Microbiology and Nursing Research
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Item Hesistancy to Covid-19 Vaccine Uptake in Sub-Saharan Africa: a Systematic Review(Journal of Clinical Epidemiology and Public Health, 2025-05-28) Ndukui J. Gakunga; Ishmael Makumi; Fatuma AffeyAbstract Background Information: COVID-19 vaccine coverage in Sub-Saharan Africa (SSA) is behind the rest of the world, given that the region is home to nearly 1.2 billion people which contribute to 15% of the global popula- tion. The hesitance to the COVID-19 vaccine in SSA has posed a great challenge to the public health. Therefore, achieving high levels of COVID-19 vaccination in SSA is paramount to containing the pandemic globally. There- fore, this systemic review was carried out to synthesize existing literature on key factors that derailed the uptake of COVID-19 vaccine in Sub-Saharan Africa. Materials and Methods: The study searched and accessed articles from open- research journal through the fol- lowing databases; Pub-med, Research gate, Scopus, Google Scholar, Academia, and African Index Medicus for studies published from May 1, 2020, to April, 2025, examining hesitancy towards uptake of the COVID-19 vaccine in Sub-Saharan Africa. Results: A total of 30 articles met the eligibility criteria and were included in this review. Majority of the studies included in this review were from pubmed, google scholar and Scopus. The reviewed research studies were from Ethipopia, Botswana, Cameroun, Cote D’Ivoire, DR Congo, Ghana, Kenya, Morocco, Mozambique, Nigeria, So- malia, South Africa, Sudan, Togo, Uganda, Zambia, and Zimbabwe. The major reasons for vaccine hesitancy were; vaccine safety, cultural beliefs and side effects, lack of trust for pharmaceutical industries and misinformation or conflicting information from the media. Factors associated with positive attitudes towards the vaccine included being male, having a higher level of education, and fear of contracting the virus. Conclusion: The review found that there is a combination of misinformation, cultural beliefs, public trust, and concerns on vaccine safety and efficacy as key drivers to hesitancy to COVID-19 vaccine uptake in SSA. Therefore, there is the need for context-specific interventions through tailored communication with culturally and linguistic acceptance among the target population.Item Determinants of cancer care pathways at Wajir County, Kenya: patient perspectives(Researchecancer, 2025-02-12) Affey, Fatuma; Halake, Dabo Galgalo; Wainaina, Grace Muira; Osman, Hussein Ali; Ndukui, James G; Abdourahman, Houda; Abdihamid, OmarBackground: Cancer represents a major public health issue with substantial morbidity and mortality in low-resource settings such as Kenya. This study focuses on Wajir County in northern Kenya, a region with limited cancer care infrastructure and high unmet needs. Despite recent efforts to decentralize cancer care in Kenya, including establishing regional cancer centres in Garissa, Nakuru, and Mombasa, access to screening, diagnostics, and treatment remains constrained, particularly in rural areas. The absence of comprehen- sive cancer care pathways and a specialized oncology workforce in Wajir County exac- erbates challenges in early detection, treatment, and palliative care. The study evaluated the availability of cancer care services at Wajir County Referral Hospital (WCRH), includ- ing screening, diagnostic services, treatment modalities, and referral systems. The study further explores the gaps in cancer care, focusing on patient perspectives, and proposes potential solutions to address these challenges. Methods: This study used mixed-methods (qualitative and quantitative) methods to understand cancer care from the perspective of patients at WCRH. It involved adult patients (over 18) with a confirmed cancer diagnosis who were receiving treatment or follow-up care between February and April 2024. Data were gathered through inter- views and surveys, with research assistants helping with language translation and com- munity navigation. The study collected information on demographics, cancer types, and prevalence rates, which were analysed using descriptive statistics. The qualitative data focused on patients' experiences with cancer awareness, treatment, and care gaps, and were analysed for common themes. Ethical approval was obtained, and informed consent was given by all participants. Results: This study involved 25 cancer patients (12 males, 13 females) receiving treat- ment at WCRH. The most common cancers were esophageal (44%), cervical (28%), breast (24%), and prostate (8%). Delays in diagnosis were significant, with 12% of patients wait- ing over 6 years, 24% waiting 4–6 years, and 40% waiting 1–3 years before seeking care. Most diagnoses were made at WCRH (64%), with others diagnosed at the Garissa Can- cer Centre (22%) or in Nairobi (20%). Diagnostic tools available at WCRH included pap smears, mammograms, PSA tests, ultrasound, CT scans, and biopsies. However, access to these tools was limited, with barium swallow (32%) being the most frequently used for esophageal cancer, followed by pap smears, biopsies, and ultrasound (16% each). Patient awareness of cancer screening was higher for cervical (68%) and breast cancer (60%) but lower for prostate cancer (32%) and esophageal cancer (4%). Despite awareness, only 8% had previously undergone screening. Regarding treatment, most patients (80%) were aware of surgical options, while fewer knew about chemo- therapy (28%) or palliative care (12%). When treatment was unavailable at WCRH, most patients preferred the Garissa Cancer Centre (80%) or Nairobi (52%). Financial challenges were the primary barrier to treatment for 88% of patients, and patients suggested improving local cancer care, subsidizing treatment, and enhancing early detection and screening services. Conclusion: The findings indicate a high burden of late-stage cancer diagnoses, insufficient cancer screening and treatment services, and limited access to cancer care pathways and patient navigation systems. These results underscore the urgent need for improved cancer care pathways, enhanced awareness, and increased healthcare capacity to reduce cancer morbidity and mortality in northern Kenya. This study contributes to understanding the cancer care landscape in Wajir County and provides a foundation for future health policy initiatives aimed at bridging existing gaps in cancer care.Item Influence of Cultural Competence Training among Health Care Workers on Patient Satisfaction and Health Outcomes in Diverse Communities(Asian Journal of Research in Nursing and Health, 2024-10-30) Musembi Mary; Affey, FatumaThis study aimed at exploring impact of cultural competence training on enhancing patients satisfaction and improving health outcomes within such communities. Study Design: Analytical-cross sectional study design approach was applied in this study, both qualitative and quantitative methods were utilized to collect data. Relationship between cultural competence training and its effects on patient satisfaction and health outcomes was examined as well as mechanisms through which cultural competence training influences healthcare delivery in diverse settings was explored. Place and Duration of Study: The study was conducted in Kiambu Level 5 Hospital in Kiambu County, Kenya. This region hosts a mixed population with varying cultures, and it is a level 5 hospital with high referrals of various cases from different parts of the county. The area provided conducive environment for this study since it borders Nairobi and its populationItem Unveiling the hidden battle: Impact of Charlson comorbidities index on critical illness rate and mortality among hospitalized COVID-19 patients, comparing vaccinated and unvaccinated individuals in Kenya: A retrospective study(African Journal of Medical and Health Sciences, 2024-01) Isinta, M. Elijah; Kitagwa, W.; Halake, Dabo G; Wang, YouxinFatal outcomes were observed in hospitalized COVID-19 patients, particularly among those who were unvaccinated and had comorbidities. Robust research is needed to validate these findings in both vaccinated and unvaccinated groups. The study, involving 1792 COVID-19 patients, explored the links between comorbidities and fatal outcomes. This single-center retrospective cohort study employed Cox proportional hazard regression to analyze the impact of comorbidities on COVID-19 fatalities, adjusting for age, sex, smoking and vaccination status. Males experienced severe illness (75%) or mortality (76.8%). Notably, most people admitted to the ICU were over 31 years old (96.2%), with individuals over 60 years old facing the highest fatality rate (61.6%). The proportion of ICU admissions increased with the Charlson Comorbidities Index (CCI), with CCI 1-3 at 51.0% and CCI >4 at 52.6%. Mortality linked to CCI was 55.4% for CCI 1-3 and 52.6% for CCI >4. The risk of ICU admission and mortality both increased with higher CCIs. Common comorbidities such as obesity, cardiovascular diseases, diabetes, chronic liver disease, chronic pulmonary obstructive disease, cancer/malignancy, chronic kidney disease and hypertension predicted critical illness and mortality among COVID-19 patients. The area under the receiver operating characteristic curve (AUC-ROC) for predicting critical illness was 0.90 (95% CI: 0.89-0.93), and for mortality, it was 0.90 (95% CI: 0.88-0.91). Additional factors, such as HIV and rheumatoid arthritis, independently predicted critical illness and mortality. The risk of critical illness and mortality showed an increase with the Charlson Comorbidities Index, both among vaccinated and unvaccinated individualsItem Association between the workload of nurses and patients’ safety consequences at Erdogan referral hospital, Mogadishu, Somalia; A cross-sectional Study(2023-09-01) Abdirahman, Sowda Ibrahim; Hussein, Anisa Abdullahi; Mohammed, Zeynab Ahmed; Osman, Hussein Ali; Elmi, Omar SaladThe nursing workload is a significant public health concern and one of the most persistent themes in health worldwide. The Insufficient nurses staffing or overworked of nurses in hospital-based care could lead severe consequences of patients' safety outcomes, such as mortality, infections, and failure to rescue, as well as decrease quality of care. No previous study has been done in Somalia in this regard. Therefore. This study aimed to determine the association between nurses' workload and patient safety outcomes at Mogadishu, Turkey's Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Somalia. The study was a cross-sectional study was conducted among registered working nurses and selected patients who were registered and admitted at Mogadishu, Somalia—Turkey's Recep Tayyip Erdogan Training and Research Hospital. The study populations were selected using simple random sampling methods, and data were analysed using multiple logistic regression analysis. A total of 360 participants were analysed. Overwhelmingly, 93 (51.7%) nurses worked between 8 and 12 hours per day in each shift on daily based. Every five nurse respondents, one worked more than 12 hours daily—63 (35%). According to the findings of this study, the majority of nurses (82.88%) were have felt stressed due to their workload. Multiple logistic regression analysis revealed the risk factors associated with patients’ safety outcomes were Urinary Trac Infection (UTI) was (AOR = 0.03 95% CI = (0.163-0.571, P = 0.001), Blood Stream Infection (BSI) (OR = 3.909, 95% CI = 2.312-6.610, P = 0.001), and patient monitoring tragedy (AOR = 0.61 95% CI = (0.031-0.199, P = 0.001). The results revealed that most nurses worked between 8 and 12 hours per day and were highly stressed due to the burden of their work. The risk factors associated with nurses' workload and patients' safety were the incidence of UTI, BSI and patient monitoring tragedy. This study emphasised that nurses' workloads directly affected patients' safety consequences. This study reported a lack of the following recommended international Labouré Standardization (ILS) guidelines in Somalia for nurses' rights and work standardisation. Also, immediate action needs to be taken by Somalia's health authorities to protect the nurse's rights.Item A Global Survey of COVID-19 Vaccine Acceptance Among Healthcare Workers(Frontiers in public health, 2022-02-08) Noushad, Mohammed; Rastam, Samer; Nassani, Mohammad Zakaria; Al-Saqqaf, Inas Shakeeb; Hussain, Mudassir; Yaroko, Ali Ango; Arshad, Mohammed; Kirfi, Abdullahi Musa; Koppolu, Pradeep; Niazi, Fayez Hussain; Elkandow, Ali; Darwish, Mahmoud; Nassar, Ahmad Salim Abdalla; Mohammed, Sami Osman Abuzied; Hassan, Nasser Hassan Abdalrady; Abusalim, Ghadah Salim; Samran, Abdulaziz; Alsalhani, Anas B; Demachkia, Amir Mohiddin; Marques de Melo, Renata; Luddin, Norhayati; Husein, Adam; Habib, Adnan; Suleyman, Firas; Osman, Hussein Ali; Al-Awar, Mohammed Sadeg; Dimashkieh, Mohiddin R.; Swapna, Lingam Amara; Barakat, Ali; Alqerban, AliEven though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample.