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John Y Rhee, Eduardo Garralda, Eve Namisango, Emmanuel Luyirika, Liliana de Lima, Richard A Powell, Jesús López-Fidalgo, Carlos Centeno
CONTEXT: To date, there is no study comparing palliative care (PC) development among African countries. OBJECTIVE: To analyze comparatively PC development in African countries based on region-specific indicators. METHODS: Data were obtained from the APCA Atlas of PC in Africa and a comparative analysis conducted. Nineteen indicators were developed and defined through qualitative interviews with African PC experts and a two-round modified Delphi consensus process with international experts on global PC indicators...
May 14, 2018: Journal of Pain and Symptom Management
Christine Mutaganzwa, Leah Wibecan, Hari S Iyer, Evrard Nahimana, Anatole Manzi, Francois Biziyaremye, Merab Nyishime, Fulgence Nkikabahizi, Lisa R Hirschhorn, Hema Magge
Objective: Identify predictors of patient satisfaction with antenatal care (ANC) and maternity services in rural Rwanda. Design: Cross-sectional. Setting: Twenty-six health facilities in Southern Kayonza (SK) and Kirehe districts. Participants: Sample of women ≥ 16 years old receiving antenatal and delivery care between November and December 2013. Intervention: Survey of patient satisfaction with antenatal and delivery care to inform quality improvement (QI) initiatives aimed at reducing neonatal mortality...
May 15, 2018: International Journal for Quality in Health Care
Jean Damascene Kabakambira, Zachee Niyonsenga, Marthe Hategeka, Grace Igiraneza, Genevieve Benurugo, Don Eliseo Lucero-Prisno, Celestin Hategeka
Cardiovascular diseases (CVD) are the leading cause of mortality globally. Hypertension is a known modifiable risk factor for CVD. Diagnosis and management of hypertension hinges upon accurate blood pressure (BP) measurement. In this study, we assessed performance to recommended guidelines for BP measurement in Rwanda. In 2017, a cross-sectional study investigating performance on 11 techniques recommended for BP measurement was undertaken across outpatient settings of 3 departments at the University Teaching Hospital of Kigali, Rwanda...
May 16, 2018: Journal of Clinical Hypertension
Peter P Moschovis, Matthew O Wiens, Lauren Arlington, Olga Antsygina, Douglas Hayden, Walter Dzik, Julius P Kiwanuka, David C Christiani, Patricia L Hibberd
OBJECTIVE: Anaemia affects the majority of children in sub-Saharan Africa (SSA). Previous studies of risk factors for anaemia have been limited by sample size, geography and the association of many risk factors with poverty. In order to measure the relative impact of individual, maternal and household risk factors for anaemia in young children, we analysed data from all SSA countries that performed haemoglobin (Hb) testing in the Demographic and Health Surveys. DESIGN AND SETTING: This cross-sectional study pooled household-level data from the most recent Demographic and Health Surveys conducted in 27 SSA between 2008 and 2014...
May 14, 2018: BMJ Open
Evonne Woodson, Alec Goldberg, Clive Michelo, Debby Basu, Sijia Tao, Raymond Schinazi, Yong Jiang, William Kilembe, Etienne Karita, Susan Allen, Eric Hunter
OBJECTIVE: This study aims to understand the basis of continued HIV-1 transmission in Zambian and Rwandan HIV-1 discordant couples in the context of ART. DESIGN: We identified 9 Zambian and 7 Rwandan acutely-infected, epidemiologically-linked couples from government CVCT clinics where transmitting partners reported being on ART near the time of transmission. METHODS: We quantified viral load (VL) and plasma antiretroviral (ARV) drug concentrations near the time of transmission and used these as surrogate measures for adherence...
May 11, 2018: AIDS
Hassan Sibomana, Celse Rugambwa, Jason M Mwenda, Felix Sayinzoga, Gisele Iraguha, Jeanine Uwimana, Umesh D Parashar, Jacqueline E Tate
BACKGROUND: Rwanda introduced pentavalent rotavirus vaccine into its national immunization program in 2012. To determine the long-term impact of rotavirus vaccine on disease burden in a high burden setting, we examined trends in rotavirus and all-cause diarrhea hospitalizations in the first four years following rotavirus vaccine introduction. METHODS: We used data from an active surveillance system, from a review of pediatric ward registries, and from the Health Management Information System to describe trends in rotavirus and all-cause diarrhea hospitalizations from January 2009 through December 2016...
May 10, 2018: Vaccine
Jewel Gausman, Ivan Meija Guevara, S V Subramanian, Fahad Razak
BACKGROUND: Adult height reflects childhood circumstances and is associated with health, longevity, and maternal-fetal outcomes. Mean height is an important population metric, and declines in height have occurred in several low- and middle-income countries, especially in Africa, over the last several decades. This study examines changes at the population level in the distribution of height over time across a broad range of low- and middle-income countries during the past half century...
May 2018: PLoS Medicine
Kai Liu, Chunling Lu
BACKGROUND: Ensuring equal access to care and providing financial risk protection are at the center of the global health agenda. While Rwanda has made impressive progress in improving health outcomes, inequalities in medical care utilization and household catastrophic health spending (HCHS) between the impoverished and non-impoverished populations persist. Decomposing inequalities will help us understand the factors contributing to inequalities and design effective policy instruments in reducing inequalities...
May 10, 2018: International Journal for Equity in Health
Sojung Yi, Yihan Lin, Grace Kansayisa, Ainhoa Costas-Chavarri
Access to surgical care in low- and middle-income countries (LMICs) remains deficient without an adequate workforce. There is limited understanding of the gender gap in surgical trainees in LMICs. In Rwanda, females fill only one of 20 positions available. Understanding surgeons' experiences and perceptions of surgical careers may help facilitate support for females to contribute to the global surgical workforce. We performed qualitative analysis on perceptions of surgical careers through semi-structured interviews of all female surgeons (n = 6) and corresponding male surgeons (n = 6) who are training or have trained at University of Rwanda...
2018: PloS One
Janet Njelesani, Jenna Siegel, Emily Ullrich
This scoping study assessed the realization of the rights for persons with disabilities in Rwanda since the signing of the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD) in 2008. Underpinned by the five-stage framework of Arksey and O'Malley, the scoping study examined peer-reviewed literature published between 2008 and 2017. Nine electronic databases were searched using keywords specific to disability in Rwanda. Data were charted by three reviewers according to pre-determined and emergent categories...
2018: PloS One
Charles André
Belgian colonizers used phrenology to create an irreducible division between the two major groups living for centuries in Rwanda-Urundi. This formed the basis for the implementation of systematic efforts to subdue the large Hutu population. Both the Hutus and the smaller, and initially privileged, Tutsi group soon incorporated the racist discourse, which was pivotal to the gradual increase in violence before and after Rwandan independence in 1962. The Rwandan genocide in 1994 culminated in the horrible pinnacle of this process, involving recurrent episodes of slaughtering...
April 2018: Arquivos de Neuro-psiquiatria
Kristin A Sonderman, Theoneste Nkurunziza, Fredrick Kateera, Magdalena Gruendl, Rachel Koch, Erick Gaju, Caste Habiyakare, Alexi Matousek, Evrard Nahimana, Georges Ntakiyiruta, Robert Riviello, Bethany L Hedt-Gauthier
INTRODUCTION: Surgical site infections (SSIs) are a significant cause of morbidity and mortality in low-income and middle-income countries, where rates of SSIs can reach 30%. Due to limited access, there is minimal follow-up postoperatively. Community health workers (CHWs) have not yet been used for surgical patients in most settings. Advancements in telecommunication create an opportunity for mobile health (mHealth) tools to support CHWs. We aim to evaluate the use of mHealth technology to aid CHWs in identification of SSIs and promote referral of patients back to healthcare facilities...
May 8, 2018: BMJ Open
Abias Uwimana, Anne A van Dam, Gretchen M Gettel, Kenneth Irvine
Factors affecting the retention and export of water, sediments (TSS), nitrogen (TN) and phosphorus (TP) were examined in the Migina river catchment, southern Rwanda from May 2012 to May 2013. Landscape characteristics and seasonal changes in land use and land cover (LULC), rainfall, discharge, and area-specific net stream yields of TSS, TP and TN were measured monthly in 16 reaches of the Munyazi sub-catchment with five valley bottom LULC categories (grass/forest, ponds/reservoirs, ploughed, rice, and vegetables)...
May 4, 2018: Journal of Environmental Management
Carine Weiss, Yajna Elouard, Jana Gerold, Sonja Merten
OBJECTIVES: This survey investigates whether relevant training and availability of guidelines improve self-reported competencies of nurses in the provision of youth-friendly sexual and reproductive health services in South-Kivu Province in the Democratic Republic of the Congo, Burundi, and Rwanda. METHODS: A quantitative baseline survey was conducted among nurses in randomly selected health facilities. Nurses providing youth-friendly sexual and reproductive health services were asked to self-rate their competencies with regards to technical knowledge, clinical, and communication skills...
May 5, 2018: International Journal of Public Health
Aloys Tuyizere, Alphonse Ndayambaje, Timothy D Walker, Claude Bayingana, Cyprien Ntirenganya, Vincent Dusabejambo, DeVon C Hale
Background: Strongyloides stercoralis is one of the most neglected tropical diseases. Sparse, dated central African and Rwandan data on seroprevalence are available to guide public health efforts and clinical care. Methods: In February 2016 we conducted a community-based cross-sectional study among 539 asymptomatic participants in a rural area in the Gisagara District, Southern Province, Rwanda. Direct faecal smear (DFS) and modified Koga agar plate culture (APC) were used to detect S...
May 2, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
Vincent Kalumire Cubaka, Michael Schriver, Peter Vedsted, Gregory Makoul, Per Kallestrup
OBJECTIVE: To identify, adapt and validate a measure for providers' communication and interpersonal skills in Rwanda. METHODS: After selection, translation and piloting of the measure, structural validity, test-retest reliability, and differential item functioning were assessed. RESULTS: Identification and adaptation: The 14-item Communication Assessment Tool (CAT) was selected and adapted. VALIDITY AND RELIABILITY TESTING: Content validation found all items highly relevant in the local context except two, which were retained upon understanding the reasoning applied by patients...
April 23, 2018: Patient Education and Counseling
Jenevieve Mannell, Iran Seyed-Raeisy, Rochelle Burgess, Catherine Campbell
Intimate partner violence (IPV) has significant impacts on mental health. Community-focused interventions have shown promising results for addressing IPV in low-income countries, however, little is known about the implications of these interventions for women's mental wellbeing. This paper analyses data from a community-focused policy intervention in Rwanda collected in 2013-14, including focus group discussions and in-depth interviews with community members (n = 59). Our findings point to three ways in which these community members responded to IPV: (1) reconciling couples experiencing violence, (2) engaging community support through raising cases of IPV during community discussions, (3) navigating resources for women experiencing IPV, including police, social services and legal support...
2018: PloS One
Tess Bright, Hannah Kuper, David Macleod, David Musendo, Peter Irunga, Jennifer L Y Yip
BACKGROUND: Universal access to Primary Eye Care (PEC) is a key global initiative to reduce and prevent avoidable causes of visual impairment (VI). PEC can address minor eye conditions, simple forms of uncorrected refractive error (URE) and create a referral pathway for specialist eye care, thus offering a potential solution to a lack of eye health specialists in low-income countries. However, there is little information on the population need for PEC, including prevalence of URE in all ages in Sub-Saharan Africa...
2018: PloS One
Regis Hitimana, Lars Lindholm, Gunilla Krantz, Manasse Nzayirambaho, Jeanine Condo, Jean Paul Semasaka Sengoma, Anni-Maria Pulkki-Brännström
BACKGROUND: Despite the widespread use of antenatal care (ANC), its effectiveness in low-resource settings remains unclear. In this study, self-reported health-related quality of life (HRQoL) was used as an alternative to other maternal health measures previously used to measure the effectiveness of antenatal care. The main objective of this study was to determine whether adequate antenatal care utilization is positively associated with women's HRQoL. Furthermore, the associations between the HRQoL during the first year (1-13 months) after delivery and socio-economic and demographic factors were explored in Rwanda...
April 27, 2018: Journal of Health, Population, and Nutrition
M Chantal Umulisa, Silvia Franceschi, Iacopo Baussano, Vanessa Tenet, Mathilde Uwimbabazi, Belson Rugwizangoga, Daniëlle A M Heideman, Anne M Uyterlinde, Teresa M Darragh, Peter J F Snijders, Felix Sayinzoga, Gary M Clifford
BACKGROUND: A pilot screening campaign in Rwanda, based on careHPV-testing followed by visual inspection with acetic acid triage (careHPV+VIA triage), was evaluated against other WHO-recommended screening options, namely HPV screen-and-treat and VIA screen-and-treat. METHODS: 764 women aged 30-69 underwent at visit 1: i) VIA, and cervical cell collection for ii) careHPV in Rwanda, and iii) liquid-based cytology and GP5+/6+ HR-HPV PCR in The Netherlands. All 177 women positive by VIA, careHPV and/or PCR were recalled, of whom 84% attended...
April 24, 2018: BMC Women's Health
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