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https://www.readbyqxmd.com/read/28346109/assessing-process-of-paediatric-care-in-a-resource-limited-setting-a-cross-sectional-audit-of-district-hospitals-in-rwanda
#1
Celestin Hategeka, Jeannie Shoveller, Lisine Tuyisenge, Larry D Lynd
BACKGROUND: Routine assessment of quality of care helps identify deficiencies which need to be improved. While gaps in the emergency care of children have been documented across sub-Saharan Africa, data from Rwanda are lacking. OBJECTIVE: To assess the care of sick infants and children admitted to Rwandan district hospitals and the extent to which it follows currently recommended clinical practice guidelines in Rwanda. METHODS: Data were gathered during a retrospective cross-sectional audit of eight district hospitals across Rwanda in 2012/2013...
March 27, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28336445/mortality-associated-characteristics-of-traumatic-brain-injury-patients-at-the-university-teaching-hospital-of-kigali-rwanda
#2
Elizabeth Krebs, Charles J Gerardo, Lawrence P Park, Joao Ricardo Nickenig Vissoci, Jean Claude Byiringiro, Fidele Byiringiro, Stephen Rulisa, Nathan Thielman, Catherine Staton
OBJECTIVE: Traumatic Brain Injury (TBI) is a leading cause of death and disability. TBI patients in low and middle- income countries have worse outcomes than those in high-income countries. We aimed to evaluate important clinical indicators associated with mortality for TBI patients at the University Teaching Hospital of Kigali (UTHK) Kigali, Rwanda. METHODS: Prospective consecutive sampling of TBI patients presenting to UTHK Accident and Emergency Department were screened for inclusion criteria: reported head trauma, alteration in consciousness, headache, or visible head trauma...
March 21, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28334799/the-relative-roles-of-anc-and-epi-in-the-continuous-distribution-of-llins-a-qualitative-study-in-four-countries
#3
Katherine Theiss-Nyland, Diakalia Koné, Corine Karema, Waqo Ejersa, Jayne Webster, Jo Lines
Background: The continuous distribution of long-lasting insecticidal nets (LLINs) for malaria prevention, through the antenatal care (ANC) and the Expanded Programme on Immunizations (EPI), is recommended by the WHO to improve and maintain LLIN coverage. Despite these recommendations, little is known about the relative strengths and weaknesses of the ANC and EPI-based LLIN distribution. This study aimed to explore and compare the roles of the ANC and EPI for LLIN distribution in four African countries...
December 26, 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/28328735/building-workforce-capacity-abroad-while-strengthening-global-health-programs-at-home-participation-of-seven-harvard-affiliated-institutions-in-a-health-professional-training-initiative-in-rwanda
#4
Corrado Cancedda, Robert Riviello, Kim Wilson, Kirstin W Scott, Meenu Tuteja, Jane R Barrow, Bethany Hedt-Gauthier, Gene Bukhman, Jennifer Scott, Danny Milner, Giuseppe Raviola, Barbara Weissman, Stacy Smith, Tej Nuthulaganti, Craig D McClain, Barbara E Bierer, Paul E Farmer, Anne E Becker, Agnes Binagwaho, Joseph Rhatigan, David E Golan
A consortium of 22 U.S. academic institutions is currently participating in the Rwanda Human Resources for Health Program (HRH Program). Led by the Rwandan Ministry of Health and funded by both the U.S. Government and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the primary goal of this seven-year initiative is to help Rwanda train the number of health professionals necessary to reach the country's health workforce targets. Since 2012, the participating U.S. academic institutions have deployed faculty from a variety of health-related disciplines and clinical specialties to Rwanda...
March 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28325084/application-of-a-contextual-instructional-framework-in-a-continuing-professional-development-training-program-for-physiotherapists-in-rwanda
#5
Kim Dunleavy, Julia Chevan, Antoinette P Sander, Jean Damascene Gasherebuka, Monika Mann
BACKGROUND: Continuing professional development is an important component of capacity building in low resource countries. The purpose of this case study is to describe the use of a contextual instructional framework to guide the processes and instructional design choices for a series of continuing professional development courses for physiotherapists in Rwanda. METHODS: Four phases of the project are described: (1) program proposal, needs assessment and planning, (2) organization of the program and instructional design, (3) instructional delivery and (4) evaluation...
March 22, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28323868/-waiting-for-daas-a-retrospective-chart-review-of-patients-with-untreated-hepatitis-c-in-rwanda
#6
Neil Gupta, Jules Kabahizi, Constance Mukabatsinda, Timothy David Walker, Emmanuel Musabeyezu, Athanase Kiromera, Jennifer Ilo Van Nuil, Kevin Steiner, Joia Mukherjee, Sabin Nsanzimana, Aimable Mbituyumuremyi
BACKGROUND: Access to treatment for hepatitis C virus (HCV) in sub-Saharan Africa is extremely limited. With the advent of direct acting antivirals (DAAs), highly effective and easy-to-deliver oral regimens are now available on the global market. This study was conducted to understand the background and characteristics of a national cohort of patients with HCV infection enrolled in care and awaiting therapy with DAAs. METHODS AND FINDINGS: We conducted a retrospective chart review of all adult patients with confirmed HCV infection who were currently enrolled in care and treatment at the four existing hepatitis referral centers in Rwanda...
2017: PloS One
https://www.readbyqxmd.com/read/28320390/false-negative-malaria-rapid-diagnostic-tests-in-rwanda-impact-of-plasmodium-falciparum-isolates-lacking-hrp2-and-declining-malaria-transmission
#7
Christina T Kozycki, Noella Umulisa, Stephen Rulisa, Emil I Mwikarago, Jean Pierre Musabyimana, Jean Pierre Habimana, Corine Karema, Donald J Krogstad
BACKGROUND: Rapid diagnostic tests (RDTs) for histidine rich protein 2 (HRP2) are often used to determine whether persons with fever should be treated with anti-malarials. However, Plasmodium falciparum parasites with a deletion of the hrp2 gene yield false-negative RDTs and there are concerns the sensitivity of HRP2-based RDTs may fall when the intensity of transmission decreases. METHODS: This observational study enrolled 9226 patients at three health centres in Rwanda from April 2014 to April 2015...
March 20, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28295602/child-survival-revolutions-revisited-lessons-learned-from-bangladesh-nicaragua-rwanda-and-vietnam
#8
REVIEW
Lars Åke Persson, Anisur Rahman, Rodolfo Peña, Wilton Perez, Aimable Musafili, Dinh Phuong Hoa
Analysing child mortality may enhance our perspective on global achievements in child survival. We used data from surveillance sites in Bangladesh, Nicaragua and Vietnam and Demographic Health Surveys in Rwanda to explore the development of neonatal and under-five mortality. The mortality curves showed dramatic reductions over time, but child mortality in the four countries peaked during wars and catastrophes and was rapidly reduced by targeted interventions, multi-sectorial development efforts and community engagement CONCLUSION: Lessons learned from these countries may be useful when tackling future challenges, including persistent neonatal deaths, survival inequalities and the consequences of climate change and migration...
March 12, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28292306/fertility-and-hiv-following-universal-access-to-art-in-rwanda-a-cross-sectional-analysis-of-demographic-and-health-survey-data
#9
Eric Remera, Kimberly Boer, Stella M Umuhoza, Bethany L Hedt-Gauthier, Dana R Thomson, Patrick Ndimubanzi, Eugenie Kayirangwa, Salomon Mutsinzi, Alice Bayingana, Placidie Mugwaneza, Jean Baptiste T Koama
BACKGROUND: HIV infection is linked to decreased fertility and fertility desires in sub-Saharan Africa due to biological and social factors. We investigate the relationship between HIV infection and fertility or fertility desires in the context of universal access to antiretroviral therapy introduced in 2004 in Rwanda. METHODS: We used data from 3532 and 4527 women aged 20-49 from the 2005 and 2010 Rwandan Demographic and Health Surveys (RDHS), respectively. The RDHSs included blood-tests for HIV, as well as detailed interviews about fertility, demographic and behavioral outcomes...
March 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28284197/case-review-of-perinatal-deaths-at-hospitals-in-kigali-rwanda-perinatal-audit-with-application-of-a-three-delays-analysis
#10
Aimable Musafili, Lars-Åke Persson, Cyprien Baribwira, Jessica Påfs, Patrick Adam Mulindwa, Birgitta Essén
BACKGROUND: Perinatal audit and the three-delays model are increasingly being employed to analyse barriers to perinatal health, at both community and facility level. Using these approaches, our aim was to assess factors that could contribute to perinatal mortality and potentially avoidable deaths at Rwandan hospitals. METHODS: Perinatal audits were carried out at two main urban hospitals, one at district level and the other at tertiary level, in Kigali, Rwanda, from July 2012 to May 2013...
March 11, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28278750/the-ethics-of-researching-intimate-partner-violence-in-global-health-a-case-study-from-global-health-research
#11
Jenevieve Mannell, Adrian Guta
There has been an increase in attention to intimate partner violence (IPV) as a health issue that contributes to the spread of HIV, physical and emotional stress, depression, substance use, serious injuries, and higher rates of mortality in low-income settings. This paper explores the ethical implications raised by research on IPV by global health scholars. Drawing on Hedgecoe's work on critical bioethics to analyse a qualitative study of IPV in Rwanda, this paper discusses the risks and benefits of conducting research on IPV as part of the global health agenda...
February 20, 2017: Global Public Health
https://www.readbyqxmd.com/read/28275841/individual-level-factors-associated-with-mental-health-in-rwandan-youth-affected-by-hiv-aids
#12
Pamela Scorza, Cristiane S Duarte, Anne Stevenson, Christine Mushashi, Fredrick Kanyanganzi, Morris Munyana, Theresa S Betancourt
PURPOSE: Prevention of mental disorders worldwide requires a greater understanding of protective processes associated with lower levels of mental health problems in children who face pervasive life stressors. This study aimed to identify culturally appropriate indicators of individual-level protective factors in Rwandan adolescents where risk factors, namely poverty and a history of trauma, have dramatically shaped youth mental health. METHODS: The sample included 367 youth aged 10-17 in rural Rwanda...
March 8, 2017: Social Psychiatry and Psychiatric Epidemiology
https://www.readbyqxmd.com/read/28267286/differentiation-of-effect-across-systemic-literacy-programs-in-rwanda-the-philippines-and-senegal
#13
REVIEW
Rachel Christina, Elena Vinogradova
In this article, we compare three localized applications (in Rwanda, Senegal, and the Philippines) of a literacy approach for resource-lean environments and examine the factors influencing its impact in each context, considering dosage, duration, and environment. In Rwanda, a bilingual early grade literacy initiative implemented in partnership with the ministry of education included literacy standards development, training for early grade teachers, materials development, leadership support, and community-based activities...
March 2017: New Directions for Child and Adolescent Development
https://www.readbyqxmd.com/read/28258591/point-of-care-ultrasound-use-accuracy-and-impact-on-clinical-decision-making-in-rwanda-hospitals
#14
Patricia C Henwood, David C Mackenzie, Andrew S Liteplo, Joshua S Rempell, Alice F Murray, Megan M Leo, Damas Dukundane, Anthony J Dean, Stephen Rulisa, Vicki E Noble
OBJECTIVES: Few studies of point-of-care ultrasound training and use in low resource settings have reported the impact of examinations on clinical management or the longer-term quality of trainee-performed studies. We characterized the long-term effect of a point-of-care ultrasound program on clinical decision making, and evaluated the quality of clinician-performed ultrasound studies. METHODS: We conducted point-of-care ultrasound training for physicians from Rwandan hospitals...
March 4, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28257500/pediatric-emergency-care-capacity-in-a-low-resource-setting-an-assessment-of-district-hospitals-in-rwanda
#15
Celestin Hategeka, Jean Shoveller, Lisine Tuyisenge, Cynthia Kenyon, David F Cechetto, Larry D Lynd
BACKGROUND: Health system strengthening is crucial to improving infant and child health outcomes in low-resource countries. While the knowledge related to improving newborn and child survival has advanced remarkably over the past few decades, many healthcare systems in such settings remain unable to effectively deliver pediatric advance life support management. With the introduction of the Emergency Triage, Assessment and Treatment plus Admission care (ETAT+)-a locally adapted pediatric advanced life support management program-in Rwandan district hospitals, we undertook this study to assess the extent to which these hospitals are prepared to provide this pediatric advanced life support management...
2017: PloS One
https://www.readbyqxmd.com/read/28257418/epidemiology-of-pediatric-surgical-needs-in-low-income-countries
#16
Elissa K Butler, Tu M Tran, Neeraja Nagarajan, Joseph Canner, Anthony T Fuller, Adam Kushner, Michael M Haglund, Emily R Smith
OBJECTIVE: According to recent estimates, at least 11% of the total global burden of disease is attributable to surgically-treatable diseases. In children, the burden is even more striking with up to 85% of children in low-income and middle-income countries (LMIC) having a surgically-treatable condition by age 15. Using population data from four countries, we estimated pediatric surgical needs amongst children residing in LMICs. METHODS: A cluster randomized cross-sectional countrywide household survey (Surgeons OverSeas Assessment of Surgical Need) was done in four countries (Rwanda, Sierra Leone, Nepal and Uganda) and included demographics, a verbal head to toe examination, and questions on access to care...
2017: PloS One
https://www.readbyqxmd.com/read/28257319/contextual-challenges-to-safe-surgery-in-a-resource-limited-setting-a-multicenter-multiprofessional-qualitative-study
#17
John W Scott, Yihan Lin, Georges Ntakiyiruta, Zeta A Mutabazi, William Austin Davis, Megan A Morris, Douglas S Smink, Robert Riviello, Steven Yule
OBJECTIVES: Safe surgery should be available to all patients, no matter the setting. The purpose of this study was to explore the contextual-specific challenges to safe surgical care encountered by surgeons and surgical teams in many in low- and middle-income countries (LMICs), and to understand the ways in which surgical teams overcome them. BACKGROUND: Optimal surgical performance is highly complex and requires providers to integrate and communicate information regarding the patient, task, team, and environment to coordinate team-based care that is timely, effective, and safe...
March 2, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28255629/validation-of-the-surgical-apgar-score-after-laparotomy-at-a-tertiary-referral-hospital-in-rwanda
#18
Christian Ngarambe, Blair J Smart, Neeraja Nagarajan, Jennifer Rickard
BACKGROUND: The surgical Apgar score (SAS) has demonstrated utility in predicting postoperative outcomes in a variety of surgical disciplines. However, there has not been a study validating the utility of the SAS in surgical patients in low-income countries. We conducted a prospective, observational study of patients undergoing laparotomy at a tertiary referral hospital in Rwanda and determined the ability of SAS to predict inpatient major complications and mortality. METHODS: All adult patients undergoing laparotomy in a tertiary referral hospital in Rwanda from October 2014 to January 2015 were included...
March 2, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28253540/payment-methods-for-outpatient-care-facilities
#19
REVIEW
Beibei Yuan, Li He, Qingyue Meng, Liying Jia
BACKGROUND: Outpatient care facilities provide a variety of basic healthcare services to individuals who do not require hospitalisation or institutionalisation, and are usually the patient's first contact. The provision of outpatient care contributes to immediate and large gains in health status, and a large portion of total health expenditure goes to outpatient healthcare services. Payment method is one of the most important incentive methods applied by purchasers to guide the performance of outpatient care providers...
March 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28252675/prevalence-of-rheumatic-valvular-heart-disease-in-rwandan-school-children-echocardiographic-evaluation-using-the-world-heart-federation-criteria
#20
J Mucumbitsi, B Bulwer, L Mutesa, V Ndahindwa, M Semakula, E Rusingiza, P Arya, S Breakey, C Patton-Bolman, E L Kaplan
BACKGROUND: Rheumatic fever (RF) and rheumatic valvular heart disease (RHD) remain important medical, surgical and public health concerns in many parts of the world, especially in sub-Saharan Africa. However, there are no published data from Rwanda. We performed a RHD prevalence study in a randomly selected sample of Rwandan school children using the 2012 World Heart Federation (WHF) criteria. METHODS: Echocardiographic assessment of 2 501 Rwandan school children from 10 schools in the Gasabo district near Kigali was carried out...
March 1, 2017: Cardiovascular Journal of Africa
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