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Research Article
Outcomes and Associated Factors of Traumatic Brain Injury Among Adult Patients Treated in Buea Health District (BHD), Cameroon
Nnoko Sona Akwo*
,
David Oben Bate,
Esembieng Esua Fomanka,
Enow Nkah Bruno Enow,
Ntungwe Ekwelle Smith,
Oben Joan Ayuk,
Yoah Aldof Tah,
Kingsley Enow Nkongho,
Maxwell Kofi Danso,
Isaac Obeng Gyasi,
Emeh Nathan Agbor
Issue:
Volume 11, Issue 3, September 2026
Pages:
221-233
Received:
25 May 2026
Accepted:
8 June 2026
Published:
8 July 2026
DOI:
10.11648/j.wjph.20261103.11
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Abstract: Traumatic brain injury (TBI) represents a significant public health challenge in sub-Saharan Africa, with limited data on outcomes in Cameroon. This prospective observational study evaluated outcomes and associated factors of TBI among adult patients treated in Buea Health District (BHD), Cameroon, from January 2020 to December 2025. A total of adult patients diagnosed with TBI were included. Data on socio-demographic characteristics, clinical severity (Glasgow Coma Scale scores), injury mechanisms, treatment pathways, and outcomes were collected using structured questionnaires and medical records. The primary outcome was functional status at discharge assessed using the Glasgow Outcome Scale (GOS), dichotomised into favourable (GOS 4–5) and unfavourable (GOS 1–3) outcomes. Statistical analysis included descriptive statistics, chi-square tests, and bivariable and multivariable logistic regression to identify independent predictors. Results showed that 74% of patients achieved favourable outcomes, with road traffic injuries (60%) being the leading cause, followed by falls (23%) and assaults (10%). Most patients were young adult males (78%), consistent with global patterns. Clinical severity indicators were strongly predictive of outcomes: patients with GCS scores 13–15 had overwhelmingly favourable outcomes (79%), while those with GCS < 8 had predominantly unfavourable outcomes (χ2 = 93.605, p < 0.001). Duration of unconsciousness >24 hours and post-traumatic amnesia were significant negative predictors (p < 0.001). Socio-demographic variables showed no significant associations with outcomes. Quality of life assessments revealed 76.5% were discharged successfully, though 23.5% experienced residual complaints, including seizures (10.5%), memory loss (4.5%), and paralysis (2%). These findings highlight that TBI in BHD predominantly affects young adult males through preventable mechanisms. Clinical severity remains the most critical outcome predictor, underscoring the need for improved pre-hospital care, timely presentation, and neurosurgical capacity to reduce the burden of TBI in Cameroon.
Abstract: Traumatic brain injury (TBI) represents a significant public health challenge in sub-Saharan Africa, with limited data on outcomes in Cameroon. This prospective observational study evaluated outcomes and associated factors of TBI among adult patients treated in Buea Health District (BHD), Cameroon, from January 2020 to December 2025. A total of adu...
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Research Article
The Role of Health Policy in Enhancing Health Security:
A Case Study of Nigeria’s National Action Plan for Health Security (NAPHS)
Paul Imolemen Irabor*
Issue:
Volume 11, Issue 3, September 2026
Pages:
234-248
Received:
4 June 2026
Accepted:
17 June 2026
Published:
11 July 2026
DOI:
10.11648/j.wjph.20261103.12
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Abstract: Health security remains a critical concern in global public health, particularly in low- and middle-income countries facing recurrent infectious disease outbreaks. National health security plans provide the policy architecture for translating international commitments into domestic preparedness capacities, yet their operational effectiveness depends on stakeholder awareness, financing, coordination and subnational implementation. This study examines the role of health policy in enhancing health security in Nigeria, using the National Action Plan for Health Security (NAPHS) as a case study. Specifically, it assesses stakeholders’ awareness of NAPHS, perceived relevance of the policy framework, implementation effectiveness, perceived improvements in health security domains, barriers to implementation and recommendations for strengthening Nigeria’s preparedness system. A quantitative cross-sectional survey design supported by documentary policy analysis was adopted. Data were collected from 380 purposively selected stakeholders using a structured questionnaire covering institutional profile, familiarity with NAPHS, perceived relevance, implementation effectiveness, preparedness improvements, funding adequacy, inter-agency coordination, One Health awareness, training exposure, barriers and recommendations. Descriptive statistics, cross-tabulations, chi-square tests of independence and Cramér’s V were used for analysis. NAPHS was widely recognised as relevant (90.3%) and strategically aligned with national and international frameworks (81.1% and 80.8%, respectively). However, only 9.2% rated implementation as very effective, while 60.3% rated it moderately effective. Familiarity was strongly concentrated at the federal level (92.4%) compared with state (44.2%) and community/facility levels (15.8%). The strongest improvements were observed in disease surveillance (69.2%) and laboratory capacity (67.1%), whereas funding mobilisation (15.0%), workforce training (26.0%) and inter-agency coordination (26.8%) were the weakest domains. Inadequate funding (84.7%) and weak coordination (76.1%) were the most frequently reported barriers. While NAPHS provides a strong policy foundation for health security in Nigeria, its operational impact depends on sustainable domestic financing, decentralised implementation, strengthened coordination, workforce development and improved subnational awareness. The study contributes evidence-based recommendations for strengthening national preparedness planning in resource-constrained settings.
Abstract: Health security remains a critical concern in global public health, particularly in low- and middle-income countries facing recurrent infectious disease outbreaks. National health security plans provide the policy architecture for translating international commitments into domestic preparedness capacities, yet their operational effectiveness depend...
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Research Article
Effects of Manual and Digital Registration Systems on Data Quality, Waiting Time, and Healthcare Worker Satisfaction in Tertiary Hospitals in Kogi State, Nigeria
Issue:
Volume 11, Issue 3, September 2026
Pages:
249-263
Received:
11 June 2026
Accepted:
23 June 2026
Published:
22 July 2026
DOI:
10.11648/j.wjph.20261103.13
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Abstract: Patient registration systems play an important role in ensuring accurate health information management and efficient service delivery within healthcare facilities. In many Nigerian tertiary hospitals, manual and digital registration systems continue to operate simultaneously, yet evidence comparing their influence on data quality, patient waiting time, and healthcare worker satisfaction remains limited. This study assessed the effects of manual and digital registration systems on data quality, waiting time, and healthcare worker satisfaction in tertiary hospitals in Kogi State, Nigeria. The facility-based cross-sectional study was conducted among 452 healthcare workers selected through stratified random sampling from two tertiary hospitals in Kogi State. Data were collected using a structured questionnaire and analyzed using descriptive statistics, independent samples t-tests, and multiple linear regression. Statistical significance was set at p < 0.05. Most respondents were aged 25–29 years (30.31%), female (67.70%), Christian (57.08%), and married (76.99%). Respondents using digital registration systems reported higher data quality scores (2.96 ± 0.36) than those using manual registration systems (2.72 ± 0.37; p < 0.001). Similarly, digital registration systems recorded better waiting-time performance (2.17 ± 0.26) compared with manual registration systems (2.07 ± 0.23; p = 0.001). Healthcare worker satisfaction was significantly lower among users of manual-only registration systems (β = −0.527, 95% CI: −0.678 to −0.376; p < 0.001), whereas satisfaction among digital-only users did not differ significantly from that of hybrid-system users (β = 0.027, 95% CI: −0.142 to 0.197; p = 0.750). The study concludes that digital registration systems offer advantages in data quality, waiting time, and healthcare worker satisfaction compared with manual registration systems. Strengthening digital health infrastructure, providing continuous staff training, and ensuring adequate technical support may enhance the effectiveness of registration systems and improve health information management in tertiary healthcare facilities.
Abstract: Patient registration systems play an important role in ensuring accurate health information management and efficient service delivery within healthcare facilities. In many Nigerian tertiary hospitals, manual and digital registration systems continue to operate simultaneously, yet evidence comparing their influence on data quality, patient waiting t...
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Research Article
Socioprofessional Impact on Patients with Chronic Kidney Disease at Aristide Le Dantec Hospital in Dakar:
Out-of-Pocket Expenditures Burden and Catastrophic Household Finances
Issue:
Volume 11, Issue 3, September 2026
Pages:
264-270
Received:
25 May 2026
Accepted:
8 June 2026
Published:
24 July 2026
DOI:
10.11648/j.wjph.20261103.14
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Abstract: Background: Chronic kidney disease (CKD) represents a major public health burden in sub-Saharan Africa, predominantly affecting young working-age adults. Despite free dialysis policies implemented in Senegal since 2012, the broader socioeconomic consequences of end-stage kidney disease (ESKD) on patients and their families remained poorly documented. Aim: This study aimed to estimate the socioprofessional and economic impact of dialysis on ESKD patients and their families in 2019. Setting: The nephrology and dialysis department of Aristide Le Dantec Hospital, a national level III referral center in Dakar, Senegal. Methods: An analytical cross-sectional study was conducted from January to December 2019. Data were collected through medical record reviews and face-to-face interviews. Direct and indirect costs were calculated, and catastrophic health expenditure was assessed using a 20% annual household income threshold. Results: A total of 89 patients were enrolled. The mean age was 47.83 years and 87.36% had no health insurance. Weekly working hours declined from 38.32 before diagnosis to 4.93 hours after. Job loss affected 59.09% of patients. Nearly all patients (89.53%) reported social repercussions, primarily activity limitations. Additionally, 43.68% sold personal assets to cover treatment costs, and 18.39% contracted loans. Catastrophic health expenditure affected 95.98% of patients, with out-of-pocket costs representing 52.86% of total management expenditures. Conclusion: Despite state subsidies, ESKD imposed a devastating socioeconomic burden on patients and families. Strengthening health insurance coverage and expanding social protection for CKD patients is strongly recommended. Contribution: This study provides critical evidence on the socioprofessional consequences of ESKD in West Africa, informing equitable health policy and resource allocation for kidney disease management in low- and middle-income countries.
Abstract: Background: Chronic kidney disease (CKD) represents a major public health burden in sub-Saharan Africa, predominantly affecting young working-age adults. Despite free dialysis policies implemented in Senegal since 2012, the broader socioeconomic consequences of end-stage kidney disease (ESKD) on patients and their families remained poorly documente...
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