BackgroundStunting is one of the most public health burdens in Rwanda. Most deaths due to stunting are associated with inappropriate feeding practices that occur in the first 5 years of life. This study aimed at determining the risk factors for stunting in children under 5 years of age in the Eastern and Western provinces of Rwanda.MethodCross-sectional study using secondary data from Rwanda Demographic Health Survey 2014/2015.ResultsStunting was highly prevalent in eastern province compared to Western province. It was also highly prevalent in rural area in both provinces. Results indicated a significant association between maternal education and stunting (=6.868; p=0.001), maternal age group (=15.44; p=0.017), maternal occupation (=30.012; p=0.000), wealth index (=14.327; p=0.006), sex of child (=2.91; p=0.008) and giving child fortified food (=4.256; p=0.039). Results indicated that antenatal care visits were significantly associated with stunting (=6.653; p=0.01). Sharing a toilet was significantly associated with stunting (=25.88; p=0.000). Multiple logistic regression indicated that the gender of child [OR=1.08; 95% CI (1.057–1.093), p=0.008], household wealth index [OR=0.386; 95% CI (0.357–0.414)] and breastfeeding [OR=0.02; 95% CI (0.004–0.036), p=0.013] were the risk factors of stunting in eastern and western provinces.ConclusionImmediate and appropriate interventions targeted at community management of acute malnutrition and stunting are needed to manage the associated morbidity and mortality. Strengthening the health system for improving child health through prioritizing maternal and child by addressing poverty and increase food access is mostly needed. These tactics yield more sustainable improvement in child nutrition within Eastern and Western provinces.

No abstract

Background Psychological well-being (PWB) refers to inter- and intra-individual levels of positive functioning that include one’s relatedness with others and self-referent attitudes that include one’s sense of mastery and personal growth. PWB consists of hedonism and eudaimonia building on thoughts, feelings, and behaviors. Sociotherapy is a community-based health intervention that contributes to the promotion of PWB worldwide. Starting from an analysis of trauma transmitted from the perpetrators and survivors of the Rwandan genocide to their descendants, this article is aimed at exploring the contribution of therapeutic sessions to PWB among youth. Method A qualitative study design based on shared testimonies was carried out. Field reports from the sociotherapists, written texts, and testimonies of changes presented in the conviviality meetings were analyzed using transactional analysis. We included 24 reflexive texts upon completion of 8 months of the therapeutic program. Results Results indicated that before sociotherapy sessions, youth born to genocide survivors and perpetrators had psychosocial distress, including low self-esteem, hopelessness, anxiety, stigma, thoughts of revenge, shame, depression, and antisocial behaviors. Sociotherapy significantly contributed to the reduction of these psychosocial problems. Participating youth reported feeling safe, trusted, respected, and healthier than before the sociotherapy. This intervention created inner healing, social cohesion, alleviated their sufferings of trauma, restored their families and contributed to community resilience. Results revealed that youth developed PWB, helping them to what appeared to be psychosocial problems as being potentially healthy, enhancing self-acceptance, and respecting humanity. Youth also became the vector for the reconciliation and reconstruction of their humanity. Conclusion Sociotherapy is a community health intervention that has an effective outcome on the personal well-being of of youth. This therapy impacted the individual, social, and familial resilience of youth who developed their capacity to regain and maintain health. The intervention restored their PWB, characterized by increased positive functioning specifically in the areas of autonomy, ecological mastery, individual growth, purpose in life, good relationships with others, and improved self-esteem.

Background: Low birth weight (LBW) remains the global unfinished agenda in most countries of the world especially in low- and middle-income countries. LBW subsequently has harmful effects on the lifestyle, psychosocial and physiological development of the child. Although it is known that antenatal care (ANC) visits are important interventions contributing to prediction of newborn birth weight, little has been conducted on effect of ANC visits on birth weight in Rwanda. This study aimed at determining the association between regular ANC visits and risk of LBW among newborns in Rwanda. Methods: A cross-sectional study design was conducted to analyse the effects of ANC on LBW using the 2014/2015 Rwanda Demographic Health Survey. Associations of socio-demographic, socio-economic, and individual factors of the mother with LBW newborns were performed using bivariate and multiple logistic regression analyses. Results: Prevalences of LBW and macrosomia were 5.8% and 17.6%, respectively. Newborns delivered from mothers attending fewer than four ANC visits were at almost three-times greater risk of having LBW [aOR=2.8; 95%CI (1.5–5.4), p=0.002] compared to those whose mothers attending four or more ANC visits. Residing in a rural area for pregnant women was significantly associated with LBW [aOR=1.1; 95%CI (0.7–1.6), p=0.008]. Maternal characteristics, such as anemia, predicted an increase in LBW [aOR=3.5; 95%CI (1.5–5.4), p<0.001]. Those who received no nutritional counseling [aOR=2.5; 95%CI (2–8.5), p<0.001] and who were not told about maternal complications [aOR=3.3; 95%CI (1.5–6.6), p=0.003] were more prone to deliver newborns with LBW than those who received them. Pregnant women who received iron and folic acid were less likely to have LBW newborns [aOR=0.5; 95%CI (0.3–0.9), p=0.015]. Conclusion: ANC visits significantly contributed to reducing the incidence of LBW. This study underscores the need for early, comprehensive, and high-quality ANC services to prevent LBW in Rwanda.

Background The prevalence of depressive disorders remains high in patients with cancer and their diagnosis and treatment remain an epidemiologic concern. Without proper screening and diagnosis, the necessary care and follow-up would not be possible for these patients who need potential support to increase their quality of mental health. Hence, the screening tools for depression are prominent in diagnosing this mental health disorder; however, there are few studies conducted for assessing psychometric properties of Beck Depression Inventory (BDI-II) amongst the cancer patients from developing countries. We, therefore, determined psychometric properties of the BDI-II among cancer patients from Butaro Ambulatory Cancer Center (BACC). Methods Cross-sectional study design was conducted among 425 cancer patients from the BACC, Rwanda. Confirmatory and exploratory factor (CFA) analyses were performed to compare the fit indices of three-factor and two-factor models of the BDI-II. The eligible participants were administered the BDI-II instrument. Results Average scores of depression was 16.3 (SD=9.8). Results showed an adequate consistency (Cronbach’s α=0.904) and high correlations with the subscales of this instrument. Our findings showed that the area under the curve of the receiver operating characteristics analysis of BDI-II was 0.805. Our CFA results revealed that three-factor model (χ 2 =1699.921, p <0.001) represented a better model fit than the two-factor model of BDI-II (χ 2 =2115.397, p <0.001). In addition, the goodness of fit indices were tested and showed that the Beck’s three-factor model had a better performance than the two-factor model. Kaiser–Meyer–Olin (KMO) measure of 0.916 demonstrated that the factor structure or sampling was adequate for analysis and the Bartlett’s test of sphericity was highly significant (χ 2 =3780, p <0.001) and this revealed that the items of BDI-II were significantly correlated and sufficiently large. Conclusion BDI-II presented a good reliability and validity that represent adequate psychometric properties. Its sensitivity and specificity were suitable. This psychometric measure is important in diagnosing and treating depression in cancer patients.

Background: Low birth weight (LBW) remains the global unfinished agenda in most countries of the world especially in low- and middle-income countries. LBW subsequently has harmful effects on the lifestyle, psychosocial and physiological development of the child. Although it is known that antenatal care (ANC) visits are important interventions contributing to prediction of newborn birth weight, little has been conducted on effect of ANC visits on birth weight in Rwanda. This study aimed at determining the association between regular ANC visits and risk of LBW among newborns in Rwanda. Methods: A cross-sectional study design was conducted to analyse the effects of ANC on LBW using the 2014/2015 Rwanda Demographic Health Survey. Associations of socio-demographic, socio-economic, and individual factors of the mother with LBW newborns were performed using bivariate and multiple logistic regression analyses. Results: Prevalences of LBW and macrosomia were 5.8% and 17.6%, respectively. Newborns delivered from mothers attending fewer than four ANC visits were at almost three-times greater risk of having LBW [aOR=2.8; 95%CI (1.5–5.4), p=0.002] compared to those whose mothers attending four or more ANC visits. Residing in a rural area for pregnant women was significantly associated with LBW [aOR=1.1; 95%CI (0.7–1.6), p=0.008]. Maternal characteristics, such as anemia, predicted an increase in LBW [aOR=3.5; 95%CI (1.5–5.4),p<0.001]. Those who received no nutritional counseling [aOR=2.5; 95%CI (2–8.5), p<0.001] and who were not told about maternal complications [aOR=3.3; 95%CI (1.5–6.6), p=0.003] were more prone to deliver newborns with LBW than those who received them. Pregnant women who received iron and folic acid were less likely to have LBW newborns [aOR=0.5; 95%CI (0.3–0.9), p=0.015]. Conclusion: ANC visits significantly contributed to reducing the incidence of LBW. This study underscores the need for early, comprehensive, and high-quality ANC services to prevent LBW in Rwanda.

Background Malaria is a public health concern worldwide. A figure of 3.2 billion people is at risk of malaria a report of World Health Organization in 2013. A proportion of 89 and 91 cases of malaria reported during 2015 were respectively attributed to malaria cases and malaria deaths in Sub-Saharan Africa. Rwanda is among the Sub-Saharan Africa located in East Africa. The several reports indicate that from 2001 to 2011, malaria cases increased considerably especially in Eastern and Southern Province with five million cases. The affected districts included Bugesera in the Eastern and Gisagara in the Southern Province of Rwanda with a share of 41% of the country prevalence in 2014 and during 2017–2018 a figure of 11 deaths was attributed to malaria and both Gisagara and Bugesera Districts were the high burdened. Methodology The RDHS 2014–2015 data was used for the study and a cross-sectional survey was used in which two clusters were considered both Gisagara and Bugesera Districts in the Southern and Eastern Province of Rwanda. Bivariate analysis was used to determine the significant predictors with malaria and reduced logistic regression model was used. Results The results of the study show that not having mosquito bed nets for sleeping is 0.264 times less likely of having malaria than those who have mosquito bed nets in Gisagara District. In Bugesera District, living in low altitude is 2.768 times more likely associated with the risk of getting malaria than living in high altitude. Conclusion The results of the study concluded that environmental and geographical factor such as low altitude is the risk factor associated with malaria than the high altitude in Bugesera District. While not having mosquito bed nets for sleeping is the protective factor for malaria than those who have it in Gisagara District. On the other hand, socio-economic and demographic characteristics do not have any effect with malaria on the results of the study.

BackgroundDepression and anxiety are psychological and physiological disturbances persisting in cancer patients with high prevalence worldwide, particularly in low- and middle-income countries, due to complexities of determinants of health including biological, individual, socio-cultural, and treatment-related characteristics. Although depression and anxiety have an enormous impact on adherence, length of stay at the hospital, quality of life, and treatment outcomes, studies on psychiatric disorders remain limited. Thus, this study determined the prevalence and factors of depression and anxiety among patients with cancer in Rwanda.MethodsA cross-sectional study was conducted among 425 patients with cancer from the Butaro Cancer Center of Excellence. We administered socio-demographic questionnaires and psychometric instruments. Bivariate logistic regressions were computed to identify significant factors to be exported into the multivariate logistic models. Then, odds ratios and their 95% confidence intervals were applied, and statistical significance at p &lt; 0.05 were considered to confirm significant associations.ResultsThe prevalence of depression and anxiety was 42.6 and 40.9%, respectively. Patients with cancer initiated to chemotherapy had a greater likelihood of being depressed [AOR = 2.06; 95% CI (1.11–3.79)] than those initiated to chemotherapy and counseling. Breast cancer was significantly associated with a greater risk of depression [AOR = 2.07, 95% CI (1.01–4.22)] than Hodgikins's Lymphoma cancer. Furthermore, patients with depression had greater odds of developing anxiety [AOR = 1.76, 95% CI (1.01–3.05)] than those with no depression. Those suffering from depression were almost two times more likely to experience anxiety [AOR = 1.76; 95% CI (1.01–3.05)] than their counterparts.ConclusionOur results revealed that depressive and anxious symptomatology is a health threat in clinical settings that requires enhancement of clinical monitoring and prioritization of mental health in cancer health facilities. Designing biopsychosocial interventions to address associated factors needs special attention to promote the health and wellbeing of patients with cancer.