Mental illness, personhood, and transcendence: Spiritual and religious assistance in Catholic psychiatric contexts

In recent decades, there have been many calls for the inclusion of spirituality and religion (S/R) in therapeutic contexts. In some contexts, this has been an institutionalized form of spiritual and religious assistance (SRA). This article examines the concepts and practices involved in SRA services at three psychiatric institutions in Portugal, a country with strong Catholic roots but increasing efforts at secularity and recognition of religious diversity. The case of a user who contacted the SRA service allows us to better grasp this new practice in action. Although some SRA practices have similarities with mindfulness, a systematic comparison allows us to explore the links between SRA and the global dynamics related to S/R in mental health and the particularities of Catholic spirituality. In the contexts observed, the transition from the Catholic hospital chaplaincy system to the SRA model is developing through the integration of features of the Catholic spiritual tradition with concepts and practices drawn from the psychology of religious experience. The accompaniment of the ‘whole person’ emerges as the central concept of this form of SRA. Spirituality gains significance as an integrative approach to the subjectivity fragmented by the illness and the fragmentation of care across multiple clinical specialties. Furthermore, the prioritization of the spiritual needs expressed by users suggests that SRA combines well with the individualistic rationales and the technification of care in the field of mental health.

Diagnostic Accuracy of CareStart™ Malaria HRP2 and SD Bioline Pf/PAN for Malaria in Febrile Outpatients in Varying Malaria Transmission Settings in Cameroon

Background: There was an increase in the number of malaria cases in Cameroon in 2018 that could reflect changes in provider practice, despite effective interventions. In this study, we assessed the diagnostic performance of two malaria rapid diagnostic tests (mRDTs) for diagnostic confirmation of suspected cases of malaria in public and private health facilities in two malaria transmission settings in Cameroon. Methods: We evaluated the diagnostic performance of CareStart pf and SD Bioline Pf/PAN mRDT and compared these parameters by RDT type and transmission setting. Nested PCR and blood film microscopy were used as references. The chi square test was used for independent sample comparisons, while the McNemar’s test was used to test for the dependence of categorical data in paired sample testing. A p < 0.05 was considered significant in all comparisons. The R (v.4.0.2) software was used for analyses. Results: A total of 1126 participants consented for the study in the four sites. The diagnostic accuracy of the CareStart Pf mRDT was 0.93.6% (0.911–0.961) in Yaoundé, 0.930% (0.90–0.960) in Ngounso, 0.84% (0.794–0.891) in St Vincent Catholic Hospital Dschang and 0.407 (0.345–0.468) in Dschang district hospital. For SD Bioline Pf/PAN the accuracy was 0.759 (0.738–0.846) for St Vincent Catholic Hospital Dschang and 0.426 (0.372–0.496) for the Dschang district hospital. The accuracy was slightly lower in each case but not statistically different when PCR was considered as the reference. The likelihood ratios of the positive and negative tests were high in the high transmission settings of Yaoundé (10.99 (6.24–19.35)) and Ngounso (14.40 (7.89–26.28)) compared to the low transmission settings of Dschang (0.71 (0.37–1.37)) and St Vincent Catholic hospital (7.37 (4.32−12.59)). There was a high degree of agreement between the tests in Yaoundé (Cohen’s Kappa: 0.85 ± 0.05 (0.7–0.95)) and Ngounso (Cohen’s Kappa: 0.86 ± 0.05 (0.74, 0.97)) and moderate agreement in St Vincent hospital Dschang (k: 0.58 ± 0.06 (0.44–0.71)) and poor agreement in the District Hospital Dschang (Cohen’s Kappa: −0.11 ± 0.05 (−0.21–0.01)). The diagnostic indicators of the SD Bioline Pf/PAN were slightly better than for CareStart Pf mRDT in St Vincent Catholic hospital Dschang, irrespective of the reference test. Conclusions: Publicly procured malaria rapid diagnostic tests in Cameroon have maintained high accuracy (91–94%) in the clinical diagnosis of malaria in high malaria transmission regions of Cameroon, although they failed to reach WHO standards. We observed an exception in the low transmission region of Dschang, West region, where the accuracy tended to be lower and variable between facilities located in this town. These results underscore the importance of the routine monitoring of the quality and performance of malaria RDTs in diverse settings in malaria endemic areas.

Prevalence of Streptococcus pneumoniae in Pneumonia Patients that Attend Madonna Catholic Hospital Umuahia, Abia State, Nigeria

Aim: To determine the prevalence of Streptococcus pnenumoniae in pnenumonia patients attending Madonna Catholic Hospital, Umuahia; Abia State. Methods: The study was a cross-sectional study on the prevalence of Streptococcus pnenumoniae among patients in Madonna Catholic Hospital, Umuahia. It lasted for a period of three months (September 2019 to January 2020). Standard microbiological techniques were used to evaluate 60 sputum samples collected from pneumonia patients and the modified Kirby-Buar disk diffusion technique was used to test the sensitive pattern of the isolates to some antibiotics. Results: A total of thirty-three (33) Streptococcus pneumoniae isolates were recovered from sixty (60) sputum samples from pneumonia patients. 17(51%) were gotten from male and 16 (49%) of isolates were gotten from female. The highest frequency of occurrence among the age groups was observed with adults (19-59 years) (34.4%) followed by adolescence (13-18 years) (33.3%), while the least frequency was from those of senior adults (>60) (9.1%). However, the antibiotic susceptibility pattern of the Streptococcus pneumoniae isolates from the sputum samples shows varying degrees of sensitivity and resistance to the antibiotics. From the study, Streptomycin and Cotrimoxazole showed a high percentage of sensitivity against Streptococcus pneumoniae isolates at 78.8% and 72.7% respectively. The highest percentage of resistance was observed with Gentamicin and Tetracycline at 42.4% each. Conclusion: This study highlights that there was no distinct variation in occurrence of Streptococcus pneumoniae in relation to gender and age. As most patients were hospitalized in separated wards, this suggests a role for local dissemination of this bacterium in the respective wards rather than age or gender specific predilection. This study also suggests that streptomycin and Cotrimoxazole could be a drug of choice in the treatment of pneumonia.

No evidence of false-negative Plasmodium falciparum rapid diagnostic results in Monrovia, Liberia

Background Malaria diagnosis in many malaria-endemic countries relies mainly on the use of rapid diagnostic tests (RDTs). The majority of commercial RDTs used in Africa detect the Plasmodium falciparum histidine-rich protein 2 (PfHRP2). pfhrp2/3 gene deletions can therefore lead to false-negative RDT results. This study aimed to evaluate the frequency of PCR-confirmed, false-negative P. falciparum RDT results in Monrovia, Liberia. Methods PfHRP2-based RDT (Paracheck Pf®) and microscopy results from 1038 individuals with fever or history of fever (n = 951) and pregnant women at first antenatal care (ANC) visit (n = 87) enrolled in the Saint Joseph’s Catholic Hospital (Monrovia) from March to July 2019 were used to assess the frequency of false-negative RDT results. True–false negatives were confirmed by detecting the presence of P. falciparum DNA by quantitative PCR in samples from individuals with discrepant RDT and microscopy results. Samples that were positive by 18S rRNA qPCR but negative by PfHRP2-RDT were subjected to multiplex qPCR assay for detection of pfhrp2 and pfhrp3. Results One-hundred and eighty-six (19.6%) and 200 (21.0%) of the 951 febrile participants had a P. falciparum-positive result by RDT and microscopy, respectively. Positivity rate increased with age and the reporting of joint pain, chills and shivers, vomiting and weakness, and decreased with the presence of coughs and nausea. The positivity rate at first ANC visit was 5.7% (n = 5) and 8% (n = 7) by RDT and microscopy, respectively. Out of 207 Plasmodium infections detected by microscopy, 22 (11%) were negative by RDT. qPCR confirmed absence of P. falciparum DNA in the 16 RDT-negative but microscopy-positive samples which were available for molecular testing. Among the 14 samples that were positive by qPCR but negative by RDT and microscopy, 3 only amplified pfldh, and among these 3 all were positive for pfhrp2 and pfhrp3. Conclusion There is no qPCR-confirmed evidence of false-negative RDT results due to pfhrp2/pfhrp3 deletions in this study conducted in Monrovia (Liberia). This indicates that these deletions are not expected to affect the performance of PfHRP2-based RDTs for the diagnosis of malaria in Liberia. Nevertheless, active surveillance for the emergence of PfHRP2 deletions is required.

No Evidence of False-negative P. Falciparum Rapid Diagnostic Results in Monrovia, Liberia

Background: Malaria diagnosis relies mainly on the use of rapid diagnostic tests (RDTs). The majority of commercial RDTs used in Africa detect the Plasmodium falciparum histidine-rich protein 2 (PfHRP2). pfhrp2/3 gene deletions can therefore lead to false-negative RDT results. This study aimed to evaluate the frequency of PCR-confirmed, false-negative P. falciparum RDT results in Monrovia, Liberia.Methods: We used PfHRP2-based RDT (Paracheck Pf®) and microscopy results from 1038 individuals with fever or history of fever (n=951) and pregnant women at first antenatal care (ANC) visit (n=87) enrolled in the Saint Joseph Catholic Hospital (Monrovia) from March to July 2019 to assess the frequency of false-negative RDT results. True false negatives were confirmed by detecting the presence of P. falciparum DNA by quantitative PCR in samples from individuals with discrepant RDT and microscopy resultsResults: One hundred and eighty-six (19.6%) and 200 (21.0%) of the 951 febrile participants had a P. falciparum positive result by RDT and microscopy, respectively. Positivity rate increased with age and the reporting of joint pain, chills and shivers, vomiting and weakness, and increased with the presence of coughs and nausea. The positivity rate at first ANC visit was 5.7% (n=5) and 8% (n=7) by RDT and microscopy, respectively. Out of 207 Plasmodium infections detected by microscopy, 22 (11%) were negative by RDT. qPCR confirmed absence of P. falciparum DNA in the sixteen RDT-negative but microscopy-positive samples which were available for molecular testing. Conclusion: There is no qPCR-confirmed evidence of false-negative RDT results due to pfhrp2/pfhrp3 deletions in this study conducted in Monrovia (Liberia). This indicates the appropriate performance of PfHRP2-based RDTs for the diagnosis of malaria in Liberia. Nevertheless, active surveillance for the emergence of PfHRP2 deletions is required.

Viral Hepatitis B Screening among Asymptomatic Patients of Liver Pathology in a Secondary Health-care Facility in Nigeria

Background: HBV infection is a serious ailment which damages the liver yet not well known and hence not given adequate attention. Many are infected but are not aware because they do not manifest any sign and symptom. Aim: The purpose of this study was therefore to evaluate the prevalence of HBsAg among asymptomatic hospital attendees. Study Design: A cross sectional study. Place and Duration of Study: St Mary’s Catholic Hospital, Ibadan, Nigeria, between November 2017 and August 2018. Methodology: 1328 consecutive patients who attended the hospital were enrolled into this study after obtaining their consent. Their blood samples were aseptically collected and assayed for HBsAg using conventional method. Results: A total of 1,328 participants were enrolled, out of which 421 (31.7%) were male and 907 (68.3%) were female with a gender ratio of 1:2.2 - male to female. 5.9% (25/421) of the males tested positive to HBsAg while 5.4% (49/907) of the females tested positive to HBsAg (p=0.692). Of the overall 1328 individuals screened, 5.6% tested positive to HBsAg. The age group with the highest prevalence of HBsAg were those between 51 and 60 years with 13.1% followed by 41 - 50 years (7.2%) while > 70 years had the lowest prevalence. Conclusion: This study showed that HBsAg infection is high among asymptomatic hospital attendees in Ibadan, Nigeria. More public sensitization and awareness programmes are strongly advocated for.

Relationship of Nurse Caring Behaviour with Patient Satisfaction at the Emergency Department of Catholic Hospital of Budi Rahayu Blitar

One indicator of hospital services is patient satisfaction related to nurses caring behaviour. The caring behaviour of nurses who provide nursing services in the Emergency Department is expected to increase the satisfaction of nursing services. The purpose of this study was to study the relationship between nurses caring behaviour with patient satisfaction receiving nursing services at the Emergency Department of Catholic Hospital of Budi Rahayu Blitar. The research design was cross sectional. Sample sizes were 80 patients who received nursing services at the Emergency Department were selected by purposive sampling. The study variables were nurse caring behaviour and patient satisfaction. Data were collected using a questionnaire. Analysis using the Spearman rank test. The analysis results obtained p = 0.000 and r = 0.618, which means there is a strong positive relationship between nurses caring behaviour with patient satisfaction. Suggestion, nurses maintain and even increase caring behaviour, especially communication skills in the orientation phase.