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3. Performance of a Nonelectric Infant Warmer in Rwandan Health Centers

Author

May, Leana, Nshimyiryo, Alphonse, Kubwimana, Marthe, Nahimana, Evrard, Schoen, Natalie, Gadgil, Ashok, Kateera, Fredrick, Feldman, Henry A, Nyishime, Merab, and Hansen, Anne

Subjects
Health Services and Systems, Health Sciences, Pediatric, Clinical Research, Good Health and Well Being, Newborn, hypothermia, kangaroo mother care, non-electric warmer, resource-limited setting, Paediatrics, Health services and systems, Public health
Abstract

Background. Neonatal hypothermia remains a challenge in resource-limited settings. Methods. We conducted a prospective mixed-methods cohort study in rural Rwandan health centers to assess the performance of an infant warmer we designed for low-resource settings. All hypothermic infants were eligible for enrollment. Outcomes. Safety: incidence of adverse reactions. Effectiveness: attainment of euthermia, rate of temperature rise. Feasibility: correct use of warmer, signs of wear. Interviews of caregivers and nurses. Findings. Of 102 encounters, there were no adverse reactions. Of 80 encounters for hypothermia when infants on warmer for ≥1 hour, 79 achieved euthermia; 73 in ≤2 hours. Of the 80 encounters, 64 had temperature rise ≥0.5°C/h. Of the 102 encounters, there were no instances of the warmer being prepared, used, or cleaned incorrectly. Five out of the 12 warmers exhibited wear. Interview participants were predominantly positive; some found time for readiness of warmer challenging. Interpretation. The warmer performed well. It is appropriate to study in larger scale.

Published
2019

5. Safety and efficacy of sofosbuvir–velpatasvir–voxilaprevir for re-treatment of chronic hepatitis C virus infection in patients with previous direct-acting antiviral treatment failure in Rwanda (SHARED-3): a single-arm trial

Author

Gupta, Neil, Manirambona, Linda, Shumbusho, Fabienne, Kabihizi, Jules, Murangwa, Anthere, Serumondo, Janvier, Makuza, Jean Damascene, Nsanzimana, Sabin, Muvunyi, Claude Mambo, Mukabatsinda, Constance, Musabeyezu, Emmanuel, Camus, Gregory, Grant, Philip M, and Kateera, Fredrick

Published
2022
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9. Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For Mine Workers in Rural Rwanda

Author

Tumusime, Robert, primary, Miller, Michael S., additional, Niyigena, Anne, additional, Dusabeyezu, Symaque, additional, Uwitonze, Pierrot, additional, Harerimana, Emmanuel, additional, Umugiraneza, Grace, additional, Dusingizimana, Wellars, additional, Hatfield, Samuel, additional, Savarimuthu, Stella, additional, Lawrence, Juliana, additional, Hagenimana, Pacifique, additional, Ngenzi, Jean Marie Vianney, additional, Murara, Aristarque, additional, Mwiseneza, Phoebe, additional, Sonenthal, Paul, additional, Cubaka, Vincent K., additional, Kateera, Fredrick, additional, and Kamali, Innocent, additional

Published
2024
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10. Decentralized, primary-care delivered epilepsy services in Burera District, Rwanda: Service use, feasibility, and treatment

Author

Nyirandagijimana, Beatha, Nshimyiryo, Alphonse, Mukasakindi, Hildegarde, Odhiambo, Jackline, Uwimana, Eugenie, Mukamurenzi, Valerie, Bienvenu, Robert, Ndikubwimana, Jean Sauveur, Uwamaliya, Clemence, Kundu, Priya, Park, Paul H., Mpunga, Tharcisse, Raviola, Giuseppe J., Kateera, Fredrick, Rusangwa, Christian, and Smith, Stephanie L.

Published
2021
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11. Increasing access to pediatric surgical care: Assessing district hospital readiness in rural Rwanda

Author

Nuss, Sarah R., primary, Nkurunziza, Jonathan, additional, Mugabo, Carol, additional, Kubwimana, Marthe, additional, Benimana, Fanny, additional, Uwera, Cynthia, additional, Nyirasabwa, Theodette, additional, Nyirimanzi, Naphtal, additional, Forbes, Callum, additional, Majyambere, Jean Paul, additional, Kateera, Fredrick, additional, Hedt‐Gauthier, Bethany L., additional, and Cubaka, Vincent K., additional

Published
2024
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15. Implementation and Cost Analysis of a Novel Silicosis Case-Finding Program For MineWorkers in Rural Rwanda.

Author

Tumusime, Robert, Miller, Michael S., Niyigena, Anne, Dusabeyezu, Symaque, Uwitonze, Pierrot, Harerimana, Emmanuel, Umugiraneza, Grace, Dusingizimana, Wellars, Hatfield, Samuel, Savarimuthu, Stella, Lawrence, Juliana, Hagenimana, Pacifique, Vianney Ngenzi, Jean Marie, Murara, Aristarque, Mwiseneza, Phoebe, Sonenthal, Paul, Cubaka, Vincent K., Kateera, Fredrick, and Kamali, Innocent

Published
2024
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16. Effect of trimethoprim-sulphamethoxazole on the risk of malaria in HIV-infected Ugandan children living in an area of widespread antifolate resistance

Author

Gasasira, Anne F, Kamya, Moses R, Ochong, Edwin O, Vora, Neil, Achan, Jane, Charlebois, Edwin, Ruel, Theodore, Kateera, Fredrick, Meya, Denise N, Havlir, Diane, Rosenthal, Philip J, and Dorsey, Grant

Abstract

Abstract Background Daily trimethoprim-sulfamethoxazole (TS) protects against malaria, but efficacy may be diminished as anti-folate resistance increases. This study assessed the incidence of falciparum malaria and the prevalence of resistance-conferring Plasmodium falciparum mutations in HIV-infected children receiving daily TS and HIV-uninfected children not taking TS. Materials and methods Subjects were 292 HIV-infected and 517 uninfected children from two cohort studies in Kampala, Uganda observed from August 2006 to December 2008. Daily TS was given to HIV-infected, but not HIV-uninfected children and all participants were provided an insecticide-treated bed net. Standardized protocols were used to measure the incidence of malaria and identify markers of antifolate resistance. Results Sixty-five episodes of falciparum malaria occurred in HIV-infected and 491 episodes in uninfected children during the observation period. TS was associated with a protective efficacy of 80% (0.10 vs. 0.45 episodes per person year, p < 0.001), and efficacy did not vary over three consecutive 9.5 month periods (81%, 74%, 80% respectively, p = 0.506). The prevalences of dhfr 51I, 108N, and 59R and dhps 437G and 540E mutations were each over 90% among parasites infecting both HIV-infected and uninfected children. Prevalence of the dhfr 164L mutation, which is associated with high-level resistance, was significantly higher in parasites from HIV-infected compared to uninfected children (8% vs. 1%, p = 0.001). Sequencing of the dhfr and dhps genes identified only one additional polymorphism, dhps 581G, in 2 of 30 samples from HIV-infected and 0 of 54 samples from uninfected children. Conclusion Despite high prevalence of known anti-folate resistance-mediating mutations, TS prophylaxis was highly effective against malaria, but was associated with presence of dhfr 164L mutation.

Published
2010

19. Evaluating the delivery of Problem Management Plus in primary care settings in rural Rwanda: a study protocol using a pragmatic randomised hybrid type 1 effectiveness-implementation design

Author

Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, Smith, Stephanie L, Nyirandagijimana, Beatha, Hakizimana, Janvier, Levy, Roger P, Bienvenu, Robert, Uwamwezi, Anathalie, Hakizimfura, Octavien, Uwimana, Eugenie, Kundu, Priya, Mpanumusingo, Egide, Nshimyiryo, Alphonse, Rusangwa, Christian, Kateera, Fredrick, Mukasakindi, Hildegarde, Raviola, Giuseppe, Massachusetts Institute of Technology. Department of Brain and Cognitive Sciences, Smith, Stephanie L, Nyirandagijimana, Beatha, Hakizimana, Janvier, Levy, Roger P, Bienvenu, Robert, Uwamwezi, Anathalie, Hakizimfura, Octavien, Uwimana, Eugenie, Kundu, Priya, Mpanumusingo, Egide, Nshimyiryo, Alphonse, Rusangwa, Christian, Kateera, Fredrick, Mukasakindi, Hildegarde, and Raviola, Giuseppe

Abstract

IntroductionEvidence-based low-intensity psychological interventions such as Problem Management Plus (PM+) have the potential to expand treatment access for depression and anxiety, yet these interventions are not yet effectively implemented in rural, public health systems in resource-limited settings. In 2017, Partners In Health adapted PM+ for delivery by primary care nurses in rural Rwanda and began integrating PM+ into health centres in collaboration with the Rwandan Ministry of Health, using established implementation strategies for mental health integration into primary care (Mentoring and Enhanced Supervision at Health Centers for Mental Health (MESH MH)). A gap in the evidence regarding whether low-intensity psychological interventions can be successfully integrated into real-world primary care settings and improve outcomes for common mental disorders remains. In this study, we will rigorously evaluate the delivery of PM+ by primary care nurses, supported by MESH MH, as it is scaled across one rural district in Rwanda.Methods and analysisWe will conduct a hybrid type 1 effectiveness-implementation study to test the clinical outcomes of routinely delivered PM+ and to describe the implementation of PM+ at health centres. To study the clinical effectiveness of PM+, we will use a pragmatic, randomised multiple baseline design to determine whether participants experience improvement in depression symptoms (measured by the Patient Health Questionnaire-9) and functioning (measured by the WHO-Disability Assessment Scale Brief 2.0) after receiving PM+. We will employ quantitative and qualitative methods to describe and evaluate PM+ implementation outcomes using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, using routinely collected programme data and semistructured interviews.Ethics and diss

Published
2023

22. Impact of COVID-19 on access to cancer care in Rwanda: a retrospective time-series study using electronic medical records data

Author

Habinshuti, Placide, primary, Nshimyiryo, Alphonse, additional, Fejfar, Donald Luke, additional, Niyigena, Anne, additional, Cubaka, Vincent K, additional, Karema, Nadine, additional, Bigirimana, Jean Bosco, additional, Shyirambere, Cyprien, additional, Barnhart, Dale A, additional, Kateera, Fredrick, additional, and Fulcher, Isabel, additional

Published
2022
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23. IMPLEMENTATION OF A SPIROMETRY TRAINING PROGRAM FOR SILICOSIS SCREENING IN RWANDA

Author

LAWRENCE, JULIANA C, TUMUSIME, ROBERT, DUSABEYEZU, SYMAQUE, MILLER, MICHAEL S, UMUGIRANEZA, MARIE GRACE, UWITONZE, PIERROT CONSTANCE, NIYIGENA, ANNE, NIRAGIRA MUGISHA, ALLISON OPHÉLIE, HATFIELD, SAMUEL, SURYA, SANJNA, DUSINGIZIMANA, WELLARS, MUKHERJEE, JOIA, BAGANIZI, ERICK, CUBAKA, VINCENT K, KATEERA, FREDRICK, KAMALI, INNOCENT, SONENTHAL, PAUL D, and HAGENIMANA, PACIFIQUE

Published
2024
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24. RESPIRATORY SYMPTOMS IN RWANDAN MINEWORKERS WITH SILICOSIS

Author

MILLER, MICHAELS, TUMUSIME, ROBERT, DUSABEYEZU, SYMAQUE, LAWRENCE, JULIANAC, GRACE, MARIE, PIERROT, UMUGIRANEZA, UWITONZE, CONSTANCE, NIYIGENA, ANNE, OPHÉLIE, ALLISON, MUGISHA, NIRAGIRA, HATFIELD, SAMUEL, SURYA, SANJNA, DUSINGIZIMANA, WELLARS, MUKHERJEE, JOIA, BAGANIZI, ERICK, CUBAKA, VINCENTK, KATEERA, FREDRICK, KAMALI, INNOCENT, SONENTHAL, PAULD, and HAGENIMANA, PACIFIQUE

Published
2024
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25. mHealth-community health worker telemedicine intervention for surgical site infection diagnosis: a prospective study among women delivering via caesarean section in rural Rwanda

Author

Nkurunziza, Theoneste, primary, Williams, Wendy, additional, Kateera, Fredrick, additional, Riviello, Robert, additional, Niyigena, Anne, additional, Miranda, Elizabeth, additional, Bikorimana, Laban, additional, Nkurunziza, Jonathan, additional, Velin, Lotta, additional, Goodman, Andrea S, additional, Matousek, Alex, additional, Klug, Stefanie J, additional, Gaju, Erick, additional, and Hedt-Gauthier, Bethany L, additional

Published
2022
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26. Low COVID-19–related knowledge and access to adequate handwashing among patients with chronic diseases in rural Rwanda: a cross-sectional survey

Author

Nshimyiryo, Alphonse, primary, Barnhart, Dale A., additional, Kateera, Fredrick, additional, Mazimpaka, Christian, additional, Niyigena, Anne, additional, Ngoga, Gedeon, additional, Uwamahoro, Pacifique, additional, Galaris, Joanna, additional, Gato, Saidath, additional, Umugisha, Jean Paul, additional, Nahimana, Evrard, additional, Cubaka, Vincent K., additional, and Umutesi, Grace, additional

Published
2022
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27. Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care

Author

Kateera, Fredrick, primary, Hedt‐Gauthier, Bethany, additional, Luo, Amy, additional, Niyigena, Anne, additional, Galvin, Grace, additional, Hakizimana, Sadoscar, additional, Molina, Rose L., additional, Boatin, Adeline A., additional, Kasonde, Prisca, additional, Musabeyezu, Juliet, additional, Ngonzi, Joseph, additional, Riviello, Robert, additional, Semrau, Katherine, additional, and Sayinzoga, Félix, additional

Published
2022
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28. Community-Based Control of Malaria Vectors Using Bacillus thuringiensis var. Israelensis (Bti) in Rwanda

Author

Hakizimana, Emmanuel, primary, Ingabire, Chantal Marie, additional, Rulisa, Alexis, additional, Kateera, Fredrick, additional, van den Borne, Bart, additional, Muvunyi, Claude Mambo, additional, van Vugt, Michele, additional, Mutesa, Leon, additional, Bron, Gebbiena M., additional, Takken, Willem, additional, and Koenraadt, Constantianus J. M., additional

Published
2022
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29. mHealth-community health worker telemedicine intervention for surgical site infection diagnosis : a prospective study among women delivering via caesarean section in rural Rwanda

Author

Nkurunziza, Theoneste, Williams, Wendy, Kateera, Fredrick, Riviello, Robert, Niyigena, Anne, Miranda, Elizabeth, Bikorimana, Laban, Nkurunziza, Jonathan, Velin, Lotta, Goodman, Andrea S., Matousek, Alex, Klug, Stefanie J., Gaju, Erick, Hedt-Gauthier, Bethany L., Nkurunziza, Theoneste, Williams, Wendy, Kateera, Fredrick, Riviello, Robert, Niyigena, Anne, Miranda, Elizabeth, Bikorimana, Laban, Nkurunziza, Jonathan, Velin, Lotta, Goodman, Andrea S., Matousek, Alex, Klug, Stefanie J., Gaju, Erick, and Hedt-Gauthier, Bethany L.

Abstract

Background Surgical site infections (SSIs) cause a significant global public health burden in low and middle-income countries. Most SSIs develop after patient discharge and may go undetected. We assessed the feasibility and diagnostic accuracy of an mHealth-community health worker (CHW) home-based telemedicine intervention to diagnose SSIs in women who delivered via caesarean section in rural Rwanda. Methods This prospective cohort study included women who underwent a caesarean section at Kirehe District Hospital between September 2019 and March 2020. At postoperative day 10 (+/- 3 days), a trained CHW visited the woman at home, provided wound care and transmitted a photo of the wound to a remote general practitioner (GP) via WhatsApp. The GP reviewed the photo and made an SSI diagnosis. The next day, the woman returned to the hospital for physical examination by an independent GP, whose SSI diagnosis was considered the gold standard for our analysis. We describe the intervention process indicators and report the sensitivity and specificity of the telemedicine-based diagnosis. Results Of 787 women included in the study, 91.4% (n=719) were located at their home by the CHW and all of them (n=719, 100%) accepted the intervention. The full intervention was completed, including receipt of GP telemedicine diagnosis within 1 hour, for 79.0% (n=623). The GPs diagnosed 30 SSIs (4.2%) through telemedicine and 38 SSIs (5.4%) through physical examination. The telemedicine sensitivity was 36.8% and specificity was 97.6%. The negative predictive value was 96.4%. Conclusions Implementation of an mHealth-CHW home-based intervention in rural Rwanda and similar settings is feasible. Patients acceptance of the intervention was key to its success. The telemedicine-based SSI diagnosis had a high negative predictive value but a low sensitivity. Further studies must explore strategies to improve accuracy, such as accompanying wound images with clinical data or developing algorithms using, Funding Agencies|National Institutes of Health [NIH R21TW011229]; Partners In Health-Rwanda

Published
2022
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30. Community-Based Control of Malaria Vectors Using Bacillus thuringiensis var. Israelensis (Bti) in Rwanda

Author

Hakizimana, Emmanuel, Ingabire, Chantal Marie, Rulisa, Alexis, Kateera, Fredrick, van den Borne, Bart, Muvunyi, Claude Mambo, van Vugt, Michele, Mutesa, Leon, Bron, Gebbiena M., Takken, Willem, Koenraadt, Constantianus J.M., Hakizimana, Emmanuel, Ingabire, Chantal Marie, Rulisa, Alexis, Kateera, Fredrick, van den Borne, Bart, Muvunyi, Claude Mambo, van Vugt, Michele, Mutesa, Leon, Bron, Gebbiena M., Takken, Willem, and Koenraadt, Constantianus J.M.

Abstract

Larval source management (LSM) programs for control of malaria vectors are often vertically organized, while there is much potential for involving local communities in program implementation. To address this, we evaluated the entomological impact of community-based application of Bacillus thuringiensis var. israelensis (Bti) in a rice irrigation scheme in Ruhuha, Rwanda. A non-randomized trial with control compared a Bti implementation program that was supervised by the project team (ES) with a program that was led and carried out by local rice farming communities (CB). One other area served as a control to assess mosquito populations without Bti application. Entomological surveys were carried out every two weeks and assessed the presence and abundance of the larval, pupal, and adult stages of Anopheles mosquitoes. In ES, the per round reduction in Anopheles larval habitats was estimated at 49%. This reduction was less in CB (28%) and control (22%) although the per round reduction in CB was still significantly higher than in control. Pupal production was almost completely prevented from round 5 (out of 10) onwards in both CB (average habitat occupancy 0.43%) and ES intervention arms (average habitat occupancy 0.27%), whereas pupal occupancy rates were on average 12.8% from round 5 onwards in the control. Emergence of adult mosquitoes from rice fields was thus prevented although this was not directly noticeable in adult An. gambiae populations in houses nearby the rice fields. Together with our earlier work on the willingness to financially contribute to the LSM program and the high perceived safety and acceptance of the Bti product, the current study demonstrates that, in an environment with limited resources, communities could become more engaged in LSM program implementation and contribute directly to malaria vector control in their environment.

Published
2022

31. Implementation of Refugees' Inclusion in National Viral Hepatitis B and Hepatitis C Screening Campaign in Mahama Refugee Camp, Rwanda

Author

Nyirahabihirwe, Françoise, primary, Kamali, Innocent, additional, Barnhart, Dale A., additional, Gakuru, Jean de la Paix, additional, Musafiri, Tumusime, additional, Rwamuhinda, Dina Denis, additional, Mutabazi, Placide, additional, Mukayirabuka, Stephanie, additional, Makuza, Jean Damascene, additional, Kassim, Noor, additional, Mubiligi, Joel M., additional, Ndahimana, Jean d'Amour, additional, and Kateera, Fredrick, additional

Published
2022
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32. Rwanda’s community health workers at the front line: a mixed-method study on perceived needs and challenges for community-based healthcare delivery during COVID-19 pandemic

Author

Niyigena, Anne, primary, Girukubonye, Ignace, additional, Barnhart, Dale A, additional, Cubaka, Vincent K, additional, Niyigena, Pierre Celestin, additional, Nshunguyabahizi, Marcel, additional, Mukamana, Beatrice, additional, Kateera, Fredrick, additional, and Bitalabeho, Florence A, additional

Published
2022
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35. The Effect and Feasibility of mHealth-Supported Surgical Site Infection Diagnosis by Community Health Workers After Cesarean Section in Rural Rwanda: Randomized Controlled Trial (Preprint)

Author

Kateera, Fredrick, primary, Riviello, Robert, additional, Goodman, Andrea, additional, Nkurunziza, Theoneste, additional, Cherian, Teena, additional, Bikorimana, Laban, additional, Nkurunziza, Jonathan, additional, Nahimana, Evrard, additional, Habiyakare, Caste, additional, Ntakiyiruta, Georges, additional, Matousek, Alexi, additional, Gaju, Erick, additional, Gruendl, Magdalena, additional, Powell, Brittany, additional, Sonderman, Kristin, additional, Koch, Rachel, additional, and Hedt-Gauthier, Bethany, additional

Published
2021
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36. Evaluating the delivery of Problem Management Plus in primary care settings in rural Rwanda: a study protocol using a pragmatic randomised hybrid type 1 effectiveness-implementation design

Author

Smith, Stephanie L, primary, Nyirandagijimana, Beatha, additional, Hakizimana, Janvier, additional, Levy, Roger P, additional, Bienvenu, Robert, additional, Uwamwezi, Anathalie, additional, Hakizimfura, Octavien, additional, Uwimana, Eugenie, additional, Kundu, Priya, additional, Mpanumusingo, Egide, additional, Nshimyiryo, Alphonse, additional, Rusangwa, Christian, additional, Kateera, Fredrick, additional, Mukasakindi, Hildegarde, additional, and Raviola, Giuseppe, additional

Published
2021
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38. Peripartum traditional medicine use and surgical site infections: A prospective cohort of women delivering via cesarean section in rural Rwanda

Author

Bikorimana, Laban, primary, Oryono, Andrew, additional, Miranda, Elizabeth, additional, Niyigena, Anne, additional, Alayande, Barnabas, additional, Niyonkuru, Mathieu, additional, Goodman, Andreas S., additional, Kateera, Fredrick, additional, Riviello, Robert, additional, Hakizimana, Sadoscar, additional, Boatin, Adeline, additional, Mazimpaka, Christian, additional, and Hedt-Gauthier, Bethany, additional

Published
2021
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40. Feasibility and Efficacy of an Mhealth-community Health Worker Telemedicine Intervention for Surgical Site Infection Diagnosis Among Women Undergoing Cesarean Section in Rural Rwanda

Author

Nkurunziza, Theoneste, primary, Williams, Wendy R., additional, Kateera, Fredrick, additional, Riviello, Robert, additional, Miranda, Elizabeth, additional, Bikorimana, Laban, additional, Niyigena, Anne, additional, Klug, Stefanie J., additional, and Hedt-Gauthier, Bethany, additional

Published
2021
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44. Safe recovery after cesarean in rural Africa: Technical consensus guidelines for post‐discharge care.

Author

Kateera, Fredrick, Hedt‐Gauthier, Bethany, Luo, Amy, Niyigena, Anne, Galvin, Grace, Hakizimana, Sadoscar, Molina, Rose L., Boatin, Adeline A., Kasonde, Prisca, Musabeyezu, Juliet, Ngonzi, Joseph, Riviello, Robert, Semrau, Katherine, and Sayinzoga, Félix

Subjects
*CESAREAN section, *POSTNATAL care, *PUERPERIUM, *GROUP work in education
Abstract

Despite increasing cesarean rates in Africa, there remain extensive gaps in the standard provision of care after cesarean birth. We present recommendations for discharge instructions to be provided to women following cesarean delivery in Rwanda, particularly rural Rwanda, and with consideration of adaptable guidelines for sub‐Saharan Africa, to support recovery during the postpartum period. These guidelines were developed by a Technical Advisory Group comprised of clinical, program, policy, and research experts with extensive knowledge of cesarean care in Africa. The final instructions delineate between normal and abnormal recovery symptoms and advise when to seek care. The instructions align with global postpartum care guidelines, with additional emphasis on care practices more common in the region and address barriers that women delivering via cesarean may encounter in Africa. The recommended timeline of postpartum visits and visit activities reflect the World Health Organization protocols and provide additional activities to support women who give birth via cesarean. These guidelines aim to standardize communication with women at the time of discharge after cesarean birth in Africa, with the goal of improved confidence and clinical outcomes among these individuals. Synopsis: Recommendations of a Technical Advisory Group for postpartum instructions for women after cesarean birth in rural Africa. [ABSTRACT FROM AUTHOR]

Published
2023
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46. Prevalence and associated risk factors for hepatitis B and C viruses among refugee populations living in Mahama, Rwanda: A cross-sectional study

Author

Kamali, Innocent, primary, Barnhart, Dale A., additional, Ndahimana, Jean d’Amour, additional, Noor, Kassim, additional, Mumporeze, Jeanne, additional, Nyirahabihirwe, Françoise, additional, Gakuru, Jean de la Paix, additional, Musafiri, Tumusime, additional, Urusaro, Sandra, additional, Makuza, Jean Damascene, additional, Serumondo, Janvier, additional, Rwamuhinda, Dina Denis, additional, Nkundibiza, Maurice, additional, Kateera, Fredrick, additional, Nshogoza, Gallican Rwibasira, additional, and Mubiligi, Joel M., additional

Published
2021
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47. Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda

Author

Niyigena, Anne, primary, Gato, Saidath, additional, Alayande, Barnabas, additional, Miranda, Elizabeth, additional, Hedt-Gauthier, Bethany, additional, Goodman, Andrea S., additional, Nkurunziza, Theoneste, additional, Mazimpaka, Christian, additional, Hakizimana, Sadoscar, additional, Ngamije, Patient, additional, Kateera, Fredrick, additional, Riviello, Robert, additional, and Boatin, Adeline A., additional

Published
2021
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48. Strengthening Antimicrobial Resistance Diagnostic Capacity in Rural Rwanda: A Feasibility Assessment

Author

Umutesi, Grace, primary, Velin, Lotta, additional, Muwanguzi, Moses, additional, Faktor, Kara, additional, Mugabo, Carol, additional, Rukundo, Gilbert, additional, Rucogoza, Aniceth, additional, Yankurije, Marthe, additional, Mazimpaka, Christian, additional, De Dieu Gatete, Jean, additional, Shyirambere, Cyprien, additional, Hedt-Gauthier, Bethany, additional, Riviello, Robert, additional, Mpunga, Tharcisse, additional, Mwikarago, Emil Ivan, additional, and Kateera, Fredrick, additional

Published
2021
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49. Surgical Site Infections and Antimicrobial Resistance After Cesarean Section Delivery in Rural Rwanda

Author

Velin, Lotta, primary, Umutesi, Grace, additional, Riviello, Robert, additional, Muwanguzi, Moses, additional, Bebell, Lisa M., additional, Yankurije, Marthe, additional, Faktor, Kara, additional, Nkurunziza, Theoneste, additional, Rukundo, Gilbert, additional, De Dieu Gatete, Jean, additional, Emil, Ivan, additional, Hedt-Gauthier, Bethany L., additional, and Kateera, Fredrick, additional

Published
2021
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50. Feasibility and effectiveness of self-monitoring of blood glucose among insulin-dependent patients with type 2 diabetes: open randomized control trial in three rural districts in Rwanda.

Author

Ng'ang'a, Loise, Ngoga, Gedeon, Dusabeyezu, Symaque, Hedt-Gauthier, Bethany L., Harerimana, Emmanuel, Niyonsenga, Simon Pierre, Bavuma, Charlotte M., Bukhman, Gene, Adler, Alma J., Kateera, Fredrick, and Park, Paul H.

Subjects
INSULIN therapy, EVALUATION of medical care, HEALTH education, CONFIDENCE intervals, BLOOD sugar monitoring, RURAL conditions, GLYCEMIC control, TYPE 2 diabetes, RANDOMIZED controlled trials, DIARY (Literary form), T-test (Statistics), DISEASE prevalence, DESCRIPTIVE statistics, PSYCHOSOCIAL factors, STATISTICAL sampling, PATIENT compliance, HEALTH promotion, PEOPLE with diabetes
Abstract

Background: The prevalence of type 2 diabetes in sub Saharan Africa (SSA) has been on the rise. Effective control of blood glucose is key towards reducing the risk of diabetes complications. Findings mainly from high-income countries have demonstrated the effectiveness of self-monitoring of blood-glucose (SMBG) in controlling blood glucose levels. However, there are limited studies describing the implementation of SMBG in rural SSA. This study explores the feasibility and effectiveness of implementing SMBG among patients diagnosed with insulin-dependent type 2 diabetes in rural Rwanda. Methods: Participants were randomized into intervention (n = 42) and control (n = 38) groups. The intervention group received a glucose-meter, blood test-strips, log-book, waste management box and training on SMBG in addition to usual care. The control group continued with their usual care consisting of, routine monthly medical consultation and health education. The primary outcomes were adherence to the implementation of SMBG (testing schedule and recording data in the log-book) and change in hemoglobin A1c. Descriptive statistics and a paired t-test were used to analyze the primary outcomes. Results: In both the intervention and control arms, majority of the participants were female (59.5% vs 52.6%) and married (71.4% vs 73.7%). Most had at most a primary level education (83.3% vs. 89.4%) and were farmers (54.8% vs. 50.0%). Among those in the intervention group, 63.4% showed good adherence to implementing SMBG based on the number of tests recorded in the glucose meter. Only 20.3% demonstrated accurate recording of the glucose level tests in log-books. The mean difference of the HbA1C from baseline to six months post-intervention was significantly better among the intervention group -0.94% (95% CI -1.46, -0.41) compared to the control group 0.73% (95% CI -0.09, 1.54) p < 0.001. Conclusion: Our study showed that among patients with insulin-dependent type 2 diabetes residing in rural Rwanda, SMBG was feasible and demonstrated positive outcomes in improving blood glucose control. However, there is need for strategies to enhance accuracy in recording blood glucose test results in the log-book. Trial registration: The trial was registered retrospectively on the Pan African Clinical Trial Registry, on 17th May 2019. The registration number is PACTR201905538846394. [ABSTRACT FROM AUTHOR]

Published
2022
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