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https://www.readbyqxmd.com/read/28725165/cost-effectiveness-of-pre-referral-antimalarial-treatment-in-severe-malaria-among-children-in-sub-saharan-africa
#1
Vivian Rakuomi, Faith Okalebo, Stanley Ndwigah, Levi Mbugua
BACKGROUND: In 2013, 78% of malaria deaths occurred in children aged 5 years and below, in sub-Saharan Africa. Treatment of severe malaria requires a health facility with inpatient care. However, in most sub-Sahara African countries, access to health facilities is a major problem. Pre-referral antimalarial treatments aim to delay the progress of severe malaria as patients seek to access health facilities. Rectal artesunate can be administered in the community as a pre-referral treatment in rural hard-to-reach areas...
2017: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/28720039/the-revamp-trial-to-evaluate-hiv-resistance-testing-in-sub-saharan-africa-a-case-study-in-clinical-trial-design-in-resource-limited-settings-to-optimize-effectiveness-and-cost-effectiveness-estimates
#2
Mark J Siedner, Mwebesa B Bwana, Mahomed-Yunus S Moosa, Michelle Paul, Selvan Pillay, Suzanne McCluskey, Isaac Aturinda, Kevin Ard, Winnie Muyindike, Pravikrishnen Moodley, Jaysingh Brijkumar, Tamlyn Rautenberg, Gavin George, Brent Johnson, Rajesh T Gandhi, Henry Sunpath, Vincent C Marconi
BACKGROUND: In sub-Saharan Africa, rates of sustained HIV virologic suppression remain below international goals. HIV resistance testing, while common in resource-rich settings, has not gained traction due to concerns about cost and sustainability. OBJECTIVE: We designed a randomized clinical trial to determine the feasibility, effectiveness, and cost-effectiveness of routine HIV resistance testing in sub-Saharan Africa. APPROACH: We describe challenges common to intervention studies in resource-limited settings, and strategies used to address them, including: (1) optimizing generalizability and cost-effectiveness estimates to promote transition from study results to policy; (2) minimizing bias due to patient attrition; and (3) addressing ethical issues related to enrollment of pregnant women...
July 18, 2017: HIV Clinical Trials
https://www.readbyqxmd.com/read/28705184/prevalence-of-gestational-diabetes-mellitus-based-on-various-screening-strategies-in-western-kenya-a-prospective-comparison-of-point-of-care-diagnostic-methods
#3
Sonak D Pastakia, Benson Njuguna, Beryl Ajwang' Onyango, Sierra Washington, Astrid Christoffersen-Deb, Wycliffe K Kosgei, Ponnusamy Saravanan
BACKGROUND: Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting...
July 14, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28702174/costs-of-implementing-integrated-community-case-management-iccm-in-six-african-countries-implications-for-sustainability
#4
Emmanuelle Daviaud, Donnela Besada, Natalie Leon, Sarah Rohde, David Sanders, Nicholas Oliphant, Tanya Doherty
BACKGROUND: Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduced to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level scale-up implications...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28687993/rapid-total-sulphur-reduction-in-coal-samples-using-various-dilute-alkaline-leaching-reagents-under-microwave-heating-preventing-sulphur-emissions-during-coal-processing
#5
Nomvano Mketo, Philiswa Nosizo Nomngongo, Jane Catherine Ngila
Currently in South Africa, online flue gas desulphurisation (FGD) is being utilized as one of the most effective methods for total sulphur reduction in coal samples during the combustion process. However, the main disadvantage associated with FGD is the formation of its by-products (FGD gypsum). The latter is mostly formed in low grade quality, thereby bringing secondary pollution problems and extra disposal costs. Therefore, the current study describes the development of total sulphur extraction in coal under microwave heating using different dilute alkaline solutions such as NaOH, NaOH-H2O2, NH4OH, and NH4OH-H2O2...
July 7, 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28632768/the-cost-of-demand-creation-activities-and-voluntary-medical-male-circumcision-targeting-school-going-adolescents-in-kwazulu-natal-south-africa
#6
Gavin George, Michael Strauss, Elias Asfaw
BACKGROUND: Voluntary medical male circumcision is an integral part of the South African government's response to the HIV and AIDS epidemic. However, there remains a limited body of economic analysis on the cost of VMMC programming, and the demand creation activities used to mobilize males, especially among adolescent boys in school. This study addresses this gap by presenting the costs of a VMMC program which adopted two demand creation strategies targeting school-going males in South Africa...
2017: PloS One
https://www.readbyqxmd.com/read/28617733/economic-costs-and-health-related-quality-of-life-outcomes-of-hiv-treatment-after-self-and-facility-based-hiv-testing-in-a-cluster-randomized-trial
#7
Hendramoorthy Maheswaran, Stavros Petrou, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
BACKGROUND: The scale-up of HIV self-testing (HIVST) in Africa is recommended, but little is known about how this novel approach influences economic outcomes following subsequent antiretroviral treatment (ART) compared with established facility-based HIV testing and counseling (HTC) approaches. SETTING: HIV clinics in Blantyre, Malawi. METHODS: Consecutive HIV-positive participants, diagnosed by HIVST or facility-based HTC as part of a community cluster-randomized trial (ISRCTN02004005), were followed from initial assessment for ART until 1-year postinitiation...
July 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28597489/development-of-a-web-based-application-and-multicountry-analysis-framework-for-assessing-interdicted-infections-and-cost-utility-of-screening-donated-blood-for-hiv-hcv-and-hbv
#8
B Custer, M P Janssen, G Hubben, M Vermeulen, M van Hulst
BACKGROUND AND OBJECTIVES: Most countries test donations for HIV, HCV and HBV using serology with or without nucleic acid testing (NAT). Cost-utility analyses provide information on the relative value of different screening options. The aim of this project was to develop an open access risk assessment and cost-utility analysis web-tool for assessing HIV, HCV and HBV screening options (http://www.isbtweb.org/working-parties/transfusion-transmitted-infectious-diseases/). An analysis for six countries (Brazil, Ghana, the Netherlands, South Africa, Thailand and USA) was conducted...
June 8, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28558737/improving-active-case-finding-for-tuberculosis-in-south-africa-informing-innovative-implementation-approaches-in-the-context-of-the-kharitode-trial-through-formative-research
#9
Deanna Kerrigan, Nora West, Carrie Tudor, Colleen F Hanrahan, Limakatso Lebina, Reginah Msandiwa, Lesego Mmolawa, Neil Martinson, David Dowdy
BACKGROUND: Tuberculosis (TB) is the leading infectious killer worldwide, with approximately 1.8 million deaths in 2015. While effective treatment exists, implementation of active case finding (ACF) methods to identify persons with active TB in a timely and cost-effective manner continues to be a major challenge in resource-constrained settings. Limited qualitative work has been conducted to gain an in-depth understanding of implementation barriers. METHODS: Qualitative research was conducted to inform the development of three ACF strategies for TB to be evaluated as part of the Kharitode cluster-randomised trial being conducted in a rural province of South Africa...
May 30, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28506226/institutional-delivery-service-utilization-and-associated-factors-among-women-of-reproductive-age-in-the-mobile-pastoral-community-of-the-liban-district-in-guji-zone-oromia-southern-ethiopia-a-cross-sectional-study
#10
Wako Golicha Wako, Dejene Hailu Kassa
BACKGROUND: Globally, an estimated 289,000 maternal deaths occurred in 2013. Majority of these deaths occurred in sub-Saharan Africa and Southern Asia. Mobility of pastoralists is a well-recognized survival strategy in arid and semi-arid land of sub-Saharan Africa. However governments often encourage settlement as a solution to the difficulty of providing health services for mobile pastoralists. This study aimed to assess utilization of institutional delivery and associated factors among women of reproductive age in the mobile pastoral community of the Liban District in Guji zone, Oromia, Ethiopia...
May 15, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28485220/menstrual-hygiene-management-among-adolescent-girls-in-sub-saharan-africa
#11
Derrick Ssewanyana, Byron Kiiza Yafesi Bitanihirwe
Menstruation is a delicate physiological process through which a shedding of uterine lining occurs each month in females of reproductive age. Often considered a taboo subject, menstruation is seldom openly discussed in developing parts of the world. This article explores menstrual hygiene management (MHM) in sub-Saharan Africa and emphasizes the urgent and neglected need for feasible solutions, especially among adolescent girls. Optimizing menstrual hygiene interventions will require an integration of both knowledge and skill training gained through education on MHM alongside an improvement of access to girl-friendly water, sanitation and hygiene facilities in addition to access to low-cost hygienic sanitary products...
May 1, 2017: Global Health Promotion
https://www.readbyqxmd.com/read/28367971/a-paper-based-test-for-screening-newborns-for-sickle-cell-disease
#12
Nathaniel Z Piety, Alex George, Sonia Serrano, Maria R Lanzi, Palka R Patel, Maria P Noli, Silvina Kahan, Damian Nirenberg, João F Camanda, Gladstone Airewele, Sergey S Shevkoplyas
The high cost, complexity and reliance on electricity, specialized equipment and supplies associated with conventional diagnostic methods limit the scope and sustainability of newborn screening for sickle cell disease (SCD) in sub-Saharan Africa and other resource-limited areas worldwide. Here we describe the development of a simple, low-cost, rapid, equipment- and electricity-free paper-based test capable of detecting sickle hemoglobin (HbS) in newborn blood samples with a limit of detection of 2% HbS. We validated this newborn paper-based test in a cohort of 159 newborns at an obstetric hospital in Cabinda, Angola...
April 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#13
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
July 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28328545/economic-costs-and-health-related-quality-of-life-outcomes-of-hiv-treatment-following-self-and-facility-based-hiv-testing-in-a-cluster-randomised-trial
#14
Hendramoorthy Maheswaran, Stavros Petrou, Peter MacPherson, Felistas Kumwenda, David G Lalloo, Elizabeth L Corbett, Aileen Clarke
BACKGROUND: HIV self-testing (HIVST) is recommended in Africa, but little is known about how this approach influences economic outcomes following subsequent antiretroviral treatment (ART) compared to facility-based HIV testing and counselling (HTC). METHODS: HIV-positive participants attending HIV clinics, diagnosed by HIVST or facility-based HTC as part of a community cluster-randomised trial (ISRCTN02004005), were followed from initial assessment for ART until one-year postinitiation...
March 17, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28327143/the-imperative-for-systems-thinking-to-promote-access-to-medicines-efficient-delivery-and-cost-effectiveness-when-implementing-health-financing-reforms-a-qualitative-study
#15
Tom Achoki, Abaleng Lesego
BACKGROUND: Health systems across Africa are faced with a multitude of competing priorities amidst pressing resource constraints. Expansion of health insurance coverage offers promise in the quest for sustainable healthcare financing for many of the health systems in the region. However, the broader policy implications of expanding health insurance coverage have not been fully investigated and contextualized to many African health systems. METHODS: We interviewed 37 key informants drawn from public, private and civil society organizations involved in health service delivery in Botswana...
March 21, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28320384/diagnostic-accuracy-incremental-yield-and-prognostic-value-of-determine-tb-lam-for-routine-diagnostic-testing-for-tuberculosis-in-hiv-infected-patients-requiring-acute-hospital-admission-in-south-africa-a-prospective-cohort
#16
Stephen D Lawn, Andrew D Kerkhoff, Rosie Burton, Charlotte Schutz, Andrew Boulle, Monica Vogt, Ankur Gupta-Wright, Mark P Nicol, Graeme Meintjes
BACKGROUND: We previously reported that one-third of HIV-positive adults requiring medical admission to a South African district hospital had laboratory-confirmed tuberculosis (TB) and that almost two-thirds of cases could be rapidly diagnosed using Xpert MTB/RIF-testing of concentrated urine samples obtained on the first day of admission. Implementation of urine-based, routine, point-of-care TB screening is an attractive intervention that might be facilitated by use of a simple, low-cost diagnostic tool, such as the Determine TB-LAM lateral-flow rapid test for HIV-associated TB...
March 21, 2017: BMC Medicine
https://www.readbyqxmd.com/read/27921291/evaluation-of-capillary-electrophoresis-for-the-analysis-of-rooibos-and-honeybush-tea-phenolics
#17
William J Arries, Andreas G J Tredoux, Dalene de Beer, Elizabeth Joubert, André de Villiers
Rooibos and honeybush are popular herbal teas produced from the shrubs of Aspalathus linearis and Cyclopia spp., respectively, which are indigenous to South Africa. Both herbal teas are rich in polyphenols and their consumption is associated with several health benefits, partly ascribed to their phenolic constituents. Quantification of phenolics in extracts and teas for quality control and research purposes is generally performed using HPLC, although dedicated and often species-specific methods are required...
March 2017: Electrophoresis
https://www.readbyqxmd.com/read/27832107/the-financial-burden-of-non-communicable-chronic-diseases-in-rural-nigeria-wealth-and-gender-heterogeneity-in-health-care-utilization-and-health-expenditures
#18
Wendy Janssens, Jann Goedecke, Godelieve J de Bree, Sunday A Aderibigbe, Tanimola M Akande, Alice Mesnard
OBJECTIVES: Better insights into health care utilization and out-of-pocket expenditures for non-communicable chronic diseases (NCCD) are needed to develop accessible health care and limit the increasing financial burden of NCCDs in Sub-Saharan Africa. METHODS: A household survey was conducted in rural Kwara State, Nigeria, among 5,761 individuals. Data were obtained using biomedical and socio-economic questionnaires. Health care utilization, NCCD-related health expenditures and distances to health care providers were compared by sex and by wealth quintile, and a Heckman regression model was used to estimate health expenditures taking selection bias in health care utilization into account...
2016: PloS One
https://www.readbyqxmd.com/read/27809980/application-of-a-new-pcr-rflp-panel-suggests-a-restricted-population-structure-for-eimeria-tenella-in-uk-and-irish-chickens
#19
Elaine Pegg, Kate Doyle, Emily L Clark, Isa D Jatau, Fiona M Tomley, Damer P Blake
Eimeria species cause coccidiosis, most notably in chickens where the global cost exceeds US$3 billion every year. Understanding variation in Eimeria population structure and genetic diversity contributes valuable information that can be used to minimise the impact of drug resistance and develop new, cost-effective anticoccidial vaccines. Little knowledge is currently available on the epidemiology of Eimeria species and strains in different regions, or under different chicken production systems. Recently, 244 Eimeria tenella isolates collected from countries in Africa and Asia were genotyped using a Sequenom single nucleotide polymorphism (SNP) tool, revealing significant variation in haplotype diversity and population structure, with a marked North/South regional divide...
October 15, 2016: Veterinary Parasitology
https://www.readbyqxmd.com/read/27756712/clinical-management-of-adults-and-children-with-multidrug-resistant-and-extensively-drug-resistant-tuberculosis
#20
REVIEW
K Dheda, K C Chang, L Guglielmetti, J Furin, H S Schaaf, D Chesov, A Esmail, C Lange
BACKGROUND: Globally there is a burgeoning epidemic of drug monoresistant tuberculosis (TB), multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB). Almost 20% of all TB strains worldwide are resistant to at least one major TB drug, including isoniazid. In several parts of the world there is an increasing incidence of MDR-TB, and alarmingly, almost a third of MDR-TB cases globally are resistant to either a fluoroquinolone or aminoglycoside. This trend cannot be ignored because drug-resistant TB is associated with greater morbidity compared to drug-susceptible TB, accounts for almost 25% of global TB mortality, is extremely costly to treat, consumes substantial portions of budgets allocated to national TB programmes in TB-endemic countries and is a major threat to healthcare workers, who are already in short supply in resource-poor settings...
March 2017: Clinical Microbiology and Infection
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