2,425 results
Search Results
2. The published research paper: is it an important indicator of successful operational research at programme level?
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Zachariah, R., Tayler-Smith, K., Ngamvithayapong-Yanai, J., Ota, M., Murakami, K., Ohkado, A., Yamada, N., Van Den Boogaard, W., Draguez, B., Ishikawa, N., and Harries, A. D.
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- 2010
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3. Field evaluation of the CATT/Trypanosoma brucei gambiense on blood-impregnated filter papers for diagnosis of human African trypanosomiasis in southern Sudan
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Chappuis, F., Pittet, A., Bovier, P. A., Adams, K., Godineau, V., Hwang, S. Y., Magnus, E., and Büscher, P.
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- 2002
4. Neurocysticercosis: validity of ELISA after storage of whole blood and cerebrospinal fluid on paper
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Fleury, A., Bouteille, B., Garcia, E., Marquez, C., Preux, P.M., Escobedo, F., Sotelo, J., and Dumas, M.
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- 2001
5. Seroprevalence of Chagas disease in rural communities at Campinas do Piauí city, Brazil.
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Aquino Santana, Maricélia, Silva Ferreira, Ana Laura, Santos, Luan Victor Brandão, Furtado Campos, José Henrique, Sena, Layara Larice Jesuino, and Mendonça, Vagner José
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CHAGAS' disease ,ENZYME-linked immunosorbent assay ,SEROPREVALENCE ,RURAL population ,ELECTRONIC paper - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2021
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6. Bibliometric analysis of research published inTropical Medicine and International Health1996–2003.
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Glover, Steven W. and Bowen, Sarah L.
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BIBLIOMETRICS ,BIBLIOGRAPHY ,BIBLIOGRAPHICAL citations ,TROPICAL medicine ,MEDICAL climatology ,MEDICINE - Abstract
We examine the bibliometric profile ofTropical Medicine and International Healthusing the subjects of the articles published and the geographical distribution of the authors. The most common subject areas of papers published during 1996–2003 are highlighted, and the most cited papers indicated. [ABSTRACT FROM AUTHOR]
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- 2004
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7. Re.: Paper by Van Hoogstraten et al. (2000)
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- 2001
8. Evidence for causal links between education and maternal and child health: systematic review.
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Mensch, Barbara S., Chuang, Erica K., Melnikas, Andrea J., and Psaki, Stephanie R.
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META-analysis ,CHILDREN'S health ,MATERNAL health ,CHILD mortality ,INFANT mortality - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2019
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- View/download PDF
9. Reasons for mosquito net non‐use in malaria‐endemic countries: A review of qualitative research published between 2011 and 2021.
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Ladu, Hadiza Isa, Shuaibu, Umar, and Pulford, Justin
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MOSQUITO nets , *INSECTICIDE-treated mosquito nets , *QUALITATIVE research , *MALARIA prevention , *CINAHL database - Abstract
Mosquito nets, particularly insecticide‐treated nets, are the most recommended method of malaria control in endemic countries. However, individuals do not always have access to insecticide‐treated nets or use them as recommended. The current paper expands on a previous review published in 2011 which highlighted a need for more qualitative research on the reasons for mosquito net non‐use. We present a systematic review of qualitative research published in the past decade to assess the growth and quality of qualitative papers about net non‐use and examine and update the current understanding. A comprehensive literature search was carried out in MEDLINE, CINAHL, and Global Health, in addition to a citation search of the initial review. Relevant papers were screened and discussed. The critical appraisal assessment tool was used to ensure quality. Thematic synthesis was used to extract, synthesise, and analyse study findings. Compared with the initial review, the results showed a 10‐fold increase in qualitative research on the reasons for mosquito net non‐use between 2011 and 2021. In addition, the quality of the research has improved, with more than 90% of the papers receiving high scores, using the critical appraisal assessment tool. The reported reasons for non‐use were categorised into four themes: human factors, net factors, housing structure, and net access. More than two thirds of the studies (25/39) were led by authors affiliated with institutions in malaria‐endemic countries. Despite the distribution of free mosquito nets in malaria‐endemic countries, earlier reported challenges remain pertinent. The most common reasons for net non‐use across all regions of Malaria endemic countries pertained to human‐ and net‐related factors. The research focus should shift towards intervention studies to address these issues. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Gaps in hypertension care and control: a population‐based study in low‐income urban Medellin, Colombia
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Esteban Londoño Agudelo, Tullia Battaglioli, Patrick Van der Stuyft, Viviana Pérez Ospina, Cecilia Taborda Pérez, and Rubén Darío Gómez-Arias
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Male ,Pediatrics ,Urban Population ,Primary health care ,Blood Pressure ,Logistic regression ,hypertension control ,chronic diseases ,0302 clinical medicine ,DISPARITIES ,Risk Factors ,Hypertension prevalence ,Surveys and Questionnaires ,Medicine and Health Sciences ,Prevalence ,Medicine ,BLOOD-PRESSURE CONTROL ,LATIN-AMERICA ,Middle Aged ,PREVALENCE ,Infectious Diseases ,Hypertension ,NONCOMMUNICABLE DISEASES ,Original Article ,Female ,Public Health ,health care gaps ,hypertension awareness ,Low income ,Adult ,AWARENESS ,medicine.medical_specialty ,030231 tropical medicine ,Colombia ,Interviews as Topic ,03 medical and health sciences ,Diabetes mellitus ,Humans ,Healthcare Disparities ,Antihypertensive Agents ,BARRIERS ,Hypertension control ,cascade of hypertension care ,business.industry ,Environmental and Occupational Health ,Public Health, Environmental and Occupational Health ,Patient Acceptance of Health Care ,medicine.disease ,PREVENTION ,Population based study ,primary health care ,Blood pressure ,Latin America ,Socioeconomic Factors ,Parasitology ,business ,Original Research Papers - Abstract
Objectives To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. Methods We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as those without previous diagnosis whose average blood pressure was equal to or above 140/90 mmHg. For aware hypertensive patients, control was delimited as average blood pressure below 140/90 if under 59 years old or diabetic, and as less than 150/90 otherwise. We used logistic regression to identify care gap‐associated factors. Results Hypertension prevalence was 43.5% (95% CI 41.2–45.7). We found 28.2% aware and 15.3% unaware hypertensive individuals, which corresponds to a 35.1% (95% CI 31.9–38.5) underdiagnosis. This gap was determined by age, sex, education and lifestyle factors. 14.4% (95% CI 11.6–17.6) of aware hypertensive patients presented a follow‐up gap, 93.4% (95% CI 90.9–95.2) were prescribed antihypertensive drugs, but 38.9% (95% CI 34.7–43.3) were not compliant. The latter was strongly associated with follow‐up. The hypertension control gap in aware hypertensive patients, 39.0% (95% CI: 34.9–43.2), was associated with being older, having diabetes, weakly adhering to pharmacological treatment and receiving poor non‐pharmacological advice. Overall, 60.4% (95% CI 57.0–63.8) of aware and unaware hypertensive participants had either diagnosed but uncontrolled or undiagnosed hypertension. Conclusions We found high hypertension prevalence coupled with, from an international perspective, encouraging awareness and control figures. Still, there remains ample room for improvement. Our findings can assist in designing integrated primary healthcare measures that further strengthen equitable and effective access to hypertension care and control.
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- 2021
11. Determinants and patterns of antibiotic consumption for children under five in Nepal: analysis and modelling of Demographic Health Survey data from 2006 to 2016
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Gerald Jamberi Makuka, H. Rogier van Doorn, Sonia Lewycka, Charlotte Zheng, Abilasha Karkey, and Tianyi Wang
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Male ,Rural Population ,Sanitation ,Prevalence ,Psychological intervention ,Pediatrics ,antibiotics ,0302 clinical medicine ,Health care ,DHS (Demographic health survey) ,Respiratory Tract Infections ,Family Characteristics ,Under-five ,Child Health ,Respiratory infection ,Anti-Bacterial Agents ,Infectious Diseases ,Child, Preschool ,Original Article ,Private Sector ,Guideline Adherence ,Diarrhea ,Fever ,030231 tropical medicine ,Measles ,03 medical and health sciences ,Nepal ,Environmental health ,Drug Resistance, Bacterial ,medicine ,Humans ,ARI (acute respiratory infection) ,business.industry ,Public Health, Environmental and Occupational Health ,Infant ,Patient Acceptance of Health Care ,medicine.disease ,Health Surveys ,diarrhoea ,Cross-Sectional Studies ,Social Class ,Parasitology ,Health Facilities ,Rural area ,under‐five ,business ,Original Research Papers ,Delivery of Health Care - Abstract
Objectives: Our aims were to examine AMR‐specific and AMR‐sensitive factors associated with antibiotic consumption in Nepal between 2006 and 2016, to explore health care‐seeking patterns and the source of antibiotics. Methods: Cross‐sectional data from children under five in households in Nepal were extracted from the 2006, 2011 and 2016 Demographic Health Surveys (DHS). Bivariable and multivariable analyses were carried out to assess the association of disease prevalence and antibiotic use with age, sex, ecological location, urban/rural location, wealth index, household size, maternal smoking, use of clean fuel, sanitation, nutritional status, access to health care and vaccinations. Results: Prevalence of fever, acute respiratory infection (ARI) and diarrhoea decreased between 2006 and 2016, whilst the proportion of children under five receiving antibiotics increased. Measles vaccination, basic vaccinations, nutritional status, sanitation and access to health care were associated with antibiotic use. Those in the highest wealth index use less antibiotics and antibiotic consumption in rural areas surpassed urban regions over time. Health seeking from the private sector has overtaken government facilities since 2006 with antibiotics mainly originating from pharmacies and private hospitals. Adherence to WHO‐recommended antibiotics has fallen over time. Conclusions: With rising wealth, there has been a decline in disease prevalence but an increase in antibiotic use and more access to unregulated sources. Understanding factors associated with antibiotic use will help to inform interventions to reduce inappropriate antibiotic use whilst ensuring access to those who need them.
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- 2021
12. Using ex‐ante economic evaluation to inform research priorities in pesticide self‐poisoning prevention: the case of a shop‐based gatekeeper training programme in rural Sri Lanka
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Kristian S. Hansen, Sabine Margarete Damerow, Michael Eddleston, Manjula Weerasinghe, Lizell B Madsen, Melissa Pearson, and Flemming Konradsen
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établissement des priorités de recherche ,Rural Population ,prévention du suicide ,IMPACT ,analyse du seuil de rentabilité ,Cost-Benefit Analysis ,pesticide self‐poisoning ,Suicide, Attempted ,Gross domestic product ,0302 clinical medicine ,Per capita ,évaluation économique ex ante ,Training programme ,health care economics and organizations ,research priority setting ,Gatekeeping ,cost‐effectiveness threshold analysis ,Commerce ,CHOICE ,Test (assessment) ,Infectious Diseases ,auto‐intoxication aux pesticides ,Original Article ,suicide prevention ,STORAGE ,medicine.medical_specialty ,SUICIDE ,DEATHS ,030231 tropical medicine ,cost-effectiveness threshold analysis ,HARM ,Education ,03 medical and health sciences ,Environmental health ,medicine ,Humans ,Pesticides ,Sri Lanka ,Discounting ,Ex-ante ,Public health ,Public Health, Environmental and Occupational Health ,GLOBAL BURDEN ,Economic evaluation ,ex‐ante economic evaluation ,pesticide self-poisoning ,Parasitology ,Business ,Original Research Papers ,ex-ante economic evaluation - Abstract
Suicide by pesticide self-poisoning is a major public health challenge in low- and middle-income countries. While effectiveness studies are required to test alternative prevention approaches, economic evidence is lacking to inform decision-making in research priority setting. Therefore, this study aimed to estimate the costs of a shop-based gatekeeper training programme for pesticide vendors seeking to prevent pesticide self-poisoning in rural Sri Lanka and assess its potential for cost-effectiveness.Ex-ante cost and cost-effectiveness threshold (CET) analyses were performed from a governmental perspective based on a three-year analytic horizon, using 'no programme' as a comparator. A programme model targeting all 535 pesticide shops in the North Central Province and border areas was applied. Total programme costs (TPC) were estimated in 2019 USD using an ingredients approach and 3% annual discounting. The Sri Lankan gross domestic product per capita and life years saved were used as CET and effectiveness measure, respectively. Sensitivity analyses were performed.TPC were estimated at 31 603.03 USD. TPC were sensitive to cost changes of training material and equipment and the programme lifetime. The programme needs to prevent an estimated 0.23 fatal pesticide self-poisoning cases over three years to be considered cost-effective. In the sensitivity analyses, the highest number of fatal cases needed to be prevented to obtain cost-effectiveness was 4.55 over three years.From an economic perspective, the programme has a very high potential to be cost-effective. Research assessing its effectiveness should therefore be completed, and research analysing its transferability to other settings prioritised.Le suicide par auto-intoxication par les pesticides est un défi majeur de santé publique dans les pays à revenu faible ou intermédiaire. Bien que des études d'efficacité soient nécessaires pour tester d'autres approches de prévention, les données économiques manquent pour informer la prise de décision dans les priorités de recherche. Par conséquent, cette étude visait à estimer les coûts d'un programme de formation des vendeurs dans les magasins de pesticides visant à prévenir l'auto-intoxication par les pesticides dans les régions rurales du Sri Lanka et à évaluer son potentiel de rentabilité. MÉTHODES: Les analyses ex-ante des coûts et des seuils de rentabilité (SR) ont été réalisées dans une perspective gouvernementale sur la base d'un horizon analytique de trois ans, en utilisant «l’absence de programme» comme comparateur. Un modèle de programme ciblant les 535 magasins de pesticides de la province du Centre-Nord et des zones frontalières a été appliqué. Les coûts totaux du programme (CTP) ont été estimés en USD 2019 en utilisant une approche d’ingrédients et une remise annuelle de 3%. Le produit intérieur brut sri-lankais par habitant et les années de vie sauvées ont été utilisés comme SR et mesure d'efficacité, respectivement. Des analyses de sensibilité ont été effectuées. RÉSULTATS: le CTP a été estimé à 31.603,03 USD. Le CTP était sensible aux changements de coût du matériel et de l'équipement de formation et de la durée de vie du programme. Le programme devrait prévenir environ 0,23 cas d'auto-intoxication mortelle par des pesticide sur trois ans pour être considéré comme rentable. Dans les analyses de sensibilité, le plus grand nombre de cas mortels à prévenir pour obtenir une rentabilité était de 4,55 sur trois ans.D'un point de vue économique, le programme a un potentiel très élevé pour être rentable. La recherche évaluant son efficacité doit donc être complétée et la recherche analysant sa transférabilité à d'autres contextes doit être priorisée.
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- 2020
13. Spatial distribution and characteristics of HIV clusters in Ethiopia*
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Bruce R. Schackman, Stéphane Verguet, Lelisa Fekadu, and Roger Ying
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Sexual partner ,Adult ,Male ,Adolescent ,Scan statistic ,030231 tropical medicine ,Human immunodeficiency virus (HIV) ,HIV Infections ,Total population ,Spatial distribution ,medicine.disease_cause ,Afrique subsaharienne ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Risk Factors ,Surveys and Questionnaires ,medicine ,Prevalence ,Cluster Analysis ,Humans ,Hiv transmission ,Demography ,points chauds ,spatial distribution ,business.industry ,1. No poverty ,Public Health, Environmental and Occupational Health ,HIV ,VIH ,distribution spatiale ,Targeted interventions ,Middle Aged ,Antiretroviral therapy ,3. Good health ,hot spots ,Infectious Diseases ,Geographic Information Systems ,Parasitology ,Original Article ,Female ,Ethiopia ,business ,Original Research Papers ,sub‐Saharan Africa ,Ethiopie ,facteurs de risque - Abstract
Ethiopia's HIV prevalence has decreased by 75% in the past 20 years with the implementation of antiretroviral therapy, but HIV transmission continues in high-risk clusters. Identifying the spatial and temporal trends, and epidemiologic correlates, of these clusters can lead to targeted interventions.We used biomarker and survey data from the 2005, 2011 and 2016 Ethiopia Demographic and Health Surveys (DHS). The spatial-temporal distribution of HIV was estimated using the Kulldorff spatial scan statistic, a likelihood-based method for determining clustering. Significant clusters (P 0.05) were identified and compared based on HIV risk factors to non-cluster areas.In 2005, 2011 and 2016, respectively, 219, 568 and 408 individuals tested positive for HIV. Four HIV clusters were identified, representing 17% of the total population and 43% of all HIV cases. The clusters were centred around Addis Ababa (1), Afar (2), Dire Dawa (3) and Gambella (4). Cluster 1 had higher rates of unsafe injections (4.9% vs. 2.2%, P 0.001) and transactional sex (6.0% vs. 1.6%, P 0.001) than non-cluster regions, but more male circumcision (98.5% vs. 91.3%, P 0.001). Cluster 2 had higher levels of transactional sex (4.9% vs. 1.6%, P 0.01), but lower levels of unsafe injections (0.8% vs. 2.2%, P 0.01). Cluster 3 had fewer individuals with 1 sexual partner (0% vs. 1.7%, P 0.001) and more male circumcision (100% vs. 91.3%, P 0.001). Cluster 4 had less male circumcision (59.1% vs. 91.3%, P 0.01).In Ethiopia, geographic HIV clusters are driven by different risk factors. Decreasing the HIV burden requires targeted interventions.La prévalence du VIH en Ethiopie a diminué de 75% au cours des 20 dernières années avec l’implémentation du traitement antirétroviral, mais la transmission du VIH se poursuit dans les grappes à haut risque. L'identification des tendances spatiales et temporelles et des corrélations épidémiologiques de ces grappes peut mener à des interventions ciblées. MÉTHODES: Nous avons utilisé des biomarqueurs et des données d'enquête provenant des Surveillances Démographiques et de Santé (SDS) en Ethiopie de 2005, 2011 et 2016. La distribution spatiotemporelle du VIH a été estimée à l'aide de la statistique de balayage spatial de Kulldorff, une méthode basée sur la probabilité de déterminer des regroupements. Des grappes significatives (P 0.05) ont été identifiées et comparées sur base des facteurs de risque du VIH dans les zones sans regroupements. RÉSULTATS: En 2005, 2011 et 2016, respectivement, 219, 568 et 408 personnes ont été testées positives pour le VIH. Quatre grappes de VIH ont été identifiées, représentant 17% de la population totale et 43% de tous les cas de VIH. Les grappes étaient centrées sur Addis-Abeba (1), Afar (2), Dire Dawa (3) et Gambella(4). La grappe 1 avait des taux plus élevés d'injections à risque (4,9% contre 2,2%, P 0.001) et de rapports sexuels transactionnels (6,0% contre 1,6%, P 0.001) que les régions sans regroupement, mais plus de circoncisions masculines (98,5% contre 91,3%, p0,001). La grappe 2 avait des taux plus élevés de rapports sexuels transactionnels (4,9% contre 1,6%, P 0.01), mais des taux inférieurs d'injections à risque (0,8% contre 2,2%, P 0.01). La grappe 3 avait moins d'individus avec1 partenaire sexuel (0% contre 1,7%, P 0.001) et plus de circoncisions masculines (100% contre 91,3%, P 0.001). La grappe 4 avait moins de circoncisions masculines (59,1% contre 91,3%, P 0.01).En Ethiopie, les grappes géographiques du VIH sont guidées par différents facteurs de risque. La réduction de la charge du VIH nécessite des interventions ciblées.
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- 2020
14. Socioeconomic inequalities in the utilisation of hypertension and type 2 diabetes management services in Indonesia
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Joko Mulyanto, Anton E. Kunst, Dionne S. Kringos, Graduate School, APH - Aging & Later Life, APH - Global Health, APH - Health Behaviors & Chronic Diseases, APH - Quality of Care, and Public and occupational health
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Male ,endocrine system diseases ,0302 clinical medicine ,Residence Characteristics ,soins de santé ,Mass Screening ,Medicine ,Disease management (health) ,Location ,statut socioéconomique ,media_common ,education.field_of_study ,Relative index of inequality ,healthcare ,Middle Aged ,Family life ,Indonésie ,Infectious Diseases ,Female ,Original Article ,type 2 diabetes ,Adult ,endocrine system ,hypertension ,diabète de type 2 ,Adolescent ,Inequality ,media_common.quotation_subject ,030231 tropical medicine ,Population ,socioeconomic status ,Young Adult ,03 medical and health sciences ,inequalities ,Environmental health ,Humans ,Hypoglycemic Agents ,Healthcare Disparities ,education ,Socioeconomic status ,Antihypertensive Agents ,Aged ,Consumption (economics) ,business.industry ,Public Health, Environmental and Occupational Health ,nutritional and metabolic diseases ,Health Status Disparities ,Patient Acceptance of Health Care ,Cross-Sectional Studies ,Diabetes Mellitus, Type 2 ,Socioeconomic Factors ,Indonesia ,Parasitology ,business ,Original Research Papers ,Inégalités ,human activities - Abstract
To describe socioeconomic inequalities in the utilisation of hypertension and type 2 diabetes (T2D) management services in the Indonesian population and to determine whether education level and geographical location contribute to inequalities.Cross-sectional study using data from the 2014 Indonesia Family Life Survey (N = 30 762 for hypertension; N = 6758 for T2D). Socioeconomic status was measured by household consumption. The prevalence of hypertension and T2D was determined using internationally standardised clinical measurement, while disease management was defined by participation in screening and current use of medication. The relative index of inequality (RII) was used to estimate inequalities, adjusted to education level and geographical location.For all household consumption quintiles, we observed low rates of screening participation for T2D and low medication use in both hypertension and T2D. We found socioeconomic inequalities in screening participation for hypertension (RII 2.68, 95% CI 2.42-2.96) and T2D (RII 7.30, 95% CI 5.48-9.72) and also for medication use in hypertension (RII 3.09, 95% CI 2.28-4.18) and T2D (RII 2.81, 95% CI 1.09-7.27). Education level contributed to socioeconomic inequalities in screening utilisation for both hypertension and T2D. Geographical location contributed to inequalities in screening utilisation and medication use for T2D. Socioeconomic inequalities in medication use for hypertension and T2D were larger among men than women.Large socioeconomic inequalities were found in the utilisation of hypertension and T2D management services in Indonesia. Improving affordability, availability and approachability of services is crucial to reduce such inequalities.INÉGALITÉS SOCIOÉCONOMIQUES DANS L'UTILISATION DES SERVICES DE PRISE EN CHARGE DE L'HYPERTENSION ET DU DIABÈTE DE TYPE 2 EN INDONÉSIE: OBJECTIFS: Décrire les inégalités socioéconomiques dans l'utilisation des services de prise en charge de l'hypertension et du diabète de type 2 (DT2) au sein de la population indonésienne et déterminer si le niveau d’éducation et la localisation géographique contribuent aux inégalités. MÉTHODES: Etude transversale utilisant les données de l'enquête 2014 sur la vie de famille en Indonésie (N = 30.762 pour l'hypertension; N = 6.758 pour le DT2). Le statut socioéconomique a été mesuré par la consommation des ménages. La prévalence de l'hypertension et du DT2 a été déterminée à l'aide de mesures cliniques standardisées à l’échelle internationale, tandis que la prise en charge de la maladie était définie par la participation au dépistage et à l'utilisation courante de médicaments. L'indice relatif d'inégalité (RII) a été utilisé pour estimer les inégalités, ajustées à l’échelle de l’éducation et à la localisation géographique. RÉSULTATS: Pour tous les quintiles de consommation des ménages, nous avons observé de faibles taux de participation au dépistage du DT2 et une faible utilisation de médicaments dans l'hypertension et le DT2. Nous avons constaté des inégalités socioéconomiques dans la participation au dépistage de l'hypertension (RII= 2,68; IC95%: 2,42 à 2,96) et du DT2 (RII= 7,30; IC95%: 5,48 à 9,72), ainsi que de l'utilisation de médicaments pour l'hypertension (IIR= 3,09; IC95%: 2,28 à 4.18) et pour le DT2 (RII= 2,81; IC95%: 1,09-7,27). Le niveau d’éducation a contribué aux inégalités socioéconomiques dans l'utilisation du dépistage pour l'hypertension et le DT2. La localisation géographique a contribué aux inégalités dans l'utilisation du dépistage et de l'utilisation de médicaments pour le DT2. Les inégalités socioéconomiques dans l'utilisation des médicaments contre l'hypertension et le DT2 étaient plus importantes chez les hommes que chez les femmes. CONCLUSIONS: De grandes inégalités socioéconomiques ont été constatées dans l'utilisation des services de prise en charge de l'hypertension et du DT2 en Indonésie. Améliorer l'aspect abordable, la disponibilité et l'accessibilité des services est crucial pour réduire ces inégalités.
- Published
- 2019
15. Effect of a maternal and newborn health system quality improvement project on the use of facilities for childbirth: a cluster‐randomised study in rural Tanzania
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Larson, Elysia, Gage, Anna D., Mbaruku, Godfrey M., Mbatia, Redempta, Haneuse, Sebastien, and Kruk, Margaret E.
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Adult ,Rural Population ,Tanzanie ,essai contrôlé randomisé en grappes ,évaluation ,cluster‐randomised controlled trial ,maternal and newborn health ,Tanzania ,Pregnancy ,Infant Mortality ,Humans ,Maternal Health Services ,Home Childbirth ,Quality of Health Care ,evaluation ,qualité ,Infant, Newborn ,Parturition ,Infant ,Prenatal Care ,Patient Acceptance of Health Care ,utilisation ,Delivery, Obstetric ,Quality Improvement ,santé maternelle et néonatale ,Maternal Mortality ,quality ,Original Article ,Female ,Health Facilities ,Original Research Papers ,Delivery of Health Care ,Program Evaluation - Abstract
Reduction in maternal and newborn mortality requires that women deliver in high quality health facilities. However, many facilities provide sub-optimal quality of care, which may be a reason for less than universal facility utilisation. We assessed the impact of a quality improvement project on facility utilisation for childbirth.In this cluster-randomised experiment in four rural districts in Tanzania, 12 primary care clinics and their catchment areas received a quality improvement intervention consisting of in-service training, mentoring and supportive supervision, infrastructure support, and peer outreach, while 12 facilities and their catchment areas functioned as controls. We conducted a census of all deliveries within the catchment area and used difference-in-differences analysis to determine the intervention's effect on facility utilisation for childbirth. We conducted a secondary analysis of utilisation among women whose prior delivery was at home. We further investigated mechanisms for increased facility utilisation.The intervention led to an increase in facility births of 6.7 percentage points from a baseline of 72% (95% Confidence Interval: 0.6, 12.8). The intervention increased facility delivery among women with past home deliveries by 18.3 percentage points (95% CI: 10.1, 26.6). Antenatal quality increased in intervention facilities with providers performing an additional 0.5 actions across the full population and 0.8 actions for the home delivery subgroup.We attribute the increased use of facilities to better antenatal quality. This increased utilisation would lead to lower maternal mortality only in the presence of improvement in care quality.La réduction de la mortalité maternelle et néonatale exige que les femmes accouchent dans des établissements de santé de haute qualité. Cependant, de nombreux établissements offrent une qualité de soins sous-optimale, ce qui peut expliquer l'utilisation moins généralisée des établissements. Nous avons évalué l'impact d'un projet d'amélioration de la qualité sur l'utilisation des établissements pour l'accouchement. MÉTHODES: Dans cet essai randomisé en grappes mené dans quatre districts ruraux de Tanzanie, 12 cliniques de soins primaires et leurs zones de recrutement ont bénéficié d'une intervention d'amélioration de la qualité consistant en une formation au cours du service, une supervision par un encadrement et un accompagnement, un appui en infrastructure et des relations avec les pairs tandis que 12 établissements et leur zone de recrutement ont servi de contrôles. Nous avons procédé à un recensement de tous les accouchements dans la zone de recrutement et utilisé une analyse de la différence des différences pour déterminer l'effet de l'intervention sur l'utilisation des établissements pour l'accouchement. Nous avons effectué une analyse secondaire de l'utilisation chez les femmes dont l'accouchement précédent avait eu lieu à domicile. Nous avons également investigué les mécanismes permettant d'accroître l'utilisation des établissements. RÉSULTATS: L'intervention a entraîné une augmentation du nombre de naissances dans les établissements de 6,7 points de pourcentage par rapport à une de référence base de 72% (intervalle de confiance à 95%: 0.6-12.8). L'intervention a augmenté de 18.3 points de pourcentage l'accouchement dans un établissement pour les femmes ayant accouché à domicile précédemment (IC 95%: 10.1-26.6). La qualité prénatale a augmenté dans les établissements d'intervention, les prestataires effectuant 0.5 action supplémentaire sur l'ensemble de la population et 0.8 action pour le sous-groupe des accouchements à domicile.Nous attribuons l'utilisation accrue des établissements à une meilleure qualité prénatale. Cette utilisation accrue ne ferait baisser la mortalité maternelle que si la qualité des soins s'améliorait.
- Published
- 2019
16. Insecticide susceptibility of Phlebotomus argentipes sandflies, vectors of visceral leishmaniasis in India.
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Dinesh, Diwakar S., Hassan, Faizan, Kumar, Vijay, Kesari, Shreekant, Topno, Roshan K., and Yadav, Rajpal S.
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VISCERAL leishmaniasis ,PHLEBOTOMUS ,SAND flies ,INSECTICIDES ,PYRETHROIDS - Abstract
Objectives: Indoor residual spraying (IRS) with insecticides is the main vector control intervention for the elimination of visceral leishmaniasis in India. After a change in IRS policy in 2015 due to widespread resistance of Phlebotomus argentipes to DDT, IRS with DDT was replaced with alpha‐cypermethrin IRS in 2016. The objective of the present study was to evaluate the susceptibility of P. argentipes to DDT and its alternatives, namely malathion and pirimiphos‐methyl (organophosphates); alpha‐cypermethrin, deltamethrin, lambda‐cyhalothrin and permethrin (pyrethroids), and bendiocarb and propoxur (carbamates), in support of visceral leishmaniasis elimination in India. Methods: Phlebotomus argentipes sandflies were collected from the visceral‐leishmaniasis endemic states of Bihar, Jharkhand and West Bengal. In the WHO tube tests, the phenotypic susceptibility of F1, 2‐day old, non‐blood fed females were determined against filter papers impregnated with DDT 4%, malathion 5%, pirimiphos‐methyl 0.25%, alpha‐cypermethrin 0.05%, deltamethrin 0.05%, lambda‐cyhalothrin 0.05%, permethrin 0.75%, bendiocarb 0.1% and propoxur 0.1%, which were sourced from Universiti Sains Malaysia. The knockdown of sandflies after 1‐h exposure and mortality at 24 h after the 1‐h exposure period were scored. Results: Mean mortality of P. argentipes 24 h after exposure in tube tests was 22.6% for DDT and ≥ 98% for other insecticide‐impregnated papers tested. Conclusion: Phlebotomus argentipes continues to be highly resistant to DDT with no reversal of resistance after DDT's withdrawal from IRS. P. argentipes was fully susceptible to pyrethroid, organophosphate and carbamate insecticides tested. Regular monitoring is warranted for insecticide resistance management in sandfly vectors. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Distance to care, care seeking and child mortality in rural Burkina Faso: findings from a population‐based cross‐sectional survey
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Sarrassat, S., Meda, N., Badolo, H., Ouedraogo, M., Somé, H., and Cousens, S.
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Adult ,Rural Population ,neonatal mortality ,mortalité néonatale ,Health Services Accessibility ,under‐five child mortality ,Pregnancy ,Burkina Faso ,Infant Mortality ,Humans ,Maternal Health Services ,Child ,mortalité des moins de 5 ans ,Maternal Welfare ,Travel ,Infant, Newborn ,Infant ,Prenatal Care ,distance to care ,care seeking ,recherche de soins ,Cross-Sectional Studies ,Transportation of Patients ,Socioeconomic Factors ,Child, Preschool ,Child Mortality ,Original Article ,Female ,distance aux soins ,Original Research Papers - Abstract
Objective Although distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self‐reported care seeking behaviours, neonatal and post‐neonatal under‐five child mortality in rural areas of Burkina Faso. Methods We performed a cross‐sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed‐effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey. Results Thirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post‐neonatal under‐five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association. Conclusion While better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services.
- Published
- 2018
18. Magnitude and pattern of improvement in processes of care for hospitalised children with diarrhoea and dehydration in Kenyan hospitals participating in a clinical network
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Samuel Akech, Grace Irimu, P. Ayieko, Kasia Stepniewska, and Mike English
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Diarrhea ,Male ,medicine.medical_specialty ,Kenya ,déshydratation ,Quality Assurance, Health Care ,030231 tropical medicine ,Psychological intervention ,diarrhée ,enfants ,Child Welfare ,Patient care ,03 medical and health sciences ,0302 clinical medicine ,children ,Medicine ,Humans ,Quality of care ,Quality of Health Care ,Dehydration ,business.industry ,qualité ,hôpitaux ,Public Health, Environmental and Occupational Health ,Infant, Newborn ,Disease Management ,Infant ,Process of care ,Methods observational ,3. Good health ,diarrhoea ,Infectious Diseases ,quality ,Who guidelines ,Child, Preschool ,Emergency medicine ,Parasitology ,Original Article ,Female ,business ,hospitals ,Original Research Papers ,Child, Hospitalized - Abstract
Objective WHO recommends optimisation of available interventions to reduce deaths of under‐five children with diarrhoea and dehydration (DD). Clinical networks may help improve practice across many hospitals but experience with such networks is scarce. We describe magnitude and patterns of changes in processes of care for children with DD over the first 3 years of a clinical network. Methods Observational study involving children aged 2–59 months with DD admitted to 13 hospitals participating in the clinical network. Processes of individual patient care including agreement of assessment, diagnosis and treatment according to WHO guidelines were combined using the composite Paediatric Admission Quality of Care (PAQC) score (range 0–6). Results Data from 7657 children were analysed and improvements in PAQC scores were observed. Predicted mean PAQC score for all the hospitals at enrolment was 59.8% (95% CI: 54.7, 64.9) but showed a wide variation (variance 10.7%, 95% CI: 5.8, 19.6). Overall mean PAQC score increased by 13.8% (95% CI: 8.7–18.9, SD between hospitals: ±8.2) in the first 12 months, with an average 0.9% (95% CI: 0.3–1.5, SD ± 1.0) increase per month and plateaued thereafter, and changes were similar in two groups of hospitals joining the network at different times. Conclusion Adherence to guidelines for children admitted with DD can be improved through participation in a clinical network but improvement is limited, not uniform for all aspects of care and contexts and occurs early. Future research should address these issues.
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- 2018
19. Association of intestinal pathogens with faecal markers of environmental enteric dysfunction among slum‐dwelling children in the first 2 years of life in Bangladesh
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Fahim, Shah Mohammad, Das, Subhasish, Gazi, Md. Amran, Mahfuz, Mustafa, and Ahmed, Tahmeed
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Male ,intestinal pathogens ,Bangladesh ,trichocéphalose ,Infant ,Environmental enteric dysfunction ,pathogènes intestinaux ,Gastrointestinal Microbiome ,giardiasis ,trichuriasis ,Feces ,Intestinal Diseases ,dysfonction environnementale entérique ,Child, Preschool ,Poverty Areas ,Humans ,Original Article ,Female ,giardiase ,Original Research Papers ,Biomarkers ,Environmental Monitoring - Abstract
Objective Environmental Enteric Dysfunction (EED) can be assessed by faecal biomarkers such as Myeloperoxidase (MPO), Neopterin (NEO) and Alpha‐1 anti‐trypsin (AAT). We aimed to test the association of intestinal pathogens with faecal markers of EED among slum‐dwelling children in first 2 years of life. Methods The MAL‐ED birth cohort data of Bangladesh site were used to conduct this analysis. Multivariable analyses using Generalized Estimating Equations (GEE) were performed to test the association between intestinal pathogens and faecal markers of EED. Results Giardiasis, ascariasis and trichuriasis were the most frequent parasitic infections and Campylobacter spp., Enteroaggregative Escherichia coli (EAEC) and Enterotoxigenic Escherichia coli (ETEC) were the common bacterial pathogens observed in stool samples of the children. Overall, 71%, 97% and 58% of stool samples were above values considered normal in non‐tropical settings for MPO, NEO and AAT respectively. Giardiasis was found to be significantly associated with MPO (Coefficient = 0.55; 95% CI = 0.15, 0.95; P‐value = 0.008) and AAT concentrations (Coefficient = 0.34; 95% CI = 0.04, 0.63; P‐value = 0.03). A significant association was found between trichuriasis and NEO (Coefficient = 0.90; 95% CI = 0.19, 1.61; P‐value = 0.01). Trichuriasis (Coefficient = 1.71; 95% CI = 0.32, 3.11; P‐value = 0.02) and giardiasis (Coefficient = 1.51; 95% CI = 0.79, 2.23; P‐value
- Published
- 2018
20. Botanical monoterpenes synergise the toxicity of azamethiphos in the vector of Chagas disease, Triatoma infestans (Hemiptera: Reduviidae).
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Reynoso, Mercedes María Noel, Seccacini, Emilia Ana, Zerba, Eduardo Nicolás, and Alzogaray, Raúl Adolfo
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CHAGAS' disease ,DISEASE vectors ,TRIATOMA ,ASSASSIN bugs ,MONOTERPENES ,TRICHOMONIASIS - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2020
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21. Review of authorship for COVID‐19 research conducted during the 2020 first‐wave epidemic in Africa reveals emergence of promising African biomedical research and persisting asymmetry of international collaborations.
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Tonen‐Wolyec, Serge, Mbumba Lupaka, Dieu‐Merci, Batina‐Agasa, Salomon, Mbopi Keou, François‐Xavier, and Bélec, Laurent
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MEDICAL research ,COVID-19 ,REGIONAL disparities ,EPIDEMICS ,AUTHORSHIP - Abstract
Objectives: The contribution of African authors to the biomedical literature is small. We evaluated the African and non‐African scientific production published in the international literature on the COVID‐19 in Africa during the first year of the epidemic (2020). Methods: Papers on COVID‐19 in Africa were extracted from the Medline (PubMed) database for bibliometric analysis including the proportions of three leading and last authors by study type, study country, authors' and laboratories/institutions' countries of affiliation and journal ranking. Results: A total of 160 articles fulfilling the inclusion criteria were analysed. The majority (91.3%) was produced by half (53.7%) of African countries, with important regional disparities, and generally without sources of funding mentioned. The majority (>85.0) of authors in lead positions (first, second, third and last authors) were Africans. Only a small number (8.7%) of studies on COVID‐19 in Africa were carried out by laboratories not on the African continent (mainly Europe, USA and China) and generally received funding. The last and first authors were more frequently of non‐African origin in journals with an Impact Factor ranking ≥1, and more frequently of African origin in journals with a lower ranking (< 1). The first and last non‐African authors tended to report their studies in high ranking ≥1 journals. Conclusions: Our study demonstrates that the emergence of promising African research capable of publishing in indexed but low‐impact factor medical journals and reveals the persistence of a North‐South asymmetry in international cooperation in biomedical research with Africa. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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22. AIDS and hospital bed occupancy: an overview[Paper pres].
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Buvé, Anne
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- 1997
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23. Health workers' views on audit in maternal and newborn healthcare in LMICs: a qualitative evidence synthesis.
- Author
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Rousseva, Christiana, Kammath, Vishnu, Tancred, Tara, and Smith, Helen
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MIDDLE-income countries ,KEYWORD searching ,EMPLOYEES ,DATABASE searching ,WORLD health - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2020
- Full Text
- View/download PDF
24. Examining levels, distribution and correlates of health insurance coverage in Kenya
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Jacob Kazungu and Edwine Barasa
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Male ,health financing ,Distribution (economics) ,Logistic regression ,Insurance Coverage ,Universal Health Insurance ,10. No inequality ,media_common ,education.field_of_study ,Family Characteristics ,assurance santé ,Informal sector ,Health Equity ,030503 health policy & services ,1. No poverty ,Middle Aged ,financement de la santé ,Infectious Diseases ,Geography ,8. Economic growth ,health insurance ,Original Article ,Female ,0305 other medical science ,Adult ,Inequality ,Adolescent ,media_common.quotation_subject ,Population ,Context (language use) ,Odds ,03 medical and health sciences ,Young Adult ,inequalities ,Environmental health ,Humans ,Healthcare Disparities ,education ,Poverty ,030505 public health ,Insurance, Health ,business.industry ,Public Health, Environmental and Occupational Health ,Kenya ,Health Surveys ,Logistic Models ,inégalités ,Socioeconomic Factors ,Parasitology ,business ,Original Research Papers - Abstract
Objective To examine the levels, inequalities, and factors associated with health insurance coverage in Kenya. Methods We analyzed secondary data from the Kenya Demographic and Health Survey (KDHS) conducted in 2009 and 2014. We examined the level of health insurance coverage overall, and by type, using an asset index to categorize households into 5 socio-economic quintiles with quintile 5 (Q5) being the richest and quintile 1 (Q1) being the poorest. The high-low ratio (Q5/Q1 ratio), concentration curve, and concentration index (CIX) were employed to assess inequalities in health insurance coverage, and logistic regression to examine correlates of health insurance coverage. Results Overall health insurance coverage increased from 8.17% to 19.59% between 2009 and 2014. There was high inequality in overall health insurance coverage, even though this inequality decreased between 2009 (Q5/Q1 ratio of 31.21, CIX=0.61, 95% CI 0.52-0.0.71) and 2014 (Q5/Q1 ratio 12.34, CIX=0.49, 95% CI 0.45-0.52). Individuals that were older, employed in the formal sector, married, exposed to media, male, belonged to a small household, had a chronic disease, and belonged to rich households, had increased odds of health insurance coverage. Conclusion Health insurance coverage in Kenya remains low and is characterized by significant inequality. In a context where over 80% of the population is in the informal sector, and close to 50% live below the national poverty line, achieving high and equitable coverage levels with contributory, and voluntary health insurance mechanism is problematic. Kenya should consider a universal, tax-funded mechanism that ensures revenues are equitably and efficiently collected, and everyone (including the poor and those in the informal sector) is covered. This article is protected by copyright. All rights reserved.
- Published
- 2017
25. Index case finding facilitates identification and linkage to care of children and young persons living with HIV/AIDS in Malawi
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Elijah Kavuta, Maria H. Kim, Spencer Dick, Peter N. Kazembe, Frank Linzie, Mwelura Harawa, Nora E. Rosenberg, Katie Simon, Rachael Sabelli, and Saeed Ahmed
- Subjects
0301 basic medicine ,Gerontology ,Adult ,Counseling ,Malawi ,recherche des cas ,Adolescent ,Anti-HIV Agents ,HIV Infections ,Hiv testing ,03 medical and health sciences ,Young Adult ,Acquired immunodeficiency syndrome (AIDS) ,VIH pédiatrique ,case finding ,medicine ,dépistage du VIH ,Humans ,Mass Screening ,adolescents ,Community Health Services ,Young adult ,10. No inequality ,Child ,Index case ,Mass screening ,linkage to care ,Linkage (software) ,Community Health Workers ,Family Characteristics ,business.industry ,1. No poverty ,Public Health, Environmental and Occupational Health ,paediatric HIV ,medicine.disease ,030112 virology ,HIV testing ,Infectious Diseases ,Median time ,Child, Preschool ,Community health ,Parasitology ,Original Article ,business ,Original Research Papers ,liaison aux soins - Abstract
Objectives Evaluation of a novel index case-finding and linkage-to-care program to identify and link HIV-infected children (1-15 years) and young adults (>15-24 years) to care. Methods HIV-infected patients enrolled in HIV services were screened and those who reported untested household members (index cases) were offered home or facility-based HIV testing and counseling (HTC) of their household by a community health worker (CHW). HIV-infected household members identified were enrolled in a follow-up program offering home and facility-based follow-up by CHWs. Results Of the 1567 patients enrolled in HIV services, 1030 (65.7%) were screened and 461 (44.8%) identified as index cases. 93.5% consented to HIV testing of their households and of those, 279 (64.7%) reported an untested child or young person. CHWs tested 711 children and young adults, newly diagnosed 28 HIV-infected persons (yield 4.0%; 95% CI: 2.7-5.6), and identified an additional two HIV-infected persons not enrolled in care. Of the 30 HIV-infected persons identified, 23 (76.6%) were linked to HIV services. 18 of the 20 eligible for ART (90.0%) were initiated. Median time (IQR) from identification to enrollment into HIV services was 4 days (1-8) and from identification to ART start was 6 days (1-8). Conclusions Almost half of HIV-infected patients enrolled in treatment services had untested household members, many of whom were children and young adults. Index case-finding, coupled with home-based testing and tracked follow-up is acceptable, feasible, and facilitates the identification and timely linkage to care of HIV-infected children and young adults. This article is protected by copyright. All rights reserved.
- Published
- 2017
26. Complications of traditional bonesetting in contemporary fracture care in low‐ and middle‐income countries: A systematic review.
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Onyemaechi, Ndubuisi O., Menson, William Nii Ayitey, Goodman, Xan, Slinkard, Samantha, Onwujekwe, Obinna E., Enweani, Ugochukwu N., Nwankwo, Okechukwu E., Nwomeh, Benedict C., Nwariaku, Fiemu E., and Ezeanolue, Echezona E.
- Subjects
MIDDLE-income countries ,TREATMENT of fractures ,THERAPEUTIC complications ,TREATMENT effectiveness ,PATIENT dumping ,SCIENTIFIC observation - Abstract
Objective: To provide an overview of the evidence on the prevalence and pattern of complications among patients treated by traditional bonesetting presenting for modern orthopaedic services in low‐ and middle‐income countries (LMIC). Methods: Systematic review following PRISMA guidelines. Articles were identified by searching PubMed, Embase, ScienceDirect, SCOPUS, and Web of Science using the keywords "fracture care", "traditional bonesetters" and "complications". Papers included for review were original articles set in an LMIC that directly reported the prevalence and pattern of musculoskeletal complications of traditional bonesetters' fracture treatment in LMIC settings. Results: A total of 176 papers were screened for eligibility and 15 studies were finally included. Nine were prospective studies, six were retrospective studies. All were hospital‐based, observational studies that investigated the outcomes of treatment of fractures by traditional bonesetters published between 1986 and 2018. In total, this review covers 1389 participants with 1470 complications of fracture treatment. Conclusion: Traditional bonesetting complications are associated with significant morbidity. However, traditional bonesetters have the potential to contribute positively to primary fracture care when they are trained. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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27. Factors associated with pyomyositis: A systematic review and meta‐analysis.
- Author
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Ngor, Chamnab, Hall, Lisa, Dean, Judith A., and Gilks, Charles F.
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HIV infections ,NEGLECTED diseases ,BACTERIAL diseases ,STAPHYLOCOCCUS aureus ,HIGH-income countries - Abstract
Objectives: Pyomyositis, an acute bacterial infection of skeletal muscle usually resulting in abscess formation, is well recognised in tropical regions where it can account for up to 4% of adult surgical admissions. It is increasingly being reported from high‐income temperate countries. Pyomyositis occurs across all ages and in both sexes. Mortality ranges from 1% to 23%. Many risk factors have been suggested. We aimed to identify factors associated with pyomyositis. Methods: We undertook a systematic review and meta‐analysis, using PubMed, EMBASE, Scopus and the Cochran Library and hand‐searching published papers. The random‐effects model meta‐analysis was used to calculate pooled estimated odd ratios with the corresponding 95% confidence interval. Results: All studies in the systematic review (n = 25) and the meta‐analysis (n = 12) were hospital‐based. Seven only included children. Relatively few studies have been published in the last decade, the majority of which are from high‐income temperate settings. Staphylococcus aureus was the main organism isolated. Males under the age of 20 predominated, and mortality of up to 20% was reported. Factors associated with pyomyositis were HIV infection (OR = 4.82; 95% CI: 1.67–13.92) and fulfilling an AIDS surveillance definition (OR = 6.08; 95% CI: 2.79–13.23). Conclusions: Our meta‐analysis indicated significant associations between pyomyositis infection and HIV/AIDS. Major gaps in our understanding of the epidemiology, pathogenesis, clinical presentation, and outcome remain, highlighting the need for further research and more systematic studies. Pyomyositis merits consideration as a neglected tropical disease. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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28. Risk factors for ocular surface squamous neoplasia in Kenya: a case–control study
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Gichuhi, Stephen, Macharia, Ephantus, Kabiru, Joy, Zindamoyen, Alain M'bongo, Rono, Hillary, Ollando, Ernest, Wachira, Joseph, Munene, Rhoda, Onyuma, Timothy, Jaoko, Walter G., Sagoo, Mandeep S., Weiss, Helen A., and Burton, Matthew J.
- Subjects
Adult ,Male ,ultraviolet radiation ,Biopsy ,antiretroviral therapy ,Conjunctival Neoplasms ,HIV Infections ,conjonctivite allergique ,Protective Clothing ,Risk Factors ,Occupational Exposure ,Odds Ratio ,Humans ,Conjunctivitis, Allergic ,ocular surface squamous neoplasia ,HIV ,VIH ,Middle Aged ,Kenya ,allergic conjunctivitis ,rayonnement ultraviolet ,Case-Control Studies ,néoplasie squameuse de la surface oculaire ,Carcinoma, Squamous Cell ,Sunlight ,Original Article ,Female ,Original Research Papers ,traitement antirétroviral ,Conjunctiva ,facteurs de risque - Abstract
Objective To determine modifiable risk factors of ocular surface squamous neoplasia (OSSN) in Kenya using disease‐free controls. Methods Adults with conjunctival lesions were recruited at four eye care centres in Kenya and underwent excision biopsy. An equal number of controls having surgery for conditions not affecting the conjunctiva and unrelated to ultraviolet light were group‐matched to cases by age group, sex and eye care centre. Associations of risk factors with OSSN were evaluated using multivariable logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs). Continuous variables were compared using the t‐test or the Wilcoxon–Mann–Whitney U‐test depending on their distribution. Results A total of 131 cases and 131 controls were recruited. About two‐thirds of participants were female, and the mean age of cases and controls was 42.1 years and 43.3 years, respectively. Risk factors for OSSN were HIV infection without antiretroviral therapy (ART) use (OR = 48.42; 95% CI: 7.73–303.31) and with ART use (OR = 19.16; 95% CI: 6.60–55.57), longer duration of exposure to the sun in the main occupation (6.9 h/day vs. 4.6 h/day, OR = 1.24; 95% CI: 1.10–1.40) and a history of allergic conjunctivitis (OR = 74.61; 95% CI: 8.08–688.91). Wearing hats was protective (OR = 0.22; 95% CI: 0.07–0.63). Conclusion Measures to prevent and control HIV, reduce sun exposure such as wearing hats and control allergic conjunctivitis are recommended.
- Published
- 2016
29. A health decision analytical model to evaluate the cost‐effectiveness of female genital schistosomiasis screening strategies: The female genital schistosomiasis SCREEN framework.
- Author
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Lamberti, Olimpia, Terris‐Prestholt, Fern, Bustinduy, Amaya L., and Bozzani, Fiammetta
- Subjects
- *
HUMAN papillomavirus , *WATERBORNE infection , *FEMALE reproductive organ diseases , *MEDICAL screening , *SCHISTOSOMIASIS - Abstract
Female genital schistosomiasis is a chronic gynaecological disease caused by the waterborne parasite Schistosoma (S.) haematobium. It affects an estimated 30–56 million girls and women globally, mostly in sub‐Saharan Africa where it is endemic, and negatively impacts their sexual and reproductive life. Recent studies found evidence of an association between female genital schistosomiasis and increased prevalence of HIV and cervical precancer lesions. Despite the large population at risk, the burden and impact of female genital schistosomiasis are scarcely documented, resulting in neglect and insufficient resource allocation. There is currently no standardised method for individual or population‐based female genital schistosomiasis screening and diagnosis which hinders accurate assessment of disease burden in endemic countries. To optimise financial allocations for female genital schistosomiasis screening, it is necessary to explore the cost‐effectiveness of different strategies by combining cost and impact estimates. Yet, no economic evaluation has explored the value for money of alternative screening methods. This paper describes a novel application of health decision analytical modelling to evaluate the cost‐effectiveness of different female genital schistosomiasis screening strategies across endemic settings. The model combines a decision tree for female genital schistosomiasis screening strategies, and a Markov model for the natural history of cervical cancer to estimate the cost per disability‐adjusted life‐years averted for different screening strategies, stratified by HIV status. It is a starting point for discussion and for supporting priority setting in a data‐sparse environment. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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30. Child diarrhoea and nutritional status in rural Rwanda: a cross‐sectional study to explore contributing environmental and demographic factors
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James Habyarimana, Karen A. Grépin, Leodomir Mfura, William Jack, Jeannine Condo, Zachary Clemence, Sophie Boisson, Wolf-Peter Schmidt, Ronald Wendt, Thomas Clasen, Erin Crossett, Kris Cox, and Sheela S. Sinharoy
- Subjects
medicine.medical_specialty ,Sanitation ,Cross-sectional study ,sanitation ,030231 tropical medicine ,Population ,diarrhée ,sanitaire ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,medicine ,030212 general & internal medicine ,eau potable ,Improved sanitation ,education ,Wasting ,education.field_of_study ,business.industry ,Public health ,drinking water ,Public Health, Environmental and Occupational Health ,stunting ,Anthropometry ,diarrhoea ,Diarrhea ,Infectious Diseases ,nutrition ,Parasitology ,Original Article ,medicine.symptom ,business ,Original Research Papers ,retard de croissance - Abstract
To explore associations of environmental and demographic factors with diarrhoea and nutritional status among children in Rusizi district, Rwanda. We obtained cross-sectional data from 8,847 households in May-August 2013 from a baseline survey conducted for an evaluation of an integrated health intervention. We collected data on diarrhoea, water quality, and environmental and demographic factors from households with children
- Published
- 2016
31. Fatigue as a manifestation of psychosocial distress in a low‐income country: a population‐based panel study
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Smartt, Caroline, Medhin, Girmay, Alem, Atalay, Patel, Vikram, Dewey, Michael, Prince, Martin, and Hanlon, Charlotte
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Adult ,Adolescent ,Health Status ,détresse psychosociale ,low‐and middle‐income countries ,Body Mass Index ,Hemoglobins ,Young Adult ,Pregnancy ,Risk Factors ,Surveys and Questionnaires ,étude de panel basée sur la population ,Prevalence ,Humans ,Developing Countries ,Fatigue ,population‐based panel study ,PFR‐PRI ,psychosocial distress ,Middle Aged ,maternal CMD ,Pregnancy Complications ,Original Article ,Female ,Ethiopia ,Original Research Papers ,Ethiopie ,Stress, Psychological - Abstract
Objective Fatigue is a common complaint worldwide and associated with disability and high health service use costs. We tested the hypothesis that maternal fatigue would be associated independently with maternal common mental disorder (‘maternal CMD’) in a rural, low‐income country setting. Methods The analysis was conducted using data from a population‐based cohort located in the Butajira demographic surveillance site, Ethiopia. A total of 1065 women were recruited in pregnancy and followed up to 2.5 (n = 1009; 94.7%) and 3.5 years post‐partum (n = 989; 92.9%). Maternal CMD symptoms were measured using a locally validated version of the Self‐Reporting Questionnaire and fatigue was measured using a dichotomised item from the Patient Health Questionnaire‐15. Physical health indicators included haemoglobin level, body mass index and illness episodes. Generalised estimating equations were used to conduct hypothesis‐driven and exploratory multivariable analyses in the panel at 2.5 and 3.5 years. Results The prevalence of maternal fatigue was 8.3% at 2.5 years and 5.5% at 3.5 years post‐partum. Psychological symptoms of maternal CMD were associated independently with complaints of fatigue after adjusting for anaemia, body mass index, physical ill health, poverty and other confounding variables: adjusted odds ratio (aOR), 1.46; 95% confidence interval (CI), 1.28–1.66 for each one point increase in SRQ score. In the multivariable model, only psychosocial factors (CMD and stressful life events) and self‐reported physical ill health were associated significantly with complaints of fatigue. Conclusion Complaints of fatigue are associated strongly with maternal CMD and other psychosocial risk factors in this rural, low‐income country setting with a high burden of undernutrition and infectious disease. Fatigue should be understood as a potential indicator of CMD in primary care to improve detection and treatment.
- Published
- 2016
32. Measuring regional and district variations in the incidence of pregnancy‐induced hypertension in Ghana: challenges, opportunities and implications for maternal and newborn health policy and programmes
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Diederick E. Grobbee, Irene Akua Agyepong, Kerstin Klipstein-Grobusch, Kwadwo A. Koram, Edward Antwi, and Gloria Quansah Asare
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variation locale ,Population ,Developing country ,prise de décision ,hypertension gravidique ,030204 cardiovascular system & hematology ,maternal and newborn health ,Health informatics ,decision making ,données de routine ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,medicine ,Journal Article ,030212 general & internal medicine ,Fundal height ,education ,Health policy ,education.field_of_study ,business.industry ,pregnancy‐induced hypertension ,pregnancy-induced hypertension ,Public Health, Environmental and Occupational Health ,Gestational age ,medicine.disease ,Obesity ,santé maternelle et néonatale ,routine data ,Infectious Diseases ,Blood pressure ,local area variation ,Parasitology ,Original Article ,business ,Original Research Papers - Abstract
OBJECTIVES: The objectives were to assess the quality of health management information system (HMIS) data needed for assessment of local area variation in pregnancy induced hypertension (PIH) incidence and to describe district and regional variations in PIH incidence. METHODS: A retrospective review of antenatal and delivery records of 2,682 pregnant women in ten district hospitals in the Greater Accra and Upper West regions of Ghana was conducted in 2013. Quality of HMIS data was assessed by completeness of reporting. The incidence of PIH was estimated for each district. RESULTS: Key variables for routine assessment of PIH such as blood pressure at antenatal visits, weight and height were 95% to 100% complete. Fundal height, gestational age and blood pressure at delivery were not consistently reported. The incidence of PIH differed significantly between Greater Accra region (6.1%) and Upper West region (3.2%). Prevalence of obesity among pregnant women in Greater Accra region (13.9%) was significantly higher than that of women in Upper West region (2.2%). CONCLUSIONS: More attention needs to be given to understanding local area variations in PIH and possible relationships with urbanization and lifestyle changes that promote obesity, to inform maternal and newborn health policy. This can be done with good quality routine HMIS data. This article is protected by copyright. All rights reserved.
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- 2015
33. Causes of non‐malarial febrile illness in outpatients in Tanzania
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Ben Amos, George Mtove, Florida Muro, Helena Hildenwall, Kerstin Cederlund, and Hugh Reyburn
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Pediatrics ,medicine.medical_specialty ,Tanzanie ,aetiology ,étiologie ,Urinary system ,030231 tropical medicine ,malaria ,Physical examination ,Salmonella typhi ,Tanzania ,PCIME ,03 medical and health sciences ,0302 clinical medicine ,fièvre ,medicine ,Outpatient clinic ,030212 general & internal medicine ,Integrated Management of Childhood Illness ,fever ,IMAI ,medicine.diagnostic_test ,non‐malaria ,business.industry ,non paludique ,Public Health, Environmental and Occupational Health ,medicine.disease ,Pneumonia ,Infectious Diseases ,Integrated Management of Adolescent and Adult Illness ,Etiology ,Parasitology ,Original Article ,business ,Original Research Papers ,Malaria - Abstract
Objective In sub-Saharan Africa, the use of malaria rapid diagnostic tests (mRDT) has raised awareness of alternative fever causes in children but few studies have included adults. To address this gap, we conducted a study of mRDT-negative fever aetiologies among children and adults in Tanzania. Methods A total of 1028 patients aged 3 months to 50 years with a febrile illness and negative mRDT were enrolled from a Tanzanian hospital outpatient department. All had a physical examination and cultures from blood, nasopharynx/throat and urine. Patients were followed on Days 7 and 14 and children meeting WHO criteria for pneumonia were followed on Day 2 with chest radiology. Results Respiratory symptoms were the most frequent presenting complaint, reported by 20.3% of adults and 64.0% (339/530) of children. Of 38 X-rayed children meeting WHO pneumonia criteria, 47.4% had a normal X-ray. Overall, only 1.3% of 1028 blood cultures were positive. Salmonella typhi was the most prevalent pathogen isolated (7/13, 53.8%) and S. typhi patients reported fever for a median of 7 days (range 2–14). Children with bacteraemia did not present with WHO symptoms requiring antibiotic treatment. Young children and adults had similar prevalences of positive urine cultures (24/428 and 29/498, respectively). Conclusion Few outpatient fevers are caused by blood stream bacterial infection, and most adult bacteraemia would be identified by current clinical guidelines although paediatric bacteraemia may be more difficult to diagnose. While pneumonia may be overdiagnosed, urinary tract infection was relatively common. Our results emphasise the difficulty in identifying African children in need of antibiotics among the majority who do not.
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- 2015
34. Sleeping arrangements and mass distribution of bed nets in six districts in central and northern Mozambique
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Olinda Muguande, Tracy J. Doyle, James Colborn, Geraldo Chambe, Juliette Morgan, Eusebio Macete, Steven S. Yoon, Pedro L. Alonso, S. P. Kachur, Graça Matsinhe, Pedro Aide, Mateusz M. Plucinski, Silvia Chicuecue, and Caterina Guinovart
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Adult ,Male ,Insecticides ,Mosquito Control ,Adolescent ,Program activities ,malaria ,Malària ,Distribution (economics) ,Beds ,High coverage ,Medicina preventiva ,Statistics ,Animals ,Humans ,universal coverage ,Insecticide-Treated Bednets ,Child ,Mozambique ,Preventive medicine ,Bed nets ,Sleeping pattern ,Family Characteristics ,business.industry ,Public Health, Environmental and Occupational Health ,Infant ,bed nets ,Composite indicator ,Moçambic ,Malaria ,Universal coverage ,Primary Prevention ,Infectious Diseases ,Geography ,Child, Preschool ,Health Care Surveys ,Parasitology ,Original Article ,Female ,business ,Malaria control ,Sleep ,Original Research Papers ,Delivery of Health Care - Abstract
OBJECTIVE: Universal coverage with insecticide-treated bed nets is a cornerstone of modern malaria control. Mozambique has developed a novel bed net allocation strategy, where the number of bed nets allocated per household is calculated on the basis of household composition and assumptions about who sleeps with whom. We set out to evaluate the performance of the novel allocation strategy. METHODS: 1,994 households were visited during household surveys following two universal coverage bed net distribution campaigns in Sofala and Nampula Provinces in 2010-2013. Each sleeping space was observed for the presence of a bed net, and the sleeping patterns for each household were recorded. The observed coverage and efficiency were compared to a simulated coverage and efficiency had conventional allocation strategies been used. A composite indicator, the product of coverage and efficiency, was calculated. Observed sleeping patterns were compared with the sleeping pattern assumptions. RESULTS: In households reached by the campaign, 93% (95% CI: 93-94%) of sleeping spaces in Sofala and 84% (82-86%) in Nampula were covered by campaign bed nets. The achieved efficiency was high, with 92% (91-93%) of distributed bed nets in Sofala and 93% (91-95%) in Nampula covering a sleeping space. Using the composite indicator, the novel allocation strategy outperformed all conventional strategies in Sofala and was tied for best in Nampula. The sleeping pattern assumptions were completely satisfied in 66% of households in Sofala and 56% of households in Nampula. The most common violation of the sleeping pattern assumptions was that male children 3-10 years of age tended not to share sleeping spaces with female children 3-10 or 10-16 years of age. CONCLUSIONS: The sleeping pattern assumptions underlying the novel bed net allocation strategy are generally valid, and net allocation using these assumptions can achieve high coverage and compare favorably with conventional allocation strategies. This article is protected by copyright. All rights reserved.
- Published
- 2015
35. Small‐scale field evaluation of the entomological efficacy and the residual activity of Fludora® Fusion WP‐SB indoor residual spraying against Anopheles culicifacies s.l. in Gujarat, India.
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Kamaraju, Raghavendra, Pant, Chandra Shekhar, Uragayala, Sreehari, Baharia, Rajendra Kumar, Srivastava, Harish Chandra, and Yadav, Rajpal S.
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ANOPHELES ,DELTAMETHRIN ,CLOTHIANIDIN ,NEONICOTINOIDS ,INSECTICIDES - Abstract
Objectives: To evaluate the entomological efficacy and the residual activity of indoor residual spraying with Fludora® Fusion 562.5 WP‐SB, a combination formulation containing clothianidin, a neonicotinoid and deltamethrin, a pyrethroid, against the main rural malaria vector, Anopheles culicifacies s.l., in India in a small‐scale trial. Methods: In three study villages, suitable households were randomly allocated to five treatments: Fludora® Fusion 562.5 WP‐SB (target dose 225 mg active ingredient AI/m2); clothianidin 70 WG (target dose 200 mg AI/m2); K‐Othrine 250 WG (deltamethrin, target dose 25 mg AI/m2); Ficam VC 80 WP‐SB (bendiocarb, target dose 400 mg AI/m2) and unsprayed control. Insecticides were sprayed by hand compression sprayers with control flow valves and 8002E nozzles. Post‐spray cone bioassays were done on insecticide‐treated walls using a colonised, deltamethrin‐resistant strain of An. culicifacies. Mosquitoes were collected from treated rooms by different methods. The insecticide content on filter papers collected from the sprayed walls was determined by chemical assay to assess the spray quality. Results: The ratios of applied to target doses of insecticides were within 0.84 to 1.4, showing a good spray quality. The cone bioassays revealed residual action lasting 7 months for all insecticides without significant differences in mortality between different surfaces treated nor between the four treatment arms (P > 0.05). Considering all entomological parameters such as indoor resting density, excito‐repellency, blood‐feeding inhibition and delayed mortality, the overall efficacy of Fludora® Fusion WG‐SB was equal or better compared with other insecticides. Conclusions: Fludora® Fusion showed overall equal or better efficacy than deltamethrin and bendiocarb alone against a pyrethroid‐resistant malaria vector population and can be considered as an alternative product for management of pyrethroid resistance in malaria vectors. [ABSTRACT FROM AUTHOR]
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- 2021
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36. Evaluation of a flow cytometric test for G6PD‐deficient erythrocytes.
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Kapadia, Alpeshkumar Bipinbhai, Sharma, Prashant, Jain, Karuna, Sachdeva, Man Updesh Singh, Bose, Parveen Lata, Gupta, Minakshi, Khadwal, Alka Rani, Bal, Amanjit, Das, Reena, and Varma, Neelam
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GLUCOSE-6-phosphate dehydrogenase ,ERYTHROCYTES ,GLUCOSE-6-phosphate dehydrogenase deficiency ,FLOW cytometry ,FLUORESCENCE microscopy - Abstract
Objective: Glucose‐6‐phosphate dehydrogenase (G6PD) deficiency, an X‐linked recessive disorder, is the commonest erythrocytic enzymopathy worldwide. Reliable diagnosis and severity prediction in G6PD‐deficient/heterozygous females remain challenging. A recently developed flow cytometric test for G6PD deficiency has shown promise in precisely identifying deficient females. This paper presents our experiences with this test in a subtropical setting and presents a modification in flow cytometric data acquisition strategy. Methods: The methaemoglobin reduction + ferryl Hb generation‐based flow cytometric G6PD test was compared with the screening methaemoglobin reduction test (MRT) and confirmatory G6PD enzyme activity assay (EAA) in 20 G6PD‐deficient males, 22 G6PD‐heterozygous/deficient females and 20 controls. Stained cells were also assessed for bright/dim G6PD activity under a fluorescent microscope. Results: Flow cytometry separated and quantified %bright cells in heterozygous/deficient females, objectively classifying them into 6 normal (>85% bright cells), 14 intermediate (10‐85%) and two G6PD‐deficient (<10% bright cells). Concordance with MRT was 89% (55/62 cases) and with EAA was 77% (48/62 cases). Fluorometrically predicted violet laser excitation (405‐nm) with signal acquisition in the 425–475 nm region was a technical advancement noted for the first time in this paper. Conclusion: Flow cytometry/fluorescence microscopy represent technically straightforward methods for the detection and quantification of G6PD‐deficient erythrocytes. Based on our results, we recommend their application as a first‐line investigation to screen females who are prescribed an oxidant drug like primaquine or dapsone. [ABSTRACT FROM AUTHOR]
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- 2021
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37. Comparison of haematology and biochemistry parameters in healthy South African infants with laboratory reference intervals
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Schmidt, B, Tameris, M, Geldenhuys, H, Luabeya, A, Bunyasi, E, Hawkridge, T, McClain, J, Mahomed, H, Scriba, T, McShane, H, and Hatherill, M
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Male ,Infant Welfare ,Infant ,clinical trial ,hématologie ,Hematology ,reference interval ,intervalle de référence ,biochimie ,Reference Standards ,South African infants ,Blood Cell Count ,essai clinique ,South Africa ,nourrissons sud‐africains ,Reference Values ,Chemistry, Clinical ,haematology ,biochemistry ,Humans ,Original Article ,Female ,Public Health Surveillance ,Original Research Papers - Abstract
Objective Paediatric laboratory reference intervals used in Africa and Asia may be derived from historical intervals of predominantly Caucasian infants in Europe or North America. These intervals may therefore not be compatible with the range of normality for developing country populations. We aimed to compare haematology and biochemistry parameters in healthy South African infants with local laboratory reference intervals. Methods We compared the baseline haematology and biochemistry results of 634 (316 male and 318 female) HIV-unexposed infants, aged 3–6 months, living in a rural area of the Western Cape Province, South Africa, against laboratory reference intervals supplied by the South African National Health Laboratory Services (NHLS). We calculated the percentage of observed values out of bound (in terms of lower and upper limits) compared to laboratory reference intervals. Results Of the 634 healthy infants screened, 316 (49.84%) were male and 318 (50.16%) female. A majority (91.05%) had platelet counts above the laboratory reference interval upper limit (350 9 109cells/l), while over half, 54.85% and 56.98% had mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) values below the lower limits of 77.0–105.0 fl and 26.0–34.0 pg, respectively. A small proportion were outside the reference limits for haematocrit, namely 15.71% below and 7.14% above the normal limits of 0.31–0.38 l/l. For male and female infants, 33.65% and 18.04% of alkaline phosphatase (ALP) values and 7.01% and 14.56% of alanine transaminase (ALT) values were above the upper limits, respectively. For male infants, 10.83% of gamma-glutamyl transferase (GGT) values, and for female infants, 31.11% of GGT values were below the lower limits of 12 U/l for males and 15 U/l for females. We observed no significant deviations (>10% out of bound) from NHLS reference intervals in the remaining haematology and biochemistry parameters measured. Conclusions Haematology and biochemistry parameters in apparently healthy South African infants deviate frequently from national laboratory reference intervals, including abnormalities consistent with subclinical hypochromic microcytic anaemia. It is important that clinical laboratory reference intervals for children are derived locally, rather than being adopted from Caucasian norms in developed countries, because clinical trials of vaccines, drugs and diagnostics are increasingly conducted in sub-Saharan Africa.
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- 2017
38. Research to policy and practice change: is capacity building in operational research delivering the goods?
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Zachariah, Rony, Guillerm, Nathalie, Berger, Selma, Kumar, Ajay M. V., Satyanarayana, Srinath, Bissell, Karen, Edginton, Mary, Hinderaker, Sven Gudmund, Tayler ‐ Smith, Katie, Van den Bergh, Rafael, Khogali, Mohammed, Manzi, Marcel, Reid, Anthony J., Ramsay, Andrew, Reeder, John C., and Harries, Anthony D.
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MEDICAL practice ,HEALTH policy ,OPERATIONS research ,HEALTH programs ,RETROSPECTIVE studies ,COHORT analysis - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2014
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39. Differences in malaria care seeking and dispensing outcomes for adults and children attending drug vendors in Nasarawa, Nigeria
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Jenny Liu, Maia Sieverding, and Chinwoke Isiguzo
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Care seeking ,Health Behavior ,malaria ,Nigeria ,Antimalarials ,Young Adult ,parasitic diseases ,drug shops ,Prevalence ,Medicine ,Humans ,Healthcare Disparities ,Child ,health care economics and organizations ,Pharmacies ,Health Services Needs and Demand ,business.industry ,Diagnostic Tests, Routine ,Data Collection ,Public Health, Environmental and Occupational Health ,Age Factors ,Commerce ,Infant ,care seeking ,Patient Acceptance of Health Care ,medicine.disease ,Artemisinins ,Infectious Diseases ,Caregivers ,Child, Preschool ,Pharmaceutical Services ,Parasitology ,Drug Therapy, Combination ,Female ,business ,Humanities ,Original Research Papers ,Malaria - Abstract
Objectives To characterise the differences in care seeking behaviour and dispensing outcomes between adults and children purchasing drugs for malaria at retail shops in Nigeria. Methods In Nasarawa State, retail drug shops were enumerated and a subset of those stocking antimalarials were selected as study sites and surveyed. Customers exiting shops after purchasing antimalarial drugs were surveyed and tested with a malaria rapid diagnostic test. Sick adults and caregivers accompanying sick children were eligible, but individuals purchasing drugs for a sick person that was not present were excluded. Multivariate regression analysis was used to identify the correlates of care seeking and the quality of interaction at the shop. Results Of 737 participants, 80% were adults and 20% were children (under age 18). Caregivers of sick children were more likely to obtain a prescription prior to attending a drug retailer than adults seeking care for themselves and waited a shorter time before seeking care. Caregivers of sick children were also more likely than sick adults to have been asked about symptoms by the retailer, to have been given an examination, and to have purchased an ACT. Fewer than half of respondents had purchased an ACT. Only 14% of adults, but 27% of children were RDT-positive; RDT-positive children were more likely to have had an ACT purchased for them than RDT-positive adults. Conclusions Children with suspected malaria tend to receive better care at drug retailers than adults. The degree of overtreatment and prevalence of dispensing non-recommended antimalarials emphasise the need for routine diagnosis before treatment to properly treat both malaria and non-malaria illnesses. Objectifs Caracteriser les differences dans le comportement de recherche de soins et les resultats des prestations entre les adultes et les enfants achetant des medicaments contre le paludisme dans les boutiques de detaillants au Nigeria. Methodes Dans l’etat de Nasarawa, les commerces au detail de medicaments ont ete denombres et un sous-ensemble de ceux stockant des antipaludeens a ete choisi comme site d’etude et investigue. Les clients sortant des magasins apres l'achat de medicaments antipaludiques ont ete interroges et depistes avec un test de diagnostic rapide du paludisme. Les adultes malades et les soignants accompagnant des enfants malades etaient admissibles, mais les personnes achetant des medicaments pour une personne malade qui n’etait pas presente ont ete exclues. L'analyse de regression multivariee a ete utilisee pour identifier les correlats dans la recherche de soins et la qualite de l'interaction avec la boutique. Resultats Sur 737 participants, 80% etaient des adultes et 20% des enfants (de moins de 18 ans). Les soignants d'enfants malades etaient plus susceptibles d'obtenir une ordonnance avant de visiter un detaillant de medicaments que les adultes en quete de soins pour eux-memes et tardaient moins avant de rechercher des soins. Les soignants d'enfants malades etaient egalement plus susceptibles que les adultes malades d'avoir ete interroges sur les symptomes par le detaillant, d'avoir ete examines et d'avoir achete un traitement a base d'artemisinine (ACT). Moins de la moitie des repondants avaient achete un ACT. Seuls 14% des adultes mais 27% des enfants ont ete trouve positifs au test rapide; les enfants positifs au test rapide etaient plus susceptibles d'avoir un ACT achete que les adultes positifs. Conclusions Les enfants suspectes de paludisme ont tendance a recevoir de meilleurs soins chez les detaillants de medicaments que les adultes. Le degre de surtraitement et la prevalence de delivrance d'antipaludiques non recommandes soulignent la necessite du diagnostic de routine avant le traitement afin de traiter correctement a la fois le paludisme et les maladies non paludiques. Objetivos Caracterizar las diferencias en el comportamiento de busqueda de cuidados y los resultados en la dispensacion entre los adultos y ninos que compraron medicamentos para malaria en farmacias de venta al por menor en Nigeria. Metodos En el estado de Nasarawa, se enumeraron las farmacias de venta al por menor y se seleccionaron como lugares de estudio un subgrupo de ellas que tenia antimalaricos entre sus existencias. A los clientes que salian de las farmacias despues de haber comprado antimalaricos se les realizo la encuesta y se les hizo una prueba de diagnostico rapido de malaria. Los adultos enfermos y los cuidadores de ninos enfermos eran elegibles, pero se excluyeron los individuos que compraban medicamentos para una persona enferma que no estaba presente. Se utilizo un analisis de regresion multivariante para identificar las asociaciones entre la busqueda de cuidados y la calidad de la interaccion en la farmacia. Resultados De 737 participantes, un 80% eran adultos y un 20% eran ninos (menores de 18). Los cuidadores de ninos enfermos tenian una mayor probabilidad de obtener una prescripcion antes de ir a la farmacia que los adultos que buscaban cuidar de si mismos, y esperaban un menor periodo de tiempo para buscar la ayuda. Los cuidadores de ninos enfermos tenian mas posibilidad que los adultos enfermos de que en la farmacia se les hubiese preguntado por los sintomas, se les hubiese realizado alguna prueba y que hubiesen comprado ACT. Menos de la mitad de quienes respondian habian comprado un ACT. Solo un 14% de los adultos, pero un 27% de los ninos daban positivo en las pruebas de diagnostico rapido (PDR). Los ninos con PDR positiva tenian una mayor posibilidad de que se les comprase un ACT que los adultos con una PDR positiva. Conclusiones Los ninos con una sospecha de malaria tienden a recibir mejores cuidados en las farmacias que los adultos. El nivel de sobretratamiento y la prevalencia de dispensacion de antimalaricos no recomendados enfatizan la necesidad de un diagnostico rutinario antes del tratamiento para manejar adecuadamente tanto la malaria como otras enfermedades.
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- 2015
40. Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data
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Alison Wringe, Basia Zaba, Angela Ramadhani, Bonita Kilama, Jim Todd, Fiona Vanobberghen, and Donan Mmbando
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Anti-HIV Agents ,First line ,Population ,antiretroviral therapy ,Program activities ,HIV Infections ,Tanzania ,Young Adult ,ANTIRETROVIRAL AGENTS ,Second line ,Hiv infected ,Antiretroviral Therapy, Highly Active ,medicine ,risk factors ,Humans ,Treatment Failure ,education ,National data ,Gynecology ,education.field_of_study ,Public Health, Environmental and Occupational Health ,CD4 lymphocyte count ,Middle Aged ,Viral Load ,Antiretroviral therapy ,Infectious Diseases ,Parasitology ,Female ,Original Research Papers - Abstract
Objectives Rates of first-line treatment failure and switches to second-line therapy are key indicators for national HIV programmes. We assessed immunological treatment failure defined by WHO criteria in the Tanzanian national HIV programme. Methods We included adults initiating first-line therapy in 2004–2011 with a pre-treatment CD4 count, and ≥6-months of follow-up. We assessed subhazard ratios (SHR) for immunological treatment failure, and subsequent switch to second-line therapy, using competing risks methods to account for deaths. Results Of 121 308 adults, 7% experienced immunological treatment failure, and 2% died without observed immunological treatment failure, over a median 1.7 years. The 6-year cumulative probability of immunological treatment failure was 19.0% (95% CI 18.5, 19.7) and of death, 5.1% (4.8, 5.4). Immunological treatment failure predictors included earlier year of treatment initiation (P
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- 2015
41. The health system burden of chronic disease care: an estimation of provider costs of selected chronic diseases in Uganda
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Gerald Mutungi, Janet Seeley, Heiner Grosskurth, Sedona Sweeney, Anna Vassall, Paula Munderi, Samuel Biraro, and Stella Nalukwago Settumba
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HIV Infections ,low‐ and middle‐income countries ,coût ,pays à revenus faibles et intermédiaires ,Unit (housing) ,Pulmonary Disease, Chronic Obstructive ,Maladies non transmissibles ,parasitic diseases ,cost ,medicine ,Diabetes Mellitus ,Humans ,Uganda ,ComputingMilieux_MISCELLANEOUS ,health care economics and organizations ,Retrospective Studies ,Estimation ,Service (business) ,Epilepsy ,human immunodeficiency virus ,business.industry ,Data Collection ,Public Health, Environmental and Occupational Health ,VIH ,Health Care Costs ,medicine.disease ,Infectious Diseases ,Chronic disease ,Models, Economic ,non‐communicable diseases ,Chronic Disease ,Hypertension ,Costs and Cost Analysis ,Parasitology ,Original Article ,Medical emergency ,business ,Ouganda ,systèmes de santé ,Original Research Papers ,health systems - Abstract
Objective To explore the chronic disease services in Uganda: their level of utilisation, the total service costs and unit costs per visit. Methods Full financial and economic cost data were collected from 12 facilities in two districts, from the provider's perspective. A combination of ingredients‐based and step‐down allocation costing approaches was used. The diseases under study were diabetes, hypertension, chronic obstructive pulmonary disease (COPD), epilepsy and HIV infection. Data were collected through a review of facility records, direct observation and structured interviews with health workers. Results Provision of chronic care services was concentrated at higher‐level facilities. Excluding drugs, the total costs for NCD care fell below 2% of total facility costs. Unit costs per visit varied widely, both across different levels of the health system, and between facilities of the same level. This variability was driven by differences in clinical and drug prescribing practices. Conclusion Most patients reported directly to higher‐level facilities, bypassing nearby peripheral facilities. NCD services in Uganda are underfunded particularly at peripheral facilities. There is a need to estimate the budget impact of improving NCD care and to standardise treatment guidelines.
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- 2015
42. Association between recent internal travel and malaria in Ugandan highland and highland fringe areas
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Jane Bruce, Caroline A. Lynch, Tarekegn A. Abeku, Amit Bhasin, Jonathan Cox, and Cally Roper
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Adult ,Male ,Adolescent ,malaria ,migration ,région montagneuse ,elimination ,Risk Factors ,parasitic diseases ,medicine ,Humans ,Uganda ,élimination ,highland ,Travel ,Geography ,Public Health, Environmental and Occupational Health ,medicine.disease ,3. Good health ,Infectious Diseases ,paludisme ,Case-Control Studies ,Population Surveillance ,Parasitology ,Original Article ,Female ,Ouganda ,Humanities ,Original Research Papers ,Malaria ,geographic locations - Abstract
Objective To examine the association between travel (recency of travel, transmission intensity at destination compared to origin and duration of travel) and confirmed malaria in Uganda. Methods Health facility-based case–control study in highland (~2200 m), and highland fringe (~1500 m) areas with adjustment for other covariates. Results In the highland site, patients who had travelled to areas of higher transmission intensity than their home (origin) areas recently were nearly seven times more likely to have confirmed malaria than those who had not (OR 6.9; P = 0.01, 95% CI: 1.4–33.1). In the highland fringe site, there was also a statistically significant association between travel and malaria (OR 2.1; P = 0.04, 95% CI: 1.1–3.9). Conclusions For highland areas, or areas of low malaria transmission, health authorities need to consider internal migrants when designing malaria control programs. Control interventions should include information campaigns reminding residents in these areas of the risk of malaria infection through travel and to provide additional mosquito nets for migrants to use during travel. Health authorities may wish to improve diagnosis in health facilities in highland areas by adding travel history to malaria case definitions. Where routine monitoring data are used to evaluate the impact of interventions on the malaria burden in highland areas, health authorities and donors need ensure that only cases from the local area and not ‘imported cases’ are counted. Objectif Examiner l'association entre le voyage (recence du voyage, intensite de la transmission au lieu de destination par rapport a l'origine et la duree du voyage) et les cas confirmes de paludisme en Ouganda. Methodes Etude cas-temoins dans les etablissements de sante dans les regions montagneuses (~2200 m), et a l'oree des ces regions (~1500 m) avec ajustement pour d'autres covariables. Resultats Dans le site de montagne, les patients qui avaient recemment voyage dans des regions d'intensite de transmission plus elevee que les zones du domicile etaient pres de sept fois plus susceptibles d'avoir un paludisme confirme que ceux qui n'avaient pas voyage (OR = 6,9; p = 0,01, IC 95%: 1,4–33,1). Dans la zone a l'oree des regions montagneuse, il y avait une association statistiquement significative entre le voyage et le paludisme (OR = 2,1; p = 0,04, IC95%: 1,1 a 3,9). Conclusions Pour les zones montagneuses, les autorites sanitaires doivent tenir compte des migrants lors de la conception des programmes de lutte contre le paludisme. Les interventions de lutte devraient inclure des campagnes d'information rappelant les residents dans ces zones du risque d'infection du paludisme suite au voyage et fournir des moustiquaires supplementaires pour les migrants a utiliser lors du voyage. Les autorites sanitaires pourraient ameliorer le diagnostic dans les etablissements de sante dans les zones montagneuses en ajoutant l'histoire de voyage dans les definitions de cas de paludisme. Lorsque les donnees de surveillance de routine sont utilisees pour evaluer l'impact des interventions sur la charge du paludisme dans les zones montagneuses, les autorites sanitaires et les donateurs devraient veiller a ce que seuls les cas de la region et non les «cas importes» sont comptes. Objetivo Examinar la asociacion entre el viajar (cuan reciente habia sido el viaje, la intensidad de transmision en el lugar de destino comparada con la del origen, y duracion del viaje) y malaria confirmada en Uganda. Metodos Estudio casos control basado en la comunidad en areas de tierras altas (~2200 m), y areas limitrofes (~1500 m) con ajuste para otras covariables. Resultados En las tierras altas, los pacientes que habian viajado recientemente a areas con una intensidad de transmision mas alta que la del area de sus hogares tenian casi 7 veces mas probabilidad de tener una malaria confirmada que aquellos que no habian viajado (OR 6.9; p = 0.01, IC 95%: 1.4–33.1). En las areas limitrofes a las zonas altas existia una asociacion estadistica significativa entre el viaje y la malaria (OR 2.1; p = 0.04, IC 95%: 1.1–3.9). Conclusiones En el caso de las areas en tierras altas, las autoridades sanitarias deberian tener en cuenta a los emigrantes cuando disenan los programas de control de malaria. Las intervenciones de control deberian incluir campanas de informacion que recuerden a los residentes en estas areas del riesgo de infeccion por malaria al viajar y proveer redes mosquiteras adicionales para que los emigrantes utilicen durante el viaje. Las autoridades sanitarias podrian mejorar el diagnostico en los centros sanitarios anadiendo el historial de viajes a las definiciones de caso de malaria. En donde se utilicen datos rutinarios de monitorizacion para evaluar el impacto de las intervenciones sobre la carga de malaria en tierras altas, las autoridades sanitarias y los donantes deben asegurarse de que solo se tienen en cuenta los casos de locales y no los “importados”.
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- 2015
43. Seizures, cysticercosis and rural-to-urban migration: the PERU MIGRANT study
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Gonzales, I., Miranda, J. Jaime, Rodriguez, S., Vargas, V., Cjuno, A., Smeeth, L., Gonzalez Zariquiey, Armando Emiliano, Tsang, V.C.W., Gilman, Robert Hugh, and García Lescano, Héctor Hugo
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Male ,Rural Population ,Urban Population ,very elderly ,Population Dynamics ,antigen antibody reaction ,migration ,immunology ,Seroepidemiologic Studies ,antibody ,Peruvian ,middle aged ,Taenia solium ,Peru ,Prevalence ,animal ,resident population ,Aged, 80 and over ,Transients and Migrants ,seroprevalence ,adult ,public health ,neurocysticercosis ,Middle Aged ,aged ,female ,parasitic disease ,young adult ,Female ,purl.org/pe-repo/ocde/ford#3.03.06 [https] ,Adult ,complication ,rural area ,Article ,Antibodies ,Young Adult ,blood ,Seizures ,neurologist ,cross-sectional study ,Animals ,Humans ,human ,immunoassay ,rural-urban migration ,Aged ,health risk ,Epilepsy ,Cysticercosis ,neurology ,endemic species ,major clinical study ,migrant ,serum ,Original Research Papers ,parasite prevalence ,urban area - Abstract
Objectives To examine the prevalence of seizures, epilepsy and seropositivity to cysticercosis in rural villagers (cysticercosis-endemic setting), rural-to-urban migrants into a non-endemic urban shanty town and urban inhabitants of the same non-endemic shanty town. Methods Three Peruvian populations (n = 985) originally recruited into a study about chronic diseases and migration were studied. These groups included rural inhabitants from an endemic region (n = 200), long-term rural-to-urban migrants (n = 589) and individuals living in the same urban setting (n = 196). Seizure disorders were detected by a survey, and a neurologist examined positive respondents. Serum samples from 981/985 individuals were processed for cysticercosis antibodies on immunoblot. Results Epilepsy prevalence (per 1000 people) was 15.3 in the urban group, 35.6 in migrants and 25 in rural inhabitants. A gradient in cysticercosis antibody seroprevalence was observed: urban 2%, migrant 13.5% and rural group 18% (P
- Published
- 2015
44. Poster Presentations
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Anders Dalsgaard, Heidi L. Enemark, Heidi Huus Petersen, A. Olsen, and I. Wolsey
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Moringa ,Poster Presentations ,Infectious Diseases ,Wastewater ,biology ,Public Health, Environmental and Occupational Health ,Environmental science ,Parasitology ,Cryptosporidium ,Turbidity ,Sedimentation ,Pulp and paper industry ,biology.organism_classification - Published
- 2013
45. Critical interpretive synthesis of barriers and facilitators to TB treatment in immigrant populations.
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Lin, S. and Melendez‐Torres, G. J.
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TUBERCULOSIS treatment ,IMMIGRANTS ,DISEASE prevalence ,IMMIGRATION policy ,SYSTEMATIC reviews ,DISEASES ,DRUG therapy for tuberculosis ,CONTROL (Psychology) ,ACCULTURATION ,DRUGS ,PSYCHOLOGY of immigrants ,PATIENT-professional relations ,PATIENT compliance ,SOCIAL stigma ,COMMUNICATION barriers ,TUBERCULOSIS ,CULTURAL competence ,PSYCHOLOGY - Abstract
Copyright of Tropical Medicine & International Health is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2017
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46. Retention in care for type 2 diabetes management in Sub‐Saharan Africa: A systematic review.
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Garrib, Anupam, Njim, Tsi, Adeyemi, Olukemi, Moyo, Faith, Halloran, Natalie, Luo, Huanyuan, Wang, Duolao, Okebe, Joseph, Bates, Katie, Santos, Victor Santana, Ramaiya, Kaushik, and Jaffar, Shabbar
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TYPE 2 diabetes ,PEOPLE with diabetes ,CINAHL database ,SECONDARY care (Medicine) ,ONLINE databases - Abstract
Objective: Diabetes prevalence has risen rapidly in Sub‐Saharan Africa, but rates of retention in diabetes care are poorly understood. We conducted a systematic review and meta‐analysis to determine rates of retention in care of persons with type 2 diabetes. Methods: We searched MEDLINE, Global Health and CINAHL online databases for cohort studies and randomised control trials (RCTs) published up to 12 October 2021, that reported retention in or attrition from care for patients with type 2 diabetes in Sub‐Saharan Africa. Retention was defined as persons diagnosed with diabetes who were alive and in care or with a known outcome, while attrition was defined as loss from care. Results: From 6559 articles identified, after title and abstract screening, 209 articles underwent full text review. Forty six papers met the inclusion criteria, comprising 22,610 participants. Twenty one articles were of RCTs of which 8 trials had 1 year or more of follow‐up and 25 articles were of non‐randomised studies of which 19 had 12 months or more of follow‐up. A total of 11 studies (5 RCTs and 6 non‐randomised) were assessed to be of good quality. Sixteen RCTs were done in secondary or tertiary care settings. Their pooled retention rate (95% CI) was 80% (77%, 84%) in the control arm. Four RCTs had been done in primary care settings and their pooled retention rate (95% CI) was 53% (45%, 62%) in the control arm. The setting of one trial was unclear. For non‐randomised studies, retention rates (95% CI) were 68% (62%, 75%) among 19 studies done in secondary and tertiary care settings, and 40% (33%, 49%) among the 6 studies done in primary care settings. Conclusion: Rates of retention in care of people living with diabetes are poor in primary care research settings. [ABSTRACT FROM AUTHOR]
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- 2023
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47. Mathematical modelling of SARS and other infectious diseases in China: a review.
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Xiao-Na Han, de Vlas, Sake J., Li-Qun Fang, Dan Feng, Wu-Chun Cao, and Habbema, J. Dik F.
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SARS disease ,MATHEMATICAL models ,COMMUNICABLE diseases ,EPIDEMICS - Abstract
Objective To give an overview of the recent history of publications on mathematical modelling of infectious diseases in the Chinese literature, and a more detailed review of the models on severe acute respiratory syndrome (SARS). Method Literature review through the Chinese CAJ full-text database. Results The number of Chinese publications on mathematical modelling has at least quadrupled since the SARS epidemic in 2003. This increase not only included papers on SARS, but also on various other infectious diseases, indicating a substantial expansion of modelling experience in China. Typical problems of most studies were poor availability of data and lack of involvement of disease experts and decision-makers rendering the studies less useful for policies on control. Conclusions We expect that the recent experience on modelling and current better access to and exchange of epidemiological data have paved the way for a more substantial role of this discipline during possible future outbreaks of infectious diseases. By making Chinese modelling initiatives more visible to non-Chinese readers, we hope to attract more international collaborators. [ABSTRACT FROM AUTHOR]
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- 2009
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48. Economic evaluation of parasitic diseases: A critique of the internal and external validity of published studies.
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Walker, Damian and Fox-Rushby, Julia
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PARASITIC diseases ,COMMUNICABLE diseases - Abstract
It was estimated that in 1990, major parasitic diseases accounted for 11.7% of the disease burden from communicable disease. As advances in the prevention, diagnosis and treatment of parasitic diseases are made and implemented, there is a growing economic literature to help decision-makers choose the most efficient control method. The aim of this paper is to identify, describe and analyse the available published data on the efficiency of control strategies against parasitic diseases. Internal validity is assessed through the quality of economic evaluations over time using a series of standard questions, and external validity is assessed in terms of the potential to extrapolate results to other settings. This leads to a discussion of the legitimacy and feasibility of pooling data or results from studies for priority setting in the health sector, resulting in three recommendations: to increase the coverage of economic evaluations for parasitic diseases and types of interventions; to improve the internal validity of studies through guidelines and review procedures; and to explore the external validity of research results by examining their predictive validity across settings. [ABSTRACT FROM AUTHOR]
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- 2000
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49. The burden of travelling for cervical cancer treatment in Uganda: A mixed‐method study.
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Dau, Hallie, Zhou, Chuanlin, Nankya, Esther, Naguti, Priscilla, Basemera, Miriam, Payne, Beth A., Vidler, Marianne, Singer, Joel, McNair, Avery, AboMoslim, Maryam, Mithani, Nadia, Smith, Laurie, Orem, Jackson, Nakisige, Carolyn, and Ogilvie, Gina
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- *
CERVICAL cancer , *CANCER treatment , *THEMATIC analysis , *SEMI-structured interviews , *WOMEN travelers - Abstract
Background: Uganda has one of the highest rates of cervical cancer in the world. Many women are diagnosed and treated with advanced stages of the disease. With only one facility offering comprehensive cervical cancer care in Uganda, many women are required to travel significant distances and spend time away from their homes to receive cervical cancer care. It is important to understand the burden of time away from home while attending treatment because it can inform the expansion of cervical cancer treatment programmes. The aim of this mixed‐methods paper is to describe how the distance to cervical cancer treatment locations impacts women in Uganda. Methods: Women were recruited from 19 September, 2022, to 17 January, 2023, at the Uganda Cancer Institute (UCI) and the cancer clinic at Jinja Regional Referral Hospital (JRRF). Women were eligible for the study if they were (i) aged ≥18 years with a histopathologic diagnosis of cervical cancer; (ii) being treated at the UCI or JRRF for cervical cancer; and (iii) able to provide consent to participate in the study in English, Luganda, Lusoga, Luo, or Runyankole. All participants completed a quantitative survey and a selected group was sampled for semi‐structured interviews. Data were analysed using the convergent parallel mixed‐methods approach. Descriptive statistics were reported for the quantitative data and qualitative data using an inductive‐deductive thematic analysis approach. Results: In all, 351 women participated in the quantitative section of the study and 24 in the qualitative. The quantitative and qualitative findings largely aligned and supported one another. Women reported travelling up to 14 h to receive treatment and 20% noted that they would spend three or more nights away from home during their current visit. Major themes of the qualitative include means of transportation, spending the night away from home, and financial factors. Conclusion: Our findings show that travelling to obtain cervical cancer care can be a significant burden for women in Uganda. Approaches should be considered to reduce this burden such as additional satellite cervical cancer clinics or subsidised transportation options. [ABSTRACT FROM AUTHOR]
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- 2024
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50. Menstrual hygiene management inequalities among school girls in Badagry, Nigeria.
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Uwadia, Ruth C., Oloruntoba, Elizabeth O., Wada, Ojima Z., and Aluko, Olufemi O.
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SCHOOLGIRLS ,HYGIENE ,SANITARY napkins ,PRIVATE schools ,CONFIDENCE intervals - Abstract
Objectives: The study assessed menstrual hygiene management (MHM) inequalities among public and private in‐school adolescents in Badagry, southwest Nigeria. Also assessed was the impact of available water, sanitation and hygiene (WASH) facilities on MHM within the school premises. Methods: For this descriptive cross‐sectional study, 420 students were selected via multi‐stage sampling and data were obtained via a validated semi‐structured questionnaire and observational checklist. Data were analysed at 95% confidence limit. Results: The students had a mean age of 15.3 ± 1.6 years. All the private schools had functioning WASH facilities whereas only 50% of public schools did. The toilet to student ratios for the private and public schools were 1:155 and 1:296, respectively. Over two‐thirds (67.1%) of the students reportedly use sanitary napkins for MHM, followed by tissue (17.1%) and clothes (15.5%). Additionally, the private school students were two times less likely to use alternatives to sanitary napkins and 9.8 times more likely to obtain sanitary materials at school if required (p < 0.001). A significantly higher proportion of public‐school menstruating in‐school adolescents changed their sanitary towels in the bush (p = 0.003) due to lack of privacy and took their used sanitary materials home (p < 0.001) for management due to reduced access to sanitary bins. Conclusion: Even though the situation in the public schools was worse, both public and private schools lack the enabling environment for MHM. School health promotion interventions, such as provision of subsidised/affordable menstrual pads and basic WASH facilities and campaigns to break the culture of silence are required for the wellbeing of girls. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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