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Hellen J Amuguni, Melissa Mazan, Robert Kibuuka
Infectious diseases of grave concern to human health are emerging from wildlife and livestock populations in multiple regions of the world. Responding effectively to these emerging pandemics requires engagement of multidisciplinary groups of professionals. Using a One Health approach, One Health Central and Eastern Africa (OHCEA), a network of seven schools of public health and seven veterinary schools, with the support of the United States Agency for International Development (USAID), has engaged in curriculum review with the aim of building the skills of multidisciplinary groups of professionals to improve their capacity to respond to emerging infectious diseases...
October 25, 2016: Journal of Veterinary Medical Education
Glorieuse Uwizeye, Bandy X Lee, Thilo Kroll
No abstract text is available yet for this article.
November 2016: International Journal of Public Health
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
Patricia C Henwood, David C Mackenzie, Joshua S Rempell, Emily Douglass, Damas Dukundane, Andrew S Liteplo, Megan M Leo, Alice F Murray, Samuel Vaillancourt, Anthony J Dean, Resa E Lewiss, Stephen Rulisa, Elizabeth Krebs, A K Raja Rao, Emmanuel Rudakemwa, Vincent Rusanganwa, Patrick Kyanmanywa, Vicki E Noble
OBJECTIVE: We delivered a point-of-care ultrasound training programme in a resource-limited setting in Rwanda, and sought to determine participants' knowledge and skill retention. We also measured trainees' assessment of the usefulness of ultrasound in clinical practice. METHODS: This was a prospective cohort study of 17 Rwandan physicians participating in a point-of-care ultrasound training programme. The follow-up period was 1 year. Participants completed a 10-day ultrasound course, with follow-up training delivered over the subsequent 12 months...
October 19, 2016: Tropical Medicine & International Health: TM & IH
Felix Cyamatare Rwabukwisi, Bethany L Hedt-Gauthier, Muhayimpundu Ribakare, Joyce Mukamana, Yvonne Gatesi, Sara Stulac, Peter Drobac, Cheryl L Amoroso, Neil Gupta
Of 277 HIV-infected children in rural Rwanda enrolled in a community-based accompaniment program, 95.0% were retained in care 5 years after treatment initiation, with only 9 (3.3%) deaths and 3 (1.1%) defaults. Of 235 (84.8%) children with a documented viral load result, 201 (85.5%) demonstrated viral load suppression (<1000 copies/mL).
November 2016: Pediatric Infectious Disease Journal
Sergio Bautista-Arredondo, Sandra G Sosa-Rubí, Marjorie Opuni, David Contreras-Loya, Ada Kwan, Claire Chaumont, Abson Chompolola, Jeanine Condo, Omar Galárraga, Neil Martinson, Felix Masiye, Sabin Nsanzimana, Ivan Ochoa-Moreno, Richard Wamai, Joseph Wang'ombe
OBJECTIVE: We estimate facility-level average annual costs per client along the HIV testing and counselling (HTC) and prevention of mother-to-child transmission (PMTCT) service cascades. DESIGN: Data collected covered the period 2011-2012 in 230 HTC and 212 PMTCT facilities in Kenya, Rwanda, South Africa, and Zambia. METHODS: Input quantities and unit prices were collected, as were output data. Annual economic costs were estimated from the service providers' perspective using micro-costing...
October 23, 2016: AIDS
Mary Thuss, Yolanda Babenko-Mould, Mary-Anne Andrusyszyn, Heather K S Laschinger
The purpose of this study was to explore Rwandan nursing clinical instructors' (CIs) experiences of structural and psychological empowerment. CIs play a vital role in students' development by facilitating learning in health care practice environments. Quality nursing education hinges on the CI's ability to enact a professional role. A descriptive qualitative method was used to obtain an understanding of CIs empowerment experiences in practice settings. Kanter's Theory of Structural Power in Organizations and Spreitzer's Psychological Empowerment Theory were used as theoretical frameworks to interpret experiences...
October 15, 2016: International Journal of Nursing Education Scholarship
Theoneste Nkurunziza, Gabriel Toma, Jackline Odhiambo, Rebecca Maine, Robert Riviello, Neil Gupta, Caste Habiyakare, Tharcisse Mpunga, Alex Bonane, Bethany Hedt-Gauthier
BACKGROUND: In developing countries, 9 out of 10 patients lack access to timely operative care. Most patients seek care at district hospitals that often lack operative capacity, creating a need for referral. Delays in referrals contribute to substantial disability and death. This study assessed the predictors of delayed referrals for injured patients. METHODS: This retrospective cohort study included injured patients, recommended for referral between January 1, 2013, and December 31, 2013, from 3 rural district hospitals in Rwanda...
October 12, 2016: Surgery
Etienne Karita, Sabin Nsanzimana, Felix Ndagije, Kristin M Wall, Jeannine Mukamuyango, Placidie Mugwaneza, Eric Remera, Pratima L Raghunathan, Roger Bayingana, Kayitesi Kayitenkore, Brigitte Bekan-Homawoo, Amanda Tichacek, Susan Allen
BACKGROUND: Couples' voluntary HIV counseling and testing (CVCT) is a WHO-recommended intervention for prevention of heterosexual HIV transmission which very few African couples have received. We report the successful nationwide implementation of CVCT in Rwanda. METHODS: From 1988 to 1994 in Rwanda, pregnant and postpartum women were tested for HIV and requested testing for their husbands. Partner testing was associated with more condom use and lower HIV and sexually transmitted infection rates, particularly among HIV-discordant couples...
November 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Jean Christophe Rusatira, Brian Tomaszewski, Vincent Dusabejambo, Vincent Ndayiragije, Snedden Gonsalves, Aishwarya Sawant, Angeline Mumararungu, George Gasana, Etienne Amendezo, Anne Haake, Leon Mutesa
BACKGROUND: Lack of access to health and medical education resources for doctors in the developing world is a serious global health problem. In Rwanda, with a population of 11 million, there is only one medical school, hence a shortage in well-trained medical staff. The growth of interactive health technologies has played a role in the improvement of health care in developed countries and has offered alternative ways to offer continuous medical education while improving patient's care...
June 1, 2016: JMIR Med Educ
Francis Mbuza, Rosine Manishimwe, Janvier Mahoro, Thomas Simbankabo, Kizito Nishimwe
A study was conducted on 37 randomly selected broiler poultry farmers in Rwanda to characterize the production system using pre-tested semi-structured questionnaires. The data were processed in SPSS and presented as means, percentages and ranges in tables and text. All respondents kept Cobb breed and young stock was mainly (73 %) imported from abroad. The majority of respondents were males (68 %) and most farmers had attended only primary level of education (40.5 %). Most of the farms were in the peri-urban (48...
October 11, 2016: Tropical Animal Health and Production
Leonard Ndayizeye, Christian Ngarambe, Blair Smart, Robert Riviello, Jean Paul Majyambere, Jennifer Rickard
BACKGROUND: Few studies discuss causes and outcomes of peritonitis in low-income settings. This study describes epidemiology of patients with peritonitis at a Rwandan referral hospital. Identification of risk factors associated with mortality and unplanned reoperation could improve management of peritonitis. METHODS: Data were collected on demographics, clinical presentation, operative findings, and outcomes for all patients with peritonitis. Multivariate regression analysis identified factors associated with in-hospital mortality and unplanned reoperation...
October 3, 2016: Surgery
Isabell Schierenbeck, Peter Johansson, Lena M Andersson, Gunilla Krantz, Joseph Ntaganira
Traditional medicine (TM) and biomedicine represent parallel health systems in many developing countries; the latter dominating in public policies, while the former still retain considerable influence among the general public. This study investigates how mental health care professionals responsible for mental health care implementation comprehend and relate to the intersection between TM and biomedicine in the cases of Rwanda and the Eastern Cape Province, South Africa. The material is based on semi-structured interviews with mental health care stakeholders in Eastern Cape, South Africa and Rwanda...
October 7, 2016: Global Public Health
Kenneth Turinawe, Greet Vandebriel, David W Lowrance, Francois Uwinkindi, Philippe Mutwa, Kimberly R Boer, Grace Mutembayire, David Tugizimana, Sabin Nsanzimana, Eric Pevzner, Andrea A Howard, Michel Gasana
BACKGROUND: The World Health Organization (WHO) 2010 guidelines for intensified tuberculosis (TB) case finding (ICF) among people living with HIV (PLHIV) includes a recommendation that PLHIV receive routine TB screening. Since 2005, the Rwandan Ministry of Health has been using a five-question screening tool. Our study objective was to assess the operating characteristics of the tool designed to identify PLHIV with presumptive TB as measured against a composite reference standard, including bacteriologically confirmed TB...
2016: PloS One
Dana R Thomson, Muhammed Semakula, Lisa R Hirschhorn, Megan Murray, Vedaste Ndahindwa, Anatole Manzi, Assumpta Mukabutera, Corine Karema, Jeanine Condo, Bethany Hedt-Gauthier
BACKGROUND: To guide efficient investment of limited health resources in sub-Saharan Africa, local researchers need to be involved in, and guide, health system and policy research. While extensive survey and census data are available to health researchers and program officers in resource-limited countries, local involvement and leadership in research is limited due to inadequate experience, lack of dedicated research time and weak interagency connections, among other challenges. Many research-strengthening initiatives host prolonged fellowships out-of-country, yet their approaches have not been evaluated for effectiveness in involvement and development of local leadership in research...
September 29, 2016: Health Research Policy and Systems
Mary C Smith Fawzi, Lauren Ng, Fredrick Kanyanganzi, Catherine Kirk, Justin Bizimana, Felix Cyamatare, Christina Mushashi, Taehoon Kim, Yvonne Kayiteshonga, Agnes Binagwaho, Theresa S Betancourt
BACKGROUND AND OBJECTIVES: In Rwanda, significant progress has been made in advancing access to antiretroviral therapy (ART) among youth. As availability of ART increases, adherence is critical for preventing poor clinical outcomes and transmission of HIV. The goals of the study are to (1) describe ART adherence and mental health problems among youth living with HIV aged 10 to 17; and (2) examine the association between these factors among this population in rural Rwanda. METHODS: A cross-sectional analysis was conducted that examined the association of mental health status and ART adherence among youth (n = 193)...
September 27, 2016: Pediatrics
Margaret E Kruk, Hannah H Leslie, Stéphane Verguet, Godfrey M Mbaruku, Richard M K Adanu, Ana Langer
BACKGROUND: Global efforts to increase births at health-care facilities might not reduce maternal or newborn mortality if quality of care is insufficient. However, little systematic evidence exists for the quality at health facilities caring for women and newborn babies in low-income countries. We analysed the quality of basic maternal care functions and its association with volume of deliveries and surgical capacity in health-care facilities in five sub-Saharan African countries. METHODS: In this analysis, we combined nationally representative health system surveys (Service Provision Assessments by the Demographic and Health Survery Programme) with data for volume of deliveries and quality of delivery care from Kenya, Namibia, Rwanda, Tanzania, and Uganda...
November 2016: Lancet Global Health
Richard Neugebauer, Allana Forde, Kinga E Fodor, Prudence W Fisher, J Blake Turner, Tasha Stehling-Ariza, Saori Yamabe
Whether children or adolescents exhibit higher levels of posttraumatic stress symptoms (PTSS) in response to violence is an unresolved research question. We examine this issue in UNICEF's 1995 National Trauma Survey (NTS) of 8-19-year-olds (n = 942) who survived the Rwandan Genocide and lived and attended schools in the community. PTSS were assessed with a symptom checklist based on DSM-IV indexed using an overall score comprising the sum of scores on all items and mean item scores of each of five distinct factors identified in a factor analysis within this sample...
September 22, 2016: Journal of Nervous and Mental Disease
A Furdová, V Krčméry, K Horkovičová, Ad Furdová, T Sláviková
: Documentation of the anterior segment and the eye fundus with instruments that enable quality precision diagnostics is a common and important part of screening in humanitarian ophthalmology projects. It is the essential element in diagnosis, monitoring and management of eye diseases. In sub saharan countries within the screening for ophthalmologist are not available the modern technologies such as biomicroscope (slit lamp) or fundus camera. We describe our experience with photographs of anterior segment of the eye by using digital camera and Smartphone...
2016: Ceská a Slovenská Oftalmologie
Fredrick Kateera, Sam L Nsobya, Steven Tukwasibwe, Emmanuel Hakizimana, Leon Mutesa, Petra F Mens, Martin P Grobusch, Michèle van Vugt, Nirbhay Kumar
Faced with intense levels of chloroquine (CQ) resistance in Plasmodium falciparum malaria, Rwanda replaced CQ with amodiaquine (AQ)+sulfadoxine-pyrimethamine (SP) in 2001, and subsequently with artemether-lumefantrine (AL) in 2006, as first-line treatments for uncomplicated malaria. Following years of discontinuation of CQ use, re-emergence of CQ-susceptible parasites has been reported in countries including Malawi, Kenya and Tanzania. In contrast, high levels of SP resistant mutant parasites continue to be reported even in countries of presumed reduced SP drug selection pressure...
September 17, 2016: Acta Tropica
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