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https://www.readbyqxmd.com/read/28631150/low-dose-subcutaneous-ketamine-for-postoperative-pain-management-in-rwanda-a-dose-finding-study
#1
Jon Tuchscherer, William P McKay, Theogene Twagirumugabe
PURPOSE: Good pain control is not a normal part of surgical care in sub-Saharan Africa due to lack of resources. The primary objective of this study was to determine an efficacious dose of subcutaneous ketamine for postoperative pain for use in a future randomized controlled trial. METHODS: Following research ethics board and local hospital approval for this research, we obtained informed consent from 31 patients undergoing major surgery for a random walk dose-finding study...
June 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28630794/a-case-of-presumed-tuberculosis-uveitis-with-occlusive-vasculitis-from-an-endemic-region
#2
Berna Başarır, Yalçın Karaküçük, Çiğdem Altan, Banu Şatana, Bulut Ocak, Aslı İnal
In this report, we present a case with presumed unilateral tuberculosis uveitis from an endemic region. A 23-year-old male presented with decreased vision in his left eye for 15 days. Visual acuities were 1.0 in his right eye and 0.3 in his left eye. Ophthalmologic examination was normal for the right eye. Slit-lamp examination revealed 2+ cells in the vitreous without anterior chamber reaction in his left eye. Fundus examination revealed occlusive vasculitis and granuloma. His history revealed that he had a respiratory infection with fever 3 months ago while visiting his native country, Rwanda, and was treated with non-specific antibiotic therapy...
June 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/28630744/maternal-predictors-of-neonatal-outcomes-after-emergency-cesarean-section-a-retrospective-study-in-three-rural-district-hospitals-in-rwanda
#3
Naome Nyirahabimana, Christine Minani Ufashingabire, Yihan Lin, Bethany Hedt-Gauthier, Robert Riviello, Jackline Odhiambo, Joel Mubiligi, Martin Macharia, Stephen Rulisa, Illuminee Uwicyeza, Patient Ngamije, Fulgence Nkikabahizi, Theoneste Nkurunziza
BACKGROUND: In sub-Saharan Africa, neonatal mortality post-cesarean delivery is higher than the global average. In this region, most emergency cesarean sections are performed at district hospitals. This study assesses maternal predictors for poor neonatal outcomes post-emergency cesarean delivery in three rural district hospitals in Rwanda. METHODS: This retrospective study includes a random sample of 441 neonates from Butaro, Kirehe and Rwinkwavu District Hospitals, born between 01 January and 31 December 2015...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28630542/the-role-of-international-human-rights-norms-in-the-liberalization-of-abortion-laws-globally
#4
Johanna B Fine, Katherine Mayall, Lilian Sepúlveda
International and regional human rights norms have evolved significantly to recognize that the denial of abortion care in a range of circumstances violates women's and girls' fundamental human rights. These increasingly progressive standards have played a critical role in transforming national-level abortion laws by both influencing domestic high court decisions on abortion and serving as a critical resource in advancing law and policy reform. Courts in countries such as Argentina, Bolivia, Brazil, Colombia, and Nepal have directly incorporated these standards into groundbreaking cases liberalizing abortion laws and increasing women's access to safe abortion services, demonstrating the influence of these human rights standards in advancing women's reproductive freedom...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28629151/structured-additive-quantile-regression-for-assessing-the-determinants-of-childhood-anemia-in-rwanda
#5
Faustin Habyarimana, Temesgen Zewotir, Shaun Ramroop
Childhood anemia is among the most significant health problems faced by public health departments in developing countries. This study aims at assessing the determinants and possible spatial effects associated with childhood anemia in Rwanda. The 2014/2015 Rwanda Demographic and Health Survey (RDHS) data was used. The analysis was done using the structured spatial additive quantile regression model. The findings of this study revealed that the child's age; the duration of breastfeeding; gender of the child; the nutritional status of the child (whether underweight and/or wasting); whether the child had a fever; had a cough in the two weeks prior to the survey or not; whether the child received vitamin A supplementation in the six weeks before the survey or not; the household wealth index; literacy of the mother; mother's anemia status; mother's age at the birth are all significant factors associated with childhood anemia in Rwanda...
June 17, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28627069/who-delivers-where-the-effect-of-obstetric-risk-on-facility-delivery-in-east-africa
#6
Sandra Virgo, Giorgia Gon, Francesca L Cavallaro, Wendy Graham, Susannah Woodd
OBJECTIVES: Skilled attendance at birth is key for the survival of pregnant women. This study investigates whether women at increased risk of maternal and newborn complications in four East African countries are more likely to deliver in a health facility than those at lower risk. METHODS: Demographic & Health Survey data for Kenya 2014, Rwanda 2014-15, Tanzania 2015-16 and Uganda 2011 were used to study women with a live birth in the three years preceding the survey...
June 19, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28625144/detection-of-poor-quality-artemisinin-based-combination-therapy-act-medicines-marketed-in-benin-using-simple-and-advanced-analytical-techniques
#7
Achille Yemoa, Védaste Habyalimana, Jérémie K Mbinze, Victoria Crickboom, Benjamin Muhigirwa, Agnès Ngoya, Pierre-Yves Sacré, Fernand Gbaguidi, Joëlle Quetin-Leclercq, Philippe Hubert, Roland D Marini
BACKGROUND: Poor quality antimalarial medicines still represent a threat to the public health, especially in Sub-Saharan Africa who bears a disproportionate share of the global burden of malaria. It is essential and urgent to strengthen mechanisms against counterfeit medicines. One of the approaches is regular market surveillance through quality controls. METHODS: 12 samples of artemether/lumefantrine were collected from formal and informal drug sellers in Cotonou (Benin) as well as additional other similar samples from Rwanda (13 samples) and from D...
June 15, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28619410/an-international-collaboration-for-the-training-of-medical-chief-residents-in-rwanda
#8
Tim Walker, Vincent Dusabejambo, Janet J Ho, Claudine Karigire, Bradley Richards, Andre N Sofair
BACKGROUND: The year-long position of chief medical resident is a time-honored tradition in the United States that serves to provide the trainee with an opportunity to gain further skills as a clinician, leader, teacher, liaison, and administrator. However, in most training programs in the developing world, this role does not exist. OBJECTIVES: We sought to develop a collaborative program to train the first medical chief residents for the University of Rwanda and to assess the impact of the new chief residency on residency training, using questionnaires and qualitative interviews with Rwandan faculty, chief residents, and residents...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28619402/global-health-values-of-a-multidirectional-near-peer-training-program-in-surgery-pathology-anatomy-research-methodology-and-medical-education-for-haitian-rwandan-and-canadian-medical-students
#9
Malik Elharram, Trish Dinh, Annie Lalande, Susan Ge, Sophie Gao, Geoffroy Noël
BACKGROUND: As health care delivery increasingly requires providers to cross international borders, medical students at McGill University, Canada, developed a multidirectional exchange program with Haiti and Rwanda. The program integrates surgery, pathology, anatomy, research methodology, and medical education. OBJECTIVE: The aim of the present study was to explore the global health value of this international training program to improve medical education within the environment of developing countries, such as Haiti and Rwanda, while improving sociocultural learning of Canadian students...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28619228/effect-of-community-health-clubs-on-child-diarrhoea-in-western-rwanda-cluster-randomised-controlled-trial
#10
Sheela S Sinharoy, Wolf-Peter Schmidt, Ronald Wendt, Leodomir Mfura, Erin Crossett, Karen A Grépin, William Jack, Bernard Ngabo Rwabufigiri, James Habyarimana, Thomas Clasen
BACKGROUND: Community health clubs are multi-session village-level gatherings led by trained facilitators and designed to promote healthy behaviours mainly related to water, sanitation, and hygiene. They have been implemented in several African and Asian countries but have never been evaluated rigorously. We aimed to evaluate the effect of two versions of the community health club model on child health and nutrition outcomes. METHODS: We did a cluster-randomised trial in Rusizi district, western Rwanda...
July 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28616457/cervical-cancer-screening-at-a-tertiary-care-center-in-rwanda
#11
George Ruzigana, Lisa Bazzet-Matabele, Stephen Rulisa, Allison N Martin, Rahel G Ghebre
In limited resource settings such as Rwanda, visual inspection with acetic acid (VIA) is the primary model for cervical cancer screening. The objective of this study was to describe clinical characteristics and outcomes for women presenting for cervical cancer screening. A prospective, observational study was conducted between September 2015 and February 2016 at Kigali University Teaching Hospital (CHUK). Women referred to the VIA clinic were enrolled and completed a semi-structured questionnaire. During the six-month study period, 150 women were enrolled and evaluated with VIA followed by colposcopy directed biopsy for VIA positive...
August 2017: Gynecologic Oncology Reports
https://www.readbyqxmd.com/read/28599645/associations-between-perceptions-of-care-and-women-s-childbirth-experience-a-population-based-cross-sectional-study-in-rwanda
#12
Judith U Mukamurigo, Marie Berg, Joseph Ntaganira, Laetitia Nyirazinyoye, Anna Dencker
BACKGROUND: In recent years Rwanda has achieved remarkable improvement in quality of maternity care services but there is evidence of deficiencies in care quality in terms of disrespectful care. Women's overall childbirth experience is an important outcome of childbirth and a factor in assessing quality of care. The aim of this study was to investigate how women's overall childbirth experience in Rwanda was related to their perceptions of childbirth care. METHODS: A cross-sectional household study of women who had given birth 1-13 months earlier (n = 921) was performed in the Northern Province and in the capital city...
June 9, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28596087/enabling-the-sustainable-faecal-sludge-management-service-delivery-chain-a-case-study-of-dense-settlements-in-kigali-rwanda
#13
Jean Baptiste Akumuntu, Uta Wehn, Martin Mulenga, Damir Brdjanovic
The lack of access to basic sanitation is a global concern and alarmingly prevalent in low- and middle- income countries. In the densely populated settlements of these countries, on-site sanitation systems are usually the only feasible option because dwellers there have no sewers in place to connect to. Using on-site sanitation facilities results in an accumulation of faecal sludge which needs to be properly managed to ensure the well-being of the users as well as the surrounding environment. Unfortunately, often the conditions for faecal sludge management (FSM) within dense settlements are adverse and thus hamper sustainable FSM...
May 23, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28596086/use-microbiological-effectiveness-and-health-impact-of-a-household-water-filter-intervention-in-rural-rwanda-a-matched-cohort-study
#14
Miles A Kirby, Corey L Nagel, Ghislaine Rosa, Marie Mediatrice Umupfasoni, Laurien Iyakaremye, Evan A Thomas, Thomas F Clasen
Unsafe drinking water is a substantial health risk contributing to child diarrhoea. We investigated impacts of a program that provided a water filter to households in rural Rwandan villages. We assessed drinking water quality and reported diarrhoea 12-24 months after intervention delivery among 269 households in the poorest tertile with a child under 5 from 9 intervention villages and 9 matched control villages. We also documented filter coverage and use. In Round 1 (12-18 months after delivery), 97.4% of intervention households reported receiving the filter, 84...
June 1, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/28596020/challenges-to-sustainability-of-hand-hygiene-at-a-rural-hospital-in-rwanda
#15
Ian C Holmen, Dan Niyokwizerwa, Berthine Nyiranzayisaba, Timothy Singer, Nasia Safdar
BACKGROUND: Many hand hygiene (HH) programs have been implemented across Sub-Saharan Africa (SSA); however, most of these have been in large, referral hospitals. Our objective was to assess the impact of HH programs aimed at improving compliance at a rural hospital, and to identify unique challenges to HH sustainability. METHODS: Interventions to improve HH through providing handwashing stations, health care worker (HCW) training, and alcohol handrub were completed in 2014 and 2015...
June 5, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28588996/implementing-one-health-as-an-integrated-approach-to-health-in-rwanda
#16
Thierry Nyatanyi, Michael Wilkes, Haley McDermott, Serge Nzietchueng, Isidore Gafarasi, Antoine Mudakikwa, Jean Felix Kinani, Joseph Rukelibuga, Jared Omolo, Denise Mupfasoni, Adeline Kabeja, Jose Nyamusore, Julius Nziza, Jean Leonard Hakizimana, Julius Kamugisha, Richard Nkunda, Robert Kibuuka, Etienne Rugigana, Paul Farmer, Philip Cotton, Agnes Binagwaho
It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. 'One Health' refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation...
January 2017: BMJ Global Health
https://www.readbyqxmd.com/read/28587638/erratum-to-maternal-near-miss-and-mortality-due-to-postpartum-infection-a-cross-sectional-analysis-from-rwanda
#17
Denis Rwabizi, Stephen Rulisa, Aidan Findlater, Maria Small
No abstract text is available yet for this article.
June 6, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28569202/a-health-partnership-to-reduce-neonatal-mortality-in-four-hospitals-in-rwanda
#18
Placide Ntigurirwa, Kathy Mellor, Daniel Langer, Mari Evans, Emily Robertson, Lisine Tuyisenge, Alan Groves, Tom Lissauer
BACKGROUND: A health partnership to improve hospital based neonatal care in Rwanda to reduce neonatal mortality was requested by the Rwandan Ministry of Health. Although many health system improvements have been made, there is a severe shortage of health professionals with neonatal training. METHODS: Following a needs assessment, a health partnership grant for 2 years was obtained. A team of volunteer neonatologists and paediatricians, neonatal nurses, lactation consultants and technicians with experience in Rwanda or low-income countries was assembled...
June 1, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28567408/evidence-based-adaptation-and-scale-up-of-a-mobile-phone-health-information-service
#19
Kelly L'Engle, Kate F Plourde, Trinity Zan
BACKGROUND: The research base recommending the use of mobile phone interventions for health improvement is growing at a rapid pace. The use of mobile phones to deliver health behavior change and maintenance interventions in particular is gaining a robust evidence base across geographies, populations, and health topics. However, research on best practices for successfully scaling mHealth interventions is not keeping pace, despite the availability of frameworks for adapting and scaling health programs...
2017: MHealth
https://www.readbyqxmd.com/read/28555472/child-mortality-inequalities-across-rwanda-districts-a-geoadditive-continuous-time-survival-analysis
#20
François Niragire, Thomas N O Achia, Alexandre Lyambabaje, Joseph Ntaganira
Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates...
May 11, 2017: Geospatial Health
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