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Ping Sun, Torsten Wronski, Jean D Bariyanga, Ann Apio
The distribution of gastro-intestinal (GI) parasites across landscapes is closely related to the spatial distribution of hosts. In GI parasites with environmental life stages, the vitality of parasites is also affected by ecological and landscape-related components of the environment. This is particularly relevant for domestic livestock species that are often kept across habitats with varying degrees of degradation, exposing them to a wide range of environmentally robust parasite species. In our study, we examined the effect of environmental and anthropogenic factors on the prevalence and intensity of GI parasites across a free-ranging stock of Ankole cattle in the Mutara rangelands of northeastern Rwanda...
March 15, 2018: Veterinary Parasitology
Jennifer Rickard, Christian Ngarambe, Leonard Ndayizeye, Blair Smart, Robert Riviello, Jean Paul Majyambere
BACKGROUND: Management of critically ill patients is challenging in a low-resource setting. In Rwanda, peritonitis is a common surgical condition where patients often present late, with advanced disease. We aim to describe critical care management of patients with peritonitis in Rwanda. METHODS: Data were collected at a tertiary referral hospital in Rwanda on patients undergoing operation for peritonitis over a 6-month period. Data included epidemiology, hospital course and outcomes...
March 19, 2018: World Journal of Surgery
Anatole Manzi, Jean Claude Mugunga, Hari S Iyer, Hema Magge, Fulgence Nkikabahizi, Lisa R Hirschhorn
BACKGROUND: Integrated management of childhood illness (IMCI) can reduce under-5 morbidity and mortality in low-income settings. A program to strengthen IMCI practices through Mentorship and Enhanced Supervision at Health centers (MESH) was implemented in two rural districts in eastern Rwanda in 2010. METHODS: We estimated cost per improvement in quality of care as measured by the difference in correct diagnosis and correct treatment at baseline and 12 months of MESH...
2018: PloS One
Michael Schriver, Vincent Kalumire Cubaka, Peter Vedsted, Innocent Besigye, Per Kallestrup
BACKGROUND: External supervision of primary health care facilities to monitor and improve services is common in low-income countries. Currently there are no tools to measure the quality of support in external supervision in these countries. AIM: To develop a provider-reported instrument to assess the support delivered through external supervision in Rwanda and other countries. METHODS: "External supervision: Provider Evaluation of Supervisor Support" (ExPRESS) was developed in 18 steps, primarily in Rwanda...
2018: Global Health Action
Morgan Pommells, Corinne Schuster-Wallace, Susan Watt, Zachariah Mulawa
The purpose of this study was to better understand the gender violence risks that exist in communities where poor water, sanitation, and hygiene (WaSH) access is a known problem. Focus groups and key informant interviews were used to capture the lived experiences of community and health care practitioners from Rwanda, Tanzania, Uganda, and Kenya. This article provides lived narratives of the various cultural and environmental conditions leading to assaults directly attributable to inadequate WaSH. The results shed light on the complex intersections between water access and violence and have significant implications for achieving gender equity and universal access to WaSH...
March 1, 2018: Violence Against Women
E Munganyinka, E M Ateka, A W Kihurani, M C Kanyange, F Tairo, P Sseruwagi, J Ndunguru
Cassava brown streak disease (CBSD) was first observed on cassava ( Manihot esculenta ) in Rwanda in 2009. In 2014 eight major cassava-growing districts in the country were surveyed to determine the distribution and variability of symptom phenotypes associated with CBSD, and the genetic diversity of cassava brown streak viruses. Distribution of the CBSD symptom phenotypes and their combinations varied greatly between districts, cultivars and their associated viruses. The symptoms on leaf alone recorded the highest (32...
February 2018: Plant Pathology
Sori Teshale, Dirk Geysen, Gobena Ameni, Pierre Dorny, Dirk Berkvens
BACKGROUND: As evidence of the infection of domestic animals by Anaplasma phagocytophilum and Anaplasma sp. 'Omatjenne' is presently becoming available, understanding the epidemiological and ecological significance of infection is important to quantify the clinical and socio-economic impact of the diseases they cause. METHODS: The first aim of this study was to analyse the occurrence of A. phagocytophilum and Anaplasma sp. 'Omatjenne' in cattle samples collected from selected African countries using a polymerase chain reaction and restriction enzyme fragment length polymorphism...
March 9, 2018: Parasites & Vectors
Mwumvaneza Mutagoma, Dieudonné Sebuhoro, Jean Pierre Nyemazi, Edward J Mills, Jamie I Forrest, Eric Remera, Augustin Murindabigwi, Mouhamed Semakula, Sabin Nsanzimana
BACKGROUND: Retention of participants in longitudinal prospective surveys can challenging for population health researchers. Community health workers (CHWs) may help reduce attrition. METHODS: We used data came from a longitudinal prospective household-based survey targeting women and men in Rwanda, collected between June 2013 and December 2014. The sample was drawn from a population that included all residents of all 30 districts, 416 sectors, and 14,837 villages in Rwanda...
March 9, 2018: BMC Public Health
Margaret E Kruk, Anna D Gage, Godfrey M Mbaruku, Hannah H Leslie
OBJECTIVE: Describe content of clinical care for sick children in low-resource settings. DATA SOURCES: Nationally representative health facility surveys in Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda from 2007 to 2015. STUDY DESIGN: Clinical visits by sick children under 5 years were observed and caregivers interviewed. We describe duration and content of the care in the visit and estimate associations between increased content and caregiver knowledge and satisfaction...
March 7, 2018: Health Services Research
Tom Bundervoet, Sonja Fransen
Research on the impact of violence and conflict on education typically focuses on exposure among a cohort of school-aged children. In line with the fetal origins hypothesis, this paper studies the long-run effect of exposure to adverse maternal health shocks while still in the womb. Exploiting the sudden and discrete nature of the Rwandan genocide and an identification strategy based on temporal and spatial variation, we find that the cohort in utero during the genocide reported on average 0.3 fewer years of schooling in the 2012 Rwanda...
February 18, 2018: Economics and Human Biology
Faustin Habyarimana, Temesgen Zewotir, Shaun Ramroop
The main objective of this study was to assess the risk factors and spatial correlates of domestic violence against women of reproductive age in Rwanda. A structured spatial approach was used to account for the nonlinear nature of some covariates and the spatial variability on domestic violence. The nonlinear effect was modeled through second-order random walk, and the structured spatial effect was modeled through Gaussian Markov Random Fields specified as an intrinsic conditional autoregressive model. The data from the Rwanda Demographic and Health Survey 2014/2015 were used as an application...
March 1, 2018: Journal of Interpersonal Violence
JaBaris D Swain, Colleen Sinnott, Suellen Breakey, Rian Hasson Charles, Gita Mody, Napthal Nyirimanzi, Ceeya Patton-Bolman, Patricia Come, Gapira Ganza, Emmanuel Rusingiza, Nathan Ruhamya, Joseph Mucumbitsi, Jorge Borges, Martin Zammert, Jochen D Muehlschlegel, Robert Oakes, Bruce Leavitt, R Morton Bolman
OBJECTIVE: Despite its near complete eradication in resource-rich countries, rheumatic heart disease remains the most common acquired cardiovascular disease in sub-Saharan Africa. With a ratio of physicians/population of 1 per 10,500, including only 4 cardiologists for a population of 11.4 million, Rwanda represents a resource-limited setting lacking the local capacity to detect and treat early cases of strep throat and perform lifesaving operations for advanced rheumatic heart disease...
February 27, 2018: Journal of Thoracic and Cardiovascular Surgery
Thierry Habyarimana, Mohammed Attaleb, Pacifique Mugenzi, Jean Baptiste Mazarati, Youssef Bakri, Mohammed El Mzibri
Worldwide, breast cancer is the most frequent neoplasm and the second leading cause of cancer death among females. It dominates in both developed and developing countries and represents a major public health problem. The etiology is multifactorial and involves exogenous agents as well as endogenous factors. Although they account for only a small fraction of the breast cancer burden, mutations in the BRCA1 and BRCA2 genes are known to confer a high risk predisposition. Mutations in moderate/low-penetrance genes may also contribute to breast cancer risk...
February 26, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Emmanuel Hakizimana, Corine Karema, Dunia Munyakanage, John Githure, Jean Baptiste Mazarati, Jon Eric Tongren, Willem Takken, Agnes Binagwaho, Constantianus J M Koenraadt
To date, the Republic of Rwanda has not systematically reported on distribution, diversity and malaria infectivity rate of mosquito species throughout the country. Therefore, we assessed the spatial and temporal variation of mosquitoes in the domestic environment, as well as to assess nocturnal biting behavior and infection patterns of the main malaria vectors in Rwanda. For this purpose, mosquitoes were collected monthly from 2010 to 2013 by human landing catches (HLC) and pyrethrum spray collections (PSC) in seven sentinel sites...
February 21, 2018: Acta Tropica
Adriana G Ramirez, Nebil Nuradin, Fidele Byiringiro, Robinson Ssebuufu, George J Stukenborg, Georges Ntakiyiruta, Thomas M Daniel
BACKGROUND: The primary objective was to provide proof of concept of conducting thoracic surgical simulation in a low-middle income country (LMIC). Secondary objectives were to accelerate general thoracic surgery skills acquisition by general surgery residents and sustain simulation surgery teaching through a website, simulation models, and teaching of local faculty. METHODS: Five training models were created for use in a LMIC setting and implemented during on-site courses with Rwandan general surgery residents...
February 21, 2018: Annals of Thoracic Surgery
Dattesh R Davé, Neeraja Nagarjan, Joseph K Canner, Adam L Kushner, Barclay T Stewart
PURPOSE: Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. METHODS: The Surgeons OverSeas Assessment of Surgical Need (SOSAS) instrument is a cross sectional national, cluster random sampling survey administered in Nepal, Rwanda, Sierra Leone, and Uganda from 2011 to 2014...
February 20, 2018: Burns: Journal of the International Society for Burn Injuries
Anatole Manzi, Laetitia Nyirazinyoye, Joseph Ntaganira, Hema Magge, Evariste Bigirimana, Leoncie Mukanzabikeshimana, Lisa R Hirschhorn, Bethany Hedt-Gauthier
BACKGROUND: Inadequate antenatal care (ANC) can lead to missed diagnosis of danger signs or delayed referral to emergency obstetrical care, contributing to maternal mortality. In developing countries, ANC quality is often limited by skill and knowledge gaps of the health workforce. In 2011, the Mentorship, Enhanced Supervision for Healthcare and Quality Improvement (MESH-QI) program was implemented to strengthen providers' ANC performance at 21 rural health centers in Rwanda. We evaluated the effect of MESH-QI on the completeness of danger sign assessments...
February 23, 2018: BMC Health Services Research
Syed Nabeel Zafar, Joseph K Canner, Neeraja Nagarajan, Adam L Kushner
INTRODUCTION: Road traffic injuries (RTI) are a leading cause of morbidity and mortality around the world. The burden is highest in low and middle-income countries (LMICs) and is increasing. We aimed to describe the epidemiology of RTIs in 4 low-income countries using nationally representative survey data. METHODS: The Surgeons Overseas Assessment of Surgical Needs (SOSAS) survey tool was administered in four countries: Sierra Leone, Rwanda, Nepal and Uganda. We performed nationally representative cross-sectional, cluster randomized surveys in each country...
February 19, 2018: International Journal of Surgery
Germaine Tuyisenge, Celestin Hategeka, Isaac Luginaah, Yolanda Babenko-Mould, David Cechetto, Stephen Rulisa
Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda...
February 22, 2018: Maternal and Child Health Journal
Michael Naor, Samuel N Heyman, Tarif Bader, Ofer Merin
OBJECTIVE: The Israeli Defense Force (IDF) Medical Corps developed a model of airborne field hospital. This model was structured to deal with disaster settings, requiring self-sufficiency, innovation and flexible operative mode in the setup of large margins of uncertainty regarding the disaster environment. The current study is aimed to critically analyze the experience, gathered in ten such missions worldwide. METHODS: Interviews with physicians who actively participated in the missions from 1988 until 2015 as chief medical officers combined with literature review of principal medical and auxiliary publications in order to assess and integrate information about the assembly of these missions...
October 2017: American Journal of Disaster Medicine
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