Papers by Jean Baptiste Nyandwi
Vaccination and vaccine-preventable diseases in Africa
Scientific African, Jun 1, 2024
Assessment of community pharmacies readiness to dispense antiretroviral medicines in Rwanda
Journal of Pharmaceutical Policy and Practice, Dec 5, 2023
Global Health Research and Policy
Background Presumptive treatment of malaria is often practiced in community pharmacies across sub... more Background Presumptive treatment of malaria is often practiced in community pharmacies across sub-Saharan Africa (SSA).To address this issue, the World Health Organization (WHO) recommends that malaria Rapid Diagnostic Tests (m-RDTs) be used in these settings, as they are used in the public sector. However, their use remains unlicensed in the community pharmacies in Rwanda. This can lessen their availability and foster presumptive treatment. Therefore, this study investigated the availability of m-RDTs, knowledge of community pharmacists on the use of m-RDTs, and explored Pharmacists’ perceptions of the advantages and disadvantages of licensing the use of m-RDTs in community pharmacies. Methods This was a cross-sectional study among 200 licensed community pharmacists who were purposefully sampled nationwide from 11th February to 12th April 2022. Data was collected using an online data collection instrument composed of open-ended and closed-ended questions. Statistical analyses were ...
Integrated Pharmacy Research and Practice
This study aimed to explore the request and dispensing of antimalarial medicines without a prescr... more This study aimed to explore the request and dispensing of antimalarial medicines without a prescription in community pharmacies in Rwanda, as well as factors associated. Methods: We employed an embedded mixed-methods design that involved a convenience sample of 235 licensed community pharmacists between February and April 2022. To simultaneously collect qualitative and quantitative data, we used a selfadministered questionnaire containing a combination of close and open-ended questions. Bivariate and multivariate regression analyses were performed to examine the relationship between dispensing antimalarial medicines without a prescription and the selected independent variables. Statistical significance was set at p<0.05, and a 95% confidence interval was applied. The factors influencing the dispensing of antimalarial medicines without a prescription were analyzed using thematic content analysis as a qualitative analysis approach. Results: Most respondents (88.5%) were asked to dispense antimalarial medicines by clients without a prescription. More than half of them (54%) agreed, but 34.5% refused; instead, they referred clients to malaria diagnostic testing facilities. Those who had rapid diagnostic tests for malaria in stock (OR=2.08, 95% CI:1.1-3.94), and thought that antimalarials were over-the-counter medicines (OR=7.03, 95% CI:2.01-24.5) were more likely to dispense antimalarial medicines without prescriptions. The primary reasons reported by community pharmacists for dispensing antimalarial medicines without prescriptions included their prior knowledge of malaria diagnosis, client pressure, and fear of losing clients. However, non-adherence to negative results obtained from formal health facilities and long queues at these institutions have also been cited as additional factors driving clients to seek antimalarial medicines without prescriptions. Conclusion: Dispensing antimalarial medicines without prescriptions is a common practice in community pharmacies in Rwanda. The main factors contributing to this practice include lack of awareness regarding the classification of antimalarials as prescription medicines, the availability of malaria diagnostic tests, client pressure, and fear of losing clients.
The viability of micro-finance programs for the empowerment of rural poor women enterpreneurs: a case of Bujumbura rural province
The Pan African medical journal, 2019
Introduction: regional anesthesia is a safe alternative to general anesthesia. Despite benefits f... more Introduction: regional anesthesia is a safe alternative to general anesthesia. Despite benefits for perioperative morbidity and mortality, this technique is underutilized in low-resource settings. In response to an identified need, a regional anesthesia service was established at the University Teaching Hospital of Kigali (CHUK), Rwanda. This qualitative study investigates the factors influencing implementation of this service in a low-resource tertiary-level teaching hospital. Methods: following service establishment, we recruited 18 local staff at CHUK for in-depth interviews informed by the "Consolidated Framework for Implementation Research" (CFIR). Data were coded using an inductive approach to discover emergent themes. Results: four themes emerged during data analysis. Patient experience and outcomes: where equipment failure is frequent and medications unavailable, regional anesthesia offered clear advantages including avoidance of airway intervention, improved analgesia and recovery and cost-effective care. Professional satisfaction: morale among healthcare providers suffers when outcomes are poor. Participants were motivated to learn techniques that they believe improve patient care. Human and material shortages: clinical services are challenged by high workload and human resource shortages. Advocacy is required to solve procurement issues for regional anesthesia equipment. Local engagement for sustainability: participants emphasized the need for a locally run, sustainable service. This requires broad engagement through education of staff and long-term strategic planning to expand regional anesthesia in Rwanda. Conclusion: while the establishment of regional anesthesia in Rwanda is challenged by human and resource shortages, collaboration with local stakeholders in an academic institution is pivotal to sustainability.
The impact of Post COVID-19 Condition is ongoing despite the WHO declaration that the pandemic ha... more The impact of Post COVID-19 Condition is ongoing despite the WHO declaration that the pandemic has ended. In this study, we explore the prevalence of PCC among healthcare workers (HCWs) in four African Countries and its influence on their professional performance. This study was conducted as an online cross-sectional survey of healthcare workers from four African countries (Cameroon, Egypt, Nigeria, and Somalia) between the 20thof December 2021 to 12thof January 2022. We determined the prevalence of PCC based on the WHO case definition and assessed variables associated with a higher prevalence of PCC in these countries using univariable and multivariable logistic regression analyses. A total of 706 HCWs from four African countries were included in this survey. Most of the HCWs were aged between 18-34 years (75.8%, n=535). Our findings showed that 19.5% (n=138) of the HCWs had tested positive for SARS-CoV-2. However, 8.4% (n=59) were symptomatic for COVID-19 but tested negative or we...
Although the WHO declared Mpox (monkeypox) as the 7th aetiology of public health emergency of int... more Although the WHO declared Mpox (monkeypox) as the 7th aetiology of public health emergency of international concern (PHEIC) in 2022, Africa remains a battlefield for the emergence and re-emergence of deadly aetiologies including the Lassa fever virus from 1969, mpox virus from 1970, and Ebola virus from 1976 till date, among others. With the recent index case of mpox following rapid spread from Africa to different continents, a critical appraisal of the disease to x-ray its dynamics in Africa for research gap identification and policy implementation is warranted. This study integrated a mix of scoping and systematic reviews to converse the epidemiology and biosecurity/environmental issues from One Health perspective. Our scoping review used major scientific databases based on their relevance, reliability, and robust indexed contents, while the PROSPERO registered systematic review followed the PRISMA guidelines. Phylogenetic analysis was piloted to equate recent outbreaks of mpox wi...
Journal of Pharmaceutical Policy and Practice, Jan 18, 2023
Background Despite the evidence that cold chain management practices affect the potency and effec... more Background Despite the evidence that cold chain management practices affect the potency and effectiveness of both vaccines and non-vaccine commodities, most of the researches in Uganda focus on vaccines. This study assessed the cold chain management practices of non-vaccine cold chain commodities in public health facilities of the Rwenzori Region, Uganda. Methods A cross-sectional study was conducted in a random sample of 69 level III and IV health facilities. The respondents were store managers at health facilities. Data on stock and storage management practices and level of knowledge on cold chain management were assessed. Data were collected and entered into Microsoft excel 2017, cleaned, and later exported into IBM SPSS version 26 for analysis. The management practices were graded as poor (< 50% score), fair (50-75% score), or good (> 75% score). Results from the 69 facilities indicated that the stock management practices were graded as fair for lesser than half of the facilities 28 (40.6%). Few facilities were correctly filling stock cards 20 (29%) and conducting physical inventories 19 (27.5%). The refrigerator storage management practices were fair for nearly half of the facilities 32 (46.4%). Among the facilities that had a refrigerator 53 (76.8%), 39 (70.9%) utilized it for storing both vaccines and nonvaccine commodities. The cold chain management practices at service delivery points were fair for 32 (46.4%) health centers. A larger proportion of the participants 69 (65%) had knowledge of cold chain storage. Most of the participants 47 (67.8%) were knowledgeable about the heat sensitivity of the cold chain commodities, however, almost half (48.1%) of them lacked knowledge on refrigerator use. The management practices for non-vaccine cold chain commodities in health centers were fair. More than a third of the facility store managers lacked knowledge on cold chain management practices for non-vaccine commodities. There is a need to strengthen the capacity of the facilities' store managers and provide equipment specific for non-vaccine cold chain commodities.
Comparative Study of Air Pollution Levels in Rural Area and Kigali City Based on Air Quality Index
The viability of micro-finance programs for the empowerment of rural poor women enterpreneurs: a case of Bujumbura rural province
Knowledge and Practice of Hormonal Contraception among High School Teens
International Journal of TROPICAL DISEASE & Health, 2018
Pan African Medical Journal, 2019
Introduction: regional anesthesia is a safe alternative to general anesthesia. Despite benefits f... more Introduction: regional anesthesia is a safe alternative to general anesthesia. Despite benefits for perioperative morbidity and mortality, this technique is underutilized in low-resource settings. In response to an identified need, a regional anesthesia service was established at the University Teaching Hospital of Kigali (CHUK), Rwanda. This qualitative study investigates the factors influencing implementation of this service in a low-resource tertiary-level teaching hospital. Methods: following service establishment, we recruited 18 local staff at CHUK for in-depth interviews informed by the "Consolidated Framework for Implementation Research" (CFIR). Data were coded using an inductive approach to discover emergent themes. Results: four themes emerged during data analysis. Patient experience and outcomes: where equipment failure is frequent and medications unavailable, regional anesthesia offered clear advantages including avoidance of airway intervention, improved analgesia and recovery and cost-effective care. Professional satisfaction: morale among healthcare providers suffers when outcomes are poor. Participants were motivated to learn techniques that they believe improve patient care. Human and material shortages: clinical services are challenged by high workload and human resource shortages. Advocacy is required to solve procurement issues for regional anesthesia equipment. Local engagement for sustainability: participants emphasized the need for a locally run, sustainable service. This requires broad engagement through education of staff and long-term strategic planning to expand regional anesthesia in Rwanda. Conclusion: while the establishment of regional anesthesia in Rwanda is challenged by human and resource shortages, collaboration with local stakeholders in an academic institution is pivotal to sustainability.
Recent Developments in Antimalarial Drug Discovery
Anti-Infective Agents in Medicinal Chemistry, 2006
International Journal of TROPICAL DISEASE & Health, 2016
To assess the level of early sensitization and education of adolescent high school girls in Rwand... more To assess the level of early sensitization and education of adolescent high school girls in Rwanda about Breast Cancer (BC) and Breast Self-Examination (BSE) as one of strategic approaches to reduce the risk of late intervention and thence the BC related deaths. Methods: 239 girls aged 17-20 years old, randomly selected from Nyarugenge secondary schools during the academic year 2013-2014 participated in this prospective cross-sectional survey using a structured self-administered questionnaire. Results: Overall 94.6% of surveyed girls had heard about BC, but only few had limited knowledge about BC risk factors, diagnostic methods and BSE. Less than 24% practiced breast palpation and not more than 10% knew the correct frequency and technique of BSE performance. No formal
Sexual Activity and Emergency Contraception among Female Students in the University of Rwanda
International Journal of TROPICAL DISEASE & Health, 2015
Background: The death toll and economic disaster caused by SARS-CoV-2/ COVID-19 is still on the r... more Background: The death toll and economic disaster caused by SARS-CoV-2/ COVID-19 is still on the rise globally and in Africa with a case fatality ratio (CFR), 2.58 from 220,958 deaths out of 8,556,890 cases recorded across the continent as of 14th November 2021. Local, national and international health agencies have advocated multi-pronged public health strategies to limit infections and prevent deaths. The availability of a safe and effective vaccine is critical in the control of a pandemic. Several adverse events have been reported globally for different vaccines including COVID-19 with limited or no data from Africa. Methods: This cross-sectional epidemiological study investigated the adverse events following COVID-19 vaccination in Africans between April- June, 2021 using a structured questionnaire distributed via the web for public health surveillance. Results: Out of the 1200 participants recruited, a total of 80.8% (n = 969) respondents from 35 countries including 22 African c...
Journal of Pharmaceutical Policy and Practice
Background Effective vaccine management is essential to maintain the quality of vaccines, minimis... more Background Effective vaccine management is essential to maintain the quality of vaccines, minimise wastages, and prevent missed opportunities for vaccination at service delivery points. Objectives This study aims to assess vaccine management practices among vaccinators at health facilities in the Morogoro region, Tanzania. Methodology A descriptive cross-sectional study design involved health workers from 77 health facilities offering vaccination services. The study population consisted of vaccine handlers and vaccinators working in public health facilities in the Morogoro region. The vaccine management practices were assessed using data collected from ledgers and the Vaccine Information Management System (VIMS). The temperature records were downloaded from the Fridge-tag® 2 and Coldtrace5 devices. Results The findings indicated that 65 (84%) health facilities had functional refrigerators and are using power from 26 (34%), 28 (36%), and 23 (30%) of grid electricity, solar, and Lique...
International Journal of Molecular Medicine, 2022
Endothelial dysfunction during diabetes has been previously reported to be at least in part attri... more Endothelial dysfunction during diabetes has been previously reported to be at least in part attributed to increased oxidized low-density lipoprotein (oxLdL) levels mediated by high glucose (HG) levels. Endothelial inflammation increases the adhesiveness of monocytes to the endothelium in addition to increasing vascular permeability, promoting diabetic atherogenesis. In a previous study, it was reported that oxLdL treatment induced nucleotide-binding domain and leucine-rich repeat containing family, pyrin domain-containing 3 inflammasome activation in endothelial cells (Ecs) under HG conditions, in a manner that could be effectively reversed by rosmarinic acid. However, it remains unclear whether oxLdL-mediated inflammasome activation can regulate the interaction between monocytes and Ecs. The effects of oxLdL-mediated inflammasome activation on endothelial permeability under HG conditions, in addition to the effects of rosmarinic acid on these oxLdL-mediated processes, also remain poorly understood. Therefore, the present study aimed to elucidate the mechanisms involved in oxLdL-induced endothelial permeability and monocyte diapedesis under HG conditions, in addition to the potential effects of rosmarinic acid. Ecs were treated with oxLdL under HG conditions in the presence or absence of ROS scavengers mitoTEMPO and NAc, p38 inhibitor SB203580, FOXO1 inhibitor AS1842856 or transfected with the TXNIP siRNA, before protein expression levels of intercellular adhesion molecule 1 (IcAM-1), vascular cell adhesion molecule-1 (VcAM-1), phosphorylated vascular endothelial-cadherin (VE-cadhedrin), VE-cadherin and zonula occludens-1 (ZO-1) were measured by western blotting. In addition, adhesion assay and Transwell assays were performed. oxLDL was found to significantly increase the expression of IcAM-1 and VcAM-1 in Ecs under HG conditions whilst also enhancing the adhesion of monocytes to Ecs. This was found to be dependent on the reactive oxygen species (ROS)/p38 MAPK/forkhead box O1 (FOXO1)/thioredoxin interacting protein (TXNIP) signaling pathway. In addition, oxLdL-stimulated Ecs under HG conditions exhibited increased phosphorylated VE-cadherin protein levels and decreased ZO-1 protein expression levels compared with those in untreated Ecs, suggesting increased endothelial permeability. Furthermore, monocyte transmigration through the endothelial monolayer was significantly increased by oxLDL treatment under HG conditions. These oxLdL-mediated effects under HG conditions were also demonstrated to be dependent on this ROS/p38 MAPK/FOXO1/TXNIP signaling pathway. Subsequently, rosmarinic acid treatment significantly reversed oxLdL-induced overexpression of adhesion molecules and monocyte-Ec adhesion, oxLdL-induced endothelial junction hyperpermeability and monocyte transmigration through the endothelial monolayer under HG conditions, in a
Antibiotics, 2022
Using poor-quality antibiotics leads to increased risk of the development of microorganism-resist... more Using poor-quality antibiotics leads to increased risk of the development of microorganism-resistant strains, treatment failure, loss of confidence in health systems, and associated socio-economic impacts. The prevalence of poor-quality antibiotics has been found to be high in some of the Low and Middle-Income Countries (LMICs), but no data were available on the situation in Rwanda. This study was conducted to obtain data and inform health professionals on the quality of the 12 most-used selected antibiotics from private retail pharmacies in Rwanda. The investigation was conducted on 232 batches collected from randomly selected private retail pharmacies in all provinces of Rwanda, and concerned only with visual inspection and assay tests. Visual inspection was performed using a tool adopted by the International Pharmaceutical Federation (FIP) to identify manufacturing defects. An assay test quantified the Active Pharmaceutical Ingredient (API) in each collected batch using high-perf...
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Papers by Jean Baptiste Nyandwi