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Your search keyword '"Wieger Voskuijl"' showing total 3 results
Start Over Author "Wieger Voskuijl" Journal bmj open
3 results on '"Wieger Voskuijl"'

1. Prevalence and correlates of paediatric guideline non-adherence for initial empirical care in six low and middle-income settings: a hospital-based cross-sectional study

Author

Tahmeed Ahmed, Riffat Ara Shawon, Moses Ngari, Kirkby D Tickell, Robert Bandsma, Judd Walson, Md Jobayer Chisti, James Berkley, Ezekiel Mupere, Ali Faisal Saleem, Donna Denno, Wieger Voskuijl, Arianna Rubin Means, Michael Atuhairwe, Emmie Mbale, and Abdoulaye Hama Diallo

Subjects
Medicine
Abstract

Objectives This study evaluated the prevalence and correlates of guideline non-adherence for common childhood illnesses in low-resource settings.Design and setting We used secondary cross-sectional data from eight healthcare facilities in six Asian and African countries.Participants A total of 2796 children aged 2–23 months hospitalised between November 2016 and January 2019 with pneumonia, diarrhoea or severe malnutrition (SM) and without HIV infection were included in this study.Primary outcome measures We identified children treated with full, partial or non-adherent initial inpatient care according to site-specific standard-of-care guidelines for pneumonia, diarrhoea and SM within the first 24 hours of admission. Correlates of guideline non-adherence were identified using generalised estimating equations.Results Fully adherent care was delivered to 32% of children admitted with diarrhoea, 34% of children with pneumonia and 28% of children with SM when a strict definition of adherence was applied. Non-adherence to recommendations was most common for oxygen and antibiotics for pneumonia; fluid, zinc and antibiotics for diarrhoea; and vitamin A and zinc for SM. Non-adherence varied by site. Pneumonia guideline non-adherence was more likely among patients with severe disease (OR 1.82; 95% CI 1.38, 2.34) compared with non-severe disease. Diarrhoea guideline non-adherence was more likely among lower asset quintile groups (OR 1.16; 95% CI 1.01, 1.35), older children (OR 1.10; 95% CI 1.06, 1.13) and children presenting with wasting (OR 6.44; 95% CI 4.33, 9.57) compared with those with higher assets, younger age and not wasted.Conclusions Non-adherence to paediatric guidelines was common and associated with older age, disease severity, and comorbidities, and lower household economic status. These findings highlight opportunities to improve guidelines by adding clarity to specific recommendations.

Published
2024
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3. Primary motivations for and experiences with paediatric minimally invasive tissue sampling (MITS) participation in Malawi: a qualitative study

Author

Sarah Lawrence, Dave Namusanya, Sumaya B Mohamed, Andrew Hamuza, Cornelius Huwa, Dennis Chasweka, Maureen Kelley, Sassy Molyneux, Wieger Voskuijl, Donna Denno, Nicola Desmond, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Global Health, APH - Health Behaviors & Chronic Diseases, General Paediatrics, APH - Global Health, and Pediatrics

Subjects
qy_4, wa_30, Malawi, Motivation, public health, ws_20, General Medicine, paediatrics, Cause of Death, tropical medicine, Humans, anthropology, Family, Female, Child, f0e481db, Qualitative Research
Abstract

ObjectiveTo understand family member consent decision-making influences and experiences in Malawi in order to inform future minimally invasive tissue sampling (MITS) studies.DesignQualitative study.SettingQueen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, which serves as the central referral hospital for southern Malawi and where MITS participants were recruited from.ParticipantsFamilies of paediatric MITS participants.MethodsWe conducted in-depth interviews with 16 families 6 weeks after the death of paediatric MITS participants. Data were analysed using a combination of thematic content and theoretical framework approaches to explain the findings.ResultsImproved cause of death (CoD) ascertainment was the principal motivator for participation to protect remaining or future children. Community burial norms, religious doctrine and relationships with healthcare workers (HCWs) were not reported influencers among family members who consented to the procedure. Primary consenters varied, with single mothers more likely to consent independently or with only female family members present. Clear understanding of MITS procedures appeared limited 6 weeks postprocedure, but research was described as voluntary and preconsent information satisfactory for decision-making. Most families intended to share about MITS only with those involved in the consent process, for fear of rumours or judgement by extended family members and the wider community.ConclusionAmong those who consented to MITS, decision-making was informed by individual and household experiences and beliefs, but not by religious affiliation or experiences with HCWs. While understanding of the MITS procedure was limited at the time of interview, families found informed consent information sufficient for decision-making. Future MITS studies should continue to explore information presentation best practices to facilitate informed consent during the immediate grieving period.

Published
2022

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