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Objectives: This study was designed to determine the extent of non‐adherence to the different dimensions of diabetes self‐management and to identify the factors influencing non‐adherence among peripheral patients in Bangladesh. Methods: A cross‐sectional study was conducted among 990 adult diabetic patients residing in Thakurgaon district, Bangladesh. Data were collected through face‐to‐face interviews including socio‐demographic information, disease and therapeutic, health services, knowledge and adherence to self‐management components. Results: The proportion of non‐adherence to drug prescription was 66.7%, dietary regimen (68.9%), physical exercise (58.0%), follow‐up visit/blood glucose test (88.2%), stopping tobacco (50.6%), and regular foot care (93.9%). Significant predictors for non‐adherence to drug were poorest socio‐economic status (OR = 2.47), absence of diabetic complications (OR = 1.43), using non‐clinical therapy (OR = 5.61), and moderate level of knowledge (OR = 1.87). Non‐adherence to dietary recommendations was higher for women (OR = 1.72), poorest socio‐economic status (OR = 3.17), and poor technical knowledge (OR = 4.68). Non‐adherence to physical exercise was lower for women (OR = 0.62), combined family (OR = 0.63), middle socio‐economic status (OR = 0.54), and moderate knowledge on physical exercise (OR = 0.55). Non‐adherence to follow‐up visits/blood glucose test was higher among patients who did not have diabetic complications (OR = 1.81) and with own transport (OR = 2.57), and respondents from high‐income group (OR = 0.23) were less likely to be non‐adherent. Non‐adherence to stopping tobacco was higher for older individuals (OR = 1.86); but lower for women (OR = 0.48), individuals with higher education level (OR = 0.17) and patients sick for a longer time (OR = 0.52). Non‐adherence to foot care was higher for patients who needed longer time to go to hospital (OR = 4.07) and had poor basic knowledge on diabetes (OR = 17.80). Conclusion: An alarmingly high proportion of diabetic patients did not adhere to diabetes self‐management. Major predictors for non‐adherence were related to patient's demographic characteristics and their experience with disease, treatment and health care services. [ABSTRACT FROM AUTHOR]

Objectives: This study investigated the molecular epidemiology of respiratory syncytial virus (RSV) among febrile children with acute respiratory tract infection in Ghana, Gabon, Tanzania and Burkina Faso between 2014 and 2017 as well as the evolution and diversification of RSV strains from other sub-Saharan countries.Methods: Pharyngeal swabs were collected at four study sites (Agogo, Ghana: n = 490; Lambaréné, Gabon: n = 182; Mbeya, Tanzania: n = 293; Nouna, Burkina Faso: n = 115) and analysed for RSV and other respiratory viruses using rtPCR. For RSV-positive samples, sequence analysis of the second hypervariable region of the G gene was performed. A dataset of RSV strains from sub-Saharan Africa (2011-2017) currently available in GenBank was compiled. Phylogenetic analysis was conducted to identify the diversity of circulating RSV genotypes.Results: In total, 46 samples were tested RSV positive (Ghana n = 31 (6.3%), Gabon n = 4 (2.2%), Tanzania n = 9 (3.1%) and Burkina Faso n = 2 (1.7%)). The most common RSV co-infection was with rhinovirus. All RSV A strains clustered with genotype ON1 strains with a 72-nucleotide duplication and all RSV B strains belonged to genotype BAIX. Phylogenetic analysis of amino acid sequences from sub-Saharan Africa revealed the diversification into 11 different ON1 and 22 different BAIX lineages and differentiation of ON1 and BAIX strains into potential new sub-genotypes, provisionally named ON1-NGR, BAIX-KEN1, BAIX-KEN2 and BAIX-KEN3.Conclusion: The study contributes to an improved understanding of the molecular epidemiology of RSV infection in sub-Saharan Africa. It provides the first phylogenetic data for RSV from Tanzania, Gabon and Burkina Faso and combines it with RSV strains from all other sub-Saharan countries currently available in GenBank. [ABSTRACT FROM AUTHOR]

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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.)

Objective To evaluate whether community-based health insurance ( CBHI) protects household assets in rural Burkina Faso, Africa. Data Sources Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004-2007( n = 890). Study Design The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-2006. We applied different strategies to control for selection bias-ordinary least squares with covariates, two-stage least squares with instrumental variable, and fixed-effects models. Data Collection Household members were interviewed in their local language every year, and information was collected on demographic and socio-economic indicators including ownership of assets, and on self-reported morbidity. Principal Findings Fixed-effects and ordinary least squares models showed that CBHI protected household assets during 2004-2007. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004-2005. Conclusions In this study, we found that CBHI has the potential to not only protect household assets but also increase household assets. However, similar studies from developing countries that evaluate the impact of health insurance on household economic indicators are needed to benchmark these results with other settings. [ABSTRACT FROM AUTHOR]