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Quality Improvement (QI) has become a central strategy for strengthening primary healthcare systems, particularly in low- and middle-income countries where gaps between clinical guidelines and routine practice persist. This study examined the Quality Improvement initiatives implemented in three primary healthcare facilities in Sunyani, Ghana Seventh Day Adventist Hospital, Rafchik Health Centre, and Nkrankrom Community-Based Health Planning and Services compound and explored how these initiatives influence healthcare providers’ adherence to quality guidelines and protocols. A qualitative case study design was employed, guided by an interpretivist paradigm. Semi-structured interviews were conducted with twenty-one healthcare providers purposively selected for their involvement in clinical care and Quality Improvement activities. Data were analysed thematically to identify recurring patterns and meanings. The findings show that Quality Improvement activities across the facilities were organised around four main initiatives: peer review, community engagement, participation in the SafeCare programme, and the routine use of patient satisfaction surveys and clinical protocols. These initiatives focused on improving patient care, infection prevention and control, preventive health services, and operational efficiency. Healthcare providers reported that Quality Improvement initiatives contributed to better patient outcomes, smoother workflows, increased staff motivation, and improved performance in external assessments. Providers demonstrated a high level of familiarity with quality guidelines and generally strong adherence to protocols. However, full compliance was sometimes constrained by resource shortages, emergency care pressures, and the technical complexity of certain procedures. Internal supervision, peer review processes, and external inspections were identified as critical mechanisms for monitoring practice and reinforcing accountability.

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Objective: The main objective is to elaborate on the cultural representation and etiological factors responsible for the prevalence of sickle cell anaemia in Yaounde. Methods: The study design used was qualitative during field work. Data collection techniques used were: Direct observation, in-depth interviews, life histories, case studies, focus group discussions and, documentary research. Content and thematic data analyses were used analyse data collected from the field. Moreover, theories like cultural dynamism, explanatory model and cultural interpretive theories were used. Results: Our findings revealed that, so many people in Biyem Assi District, are not aware of SCA and they are living in ignorance. They are not interested or do not bother to know their blood genotypes, blood groups and talk less of trying to know the origin of SCA. Most of the time, out of ignorance and unawareness of the disease when their children suffer from it and are diagnosed in the hospital that is when they get to know more about the disease. Moreover, some of the etiological factors responsible for the prevalence of SCA in Yaounde are: ignorance, lack of knowledge, lack of sensitization, endogamous marriages, informal marriages, failure to carry out electrophoresis test before child bearing and marriage, environmental factors, unwanted pregnancies, and incompatibility of couples. Discussion: Prince (2019) explained that, Sickle cell Anemia (SCA) is a disease or it is a group of blood disorder typically inherited from both parents, mother and father. It also occurs when a person inherits two abnormal copies of the hemoglobin gene, one from each parent. It has been scientifically proven that this gene occurs in chromosome. Based on the data collected from the field and the works of other authors who carried out research in similar domain, Sickle Cell Anemia is a disease which is inherited from both parents who carry the same Sickle Cell traits in them. They bear children who suffer fro

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Background: Infections of the bloodstream and sepsis are significant causes of morbidity and mortality, especially when complicated by multidrug resistance. Molecular diagnosis represents a tool for rapid identification of causative organisms with subsequent optimization of antimicrobial therapy; however, conventional blood culture still plays a critical role as a reference method for microbial identification and susceptibility testing. Methods: The study included 110 bloodstream isolates obtained from patients with suspected bacteremia and sepsis. Conventional blood culture was used for organism identification, incubation time analysis, and antibiogram testing, while multiplex PCR was used to screen for the most prevalent resistance determinants, namely NDM, OXA-48, KPC, VIM, mecA, and VanA/VanB genes. Bloodstream and non-bloodstream isolates from selected cases of sepsis were compared. Results: Klebsiella pneumoniae: 27 (24.5%), Staphylococcus aureus13 (11.8%), Escherichia coli8 (7.3%), Enterococcus faecium (7; 6.4%), Acinetobacter baumannii (8;7.3%), Enterococcus faecalis (6; 5.5%), and Pseudomonas aeruginosa (6; 5.5%) were the most prevalent species isolated from blood. The majority of cultures became positive within 20 hours from seeding, with 24 out of 97 (24.7%) positive between 0 and 10 hours and 55 out of 97 (56.7%) positive between 11 and 20 hours. The most prevalent resistance determinants were NDM, NDM+OXA-48, mecA, and VanA/VanB. Susceptibility testing revealed that carbapenems were largely ineffective against K.pneumoniae, while aztreonam/avibactam, tigecycline, fosfomycin, linezolid, vancomycin, and teicoplanin showed good activity against several strains of bacteria. Conclusion: The present findings demonstrate the potential utility of multiplex PCR as a rapid assay for detection of multidrug-resistant bloodstream pathogens and early optimization of antimicrobial treatment. At the same time, conventional blood culture remains an indispensable tool fo

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Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary driver of cervical cancer; however, viral presence alone is insufficient to induce malignancy. The progression from initial infection to invasive carcinoma requires a coordinated series of alterations in both the viral genome and the host cell's regulatory machinery. This review focuses on three principal mechanisms by which HR-HPV bypasses host regulatory controls: epigenetic modifications, immune evasion, and endocrine signaling. Specifically, we describe how the viral oncoproteins E6 and E7 recruit host DNA methyltransferases—particularly DNMT1, DNMT3A, and DNMT3B—to silence tumor suppressor genes such as CCNA, hTERT, and E-cadherin via promoter hypermethylation. Beyond DNA methylation, HPV disrupts histone acetylation and methylation patterns through interactions with p300/CBP, the NuRD complex, and Polycomb group proteins, while simultaneously dysregulating non-coding RNAs and specific microRNAs to reinforce this transcriptionally silenced state. The review further details how HPV escapes immune clearance by driving a Th1-to-Th2 cytokine shift, downregulating MHC class I expression, and recruiting myeloid-derived suppressor cells and regulatory T cells to the cervical microenvironment. Additionally, we discuss the role of cofactors, focusing on the synergistic interaction between estradiol and HPV oncogenes; this interaction promotes local immunosuppression via estrogen receptor alpha signaling on stromal fibroblasts and infiltrating immune cells. We also examine the contribution of high parity as a key epidemiological risk factor. A comparative analysis of patient data across three distinct studies is presented to illustrate how demographic and reproductive variables correlate with cervical lesion severity in different populations. Ultimately, cervical carcinogenesis stems from multi-pathway interactions where viral oncogenes, epigenetic changes, immune escape, and hormonal factor

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The article discusses about the virulent bacterium Shigella, its clinical manifestations, the related epidemiology, treatment options that includes both preventive & curative approaches. It also discusses the supportive therapy. The public health dimension of the Shigella bacterium is also dealt with. The article discusses the role that homoeopathic therapeutics can play in the absence of any treatment options to deal with the chronic cases. Homoeopathy can be a supportive therapy that can reduce not only the morbidity but also the fatality of Shigella cases due to all the strains. Homoeopathy has repeatedly proved its efficacy in chronic bowel diseases since the last two and half centuries.

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Migration is a fundamental demographic process with profound consequences for population health globally. Increasingly driven by economic inequality, conflict, environmental change, and social transformation, migration shapes the distribution of health risks and opportunities across populations. While migration can improve socioeconomic conditions, enhance access to services, and contribute to economic development, it also introduces complex vulnerabilities related to infectious diseases, non-communicable diseases, mental health, maternal and child health, and occupational hazards. This paper provides an expanded examination of the multifaceted relationship between migration and health, analyzing underlying determinants, health system responses, and the lived experiences of migrants across different contexts. Drawing on contemporary scholarship and international frameworks, this review explores the health implications of migration in low-, middle-, and high-income countries, emphasizing structural drivers, health inequities, and the role of policy in shaping outcomes. The findings demonstrate that migrant health outcomes are shaped by interconnected social, political, and economic factors and require multisectoral and rights-based approaches to ensure equitable access to healthcare and protection of vulnerable populations. Drawing on evidence from global studies and country-specific experiences, including Nigeria, the European Union, and the United States, the article highlights key pathways through which migration influences population health. It concludes with recommendations for policy, health systems strengthening, and future research directions.

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Diabetes mellitus is a global health issue with numerous complications, and SGLT-2 inhibitors can slow kidney disease progression, reduce heart failure, and lower the risk of kidney failure and death in individuals with CKD. This study evaluated the impact of Sodium-glucose co-transporter 2 (SGLT2) inhibitors, specifically dapagliflozin and empagliflozin, on cardiovascular and renal health in Type 2 Diabetes Mellitus (T2DM) patients at Benghazi Diabetes Center (BDC). The study involved 600 T2DM patients initiating dapagliflozin or empagliflozin, and collected data from interviews, structured questionnaires, and electronic medical records. After three months of treatment, the analysis showed significant improvements in glycemic control, weight management, blood pressure, and lipid profiles, reduced albuminuria, and improved estimated glomerular filtration rate (eGFR) and ejection fraction (EF). However, drug- and sex-specific nuances were revealed. Dapagliflozin showed numerically greater improvements in BP, postprandial glucose, lipid parameters, plasma urea, and albuminuria, while empagliflozin demonstrated numerically greater reductions in weight, body mass index, fasting plasma glucose, and eGFR. Females showed greater reductions in PPG, weight, BMI, BP, and plasma urea, while males demonstrated more pronounced improvements in FPG, triglycerides, low-density lipoprotein cholesterol, albuminuria, and EF. Combined SGLT2 inhibitor use with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers did not show statistically significant differences in clinical parameters compared to SGLT2 inhibitor monotherapy. SGLT2 inhibitors show beneficial effects on cardiorenal and metabolic parameters in T2DM patients, with variations based on drug and sex, emphasizing personalized treatment plans and urging further research.