Vol 14 Issue 1 April 2026-September 2026

Abstract: Background: Family planning is an important public health strategy for improving maternal and child health. Adequate spacing between pregnancies reduces the risk of adverse maternal and neonatal outcomes. In Rwanda, family planning services are widely available, but optimal use for birth spacing remains a concern in some communities. This study assessed family planning spacing utilization, methods used, and accessibility factors among women of reproductive age attending Rukira Health Center in Ngoma District.

Methods: A descriptive cross-sectional quantitative study was conducted among women aged 15–49 years attending Rukira Health Center. The minimum sample size was calculated using Fisher’s formula and adjusted for non-response to 416 participants; 426 women participated and completed the questionnaire. Systematic random sampling was used. Data were collected using a pre-tested structured questionnaire and analyzed using descriptive statistics and chi-square tests. Qualitative information from key informant/focus group discussions was used to contextualize selected findings. Ethical approval and informed consent procedures were applied.

Results: Current family planning utilization was 52.2% (217/416 reported in the utilization analysis), while 47.8% were not currently using a method but had used family planning previously. The most commonly used current method was the implant (40.6%), followed by injectables (30.0%), pills (16.6%), intrauterine devices (9.2%), lactational amenorrhea (2.3%), and male condoms (1.4%). The main reason for use was spacing births for health reasons (56.7%). Knowledge of the recommended 24–36-month spacing interval was reported among 64.4% in the descriptive results. Community health workers were the main source of family planning information (68.7%). Geographical access was a major challenge: 52.1% lived more than 5 km from a service point, and distance was significantly associated with utilization (χ²=26.391, p<0.001). Method stock-outs were also significantly associated with utilization (χ²=23.574, p<0.001). Partner support showed a strong association with current use (χ²=52.238, p<0.001).

Conclusion: Family planning utilization for birth spacing at Rukira Health Center was moderate. Utilization was influenced by geographical access, method availability, side-effect concerns, and partner support. Strengthening community-based information, uninterrupted contraceptive supplies, client-centered counseling, and male/partner engagement may improve continuation and appropriate birth spacing.

Keywords: family planning; birth spacing; contraceptive utilization; accessibility; implants; partner support; Rwanda.

Title: DETERMINANTS OF FAMILY PLANNING SPACING UTILIZATION TO PROMOTE HEALTHY FAMILIES AMONG WOMEN OF REPRODUCTIVE AGE ATTENDING RUKIRA HEALTH CENTER IN NGOMA DISTRICT, RWANDA

Author: Rachel UMUHOZA

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 588-593

Research Publish Journals

Website: www.researchpublish.com

Published Date: 10-September-2026

Abstract: Background: Traumatic cataract with adherent leucoma is among the most complex combined anterior segment injuries, typically managed with staged surgery or primary keratoplasty, which carries risks of graft rejection, steroid dependency, and delayed rehabilitation. Non-keratoplasty reconstruction of this combination remains rare, reported only in isolated cases.

Case Description: Penetrating trauma in a 48-year-old man with hand-movement vision, adherent leucoma with iris incarceration, an inferiorly distorted pupil, dense mature cataract, and a shallow, asymmetrical anterior chamber.

Management: Instead of primary keratoplasty, four interdependent steps were combined in a single procedure while sparing the stable, non-central scar: synechiolysis, iris-hook stabilisation, capsular-tension-ring-supported small-incision cataract surgery, and in-the-bag IOL implantation with McCannel pupilloplasty.

Outcome: At day 7, the BCVA had increased to hand movements, at 1 month to 6/12, and remained stable at 6/12 at 3 months, without any recurrent synechiae or complications.

Conclusion: In selecting patients, particularly where resources and donor tissue are limited, this case demonstrates a cornea-sparing alternative to staged or keratoplasty-based management.

Keywords: Traumatic cataract, adherent leucoma, cataract surgery, staged surgery.

Title: Overcoming the Dual Challenge: Successful Visual Rescue in Traumatic Cataract with Adherent Leucoma

Author: Dr. Devesh Yadav, Dr. Arvind Ram, Dr. Avirupa K. Banik, Dr. Gunjan Sharma

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 583-587

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Website: www.researchpublish.com

Published Date: 04-September-2026

Abstract: Congenital anterior abdominal wall defects repair is complicated by surgical and anaaesthetic challenges in developing countries like ours. It remains a major source of neonatal morbidity and mortality because of poor prenatal diagnostic tools and obstetric care, unavailable parenteral nutrition, poor neonatal intensive care unit with ventilatory management, unavailability of appropriate sized intraoperative anaesthetic gadgets and poor post-operative surgical care.

We therefore report this series of three neonates with congenital anterior abdominal wall defect to draw attention to the challenges in the management.

Keywords: Neonatal Anaesthesia, Defect, Congenital Abdominal Wall.

Title: NEONATAL ANAESTHESIA FOR CONGENITAL ANTERIOR ABDOMINAL WALL DEFECT REPAIR IN UNIVERSITY OF BENIN TEACHING HOSPITAL, BENIN-CITY, NIGERIA: A CASE SERIES

Author: Elamah Ikpeminoghena .O, Inegbenosun Iluobe, Ehima Ewere

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 579-582

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Website: www.researchpublish.com

Published Date: 02-September-2026

Abstract: Dry eye disease is a common ocular surface disorder characterized by inadequate tear production and tear-film instability. Although cucumber (Cucumis sativus) is traditionally used for its soothing and hydrating properties, limited experimental evidence exists regarding its potential beneficial effect on dry eye. This study evaluated the effect of Cucumis sativus extract on experimentally induced dry eye in Wistar rats. An in vivo experimental study was conducted using 15 healthy adult Wistar albino rats weighing 150–200 g. The animals were randomly assigned into three groups of five: untreated dry-eye control, Cucumis sativus extract, and artificial tears. Dry eye was induced by topical administration of 1% atropine sulphate twice daily for three days. Aqueous and ethanolic extracts were prepared using cold extraction and subjected to phytochemical analysis, while the aqueous extract was used for treatment. Following induction, treatment groups received cucumber extract or artificial tears twice daily for 14 days. Tear production was assessed using the Schirmer test. Data were analyzed using one-way analysis of variance and post hoc testing, with significance set at p < 0.05. Phytochemical analysis revealed saponins, tannins, flavonoids, alkaloids, steroids and phenolic compounds. Ethanol extract had a higher percentage yield (12.40%) than aqueous extract (5.05%). Schirmer values in the cucumber extract group increased from 2.0 mm on day 1 to 3.8 mm on day 14, while the artificial tears group increased from 2.4 mm to 4.6 mm. One-way ANOVA showed a significant difference among treatment groups (F = 340.374, p < 0.001). Topical Cucumis sativus extract improved tear production and tear-film stability in Wistar rats with experimentally induced dry eye. These findings provide preliminary evidence supporting further investigation of Cucumis sativus as a potential plant-derived option for dry-eye management.

Keywords: Cucumis sativus, Dry Eye, Wistar Rats.

Title: Ocular Surface Responses to Cucumis sativus Extract in Experimental Dry Eye: An in Vivo Study in Wistar Rats

Author: Ugwoke Genevieve, Esenwah Emmanuel, Nwakaego Ikoro, Azuamah Young, Odimegwu Nkiru, Obiechi Nelson, Onyeberechi Macjohnson, Chukwuoha Chigozie, Eronini Yadiri

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 571-578

Research Publish Journals

Website: www.researchpublish.com

Published Date: 31-August-2026

Abstract: Artificial intelligence (AI) is increasingly integrated into healthcare decision-making, offering significant opportunities to improve diagnostic support, operational efficiency, risk prediction, access, and quality of care. Existing AI governance frameworks appropriately emphasize safety, effectiveness, transparency, equity, privacy, accountability, and human oversight. However, comparatively less policy attention has been directed toward whether healthcare professionals retain the cognitive, professional, and institutional capacity to exercise meaningful independent judgment as AI assumes greater influence over consequential decisions. This white paper identifies this emerging governance gap and proposes the Human Judgment Protection Standard (HJPS), a risk-based framework for protecting meaningful human judgment in AI-enabled healthcare. The HJPS comprises six interrelated domains: Human Decision Authority, Cognitive Independence, AI Competency and Critical Evaluation, Meaningful Human Oversight, Accountability and Traceability, and Continuous Human-Judgment Monitoring. A four-level risk classification model is proposed to align the intensity of human-judgment safeguards with the potential consequences and degree of AI influence associated with specific healthcare use cases. The framework further introduces a Human-Judgment Impact Assessment (HJIA) and a continuous organizational implementation cycle incorporating AI inventory, risk classification, workflow design, competency development, controlled deployment, dual-domain monitoring, audit, corrective action, and reassessment. The paper argues that maintaining a human formally “in the loop” is insufficient when automation bias, cognitive offloading, algorithmic authority, professional deskilling, workload, or organizational conditions undermine the individual's practical capacity to evaluate or challenge AI-generated recommendations. The HJPS therefore advances a transition from human-in-the-loop to human-capacity-in-the-loop governance. Policy recommendations emphasize risk-proportionate oversight, professional AI competency, meaningful override authority, shared accountability, organizational monitoring, accreditation integration, and continued empirical evaluation. The framework offers a human-centered approach for ensuring that advances in healthcare AI strengthen rather than inadvertently diminish the human capabilities necessary for safe, ethical, accountable, and resilient healthcare.

Keywords: artificial intelligence, healthcare AI, human judgment, human-centered AI, Human Judgment Protection Standard, meaningful human oversight, cognitive offloading, automation bias, AI governance, healthcare policy.

Title: Protecting Human Judgment in AI-Enabled Healthcare: A Policy Framework for Responsible Artificial Intelligence Use

Author: David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 549-570

Research Publish Journals

Website: www.researchpublish.com

Published Date: 25-August-2026

Abstract: Sierra Leone has expanded community-based primary healthcare (PHC), yet persistent workforce, service-delivery, financing, infrastructure, information-system, and equity constraints continue to affect service capacity and sustainability. This study examined these conditions and developed evidence-informed strategies for strengthening community health and PHC. A scoping review guided by PRISMA-ScR identified peer-reviewed and authoritative grey literature, with 18 studies and reports retained from 65 initially identified records. Evidence was mapped to the six World Health Organization Health System Building Blocks, with equity, community engagement, and resilience incorporated as cross-cutting dimensions, and subsequently analyzed using SWOT and TOWS frameworks. The analysis identified established Community Health Worker and Community Health Officer structures, community-based service platforms, PHC policy commitment, epidemic-response experience, and emerging digital-health capacity as important strengths. Major constraints included workforce shortages and maldistribution, limited workforce absorption and retention, inadequate service readiness, fragmented information systems, financing limitations, and inequitable access. Opportunities included digital integration, geospatial workforce planning, workforce development, integrated epidemic preparedness, and strategic partnerships, while epidemics, health-worker migration, financing pressures, supply-chain disruptions, and environmental risks represented significant threats. TOWS analysis consolidated these findings into six strategic priorities: a sustainable and equitably distributed workforce; strengthened PHC readiness and essential services; integrated digital health and information systems; epidemic-ready and resilient PHC; sustainable financing and coordinated governance; and equity-centered, community-responsive healthcare delivery. The findings demonstrate that sustainable community health improvement in Sierra Leone requires strengthening and integrating existing capacities rather than developing parallel systems and provide an evidence-informed pathway from health-system assessment to strategic planning and implementation.

Keywords: Sierra Leone; community health; primary healthcare; health-system strengthening; SWOT; TOWS; resilience; universal health coverage.

Title: Strategies for Strengthening Community Health in Sierra Leone: A SWOT–TOWS Matrix Approach

Author: Dr. David Bull

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 527-548

Research Publish Journals

Website: www.researchpublish.com

Published Date: 17-August-2026

Abstract: Introduction Treatment failure among youth aged 10–24 years receiving antiretroviral therapy (ART) remains a critical challenge to achieving the UNAIDS 95-95-95 targets in sub-Saharan Africa. In Rwanda, where HIV prevalence is approximately 3.0% nationally, adolescents and young adults face disproportionate adherence barriers and poorer treatment outcomes relative to older adults. Evidence on the magnitude and determinants of ART failure in this age group from decentralized Rwandan facilities is limited. This study aimed to quantify the prevalence and identify socio-demographic and clinical determinants of treatment failure among youth on ART at Rwamagana Level Two Teaching Hospital. Methods We conducted a retrospective cross-sectional study using secondary data extracted from 385 medical records of youth aged 10–24 years enrolled in HIV care and on ART for at least 12 months at Rwamagana Level Two Teaching Hospital, Rwanda (March–June 2024). Treatment failure was defined according to WHO 2023 criteria and classified as virological (viral load ≥1,000 copies/mL on two consecutive measurements following enhanced adherence counselling), immunological, or clinical failure. Socio-demographic and clinical variables were extracted using a structured data abstraction form. Data were analyzed using SPSS v26.0; descriptive statistics, chi-square tests, and multivariable logistic regression were performed. This study adheres to STROBE reporting guidelines. Results : Of 385 youth (53.8% female; median age group 20–24 years), 97 (25.2%) experienced treatment failure. Virological failure predominated (62.9%), followed by immunological (23.7%) and clinical (13.4%) failure. In the multivariable model, older youth aged 20–24 years had more than double the odds of treatment failure compared with those aged 10–14 years (AOR = 2.1; 95% CI: 1.2–3.8; p = 0.009). Female sex (AOR = 1.6; 95% CI: 1.0–2.6; p = 0.047), advanced WHO clinical stage III–IV (AOR = 3.8; 95% CI: 2.1–6.9; p < 0.001), presence of opportunistic infections (AOR = 2.2; 95% CI: 1.3–3.9; p = 0.004), and ART duration exceeding five years (AOR = 2.4; 95% CI: 1.3–4.1; p = 0.002) were independently associated with treatment failure. Conclusions: One in four youth on ART at Rwamagana Level Two Teaching Hospital experienced treatment failure, predominantly virological. Clinical disease burden, older adolescent age, female sex, and long ART duration are key risk factors. Targeted interventions including intensified viral load monitoring, gender-responsive adherence support, and early initiation of ART are urgently required. These findings inform national strategies for adolescent and youth-friendly HIV services in Rwanda and comparable settings.

Keywords: HIV; antiretroviral therapy; treatment failure; virological failure; adolescents; youth; Rwanda; sub-Saharan Africa.

Title: TREATMENT FAILURE AMONG YOUTH AGED 10-24 YEARS ON ANTIRETROVIRAL THERAPY ATA LEVEL TWO TEACHING HOSPITAL IN RWANDA

Author: Mbonigaba Youssouf, Japheths Ogendi, Monica Mochama

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 519-526

Research Publish Journals

Website: www.researchpublish.com

Published Date: 04-August-2026

Abstract: Background: Food has been used widely in parts of the world as a healing modality in naturopathic practice for more than a century. A core naturopathic principle is explained by the fact that our food choices influence our health and capacity to recover from diseases or conditions. Recent scientific research in nutrition, plant-based bioactive compounds, and the human physiology department has provided increasing evidence to support the therapeutic value of food in maintaining good health and reducing the risk of diseases.

Objective: The aim of this review is to synthesize the current evidence on the therapeutic use of foods in naturopathic practice, including the mechanisms of the action of the key dietary bioactive compounds, their role in chronic disease management, and their integration within contemporary integrative medicine frameworks.

Methods: A narrative literature review was conducted using the peer-reviewed articles from the PubMed, Scopus, and CINAHL databases (2000-2024). Studies that explore the dietary interventions in the field of naturopathic medicine, phytochemical mechanisms, gut microbiome modulation, and chronic disease outcomes were included in this study.

Results: There's evidence that the anti-inflammatory foods, fermented foods, adaptogenic herbs, and diets that are high in phytonutrients can be therapeutically effective for many chronic conditions like type 2 diabetes, cardiovascular disease, inflammatory bowel disease, autoimmune disorders, and neuropsychiatric conditions. Major mechanisms that are included are the modulation of the gut-brain-immune axis, epigenetic regulation, reduction of oxidative stress, and optimization of the microbiome.

Conclusion: The approach of the title food-as-medicine is scientifically-based, patient-centered, and cost-effective. Its inclusion in mainstream health care as part of integrative medicine holds great promise for the prevention and management of various chronic diseases. Nutrigenomic principles will be the next frontier of personalized nutrition.

Keywords: naturopathy; food as medicine; phytochemicals; gut microbiome; integrative medicine; chronic disease; anti-inflammatory diet; nutrigenomics.

Title: Therapeutic Role of Food as Medicine in Naturopathy: A Comprehensive Review

Author: Dr Keerthana .K, Dr. V. Deepa, Dr. M. Sivamani, Dr. Ishwariya, Dr. Vasunthara. M, M. Panchayathu Raja

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 512-518

Research Publish Journals

Website: www.researchpublish.com

Published Date: 04-August-2026

Abstract: This research study assessed knowledge, attitudes, and practices (KAP) regarding handwashing among mothers of children under five attending health centers in Gasabo District in 2026, Rwanda. Although handwashing is a simple and effective measure for preventing diarrhea and respiratory infections, gaps in proper handwashing practices remain. Using a cross-sectional design and systematic sampling, 385 mothers participated through structured face-to-face interviews. Results showed that 81.2% had good knowledge and 77.7% held positive attitudes toward handwashing, while 76.4% demonstrated adequate handwashing practices. Mothers with higher education were significantly more likely to practice proper handwashing, whereas those aged 25–39 years, those without household handwashing facilities, and those with negative attitudes were less likely to demonstrate adequate practices. Despite generally good knowledge and positive attitudes, important barriers to optimal handwashing behavior persisted. The study concludes that strengthening hygiene education, improving household access to handwashing facilities, and promoting positive behavioral change are essential to enhance handwashing practices and reduce preventable childhood infections in Gasabo District, Rwanda.

Keywords: Handwashing, Knowledge, Attitude, Practice, Under-five Children, Rwanda.

Title: Knowledge, Attitudes, and Practices of Handwashing among Mothers with Children Under Five Years of Age in Gasabo District in 2026, Rwanda

Author: Gasharazi Assiya, Dr. Habtu Micheal

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 497-511

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Website: www.researchpublish.com

Published Date: 31-July-2026

Abstract: Allergic rhinitis (AR) is a common allergic disease that affects so many people around the world. The main symptoms include sneezing, runny nose, and nasal itching, which may affect our daily activities and quality of life. Even though conventional treatments can reduce symptoms; some patients are still facing these symptoms. Traditional Chinese Medicine (TCM) has been used for many years as another option for treating allergic rhinitis. This review focuses on the effectiveness of TCM methods, including acupuncture, Sanfu acupoint herbal patching, auricular acupuncture, and Chinese herbal medicine. Several studies reported that these treatments could help reduce nasal symptoms and improve the quality of life of patients with allergic rhinitis. In addition, TCM was reported to be safe with few side effects. However, more studies with larger groups of patients are needed to confirm their effectiveness. This review provides an overview of the current evidence on the use of TCM for allergic rhinitis.

Keywords: Allergic rhinitis, Traditional Chinese Medicine, Acupuncture, Chinese herbal medicine.

Title: Efficacy of Traditional Chinese Medicine for the Management of Allergic Rhinitis

Author: Tiyada Yooyen

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 492-496

Research Publish Journals

Website: www.researchpublish.com

Published Date: 30-July-2026

Abstract: Aim: - To determine the prevalence of high-risk human papillomavirus infection and to describe the pattern of HR-HPV genotypes among women attending for cervical cancer screening in Karnataka, India by using a PCR based assay. The main etiologic factor of cervical cancer is persistent infection with high-risk human papillomavirus. HPV-16 and HPV-18 are the most prevalent genotypes responsible for cervical cancer globally, the distribution of HR-HPV genotypes is geographically heterogeneous. Methods: - This study was conducted at Greenarray Genomics Research and Solutions Pvt. Ltd., on cervical samples received from multiple hospitals in Karnataka, India between 2020-2026. A total of 500 clinician-collected cervical samples were screened for HR-HPV using a validated PCR-based assay. Furthermore, the genotype distribution of the positive samples was analysed. Results: Of the 500 women screened, 16 were positive for HR-HPV with the overall prevalence of 3.2%. The most detected genotype was HPV-16 (5 cases), followed by HPV-66 (4 cases). HPV-18 and HPV-33 were each found in 2 cases and HPV-31 and HPV-58 were each found in 1 case and 1 case of co-infection with HPV 16,66. Conclusions: The prevalence of HR-HPV infection in the screened population had HPV-16 as the predominant genotype followed by HPV-66. These results underscore the need for continuous regional surveillance of HR-HPV genotype distribution and support the rationale for the inclusion of extended HPV genotyping in cervical cancer screening and prevention programs. Larger multicentric studies with cytological, histopathological and longitudinal clinical follow up are warranted to better understand the epidemiology and clinical significance of HR-HPV genotypes in Indian population.

Keywords: Human papillomavirus (HPV), International Agency for Research on Cancer (IARC), Polymerase Chain Reaction (PCR), HPV 16, HPV 18, HPV 66.

Title: Region-Specific HR-HPV Prevalence and Genotype Distribution in Karnataka, India: A Multicentre Study

Author: Sarjan Shah, Hema Divakar, Arti Krishnamurthy, Shailaja Talwade, Savithri A, Bharathi Rajshekhar, Jagruti Karande, Shruti Jawale, Preeti Arora

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 489-491

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Website: www.researchpublish.com

Published Date: 17-July-2026

Abstract: Malaria remains a major public health challenge, particularly in sub-Saharan Africa, where it continues to contribute substantially to morbidity and mortality. Long-lasting insecticidal nets (LLINs) are among the most effective malaria prevention interventions; however, their utilization remains suboptimal in many high-risk settings. This study assessed the factors influencing the utilization of LLINs for malaria prevention among households in Gasabo District, Rwanda. A quantitative cross-sectional research design was employed, and data were collected using a structured questionnaire administered to 342 households selected from rural and peri-urban sectors. Data were analyzed using STATA 17.0 through descriptive statistics, binary logistic regression, and multivariable logistic regression to determine factors associated with LLIN utilization. The study was guided by the Health Belief Model (HBM) and the Social Ecological Model (SEM) to examine the influence of individual, household, and community-level factors on LLIN adoption and utilization. The findings revealed that the prevalence of LLIN utilization among households in Gasabo District was 55.8%. Awareness of LLINs was significantly associated with increased utilization (AOR = 3.5, 95% CI: 1.08–11.34, p = 0.037). Similarly, respondents who correctly identified mosquito bites as the mode of malaria transmission were significantly more likely to use LLINs appropriately (AOR = 2.7, 95% CI: 1.19–6.13, p < 0.001). Conversely, sleeping on foam mattresses (AOR = 0.62, 95% CI: 0.39–0.98, p = 0.040) and residing in houses with concrete walls (AOR = 0.61, 95% CI: 0.38–0.98, p = 0.035) were negatively associated with LLIN utilization. The findings indicate that although LLIN ownership is widespread, utilization remains inadequate and is influenced by both behavioral and structural factors. Strengthening community awareness, improving malaria education, and implementing context-specific interventions that address household environmental conditions could enhance LLIN utilization and contribute to reducing the malaria burden in Rwanda.

Keywords: Utilization, Insecticidal Nets, Malaria Prevention, Households, Gasabo District.

Title: Factors Contributing to the Utilization of Long-Lasting Insecticidal Nets in Malaria Prevention among Households in Gasabo District, Rwanda

Author: Agnes Nganyira, Dr Maurice B. Silali, Dr. Habimana Amos

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 476-488

Research Publish Journals

Website: www.researchpublish.com

Published Date: 13-July-2026

Abstract: Background: Antiretroviral therapy (ART) adherence is the cornerstone of effective HIV management; suboptimal adherence undermines viral suppression, increases transmission risk, and accelerates disease progression. Rwanda reports a 3% adult HIV prevalence, yet determinants of non-adherence at facility level, particularly in western district hospitals, remain insufficiently characterized. This study determined the prevalence and multidimensional determinants of antiretroviral drug (ARD) non-adherence among people living with HIV (PLHIV) at Kirinda District Hospital, Karongi District, Rwanda.

Methods: A cross-sectional analytical mixed-methods study was conducted among 196 adult PLHIV on ART for at least six months at Kirinda District Hospital. Participants were selected through a finite-population-adjusted sample size (Fisher formula). Data were collected via structured questionnaires and five focus group discussions (n=42). Quantitative analysis used IBM SPSS v28; bivariate chi-square and multivariate logistic regression (95% CI; p<0.05) identified independent predictors of non-adherence. Qualitative data were analyzed thematically using NVivo.

Results: The overall non-adherence prevalence was 23.0% (n=45). Among non-adherent participants, 72.4% reported missing doses at least weekly; principal self-reported barriers were HIV-related stigma (16.3%), fear of status disclosure (13.3%), and drug side effects (12.8%). Knowledge gaps were prominent: 27.6% were unaware of ARV effectiveness and 41.3% did not know the risks of non-adherence. Social support was inadequate, with 51.6% uncomfortable discussing HIV status with family. Multivariate analysis identified six independent predictors of non-adherence: widowhood (aOR=2.82, 95% CI: 1.39–12.88, p=0.043), no formal education (aOR=2.61, 95% CI: 2.37–17.24, p=0.002), less than one year on ART (aOR=0.42, 95% CI: 0.05–1.68, p=0.024), experiencing drug side effects (aOR=2.56, 95% CI: 2.30–19.86, p=0.012), lacking knowledge of non-adherence consequences (aOR=2.12, 95% CI: 1.50–8.56, p=0.012), and absence of reminder tools (aOR=1.92, 95% CI: 2.92–20.67, p=0.041). Qualitative findings corroborated these determinants, revealing four major thematic domains: biomedical challenges and side-effect burden, structural and stigma-related barriers, sociocultural dynamics, and treatment literacy gaps.

Conclusion: Non-adherence at Kirinda District Hospital is driven by intersecting biomedical, structural, sociocultural, and knowledge-related determinants. Effective responses require multilevel, patient-centered interventions including enhanced side-effect management, targeted psychosocial support for widowed PLHIV, culturally adapted treatment literacy programmes, universal reminder-tool provision, and strengthened community stigma-reduction initiatives.

Keywords: antiretroviral therapy; ART adherence; non-adherence; PLHIV; HIV; Rwanda; stigma; treatment literacy; mixed methods; district hospital.

Title: Prevalence of non-adherence to antiretroviral therapy among people living with HIV and mitigation used to control in Kirinda District Hospital

Author: Donatien Mbonyintwari, Emile Sebera, Leonisse Uwajeneza, Jerome Mfitumukiza, Larissa Mukire, Jean Damascene Dusabimana, Daniel Ukwishatse, Thierry Patrick Ishimwe, Denyse Umuhoza, Maurice Silari

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 464-475

Research Publish Journals

Website: www.researchpublish.com

Published Date: 09-July-2026

Abstract: Background: Misoprostol and tranexamic acid have been shown to reduce intra-operative haemorrhage during abdominal myomectomy, however, the side effect profiles remain understudied.

Aim: To determine whether misoprostol compared with tranexamic acid has less side effect profile when used to reduce bleeding during abdominal myomectomy in a tertiary hospital and two private specialist hospitals in Enugu. Materials and Methods: This was a non-randomized comparative prospective interventional study. A total of 52 consenting participants were recruited from women booked for abdominal myomectomy at the study centers over 7 months. They were consecutively selected by matching into group I (vaginal misoprostol 400 µg) and II (intravenous tranexamic acid 1g) one hour and 15 minutes before surgery respectively. Intraoperatively, all participants had a tourniquet application. The side effect profile, intraoperative blood loss and postoperative haematocrits were compared between the two groups. Descriptive and inferential analyses were carried out using IBM SPSS Version 26.0. A P‑ value of < 0.05 was considered statistically significant. All 26 participants (100%) completed the study according to the protocol in groups I and II, respectively. Socio-demographic characteristics were not significantly different in both groups. The side effect profile were nausea and vomiting seen each in 2(7.7%) participants in the tranexamic acid group while shivering and abdominal cramps were seen in 7(26.9%) and 3(11.5%) respectively in participants in the misoprostol group and these were tolerable in both groups. The mean intra-operative blood loss in Group I compared to Group II was not statistically difference (825 ± 471.7 ml vs 840 ± 514 ml, p = 0.918). There was also no significant difference in the mean pre and post-operative haematocrit of participants in group I and group II (5.2 ± 2.7 vs 6.2 ± 3.4, p = 0.245).

Conclusion: Among the women receiving tourniquet during open abdominal myomectomy in Enugu, the additional use of vaginal misoprostol 400 µg versus intravenous 1g tranexamic acid had comparable tolerable side effects as well as comparable effectiveness in reducing intraoperative haemorrhage.

Keywords: Misoprostol and tranexamic acid, tertiary hospital, abdominal myomectomy.

Title: Comparison of Side Effect Profile of Misoprostol Versus Tranexamic Acid Both used in Adjunction with Tourniquet in Reducing Blood Loss during Abdominal Myomectomy in Enugu: A non-randomized Prospective Multi-Centre Interventional Study

Author: Chika Thompson Ugwuanyi

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 440-450

Research Publish Journals

Website: www.researchpublish.com

Published Date: 05-July-2026

Abstract: Background: New-onset seizures in adults are an important neurological presentation and may be the first manifestation of an underlying structural, infective, metabolic, traumatic, neoplastic, or idiopathic disorder. Identification of the clinical profile and etiology is essential for early diagnosis, appropriate treatment, and prevention of recurrence.

Aim: To study the clinical profile, investigational findings, and etiological distribution of new-onset seizures in adults presenting to a tertiary care hospital.

Materials and Methods: This cross-sectional observational study was conducted among 64 adult patients presenting with new-onset seizures to the OPD, emergency department, Neuro Medicine, and Department of General Medicine at People’s College of Medical Sciences & Research Centre, Bhopal. Patients aged more than 18 years with new-onset seizures were included, while patients with previous history of seizures, pregnant women, patients aged less than 18 years, and those already taking anti-epileptic drugs were excluded. All enrolled patients underwent detailed clinical evaluation, neurological examination, biochemical investigations, neuroimaging by CT/MRI brain, and EEG. Data were analyzed using SPSS, and associations were assessed using Chi-square test or Fisher’s Exact Test. A p-value <0.05 was considered statistically significant.

Results: Among 64 patients, the maximum number belonged to the 36–55 years age group, 24 (37.5%), followed by 18–35 years, 22 (34.5%). Males were predominant, 41 (64.1%). Focal to bilateral GTCS was the most common seizure type, seen in 22 patients (34.4%), followed by focal seizure and GTCS in 21 patients each (32.8%). Stroke was the most common etiology, 17 (26.6%), followed by CNS infection and metabolic causes, 14 (21.9%) each. Brain MRI/CT was normal in 20 patients (31.3%), while ischemic infarct was the commonest abnormal finding, 12 (18.8%). EEG showed focal epileptiform discharges in 23 patients (35.9%). Abnormal sodium levels were seen in 23 patients (35.9%) and abnormal calcium levels in 14 patients (21.9%). MRI/CT findings showed a significant association with seizure etiology (p<0.001).

Conclusion: New-onset seizures in adults were more common among middle-aged males. Stroke, CNS infection, and metabolic abnormalities were the major etiologies. Neuroimaging, EEG, and biochemical evaluation are essential for early etiological diagnosis and appropriate management.

Keywords: New-onset seizures; Adults; Stroke; EEG; Neuroimaging.

Title: Clinical profile of new onset seizures in adults in a tertiary care hospital

Author: Dr Oaj Tuteja, Dr Rahul Jain, Dr Atul Patel

International Journal of Healthcare Sciences

ISSN 2348-5728 (Online)

Vol. 14, Issue 1, April 2026 - September 2026

Page No: 432-439

Research Publish Journals

Website: www.researchpublish.com

Published Date: 02-July-2026