International Journal of Public Health and Epidemiology

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (5), pp. 001-014, May, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Barriers and facilitators to childhood tuberculosis detection in Marondera District, Mashonaland East Province, Zimbabwe

Lawrence Mutewuki¹, Abigail Kapfunde², Paul Farai Matsvimbo³, and Eltony Mugomeri^4
 
1Public Health Officer, Department of Public Health and Nursing, Africa University, Mutare, Zimbabwe.
²Senior Lecturer, Maternal and Child Health-Department of Public Health and Nursing, Africa University, Mutare, Zimbabwe. ³MD-Provincial Medical Director, Mashonaland East Province, Ministry of Health and Child Care, Marondera, Zimbabwe. ⁴Associate Professor and Interim Director, Office of Research and Innovation, Africa University, Mutare, Zimbabwe.

Abstract

Received 16 February, 2026; Revised 25 March, 2026; Accepted 26 March, 2026; Published 31 May, 2026

Background: Tuberculosis (TB) remains a significant public health threat, particularly in children in low health resource settings. Despite national efforts in Zimbabwe, childhood TB case detection in Marondera District, Zimbabwe is still below 12.0% of the national target of TB notifications. The study investigated the factors associated with childhood TB case detection in Marondera District. Methods:  An analytic cross- sectional study was conducted between July and November 2025 to identify barriers and facilitators to childhood TB case detection. Structured questionnaires were administered to healthcare workers and community healthcare workers. Data were analyzed using univariate and multivariate regression in Stata 19, with statistical significance defined as p<0.050. Adjusted Odds Ratio (AOR) was used to interpret facilitators and barriers to TB case detection. Results: Key facilitators for case detection were competence in TB screening (AOR= 1.9; C.I=1.4-2.5; p=<0.001), prior contact with childhood TB (AOR=1.3; 95% C.I=1.1-1.5; p=<0.001), and TB co-infection (AOR=1.3; 95% C.I=1.1-1.5; p=<0.001). Caregiver social support (AOR=1.4; 95% C.I=1.2-1.7; p=0.002), Health education (AOR=1.8; 95% C.I=1.3-2.5; p=0.005), and community awareness (AOR=1.3; 95% C.I=1.1-1.6; p=0.033) also promoted healthcare seeking. Barriers included cultural beliefs (AOR=0.6; 95% C.I=0.5-0.8; p=0.005), lack of awareness (AOR=2.3; 95% C.I=1.6-3.3; p=<0.001), and geographical barriers (AOR=0.6; 95% C.I=0.5-0.8; p=0.002). Conclusion: Improving childhood TB case detection in low health resource settings requires strengthening healthcare workers’ clinical capacity and enhancing community-level awareness and support. Targeted interventions addressing socioeconomic and access-related barriers are essential to reduce morbidity and mortality among children.

Keywords: Barriers to TB detection; Community awareness to TB detection; TB Detection Competence; Facilitators for TB detection; TB in low health resource settings.
 

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (3), pp. 001-007, March, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Review

Contextualizing Mood Disorders: The Diagnostic Dilemma of Bipolar Disorder in the Caribbean Setting

Asha Bissessar¹* and Harrinath D. Maharajh²

¹San Fernando General Hospital, San Fernando, West Indies, Trinidad and Tobago.
²Department of Clinical Medicine, The University of the West Indies, St. Augustine, Trinidad and Tobago.

Accepted 24 October, 2025

Although there has been a surge in research relating to psychiatric disorders, diagnosing bipolar disorder still proves to be an immense feat. This dilemma can seriously impact on the quality of life of bipolar patients with psychiatric disability. These case studies sought to highlight several factors which may fuel this diagnostic uncertainty. Two in-patients at the Eric Williams Medical Sciences Complex were evaluated. In the first case, the patient admitted for approximately one month, was diagnosed with a co-morbid personality disorder. Although he met the Diagnostic and Statistical Manual (DSM IV) of mental disorders criteria for bipolar II disorder, further evaluation led to the axis II diagnosis with resulting prognostic implications. In the second case, the patient was admitted for six days and his presentation could have been accounted for by several psychiatric disorders. Understandably therefore, the art of diagnosing is complex and numerous factors such as co morbidity, socio-cultural variations, current DSM IV guidelines, cannabis use and genetics play a major role. Analysis of the DSM IV guidelines and identifying how it can be adapted for a Caribbean setting is necessary. It is also recommended that further exploration of links, if any, between bipolar disorders and personality disorders be done, thus enhancing diagnosis and eventually allowing more complete management of patients with psychiatric disability.

Key words: Bipolar disorder, psychiatric disability, Caribbean, diagnostic and statistical manual of mental disorders (DSM IV).

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (2), pp. 001-009, February, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Increased Mosquito Biting Activity Without Increased Malaria: A Zambian Urban Study

Freddie Masaninga¹, Daniel C. W. Nkhuwa2, Fastone M. Goma3, Cecilia Shinondo3, Emmanuel Chanda4, Mulakwa Kamuliwo4, Elizabeth Chizema Kawesha5, Seter Siziya6* and Olusegun Babaniyi1

1World Health Organisation Country Office, Lusaka, Zambia. 2School of Mines, University of Zambia, Lusaka, Zambia. 3School of Medicine, University of Zambia, Lusaka, Zambia.
4National Malaria Control Centre, Ministry of Health, Lusaka, Zambia.
5Ministry of Health, Ndeke House, Lusaka, Zambia.
6Public Health Unit, Clinical Sciences Department, The Copperbelt University, Ndola, Zambia.

Accepted 09 October, 2025

Unprecedented increased mosquito bites were observed in urban and peri-urban areas of Lusaka District and there was a perceived increase in malaria which necessitated a study in 2009 to determine the mosquito biting and malaria situation within urban and peri-urban settings. We analysed water bodies as sources of mosquito larvae (vegetable gardens, sewerage maturation ponds and foot paths) and, weather factors for possible effects on mosquito densities, species distribution and reviewed laboratory confirmed malaria cases and interventions implemented in the previous five years from 2009. We collected high densities of Culex quinquefasciatus mosquito larvae (mean; 250 per scoop) from sewerage maturation ponds overgrown with water hyacinth - an aquatic vegetation and collected large numbers of adult Cx. quinquefasciatus indoor (mean: 14.2, range: 2.8 to 34 per room) and up to 2,000 Cx. quinquefasciatus out-door in one open structure. However, we did not find adult Anopheles in any of these collections but we found Anopheles larvae along a footpath in one peri-urban location. There was no evidence of increased malaria cases despite reported increased mosquito biting but a district- wide and nationwide decline in malaria trends. A combination of factors; human and environmental, created suitable micro-habitats that increased densities of the Culex mosquito but not malaria vector species within urban and peri-urban settings. An intensified surveillance, monitoring and evaluation measure is vital to understanding malaria situation and delivering effective malaria interventions in different epidemiological settings.

Key words: Mosquito, malaria, Culex quinquefasciatus, larvae, water hyacinth.
 

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (2), pp. 001-007, February, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Iodine Deficiency and Growth Outcomes among Primary School Pupils in Rural Nigeria

Nwamarah, Joy Ugo* and Okeke, Elizabeth Chinwe

Department of Home Science, Nutrition and Dietetics, University of Nigeria Nsukka, Enugu State, Nigeria.

Accepted 26 September, 2025

This study was designed to assess the iodine and the anthropometric status of primary school children in a rural Nigerian community (Obukpa). Stratified random sampling technique was used in selecting the respondents for the study. The sample size was 330 children aged 6 to 12+ years. The anthropometric measurements of the children comprising 170 boys and 160 girls were obtained using standard procedures. The urine of a sub-sample of 36 children were subjected to laboratory analysis for iodine using “method H”. Data generated from this study were analyzed using Statistical Package for the Social Sciences (SPSS) version 12, means, standard deviation, student t-test, analysis of variance (ANOVA) and correlation coefficient (r) values. Anthropometric measurements of the children showed that 25% were stunted. More boys (13.7%) were stunted than girls (11.3%). Stunted children correlated negatively with wasted children significantly (P < 0.05). Urinary iodine showed that 58.3% of the children had <20 µg/L indicating severe iodine deficiency. Iodine levels in urine correlated with stunting and underweight.

Key words: Urinary iodine status, anthropometric status, primary school children.
 

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (2), pp. 001-008, February, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper

Early Detection and Prevention: A Community-Based Assessment of Breast Cancer Awareness in Rural Nigeria

Adekemi E. Olowokere1*, Adenike C. Onibokun2 and Abimbola O. Oluwatosin2

1Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
2Department of Nursing, University of Ibadan, Oyo State, Nigeria.

Accepted 11 November, 2025

Globally, the devastation that befalls women diagnosed of breast cancer remains inestimable. Early detection remains a major effective approach that should be employed to combat the disease. The issue of concern, however, is whether women in the rural underserved areas are aware of these early detection methods. This study was designed to assess rural women’s awareness and knowledge of breast cancer and their screening practices. The study was a descriptive cross-sectional study utilizing self developed structured questionnaire. Reliability of the instrument was determined and alpha correlation values range between 0.81 and 0.95 for the different components of the questionnaire. Data was processed using descriptive analysis and associations tested with Chi-square at 5% level of significance. The results of the findings showed that 52.7% of the women had adequate knowledge about breast cancer risk factors and symptoms. Regarding the women’s awareness about breast cancer screening methods, 52.8 and 51.7% of women have heard about Breast Self-Examination (BSE) and Clinical Breast Examination (CBE) respectively. However, few numbers of respondents (3.9%) were aware about mammography and these are people who did it for the purpose of diagnosing breast problem. Majority of the women (72.8%) did not practice BSE which is the most readily available screening method. Considering the lack of sophisticated diagnostic technology such as mammography for breast screening in the rural areas, BSE provided a unique opportunity for the women to be breast aware and to identify breast problems which may constitute danger to their health in the future. Health care professionals, most especially those at the primary health care level, should enhance the women’s skills to use this simple procedure effectively to promote their health.

Key words: Community health nurses, breast awareness, breast examination, knowledge, practice.

International Journal of Public Health and Epidemiology ISSN 2326-7291 Vol. 15 (1), pp. 001-008, January, 2026. Available online at www.internationalscholarsjournals.org © International Scholars Journals

Full Length Research Paper
    
Evaluation of Staphylococcus aureus and Coliform Contamination in Rural Domestic Water Supplies in Nigeria

Manji, P. L.*, Antai, S. P. and Jacob, I. O.

Department of Microbiology, Faculty of Science, University of Calabar, P. M. B. 1115, Calabar, Nigeria.

Accepted 17 September, 2025

An investigation on the incidence of Staphylococcus aureus, coliforms and antibiotic resistant Escherichia coli strains in both treated and untreated rural water supplies was carried out in Calabar South Local Government Area of Cross River State, Nigeria. Analysis revealed significant differences between the different water sources, locations and the months of sampling, with the stream and well water showing higher bacterial contamination compared to the tap water source (P<0.05). The isolation of S. aureus, Bacillus species, Pseudomonas aeruginosa and other bacterial pathogens present enough evidence that water from these sources are unfit for human consumption and constitute significant public health implications except subjected to further treatment. High percentages of the E. coli strains isolated from the water sources showed multiple resistances to most of the antibiotics commonly used by humans. Strains recovered from the stream and well water sources were most resistant and showed significantly higher minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) (P < 0.05) than those from the tap water source. The results of this investigation therefore revealed that the bacteriological quality of both the treated tap and untreated well and stream water sources failed to meet the standards for drinking water.

Key words: Incidence, Staphylococcus aureus, coliforms, Escherichia coli, antibiotic resistance, water supplies.