childbearing and Women’s Well-Being." European Scientific Journal, ESJ 14, no. 17 (June 30, 2018): 174. http://dx.doi.org/10.19044/esj.2018.v14n17p174.

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In West Africa, polygyny remained a common type of marriage. However, in spite of numerous studies exploring polygyny, the relationship between polygyny and access to resources for empowerment and equality is not well-ascertained in West Africa. This study addresses this gap by raising the question: to what extent does polygyny explains access to resources for empowerment and equality among married women? Data were extracted from 2013 Demographic and Health Surveys in The Gambia, Nigeria and Sierra-Leone. The outcome variable is access to resources for empowerment and equality measured by access to education, employment and barriers to accessing health care. The key explanatory variable is type of marriage with specific attention to polygyny. Multivariate multiple regression was applied using Stata 12. Results showed that polygyny was negatively associated with access to education in the studied countries; positively associated with access to employment in the studied countries; and negatively associated with access to health in Nigeria and Sierra Leone. It is important to refocus national attention to improving the capabilities of women because economic empowerment will not only improve women’s well-being, it will also translate to the reduction of childbearing pressures among women.

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Gamma, Anna E., Jurgita Slekiene, and Hans-Joachim Mosler. "The Impact of Various Promotional Activities on Ebola Prevention Behaviors and Psychosocial Factors Predicting Ebola Prevention Behaviors in the Gambia Evaluation of Ebola Prevention Promotions." International Journal of Environmental Research and Public Health 16, no. 11 (June 6, 2019): 2020. http://dx.doi.org/10.3390/ijerph16112020.

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The outbreak of the Ebola virus disease (EVD) from 2014 to 2016 is over. However, several outbreaks of contagious diseases have already arisen and will recur. This paper aims to evaluate the effectiveness of EVD prevention promotions in the Gambia and to assess the psychosocial factors that steer three behaviors: handwashing with soap, calling the Ebola Hotline, and not touching a person who might be suffering from EVD. In 2015, data were gathered from 498 primary care providers. The questionnaire was based on psychosocial factors from the risks, attitudes, norms, abilities, and self-regulation (RANAS) model. Three promotional activities were significantly associated with psychosocial factors of handwashing and, thus, with increased handwashing behavior: the home visit, posters, and info sheets. Norm factors, especially the perception of what other people do, had a great impact on handwashing with soap and on calling the Ebola Hotline. The perceived certainty that a behavior will prevent a disease was a predictor for all three protection behaviors. Commitment to the behavior emerged as especially relevant for the intention to call the Ebola Hotline and for not touching a person who might be suffering from EVD. Health behavior change programs should rely on evidence to target the right psychosocial factors and to maximize their effects on prevention behaviors, especially in emergency contexts.

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Tamai, Silvia Affini Borsoi, Sergio Márcio Pacheco Paschoal, Julio Litvoc, Adriana Nunes Machado, Pedro Kallas Curiati, Luis Felipe Prada, and Wilson Jacob-Filho. "Impact of a program to promote health and quality of life of elderly." Einstein (São Paulo) 9, no. 1 (March 2011): 8–13. http://dx.doi.org/10.1590/s1679-45082011ao1759.

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ABSTRACT Objective: To evaluate the effect on quality of life of elderly people enrolled in GAMIA – Multidisciplinary Care Group to Outpatient Elderly Subjects (Grupo de Assistência Multidisciplinar ao Idoso Ambulatorial) of the Geriatric Department, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo. Methods: Between 2000 and 2002, 83 elderly participants of GAMIA were assessed by the World Health Organization Quality of Life scale (WHOQOL-bref) at the beginning and the end of the program. Functionality was assessed by Katz and Lawton scales and sociodemographic data were obtained from medical charts. Results: Females predominated (79.5%) and overall mean age was 69.30 years. Data analysis showed a reduction in the physical domain of WHOQOL-bref (p = 0.014) and increased psychological health and environment domains (p = 0.029 and p = 0.007, respectively), detecting a trend of increase in social relationships and in general domains (p = 0.062 and p = 0.052, respectively). Conclusions: The clinical evaluation of the elderly detected previously unknown diseases and determination of the use of new drugs, which might have been the predominant factor for the deterioration of their perception in the physical domain. Improvement in psychological health and the environment can be related to psychological and social support that the elderly received from peers and professionals and the benefits of group activities, as well as the upward trend observed in social relationships and general domains. Participation in a program to promote healthy aging was effective in improving the quality of life of the elderly.

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Zoure, Abdou Azaque, Bagora Bayala, Hierrhum Aboubacar Bambara, Alexis Yobi Sawadogo, Charlemagne Ouedraogo, Jean-Marc A. Lobaccaro, and Jacques Simpore. "Epidemiological Situation and Medical Management of Gynaecological and Breast Cancers from 1998 to 2018 in West Africa: A Systematic Review." Asian Pacific Journal of Cancer Biology 5, no. 4 (December 7, 2020): 211–19. http://dx.doi.org/10.31557/apjcb.2020.5.4.211-219.

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Objective: Gynaecological cancers are public health diseases and contribute to the global burden of diseases. In West Africa most have been carried out on all gynaecological and breast cases to describe the epidemiological features and management modalities.Methods: Our research covered a period from 1998 to 2018. The terms “gynaecological cancers” and “West Africa”; are used to find records in the research databases (PubMed, ScienceDirect, Scopus and Google Scholar). There are countries (Cape Verde, Guinea, Gambia, Liberia, Sierra Leone) in which we have not found any work in the research databases. The process for selecting studies followed selection steps based on PRISMA 2009. Result: Cervical cancer is the commonest, followed by breast cancer, ovarian cancer, uterine or endometrial cancers, vaginal cancer and vulvar cancer. The lowest common was tubal cancers. The two English-speaking countries, Nigeria and Ghana, recorded 60 (60.82%) and 16 (15.68%) articles published respectively. At the same time, these two countries reported the most cases of gynaecological cancers including 72,848 cases (68.97%), 12, 327 cases (11.67%) and 12, 021 cases (11.38%) for Nigeria, Cote d’Ivoire and Ghana respectively. West Africa countries are characterised by poor outcome due to ignorance, superstition, self-denial, late presentation and unavailability of treatment facilities. Conclusion: Our study suggests that comprehensive national health insurance schemes as well as preventive strategies, patient and health work force education may improve the current situation. Also, West African countries must necessarily have a policy of acquiring the technical platforms to carry out these diagnostic and prognostic examinations.

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Stephenson, Nina. "Care assistants in The Gambia." British Journal of Healthcare Assistants 2, no. 8 (August 2008): 400–402. http://dx.doi.org/10.12968/bjha.2008.2.8.30863.

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Smyth, Dion. "Politics and palliative care: Gambia." International Journal of Palliative Nursing 23, no. 2 (February 2, 2017): 102. http://dx.doi.org/10.12968/ijpn.2017.23.2.102.

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Blaney, S., M. Beaudry, and M. Latham. "Determinants of undernutrition in rural communities of a protected area in Gabon." Public Health Nutrition 12, no. 10 (October 2009): 1711–25. http://dx.doi.org/10.1017/s1368980008004035.

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AbstractObjectiveTo understand how access to natural resources may contribute to nutrition.DesignIn each of the two major seasons, data were collected during a 7 d period using observations, semi-structured interviews, anthropometric measures and a weighed food consumption survey.SettingFour rural communities selected to represent inland and coastal areas of the Gamba Complex in Gabon.SubjectsIn each community, all individuals from groups vulnerable to malnutrition, i.e. children aged 0–23 months (n 41) and 24–59 months (n 63) and the elderly (n 101), as well as women caregivers (n 96).ResultsIn most groups, household access to natural resources was associated with household access to food but not with individual nutritional status. In children aged 0–23 months, access to care and to health services and a healthy environment were the best predictors of length-for-age (adjusted R2: 14 %). Health status was the only predictor of weight-for-height in children aged 24–59 months (adjusted R2: 14 %). In women caregivers, household food security was negatively associated with nutritional status, as was being younger than 20 years (adjusted R2: 16 %). Among the elderly, only nutrient adequacy predicted nutritional status (adjusted R2: 5 %).ConclusionImproving access to care and health for young children would help reverse the process of undernutrition. Reaching a better understanding of how the access of individuals to both food and other resources relate to household access could further our appreciation of the constraints to good nutrition. This is particularly relevant in women to ensure that their possibly important contribution to the household is not at their own expense.

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Kazungu, Jacob S., and Ifedayo M. O. Adetifa. "Crude childhood vaccination coverage in West Africa: Trends and predictors of completeness." Wellcome Open Research 2 (February 15, 2017): 12. http://dx.doi.org/10.12688/wellcomeopenres.10690.1.

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Background: Africa has the lowest childhood vaccination coverage worldwide. If the full benefits of childhood vaccination programmes are to be enjoyed in sub-Saharan Africa, all countries need to improve on vaccine delivery to achieve and sustain high coverage. In this paper, we review trends in vaccination coverage, dropouts between vaccine doses and explored the country-specific predictors of complete vaccination in West Africa. Methods: We utilized datasets from the Demographic and Health Surveys Program, available for Benin, Burkina Faso, The Gambia, Ghana, Guinea, Cote d’Ivoire, Liberia, Mali, Niger, Nigeria, Senegal, Sierra Leone and Togo, to obtain coverage for Bacillus Calmette-Guerin, polio, measles, and diphtheria, pertussis and tetanus (DPT) vaccines in children aged 12 – 23 months. We also calculated the DPT1-to-DPT3 and DPT1-to-measles dropouts, and proportions of the fully immunised child (FIC). Factors predictive of FIC were explored using Chi-squared tests and multivariable logistic regression. Results: Overall, there was a trend of increasing vaccination coverage. The proportion of FIC varied significantly by country (range 24.1-81.4%, mean 49%). DPT1-to-DPT3 dropout was high (range 5.1% -33.9%, mean 16.3%). Similarly, DPT1-measles dropout exceeded 10% in all but four countries. Although no single risk factor was consistently associated with FIC across these countries, maternal education, delivery in a health facility, possessing a vaccine card and a recent post delivery visit to a health facility were the key predictors of complete vaccination. Conclusions: The low numbers of fully immunised children and high dropout between vaccine doses highlights weaknesses and the need to strengthen the healthcare and routine immunization delivery systems in this region. Country-specific correlates of complete vaccination should be explored further to identify interventions required to increase vaccination coverage. Despite the promise of an increasing trend in vaccination coverage in West African countries, more effort is required to attain and maintain global vaccination coverage targets.

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Haryanto, Aji, and Ella Nurlaella Hadi. "Praktek Ibu dalam Perawatan Neonatus di Kabupaten Garut, Jawa Barat." Kesmas: National Public Health Journal 3, no. 6 (June 1, 2009): 243. http://dx.doi.org/10.21109/kesmas.v3i6.201.

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Angka kematian bayi (AKB) di Kabupaten Garut pada tahun 2005 (54,8 per 1000 kelahiran hidup) merupakan yang tertinggi di provinsi Jawa Barat, akibat kematian neonatus dalam tiga tahun terakhir terus meningkat. Studi yang bertujuan mengetahui determinan praktek ibu dalam perawatan neonatus, dilakukan dengan analisis lanjut data Survei Dasar Kesehatan Neonatus Esensial di Kabupaten Garut tahun 2007. Analisis dilakukan dengan menggunakan metoda regresi logistik ganda. Hasil studi menunjukkan, dari 577 ibu bayi 1-11 bulan yang menjadi sampel penelitian, sekitas 51,5% ibu melakukan praktek perawatan neonatus kurang baik. Faktor yang paling dominan berhubungan dengan praktek perawatan neonatus adalah pengetahuan ibu setelah dikontrol oleh duku- ngan keluarga, pendidikan ibu, pekerjaan ibu dan penyuluhan oleh tenaga kesehatan. Ibu yang berpengetahuan baik melakukan praktek perawatan neona- tus baik 2,2 kali lebih besar daripada ibu yang dengan pengetahuan kurang baik. Disarankan agar Bidan di Desa (BdD) mengubah cara pemberian informasi kepada ibu dan keluarganya dengan metode diskusi dan menggunakan gambar serta buku Kesehatan Ibu dan Anak (KIA), sehingga ibu lebih mudah mema- hami dan menerapkan kepada bayinya.Kata kunci : Perawatan neonatus, kesehatan neonatus, AKBAbstractInfant Mortality Rate (IMR) in 2005 at Garut District (54.8/1000 live births), is the highest in West Java Province, due to ever increasing neonatus mortality rates in the last three year. The purpose of this study was to investigate the determinant of mother’s practice in neonatus care at Garut District, conducted by advance analysis of Baseline Survey of Essential Neonatus Health Services at Garut District data in 2007. The data was analyzed using chi square test and multiple logistic regression. The result of this study showed that out of 577 baby mothers who had 1-11 months as the sample of this research, 51.5% had unfavorable practice in neonatus care. The most dominant factor related to practice in neonatus care was knowledge of mother after adjusting by family sup- port, mother’s education, mother’s occupation and counseling by health provider. Mothers who have good knowledge in neonatus care practice had chance 2.2 times higher compared to mothers who had unfavorable knowledge to implement good practice. Based on the result of this study, it is suggested that the Village Midwives should change the way in giving of information to mothers and her families by using more discussion method and utilizing picture, and also utilizing Maternal and Child Health book, so that it would be easier for the mothers to understand and to apply good practices to their babies.Key words : Neonatus care, neonatus health, iInfant mortality rate

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Awokola, Babatunde I., Gabriel Okello, Kevin J. Mortimer, Christopher P. Jewell, Annette Erhart, and Sean Semple. "Measuring Air Quality for Advocacy in Africa (MA3): Feasibility and Practicality of Longitudinal Ambient PM2.5 Measurement Using Low-Cost Sensors." International Journal of Environmental Research and Public Health 17, no. 19 (October 3, 2020): 7243. http://dx.doi.org/10.3390/ijerph17197243.

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Ambient air pollution in urban cities in sub-Saharan Africa (SSA) is an important public health problem with models and limited monitoring data indicating high concentrations of pollutants such as fine particulate matter (PM2.5). On most global air quality index maps, however, information about ambient pollution from SSA is scarce. We evaluated the feasibility and practicality of longitudinal measurements of ambient PM2.5 using low-cost air quality sensors (Purple Air-II-SD) across thirteen locations in seven countries in SSA. Devices were used to gather data over a 30-day period with the aim of assessing the efficiency of its data recovery rate and identifying challenges experienced by users in each location. The median data recovery rate was 94% (range: 72% to 100%). The mean 24 h concentration measured across all sites was 38 µg/m3 with the highest PM2.5 period average concentration of 91 µg/m3 measured in Kampala, Uganda and lowest concentrations of 15 µg/m3 measured in Faraja, The Gambia. Kampala in Uganda and Nnewi in Nigeria recorded the longest periods with concentrations >250 µg/m3. Power outages, SD memory card issues, internet connectivity problems and device safety concerns were important challenges experienced when using Purple Air-II-SD sensors. Despite some operational challenges, this study demonstrated that it is reasonably practicable and feasible to establish a network of low-cost devices to provide data on local PM2.5 concentrations in SSA countries. Such data are crucially needed to raise public, societal and policymaker awareness about air pollution across SSA.

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Bah, Yahya Muhammed. "Drug abuse among street children." COUNS-EDU: The International Journal of Counseling and Education 4, no. 1 (May 16, 2019): 1. http://dx.doi.org/10.23916/0020190416610.

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In The Gambia like all nations, drug abuse is seen as a social and health problem that has many serious implications for the physical, social, psychological and intellectual development of the victims more especially, the children. Therefore, it continues to be a concern to families, community leaders, educators, social workers, health care professionals, academics, government and its development partners. Though there some studies on drug abuse, there is none on children and drug abuse focusing on the street children the most vulnerable category. Street children are hypothesized to be more at risk of any epidemic including drug abuse. This study sought to determine the risk and prevalence of drug abuse among street children focusing on those in the car parks. The research was focused on six critical areas: level of knowledge of drug abuse, perception towards it, level of knowledge of the causes of it in the community and among street children, level of knowledge of negative impacts of it, level of knowledge of the preventive methods; and level of knowledge of the support services and treatments needed by victims. A structured questionnaire was used to collect the data from thirty five participants (i.e. one driver and six casual apprentices from each of the five car parks) were interviewed. The data was presented and analysed using tables and percentage. The findings revealed among other things, that there is high level of awareness of drug abuse but the feelings towards it is mixed. Like other children, street children are abusing drugs mainly due to peer influence with the ultimate objective of getting high to relief stress, group recognition, trusted by peers, etc. Similarly, participants are highly aware of the negative impacts encompassing fighting, stealing, mental illness, etc. To finance the behaviour, victims are engaged in all types of dangerous antisocial behaviour including romantic ones exposing them to a range of diseases including STIs and HIV/AIDS. Marijuana is the most commonly abused drug. Though in the minority, some have started experimenting cocaine/coke, hashish; and heroin. While participants have good knowledge of the critical methods to fight drug abuse, the support services needed by victims, victims are mostly reluctant to seek the services not only because they are hard to find but fear societal stigmatization, exclusion and discrimination and professionals’ maltreatments.

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Bah, Yahya Muhammed. "Drug Abuse among Street Children." Journal of Clinical Research In HIV AIDS And Prevention 3, no. 3 (November 28, 2018): 12–45. http://dx.doi.org/10.14302/issn.2324-7339.jcrhap-18-2291.

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In The Gambia like all nations, drug abuse is seen as a social and health problem that has many serious implications for the physical, social, psychological and intellectual development of the victims more especially, the children. Therefore, it continues to be a concern to families, community leaders, educators, social workers, health care professionals, academics, government and its development partners. Though there are some studies on drug abuse, there is none on children and drug abuse focusing on the street children the most vulnerable category. Street children are hypothesized to be more at risk of any epidemic including drug abuse. This study sought to determine the risk and prevalence of drug abuse among street children focusing on those in the car parks. The research was focused on six critical areas: level of knowledge of drug abuse, perception towards it, level of knowledge of the causes of it in the community and among street children, level of knowledge of negative impacts of it, level of knowledge of the preventive methods; and level of knowledge of the support services and treatments needed by victims. A structured questionnaire was used to collect the data from thirty five participants (i.e. one driver and six casual apprentices from each of the five car parks) were interviewed. The data was presented and analyzed using tables and percentage. The findings revealed among other things, that there is high level of awareness of drug abuse but the feelings towards it are mixed. Like other children, street children are abusing drugs mainly due to peer influence with the ultimate objective of getting high to relief stress, group recognition, desire to be trusted by peers, etc. Similarly, participants are highly aware of the negative impacts encompassing fighting, stealing, mental illness, etc. To finance the behavior, victims are engaged in all types of dangerous antisocial behavior including romantic ones exposing them to a range of diseases including STIs and HIV/AIDS. Marijuana is the most commonly abused drug. Though in the minority, some have started experimenting cocaine/coke, hashish; and heroin. While participants have good knowledge of the critical methods to fight drug abuse, the support services needed by victims, victims are mostly reluctant to seek the services not only because they are hard to find but fear societal stigmatization, exclusion and discrimination and professionals’ maltreatments.

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Kretzschmar, Imogen, Ousman Nyan, Ann Marie Mendy, and Bamba Janneh. "Mental health in the Republic of The Gambia." International Psychiatry 9, no. 2 (May 2012): 38–40. http://dx.doi.org/10.1192/s1749367600003076.

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The Republic of The Gambia, on the west coast of Africa, is a narrow enclave into Senegal (which surrounds the nation on three sides), with a coastline on the Atlantic Ocean, enclosing the mouth of the River Gambia. The smallest country on mainland Africa, The Gambia covers 11 295 km2 and has a population of 1705 000. There are five major ethnic groups: Mandinka, Fula, Wolof, Jola and Sarahuleh. Muslims represent 95% of the population. English is the official language but a miscellany of minor languages are also spoken (Serere, Aku, Mandjago, etc.). The Gambia has a history steeped in trade, with records of Arab traders dating back to the ninth century, its river serving as an artery into the continent, reaching as far as Mauritania. Indeed, as many as 3 million slaves were sold from the region during the trans-Atlantic slave trade. The Gambia gained independence from the UK in 1965 and joined the Commonwealth of Nations.

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Hoare, K. "Effective health education in rural Gambia." Journal of Tropical Pediatrics 45, no. 4 (August 1, 1999): 208–14. http://dx.doi.org/10.1093/tropej/45.4.208.

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Pasricha, Sant-Rayn, Adrian Gheorghe, Fayrouz Ashour, Amrita Arcot, Laura E. Murray-Kolb, Parmi Suchdev, and Michael Bode. "Risk-Benefit and Cost-Effectiveness of Universal Iron Interventions for Public Health Control of Anemia in Young Children in 78 Countries: A Microsimulation Study." Blood 132, Supplement 1 (November 29, 2018): 2276. http://dx.doi.org/10.1182/blood-2018-99-117611.

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Abstract Almost 300 million children worldwide are anemic. Universal distribution of iron interventions (iron supplements or iron-containing multiple micronutrient powders, MNPs) to young children (e.g. <2 years of age) is a key World Health Organization recommendation to prevent anemia in low-income countries. However, concerns of iron-induced infection risk and limited effectiveness for anemia and broader child health outcomes have raised questions about whether iron interventions produce a net health benefit and are cost-effective. This has constrained implementation. Net effects likely differ in each country according to the epidemiology of anemia and infection, and local health care costs. Quality of implementation likely also affects net benefit. This means analyses must be country-specific. To help guide policymakers, we estimated country-specific net benefit-risk and cost-effectiveness of universal intervention with MNPs or iron supplements to young children. We developed a bespoke microsimulation model to estimate country-specific net Disability Adjusted Life Years (DALYs) attributable to anemia and infection in children from age 0-18 months who received MNPs, iron supplements or control from age 6-12 months. The model utilised publically available data on anemia, malaria, diarrhoea and respiratory infection epidemiology, and modified their risks according to effect sizes from the pivotal systematic reviews of randomised trials used to inform current guidelines. We next estimated corresponding cost/ DALY averted. We modeled all 78 countries (46 in Africa, 20 in Asia and 12 in Latin America) where WHO reported that anemia prevalence exceeded 40% in 2011, or where pilot iron intervention programmes have been reported to be in place. We found that MNPs and iron supplements produced a net benefit to health in all countries, though the magnitude was heterogeneous.DALYs averted/ 10,000 children in Africa ranged from 20.2 (Egypt) to 81.8 (Burkina Faso), median 49.8; in Asia/Pacific/the Middle East from 22.7 (China) to 110.1 (Yemen), median 33.4, and in Latin America from 14.1 (Ecuador) to 68.5 (Bolivia), median 26.5.The median benefit from iron supplements in Africa was 76.4 DALYs averted/10,000 children and ranged from 39.7 in Zimbabwe to 111.6 in Burkina Faso; in Asia/Pacific/Middle East the median benefit was 71.7, ranging from 36.9 in the Phillipines to 133.3 in Pakistan and 133.0 in Yemen; and in Latin America the median benefit was 59.1, ranging from 93.5 in Bolivia to 39.5 in Guatemala. The magnitude of net benefit from MNPs and iron supplements on DALYs was strongly positively associated with the prevalence of moderate anemia (e.g. for MNPs: r=0.82, P=2.3x10-20). In Africa, MNPs cost between $961-$4341/DALY averted; in Asia/Middle-East/Pacific between $844-$3975/DALY averted, and in Latin America between $1306-$6566/DALY averted. The 10 countries where MNPs are most cost-effective were Yemen ($844/DALY averted), Burkina Faso ($961), Mauritania ($1119), The Gambia ($1165), Guinea-Bissau ($1165), Senegal ($1193), Mali ($1197), Guinea ($1267), and Ghana ($1273). Suboptimal coverage markedly reduced both DALYs averted and cost-effectiveness. The severity, not just overall prevalence of anemia, should be considered when planning a programme. Optimisation of programme coverage is essential to maximise cost-effectiveness. Our results augment existing guidelines and identify locations where iron interventions have the greatest benefit and are most cost-effective. Figure Legend Caterpillar plots and regional maps demonstrating DALYs averted/ 10,000 children for A) Multiple Micronutrient Powders, and b) Iron Supplements. Disclosures No relevant conflicts of interest to declare.

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Touray, Sunkaru, Baboucarr Sanyang, Gregory Zandrow, Fatoumatta Dibba, Kaddy Fadera, Ebrima Kanteh, Madikoi Danso, et al. "An assessment of critical care capacity in the Gambia." Journal of Critical Care 47 (October 2018): 245–53. http://dx.doi.org/10.1016/j.jcrc.2018.07.022.

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Journal articles on the topic 'Health care in Gambia'

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