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https://www.readbyqxmd.com/read/28900370/utility-of-routine-laboratory-preoperative-tests-based-on-previous-results-time-to-give-up
#1
Enrique Rodríguez-Borja, Africa Corchon-Peyrallo, Gerardo Aguilar-Aguilar, Arturo Carratala-Calvo
INTRODUCTION: The usefulness and cost-effectiveness of routine laboratory preoperative tests (POTs) have been challenged recently. In fact, the American Society of Anesthesiologists (ASA) Task Force has stated that test results obtained from the medical record within 6 months of surgery generally are mostly acceptable. The aim of our study was to evaluate the degree of utility of POTs and their clinical benefit based on this recommendation. MATERIAL AND METHODS: We studied retrospectively every routine POT request from 8 randomly selected weeks in 2016...
October 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28875531/pathogen-reduction-of-whole-blood-utility-and-feasibility
#2
REVIEW
J-P Allain, R Goodrich
OBJECTIVES: To collect information on pathogen reduction applied to whole blood. BACKGROUND: Pathogen reduction (PR) of blood components has been developed over the past two decades, and pathogen-reduced fresh-frozen plasma and platelet concentrates are currently in clinical use. High cost and incomplete coverage of components make PR out of reach for low- and middle-income countries (LMIC). However, should PR become applicable to whole blood (WB), the main product transfused in sub-Saharan Africa, and be compatible with the preparation of clinically suitable components, cost would be minimised, and a range of safety measures in place at high cost in developed areas would become redundant...
September 5, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28870567/tele-neurology-in-sub-saharan-africa-a-systematic-review-of-the-literature
#3
REVIEW
Fred S Sarfo, Sheila Adamu, Dominic Awuah, Bruce Ovbiagele
BACKGROUND: The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. OBJECTIVE: To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA...
September 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28806196/the-costs-of-hiv-treatment-and-care-in-ghana-a-longitudinal-multi-site-analysis
#4
Evelinn Mikkelsen, Jan Hontelez, Justice Nonvignon, Sam Amon, Felix A Asante, Moses K Aikins, Julie van de Haterd, Rob Baltussen
OBJECTIVE: To determine cost-functions that describe the dynamics of costs of HIV treatment and care in Ghana by CD4 cell count at treatment initiation and over time on antiretroviral therapy (ART). DESIGN: We used detailed longitudinal healthcare utilization data from clinical health records of HIV-infected patients at seven Ghanaian ART clinics to estimate cost-functions of treatment and care by CD4 cell count at treatment initiation and time on ART. METHODS: We developed two linear regression models; one with individual random effects to determine the relationship between CD4 cell count at ART initiation and costs of treatment and care, and one with individual fixed effects to determine the causal effect of time in care on costs of treatment and care...
August 12, 2017: AIDS
https://www.readbyqxmd.com/read/28725165/cost-effectiveness-of-pre-referral-antimalarial-treatment-in-severe-malaria-among-children-in-sub-saharan-africa
#5
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
#6
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 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
#7
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
#8
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
#9
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
#10
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
#11
RANDOMIZED CONTROLLED TRIAL
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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