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2. Orthopaedic research in Zimbabwe: a seminal bibliometric analysis

Author

Sibindi, Cosmas, Mageza, Akimu, and Socci, Adrienne

Subjects
Zimbabwe, bibliometric analysis, orthopaedic surgery research, research collaborations, Africa, Orthopedics and Sports Medicine
Abstract

BACKGROUND: To provide a bibliometric analysis of published orthopaedic research in the form of peer-reviewed articles as well as non-indexed articles from Zimbabwe in the past six decades. METHODS: We carried out a literature search of the 'Clarivariate Analytics' Web of Science database, specific journals not included in the database and the University of Zimbabwe repository. We then selected articles focused on research in orthopaedic pathology in Zimbabwe. These articles were then classified by year of publication; focus of research; first and last author country of origin; collaboration type between high-, middle- and low-income countries; journal title; journal country; methodology; and level of evidence. RESULTS: A total of 27 articles published from 1965 to 2020 were found in the search with 26 having a single focus of research and one multiple foci. The highest focus of research was osteoporosis with six articles (22%), while trauma was second with five articles (19%). A majority, 19/27 (70%), of studies had a first author from Zimbabwe, while a plurality, 10/27 (37%), had a Zimbabwean last author. Most collaborations, 12/27 (44%), were high-income-low-income countries, with most studies being concomitantly published in the United States, 13/27 (48%). Cross-sectional descriptive studies represented the most common methodology with 13/27 articles carried out in this method (48%). The majority of these articles, 14/27 (52%), represented a low level of evidence at level 4, while 11/27 articles (41%) of articles were of a high level of evidence (levels 1 or 2). CONCLUSION: There is a limited amount of published orthopaedic surgery research work from Zimbabwe, highlighting the need for more and higher quality research from Zimbabwe. Among different models, partnerships between Zimbabwean researchers and researchers from other international institutions appear to be the most productive in terms of research output and hence should be replicated more broadly. Level of evidence: Level 4

Published
2022

3. Improved Retention Associated With Community-Based Accompaniment for Antiretroviral Therapy Delivery in Rural Rwanda.

Author

Franke, Molly F., Kaigamba, Felix, Socci, Adrienne R., Hakizamungu, Massudi, Patel, Anita, Bagiruwigize, Emmanuel, Niyigena, Peter, Walker, Kelly D. C., Epino, Henry, Binagwaho, Agnes, Mukherjee, Joia, Farmer, Paul E., and Rich, Michael L.

Subjects
ANTIRETROVIRAL agents, HIV infections, THERAPEUTICS, COMMUNITY health workers, RURAL geography
Abstract

We found that comprehensive, integrated, community-based intervention (characterized by daily home visits from a community health worker, directly observed treatment, nutritional support, and transportation stipends) was associated with higher antiretroviral therapy retention at 1 year among adults in rural Rwanda.Background. Minimizing death and ensuring high retention and good adherence remain ongoing challenges for human immunodeficiency virus (HIV) treatment programs. We examined whether the addition of community-based accompaniment (characterized by daily home visits from a community health worker, directly observed treatment, nutritional support, transportation stipends, and other support as needed) to the Rwanda national model for antiretroviral therapy (ART) delivery would improve retention in care, viral load suppression, and change in CD4 count, relative to the national model alone.Methods. We conducted a prospective observational cohort study among 610 HIV-infected adults initiating ART in 1 of 2 programs in rural Rwanda. Psychosocial and clinical characteristics were recorded at ART initiation. Death, treatment retention, and plasma viral load were assessed at 1 year. CD4 count was evaluated at 6-month intervals. Multivariable regression models were used to adjust for baseline differences between the 2 populations.Results. Eighty-five percent and 79% of participants in the community-based and clinic-based programs, respectively, were retained with viral load suppression at 1 year. After adjusting for CD4 count, depression, physical health quality of life, and food insecurity, community-based accompaniment was protective against death or loss to follow-up during the first year of ART (hazard ratio, 0.17; 95% confidence interval [CI], .09–.35; P < .0001). In a second multivariable analysis, individuals receiving accompaniment were more likely to be retained with a suppressed viral load at 1 year (risk ratio: 1.15; 95% CI, 1.03–1.27; P = .01).Conclusions. These findings indicate that community-based accompaniment is effective in improving retention, when added to a clinic-based program with fewer patient support mechanisms. [ABSTRACT FROM AUTHOR]

Published
2013
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