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https://www.readbyqxmd.com/read/29773527/acceptability-and-feasibility-of-real-time-antiretroviral-therapy-adherence-interventions-in-rural-uganda-mixed-method-pilot-randomized-controlled-trial
#1
Angella Musiimenta, Esther C Atukunda, Wilson Tumuhimbise, Emily E Pisarski, Melanie Tam, Monique A Wyatt, Norma C Ware, Jessica E Haberer
BACKGROUND: Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. OBJECTIVE: The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda...
May 17, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29773123/circumstances-of-child-deaths-in-mali-and-uganda-a-community-based-confidential-enquiry
#2
Merlin L Willcox, Elias Kumbakumba, Drissa Diallo, Vincent Mubangizi, Peter Kirabira, Florence Nakaggwa, Birungi Mutahunga, Chiaka Diakité, Eugene Dembélé, Mamadou Traoré, Pierre Daou, Drissa Bamba, Amadou Traoré, Diafara Berthé, Nick Wooding, Kieran Dinwoodie, Sarah Capewell, Hamish Foster, Rowena Neville, Joseph Ngonzi, Jerome Kabakyenga, David Mant, Anthony Harnden
BACKGROUND: Interventions to reduce child deaths in Africa have often underachieved, causing the Millennium Development Goal targets to be missed. We assessed whether a community enquiry into the circumstances of death could improve intervention effectiveness by identifying local avoidable factors and explaining implementation failures. METHODS: Deaths of children younger than 5 years were ascertained by community informants in two districts in Mali (762 deaths) and three districts in Uganda (442 deaths) in 2011-15...
June 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29772280/an-analysis-of-palliative-care-development-in-africa-a-ranking-based-on-region-specific-macro-indicators
#3
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
https://www.readbyqxmd.com/read/29771783/hiv-1-drug-resistance-among-ugandan-adults-attending-an-urban-out-patient-clinic
#4
Amrei von Braun, Christine Sekaggya-Wiltshire, Nadine Bachmann, Deogratius Ssemwanga, Alexandra U Scherrer, Maria Nanyonjo, Anne Kapaata, Pontiano Kaleebu, Huldrych F Günthard, Barbara Castelnuovo, Jan Fehr, Andrew Kambugu
BACKGROUND: Little is known about prevalence of drug resistance among HIV-infected Ugandans, a setting with over 15 years of public-sector access to antiretroviral therapy (ART) and where virological monitoring was only recently introduced. SETTING: This study was conducted in the adults' out-patient clinic of the Infectious Diseases Institute, Kampala, Uganda. METHODS: HIV genotyping was performed in ART naïve patients and in treatment experienced patients on ART for ≥ six months with virological failure (≥1000 copies/mL)...
April 27, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29771679/acceptability-of-contraceptive-self-injection-with-dmpa-sc-among-adolescents-in-gulu-district-uganda
#5
Jane Cover, Jeanette Lim, Allen Namagembe, Justine Tumusiime, Jennifer Kidwell Drake, Carie Muntifering Cox
CONTEXT: In Uganda, an estimated one in four adolescent women have begun childbearing. Many adolescent pregnancies are unintended because of substantial barriers to contraceptive access. The injectable contraceptive is the most commonly used method in Uganda, and a new subcutaneous version offers the possibility of reducing access barriers by offering a self-injection option. However, more information about adolescent attitudes toward and interest in self-injection is needed. METHODS: In 2015, in-depth interviews were conducted with a purposive sample of 46 adolescent women aged 15-19 from rural and urban areas of Gulu District...
December 1, 2017: International Perspectives on Sexual and Reproductive Health
https://www.readbyqxmd.com/read/29770102/rolling-out-hiv-antiretroviral-therapy-in-sub-saharan-africa-2003-2017
#6
G Taylor
Multiple issues need to be addressed in order to control the HIV pandemic in sub-Saharan Africa. Combination antiretroviral therapy (cART) is key to reducing morbidity and mortality among people living with HIV and has a role in preventing HIV transmission. However, access to cART is very unevenly distributed globally, especially in sub-Saharan Africa. Although cost of cART is no longer a major barrier as effective treatment can be had for under US$100 per year, HIV management is compromised by the inadequate number of trained clinicians, the lack of clinical and laboratory infrastructure and the increased prevalence of co-morbidities (e...
February 1, 2018: Canada Communicable Disease Report, Relevé des Maladies Transmissibles Au Canada
https://www.readbyqxmd.com/read/29768457/choice-of-time-horizon-critical-in-estimating-costs-and-effects-of-changes-to-hiv-programmes
#7
Nicky McCreesh, Ioannis Andrianakis, Rebecca N Nsubuga, Mark Strong, Ian Vernon, Trevelyan J McKinley, Jeremy E Oakley, Michael Goldstein, Richard Hayes, Richard G White
BACKGROUND: Uganda changed its antiretroviral therapy guidelines in 2014, increasing the CD4 threshold for antiretroviral therapy initiation from 350 cells/μl to 500 cells/μl. We investigate what effect this change in policy is likely to have on HIV incidence, morbidity, and programme costs, and estimate the cost-effectiveness of the change over different time horizons. METHODS: We used a complex individual-based model of HIV transmission and antiretroviral therapy scale-up in Uganda...
2018: PloS One
https://www.readbyqxmd.com/read/29768127/an-evaluation-of-removal-trapping-to-control-rodents-inside-homes-in-a-plague-endemic-region-of-rural-northwestern-uganda
#8
Rebecca J Eisen, Linda A Atiku, Karen A Boegler, Joseph T Mpanga, Russell E Enscore, Katherine MacMillan, Kenneth L Gage
Rodents pose a significant threat to human health, particularly in rural subsistence farming communities in Africa, where rodents threaten food security and serve as reservoirs of human pathogens, including the agents of plague, leptospirosis, murine typhus, rat-bite fever, Lassa fever, salmonellosis, and campylobacteriosis. Our study focused on the plague-endemic West Nile region of Uganda, where a majority of residents live in Uganda government-defined poverty, rely on subsistence farming for a living, and frequently experience incursions of rodents into their homes...
May 16, 2018: Vector Borne and Zoonotic Diseases
https://www.readbyqxmd.com/read/29765777/patterns-of-authorship-on-community-health-workers-in-low-and-middle-income-countries-an-analysis-of-publications-2012-2016
#9
Helen Schneider, Nelisiwe Maleka
Introduction: Studies of authorship provide a barometer of local research capacity and ownership of research, considered key to defining appropriate research priorities, developing contextualised responses to health problems and ensuring that research informs policy and practice. This paper reports on an analysis of patterns of research authorship of the now substantial literature on community health workers (CHWs) in low-and-middle-income countries (LMICs) for the 5-year period: 2012-2016...
2018: BMJ Global Health
https://www.readbyqxmd.com/read/29764476/traumatic-brain-injury-in-uganda-exploring-the-use-of-a-hospital-based-registry-for-measuring-burden-and-outcomes
#10
Amber Mehmood, Nukhba Zia, Connie Hoe, Olive Kobusingye, Hussein Ssenyojo, Adnan A Hyder
OBJECTIVE: Lack of data on traumatic brain injuries (TBI) hinders the appreciation of the true magnitude of the TBI burden. This paper describes a scientific approach for hospital based systematic data collection in a low-income country. The registry is based on the evaluation framework for injury surveillance systems which comprises a four-step approach: (1) identifying characteristics that assess a surveillance system, (2) review of the identified variables based on adopted specific, measurable, assignable, realistic, and time-related criteria, (3) assessment of the proposed variables and system characteristics by an expert panel, and (4) development and application of a rating system...
May 15, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29762175/pregnancy-outcomes-and-infant-growth-among-babies-with-in-utero-exposure-to-tenofovir-based-pre-exposure-prophylaxis-for-hiv-prevention
#11
Renee Heffron, Nelly Mugo, Ting Hong, Connie Celum, Mark A Marzinke, Kenneth Ngure, Stephen Asiimwe, Elly Katabira, Elizabeth Bukusi, Josephine Odoyo, Edna Tindimwebwa, Nulu Bulya, Jared M Baeten
BACKGROUND: Global guidelines recommend pre-exposure prophylaxis (PrEP) use by women at risk for HIV, including during pregnancy, a period with heightened HIV risk. However, data to support safety of PrEP use during pregnancy are limited, particularly from women using PrEP throughout pregnancy. METHODS: In an open-label delivery study of PrEP integrated with ART for high risk HIV serodiscordant couples in Kenya and Uganda (the Partners Demonstration Project), women who became pregnant while using PrEP were offered the option to continue PrEP throughout pregnancy...
May 11, 2018: AIDS
https://www.readbyqxmd.com/read/29762174/reasons-for-non-adherence-to-the-dapivirine-vaginal-ring-results-of-the-mtn-032-aha-study
#12
Elizabeth T Montgomery, Jonathan Stadler, Sarita Naidoo, Ariana Katz, Nicole Laborde, Morgan Garcia, Krishnaveni Reddy, Leila Mansoor, Juliane Etima, Chifundo Zimba, Miria Chitukuta, Lydia Soto-Torres
OBJECTIVE(S): METHODS:: Former ASPIRE participants were stratified by age group (18-21; 22-45) and randomly selected at seven sites in Malawi, South Africa, Uganda and Zimbabwe, 12-17 months after trial exit. Using in-depth interviews or focus group discussions, ring use barriers were explored using structured guides and visual tools including individual-level depictions of dapivirine levels detected in plasma and returned rings. RESULTS: 187 were enrolled; 37% were 18-21 when they began ASPIRE...
May 11, 2018: AIDS
https://www.readbyqxmd.com/read/29760943/high-parity-predicts-use-of-long-acting-reversible-contraceptives-in-the-extended-postpartum-period-among-women-in-rural-uganda
#13
Ronald Anguzu, Hassard Sempeera, Juliet N Sekandi
Background: The use of implants and Intra-uterine devices (IUD) during the post-partum period is very low in Uganda especially in rural settings. Long-acting reversible contraceptives (LARC) are known to be the most cost-effective for prevention of unintended pregnancy and unsafe abortions. This study aimed at determining the factors associated with long-acting reversible contraceptive use among women in the extended postpartum period in rural Uganda. Methods: We conducted a household-based, cross-sectional study among 400 women in two rural communities in Mityana district, central Uganda...
2018: Contraception and Reproductive Medicine
https://www.readbyqxmd.com/read/29755496/banana21-from-gene-discovery-to-deregulated-golden-bananas
#14
REVIEW
Jean-Yves Paul, Robert Harding, Wilberforce Tushemereirwe, James Dale
Uganda is a tropical country with a population in excess of 30 million, >80% of whom live in rural areas. Bananas ( Musa spp.) are the staple food of Uganda with the East African Highland banana, a cooking banana, the primary starch source. Unfortunately, these bananas are low in pro-vitamin A (PVA) and iron and, as a result, banana-based diets are low in these micronutrients which results in very high levels of inadequate nutrition. This inadequate nutrition manifests as high levels of vitamin A deficiency, iron deficiency anemia, and stunting in children...
2018: Frontiers in Plant Science
https://www.readbyqxmd.com/read/29754266/reaching-the-first-90-in-uganda-predictors-of-success-in-contacting-and-testing-the-named-sexual-partners-of-hiv-index-clients-in-kiboga-district
#15
Katherine Buhikire, Joachim Voss, Joanita Kigozi, Patience Nyakato, Nickson Ankunda, Brenda Kalebbo, Michael Musiitwa, Alex Muganzi, Nelson K Sewankambo, Damalie Nakanjako
Assisted partner notification programs represent one strategy for targeted HIV testing and treatment of exposed individuals in high-risk populations. This study of a pilot Partner Services program in rural Uganda describes predictors of successful contact tracings and testing of partners of HIV+ individuals and possible barriers to contact. Partner contact tracing data was extracted from registers at seven Ministry of Health facilities between May and October 2016, to inform program implementation and scale up...
May 12, 2018: AIDS and Behavior
https://www.readbyqxmd.com/read/29752346/rates-of-asthma-exacerbations-and-mortality-and-associated-factors-in-uganda-a-2-year-prospective-cohort-study
#16
Bruce J Kirenga, Corina de Jong, Levicatus Mugenyi, Winceslaus Katagira, Abdallah Muhofa, Moses R Kamya, H Marike Boezen, Thys van der Molen
Data on asthma treatment outcomes in Africa are limited. 449 patients with asthma (age 5-93 years) in Uganda were followed up for 2 years to determine rates of exacerbations and mortality and associated factors. During follow-up the median number of exacerbations per patient was 1 (IQR 0-5) and 17 patients died (3.7%, 27.3 deaths per 1000 person years). Considering only the first year of follow-up, 59.6% of the patients experienced at least one exacerbation, 32.4% experienced three or more exacerbations. A multivariable model showed that the likelihood of experiencing at least one exacerbation in the first year of follow-up was lower with better baseline asthma control (higher asthma control test (ACT) score), with OR 0...
May 11, 2018: Thorax
https://www.readbyqxmd.com/read/29751754/examining-diffusion-to-understand-the-how-of-sasa-a-violence-against-women-and-hiv-prevention-intervention-in-uganda
#17
Elizabeth Starmann, Lori Heise, Nambusi Kyegombe, Karen Devries, Tanya Abramsky, Lori Michau, Tina Musuya, Charlotte Watts, Martine Collumbien
BACKGROUND: A growing number of complex public health interventions combine mass media with community-based "change agents" and/or mobilisation efforts acting at multiple levels. While impact evaluations are important, there is a paucity of research into the more nuanced roles intervention and social network factors may play in achieving intervention outcomes, making it difficult to understand how different aspects of the intervention worked (or did not). This study applied aspects of diffusion of innovations theory to explore how SASA!, a community mobilisation approach for preventing HIV and violence against women, diffused within intervention communities and the factors that influenced the uptake of new ideas and behaviours around intimate partner relationships and violence...
May 11, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29750787/distributional-change-of-women-s-adult-height-in-low-and-middle-income-countries-over-the-past-half-century-an-observational-study-using-cross-sectional-survey-data
#18
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
https://www.readbyqxmd.com/read/29750228/hypertension-among-newly-diagnosed-diabetic-patients-at-mulago-national-referral-hospital-in-uganda-a-cross-sectional-study
#19
Martin Muddu, Edrisa Mutebi, Isaac Ssinabulya, Samuel Kizito, Charles Kiiza Mondo
BACKGROUND: The prevalence of hypertension in patients with diabetes is approximately two-fold higher than in age-matched subjects without the disease and, conversely, individuals with hypertension are at increased risk of developing diabetes compared with normotensive persons. Up to 75% of cases of cardiovascular disease (CVD) in patients with diabetes are attributed to hypertension. Diabetics who have hypertension are more likely to develop complications and die, and appropriate blood pressure control in these individuals reduces the risk...
April 20, 2018: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29750175/towards-90-90-90-target-factors-influencing-availability-access-and-utilization-of-hiv-services-a-qualitative-study-in-19-ugandan-districts
#20
Francis Bajunirwe, Flora Tumwebaze, Denis Akakimpa, Cissy Kityo, Peter Mugyenyi, George Abongomera
Background: UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods: We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts...
2018: BioMed Research International
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