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https://www.readbyqxmd.com/read/29462322/primary-resistance-to-integrase-strand-transfer-inhibitors-in-patients-infected-with-diverse-hiv-1-subtypes-in-sub-saharan-africa
#1
Seth C Inzaule, Raph L Hamers, Marc Noguera-Julian, Maria Casadellà, Mariona Parera, Tobias F Rinke de Wit, Roger Paredes
Objectives: To investigate the prevalence and patterns of major and accessory resistance mutations associated with integrase strand transfer inhibitors (INSTIs), across diverse HIV-1 subtypes in sub-Saharan Africa. Methods: pol gene sequences were obtained using Illumina next-generation sequencing from 425 INSTI-naive HIV-infected adults from Kenya (21.2%), Nigeria (7.3%), South Africa (22.8%), Uganda (25.2%) and Zambia (23.5%). Drug resistance interpretation was based on the IAS 2017 mutation list and accessory mutations from Stanford HIVdb with resistance penalty scores of ≥10 to at least 1 INSTI...
February 14, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29458416/cholera-diagnosis-in-human-stool-and-detection-in-water-protocol-for-a-systematic-review-of-available-technologies
#2
Karin Diaconu, Jennifer Falconer, Fiona O'May, Miguel Jimenez, Joe Matragrano, Betty Njanpop-Lafourcade, Alastair Ager
BACKGROUND: Cholera is a highly infectious diarrheal disease spread via fecal contamination of water and food sources; it is endemic in parts of Africa and Asia and recent outbreaks have been reported in Haiti, the Zambia and Democratic Republic of the Congo. If left untreated, the disease can be fatal in less than 24 h and result in case fatality ratios of 30-50%. Cholera disproportionately affects those living in areas with poor access to water and sanitation: the long-term public health response is focused on improving water and hygiene facilities and access...
February 20, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/29457318/equity-dimensions-of-the-availability-and-quality-of-reproductive-maternal-and-neonatal-health-services-in-zambia
#3
Lily D Yan, Jonas Mwale, Samantha Straitz, Godfrey Biemba, Zulfiqar Bhutta, Julia F Ross, Lawrence Myananyanda, Mary Nambao, Paul Ngwakum, Eleonora Genovese, Bowen Banda, Nadia Akseer, Kojo Yeboah-Antwi, Peter Rockers, Davidson H Hamer
OBJECTIVE: To assess how quality and availability of reproductive, maternal, neonatal (RMNH) services vary by district wealth and urban/rural status in Zambia. METHODS: We conducted a retrospective analysis of data from the Millennium Development Goal Acceleration Initiative baseline assessment of 117 health facilities in 9 districts. Quality was assessed through a composite score of 23 individual RMNH indicators, ranging from 0 to 1. Availability was evaluated by density of providers and facilities...
February 19, 2018: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29456624/the-case-for-a-regional-approach-to-publication-impact
#4
EDITORIAL
Stevan Bruijns, Camillo Lamanna
Healthcare-related research is largely regional. Put simply, this is because disease burdens differ between world regions. Even global burdens, such as ischaemic heart disease and cancer, display distinctive characteristics in certain regions that are not seen in others. Regional differences in infrastructure, resources and human capital further compound the differences seen, as they affect the way in which the local scientific community can interact with the local disease burden. As such, it seems fair to assume that healthcare-related research ought to be regionally distributed...
2018: Ecancermedicalscience
https://www.readbyqxmd.com/read/29456454/putting-trapped-populations-into-place-climate-change-and-inter-district-migration-flows-in-zambia
#5
Raphael J Nawrotzki, Jack DeWaard
Research shows that the association between adverse climate conditions and human migration is heterogeneous. One reason for this heterogeneity is the differential vulnerability of populations to climate change. This includes highly vulnerable, "trapped" populations that are too poor to migrate given deep and persistent poverty, the financial costs of migrating, and the erosion of already fragile economic livelihoods under climate change. Another reason for this heterogeneity is the differential vulnerability of places ...
February 2018: Regional Environmental Change
https://www.readbyqxmd.com/read/29454211/seasonality-water-use-and-community-management-of-water-systems-in-rural-settings-qualitative-evidence-from-ghana-kenya-and-zambia
#6
Emma Kelly, Katherine F Shields, Ryan Cronk, Kristen Lee, Nikki Behnke, Tori Klug, Jamie Bartram
The sustainability of rural, community-managed water systems in sub-Saharan Africa depends in part on the ability of local water committees to repair breakdowns and carry out the operation and maintenance (O&M) of the system. Much of sub-Saharan Africa has two distinct seasons that affect the availability of water sources and how people use water. Little is known about how seasonality affects water system management. This qualitative study is based on 320 interviews and focus group discussions and examines the effects of season on community water use and management in Ghana, Kenya and Zambia...
February 14, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29452602/the-quest-for-a-framework-for-sustainable-and-institutionalised-priority-setting-for-health-research-in-a-low-resource-setting-the-case-of-zambia
#7
Lydia Kapiriri, Pascalina Chanda-Kapata
BACKGROUND: Priority-setting for health research in low-income countries remains a major challenge. While there have been efforts to systematise and improve the processes, most of the initiatives have ended up being a one-off exercise and are yet to be institutionalised. This could, in part, be attributed to the limited capacity for the priority-setting institutions to identify and fund their own research priorities, since most of the priority-setting initiatives are driven by experts...
February 17, 2018: Health Research Policy and Systems
https://www.readbyqxmd.com/read/29433443/molecular-epidemiological-investigations-of-plague-in-eastern-province-of-zambia
#8
Stanley S Nyirenda, Bernard M Hang Ombe, Edgar Simulundu, Evans Mulenga, Ladslav Moonga, Robert S Machang U, Gerald Misinzo, Bukheti S Kilonzo
BACKGROUND: Plague is a flea-borne zoonotic and invasive disease caused by a gram negative coccobacillus bacterium called Yersinia pestis. Plague has caused three devastating pandemics globally namely: the Justinian, Black Death and Oriental plague. The disease in the Eastern Province of Zambia has been reported in Nyimba and Sinda Districts in the past 15 years. The aim of this study was to investigate the molecular epidemiology of plague in the two affected districts. Polymerase Chain Reaction (PCR), targeting Plasminogen activator gene (pla gene) of Y...
January 4, 2018: BMC Microbiology
https://www.readbyqxmd.com/read/29432669/socio-economic-gradients-in-prevalent-tuberculosis-in-zambia-and-the-western-cape-of-south-africa
#9
Tom A Yates, Helen Ayles, Finbarr P Leacy, A B Schaap, Delia Boccia, Nulda Beyers, Peter Godfrey-Faussett, Sian Floyd
OBJECTIVE: To present results of the 2010 ZAMSTAR Tuberculosis Prevalence Survey, one of the first large tuberculosis prevalence surveys in Southern Africa in the HIV era, on socio-economic position. METHODS: The main analyses used data on 34,446 individuals in Zambia and 30,017 individuals in South Africa with evaluable tuberculosis culture results. Logistic regression was used to estimate adjusted odds ratios for prevalent TB by two measures of socio-economic position: household wealth, derived from data on assets using principal components analysis, and individual educational attainment...
February 12, 2018: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/29426478/taenia-solium-from-a-community-perspective-preliminary-costing-data-in-the-katete-and-sinda-districts-in-eastern-zambia
#10
Emma C Hobbs, Kabemba E Mwape, Brecht Devleesschauwer, Sarah Gabriël, Mwelwa Chembensofu, Moses Mambwe, Isaac K Phiri, Maxwell Masuku, Gideon Zulu, Angela Colston, Arve Lee Willingham, Dirk Berkvens, Pierre Dorny, Emmanuel Bottieau, Niko Speybroeck
The tapeworm Taenia solium is endemic in Zambia, however its socioeconomic cost is unknown. During a large-scale interventional study conducted in Zambia, baseline economic costs of human and porcine T. solium infections were measured. Questionnaire surveys were conducted within three neighbourhoods in Zambia's Eastern province in 2015 and 2016. A human health questionnaire, capturing costs of clinical symptoms commonly attributable to human cysticercosis and taeniasis, was conducted in randomly selected households (n = 267)...
February 15, 2018: Veterinary Parasitology
https://www.readbyqxmd.com/read/29425941/-these-african-stories-life-labor-and-dying-in-northern-zambia
#11
Joshua Garoon
This paper analyzes the effects of antiretroviral therapy (ART) on the social worlds of people living with HIV and ART (PLHA) in rural northern Zambia. Studies have demonstrated high rates of ART adherence over a range of sites in southern Africa. Drawing on a year of ethnographic research conducted in Zambia's Mukungule chiefdom between 2006 and 2008, this study investigates expectations of this exemplary adherence, and experiences of treatment failure. Motivated by the life and AIDS-related death of a Mukungule resident, Grace, it moves beyond asking "what made initial cohorts of African PLHA exceptionally adherent?" to raise the pressing question of "what happens next?" Previous scholarship addressing this question has analyzed how PLHA navigate the competing moral and political economies of local kinship and social networks and global HIV/AIDS initiatives...
February 2, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29425200/an-agent-based-model-of-tsetse-fly-response-to-seasonal-climatic-drivers-assessing-the-impact-on-sleeping-sickness-transmission-rates
#12
Simon Alderton, Ewan T Macleod, Neil E Anderson, Gwen Palmer, Noreen Machila, Martin Simuunza, Susan C Welburn, Peter M Atkinson
BACKGROUND: This paper presents the development of an agent-based model (ABM) to incorporate climatic drivers which affect tsetse fly (G. m. morsitans) population dynamics, and ultimately disease transmission. The model was used to gain a greater understanding of how tsetse populations fluctuate seasonally, and investigate any response observed in Trypanosoma brucei rhodesiense human African trypanosomiasis (rHAT) disease transmission, with a view to gaining a greater understanding of disease dynamics...
February 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29422705/does-free-public-health-care-increase-utilization-and-reduce-spending-heterogeneity-and-long-term-effects
#13
Peter Hangoma, Bjarne Robberstad, Arild Aakvik
Zambia removed user fees in publicly supported-government and faith based- health facilities in 54 out of 72 districts in 2006. This was extended to rural areas of previously unaffected districts in 2007. The natural experiment provided by the step-wise implementation of the removal policy and five waves of nationally representative household survey data enables us to study the impact of the removal policy on utilization and household health expenditure. We find that the policy increased overall use of health services in the short term and the effects were sustained in the long term...
January 2018: World Development
https://www.readbyqxmd.com/read/29421472/health-care-input-constraints-and-cost-effectiveness-analysis-decision-rules
#14
Pieter van Baal, Alec Morton, Johan L Severens
Results of cost effectiveness analyses (CEA) studies are most useful for decision makers if they face only one constraint: the health care budget. However, in practice, decision makers wishing to use the results of CEA studies may face multiple resource constraints relating to, for instance, constraints in health care inputs such as a shortage of skilled labour. The presence of multiple resource constraints influences the decision rules of CEA and limits the usefulness of traditional CEA studies for decision makers...
January 27, 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29415065/high-smad7-and-p-smad2-3-expression-is-associated-with-environmental-enteropathy-in-children
#15
Sana Syed, Vincenzo Dinallo, Najeeha T Iqbal, Laura Di Iorio, Davide Di Fusco, Shan Guleria, Beatrice C Amadi, Kamran Sadiq, Christopher Moskaluk, S Asad Ali, Paul Kelly, Giovanni Monteleone
Enteropathies such as Crohn's disease are associated with enteric inflammation characterized by impaired TGF-β signaling, decreased expression of phosphorylated (p)-SMAD2,3 and increased expression of SMAD7 (an inhibitor of SMAD3 phosphorylation). Environmental enteropathy (EE) is an acquired inflammatory disease of the small intestine (SI), which is associated with linear growth disruption, cognitive deficits, and reduced oral vaccine responsiveness in children <5 y in resource-poor countries. We aimed to characterize EE inflammatory pathways by determining SMAD7 and p-SMAD2,3 levels (using Western blotting) in EE duodenal biopsies (N = 19 children, 7 from Pakistan, 12 from Zambia) and comparing these with healthy controls (Ctl) and celiac disease (CD) patients from Italy...
February 7, 2018: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29415004/facilitators-and-barriers-for-hiv-testing-in-zambia-a-systematic-review-of-multi-level-factors
#16
Shan Qiao, Yao Zhang, Xiaoming Li, J Anitha Menon
It was estimated that 1.2 million people live with HIV/AIDS in Zambia by 2015. Zambia has developed and implemented diverse programs to reduce the prevalence in the country. HIV-testing is a critical step in HIV treatment and prevention, especially among all the key populations. However, there is no systematic review so far to demonstrate the trend of HIV-testing studies in Zambia since 1990s or synthesis the key factors that associated with HIV-testing practices in the country. Therefore, this study conducted a systematic review to search all English literature published prior to November 2016 in six electronic databases and retrieved 32 articles that meet our inclusion criteria...
2018: PloS One
https://www.readbyqxmd.com/read/29408920/examining-the-association-between-livestock-ownership-typologies-and-child-nutrition-in-the-luangwa-valley-zambia
#17
Sarah E Dumas, Lea Kassa, Sera L Young, Alexander J Travis
OBJECTIVE: To investigate the association between livestock ownership and dietary diversity, animal-source food consumption, height-for-age z-score, and stunting among children living in wildlife "buffer zones" of Zambia's Luangwa Valley using a novel livestock typology approach. METHODS: We conducted a cross-sectional study of 838 children aged 6-36 months. Households were categorized into typologies based on the types and numbers of animals owned, ranging from no livestock to large numbers of mixed livestock...
2018: PloS One
https://www.readbyqxmd.com/read/29406894/neurologic-illness-in-zambia-a-neurointensivist-s-experience
#18
Merritt W Brown, Katie Ellen Foy, Christopher Chanda, Jacqueline Mulundika, Igor J Koralnik, Omar K Siddiqi
INTRODUCTION: Management of critically ill patients in dedicated intensive care units (ICUs) is the standard of care in high income countries (HICs), but remains uncommon in low and middle-income countries (LMICs). We sought to determine the prevalence of neurologic disorders in the ICU of a LMIC and examine if resource appropriate specialized neurocritical care training could benefit these patients. METHODS: From February to March 2017, a trained neurocritical care intensivist recorded encounters in the sole ICU at the University Teaching Hospital (UTH) in Lusaka, Zambia...
February 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29405109/characterizing-potential-risks-of-fecal-oral-microbial-transmission-for-infants-and-young-children-in-rural-zambia
#19
Brie Reid, Jennifer Orgle, Khrist Roy, Catherine Pongolani, Modesta Chileshe, Rebecca Stoltzfus
Undernourished children in low-income contexts often suffer from environmental enteric disorder-damage to the intestines probably caused by chronic exposure to bacterial pathogens from feces. We aimed to identify strategies for reducing infants and young children's (IYC) exposure to human and animal feces in rural farming families by conducting direct observation of 30 caregiver-infant dyads for 143 hours and recording water, sanitation, and hygiene (WASH)-related behaviors to identify possible pathways of fecal-oral transmission of bacteria among IYC in rural Zambia...
February 5, 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29403111/implementation-research-reactive-mass-vaccination-with-single-dose-oral-cholera-vaccine-zambia
#20
Marc Poncin, Gideon Zulu, Caroline Voute, Eva Ferreras, Clara Mbwili Muleya, Kennedy Malama, Lorenzo Pezzoli, Jacob Mufunda, Hugues Robert, Florent Uzzeni, Francisco J Luquero, Elizabeth Chizema, Iza Ciglenecki
Objective: To describe the implementation and feasibility of an innovative mass vaccination strategy - based on single-dose oral cholera vaccine - to curb a cholera epidemic in a large urban setting. Method: In April 2016, in the early stages of a cholera outbreak in Lusaka, Zambia, the health ministry collaborated with Médecins Sans Frontières and the World Health Organization in organizing a mass vaccination campaign, based on single-dose oral cholera vaccine...
February 1, 2018: Bulletin of the World Health Organization
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