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https://www.readbyqxmd.com/read/28646897/an-exploration-of-facilitators-and-challenges-in-the-scale-up-of-a-national-public-sector-community-health-worker-cadre-in-zambia-a-qualitative-study
#1
Sydney Chauwa Phiri, Margaret Lippitt Prust, Caroline Phiri Chibawe, Ronald Misapa, Jan Willem van den Broek, Nikhil Wilmink
BACKGROUND: In 2010 a public sector cadre of community health workers called Community Health Assistants (CHAs) was created in Zambia through the National Community Health Worker Strategy to expand access to health services. This cadre continues to be scaled up to meet the growing demands of Zambia's rural population. We summarize factors that have facilitated the scale-up of the CHA program into a nationwide CHW cadre and the challenges of introducing and institutionalizing the cadre within the Zambian health system...
June 24, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28639469/barriers-and-facilitators-of-antiretroviral-therapy-adherence-in-rural-eastern-province-zambia-the-role-of-household-economic-status
#2
Rainier Masa, Gina Chowa, Victor Nyirenda
In Zambia, more people living with HIV now have access to lifesaving antiretroviral therapy than ever before. However, progress in HIV treatment and care has not always resulted in lower mortality. Adherence remains a critical barrier to treatment success. The objective of this study was to examine the barriers and facilitators of antiretroviral therapy adherence, particularly the role of household economic status. The study included a cross-sectional sample of 101 people living with HIV (PLHIV) in two rural communities in eastern Zambia...
June 22, 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28610616/underutilisation-of-routinely-collected-data-in-the-hiv-programme-in-zambia-a-review-of-quantitatively-analysed-peer-reviewed-articles
#3
REVIEW
Tendai Munthali, Patrick Musonda, Paul Mee, Sehlulekile Gumede, Ab Schaap, Alwyn Mwinga, Caroline Phiri, Nathan Kapata, Charles Michelo, Jim Todd
BACKGROUND: The extent to which routinely collected HIV data from Zambia has been used in peer-reviewed published articles remains unexplored. This paper is an analysis of peer-reviewed articles that utilised routinely collected HIV data from Zambia within six programme areas from 2004 to 2014. METHODS: Articles on HIV, published in English, listed in the Directory of open access journals, African Journals Online, Google scholar, and PubMed were reviewed. Only articles from peer-reviewed journals, that utilised routinely collected data and included quantitative data analysis methods were included...
June 13, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28606173/tuberculosis-caseload-in-children-with-severe-acute-malnutrition-related-with-high-hospital-based-mortality-in-lusaka-zambia
#4
Tendai Munthali, Chishala Chabala, Elson Chama, Raider Mugode, Nathan Kapata, Patrick Musonda, Charles Michelo
BACKGROUND: Tuberculosis and severe acute malnutrition (SAM) in children pose a major treatment and care challenge in high HIV burden countries in Africa. We investigated the prevalence of Tuberculosis notifications among hospitalised under-five children with severe acute malnutrition. A retrospective review of medical records for all children aged 0-59 months admitted to the University Teaching Hospital from 2009 to 2013 was performed. Descriptive statistics were employed to estimate TB caseload...
June 12, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28606143/effectiveness-of-reactive-case-detection-for-malaria-elimination-in-three-archetypical-transmission-settings-a-modelling-study
#5
Jaline Gerardin, Caitlin A Bever, Daniel Bridenbecker, Busiku Hamainza, Kafula Silumbe, John M Miller, Thomas P Eisele, Philip A Eckhoff, Edward A Wenger
BACKGROUND: Reactive case detection could be a powerful tool in malaria elimination, as it selectively targets transmission pockets. However, field operations have yet to demonstrate under which conditions, if any, reactive case detection is best poised to push a region to elimination. This study uses mathematical modelling to assess how baseline transmission intensity and local interconnectedness affect the impact of reactive activities in the context of other possible intervention packages...
June 12, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28604240/the-influence-of-social-constructs-of-hegemonic-masculinity-and-sexual-behaviour-on-acceptability-of-vaginal-microbicides-in-zambia
#6
Oliver Mweemba, Rachael Dixey, Virginia Bond, Alan White
Vaginal microbicides are heralded as a woman's HIV prevention method. This study, conducted in a microbicide clinical trial setting in Zambia, explored how the social construction of masculinity and sexual behaviour influenced the acceptability of vaginal microbicides. The data were generated from 18 In-depth Interviews and 8 Focus Group Discussions. The data were analysed thematically. The study found that hegemonic masculinity influenced the use of vaginal microbicides positively and negatively, in multiple ways including: decision to initiate gel use, autonomous use of the gel, and consistent use of the gel...
June 12, 2017: Global Public Health
https://www.readbyqxmd.com/read/28598790/croi-2017-advances-in-antiretroviral-therapy
#7
Joyce Jones, Barbara S Taylor, Hong-Van Tieu, Timothy J Wilkin
The 2017 Conference on Retroviruses and Opportunistic Infections (CROI) featured exciting preclinical data on investigational antiretroviral agents with good in vitro efficacy and long half-lives. Investigational medications, including bictegravir, demonstrated excellent efficacy and tolerability, as did dual-agent therapy with dolutegravir paired with rilpivirine or with lamivudine. Dolutegravir monotherapy proved inadvisable due to virologic failure and resistance. The gap between high- and low-income settings along the HIV care continuum is narrowing, with Zimbabwe, Malawi, and Zambia approaching the 90-90-90 targets established by the joint United Nations Programme on HIV/AIDS (UNAIDS), whereas communities in the Southern United States are falling behind...
May 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28588962/impact-of-a-community-based-package-of-interventions-on-child-development-in-zambia-a-cluster-randomised-controlled-trial
#8
Peter C Rockers, Günther Fink, Arianna Zanolini, Bowen Banda, Godfrey Biemba, Cierra Sullivan, Simon Mutembo, Vichaels Silavwe, Davidson H Hamer
BACKGROUND: Community-based programmes are a critical platform for improving child health and development. We tested the impact of a community-based early childhood intervention package in rural Zambia. METHODS: We conducted a non-blinded cluster randomised controlled trial in Southern Province, Zambia. 30 clusters of villages were matched based on population density and distance from the nearest health centre, and randomly assigned to intervention (15 clusters and 268 caregiver-child dyads) or control (15 clusters and 258 caregiver-child dyads)...
November 2016: BMJ Global Health
https://www.readbyqxmd.com/read/28588896/promoting-transparency-accountability-and-access-through-a-multi-stakeholder-initiative-lessons-from-the-medicines-transparency-alliance
#9
Taryn Vian, Jillian C Kohler, Gilles Forte, Deirdre Dimancesco
BACKGROUND: Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of transparency and accountability, inadequate attention to social services on the political agenda, and financing challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through greater transparency...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28584171/local-disease-ecosystem-livelihood-dynamics-reflections-from-comparative-case-studies-in-africa
#10
Melissa Leach, Bernard Bett, M Said, Salome Bukachi, Rosemary Sang, Neil Anderson, Noreen Machila, Joanna Kuleszo, Kathryn Schaten, Vupenyu Dzingirai, Lindiwe Mangwanya, Yaa Ntiamoa-Baidu, Elaine Lawson, Kofi Amponsah-Mensah, Lina M Moses, Annie Wilkinson, Donald S Grant, James Koninga
This article explores the implications for human health of local interactions between disease, ecosystems and livelihoods. Five interdisciplinary case studies addressed zoonotic diseases in African settings: Rift Valley fever (RVF) in Kenya, human African trypanosomiasis in Zambia and Zimbabwe, Lassa fever in Sierra Leone and henipaviruses in Ghana. Each explored how ecological changes and human-ecosystem interactions affect pathogen dynamics and hence the likelihood of zoonotic spillover and transmission, and how socially differentiated peoples' interactions with ecosystems and animals affect their exposure to disease...
July 19, 2017: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
https://www.readbyqxmd.com/read/28583185/temporal-changes-and-determinants-of-childhood-nutritional-status-in-kenya-and-zambia
#11
Daniel Hoffman, Thomas Cacciola, Pamela Barrios, James Simon
BACKGROUND: The prevalence of undernutrition is decreasing in many parts of the developing world, but challenges remain in many countries. The objective of this study was to determine factors influencing childhood nutrition status in Kenya and Zambia. The objective of this study is to determine factors associated with temporal changes in childhood nutritional status in two countries in sub-Saharan Africa. METHODS: Data from national demographic and health surveys from the World Bank for Kenya (1998-2009) and Zambia (1996-2014) were used to select the youngest child of each household with complete data for all variables studied...
June 5, 2017: Journal of Health, Population, and Nutrition
https://www.readbyqxmd.com/read/28581820/barriers-and-facilitators-to-hiv-testing-among-zambian-female-sex-workers-in-three-transit-hubs
#12
Michael M Chanda, Amaya G Perez-Brumer, Katrina F Ortblad, Magdalene Mwale, Steven Chongo, Nyambe Kamungoma, Catherine Kanchele, Andrew Fullem, Leah Barresi, Till Bärnighausen, Catherine E Oldenburg
Zambia has a generalized HIV epidemic, and HIV is concentrated along transit routes. Female sex workers (FSWs) are disproportionately affected by the epidemic. HIV testing is the crucial first step for engagement in HIV care and HIV prevention activities. However, to date little work has been done with FSWs in Zambia, and little is known about barriers and facilitators to HIV testing in this population. FSW peer educators were recruited through existing sex worker organizations for participation in a trial related to HIV testing among FSWs...
June 5, 2017: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/28578686/challenges-and-opportunities-of-optimal-breastfeeding-in-the-context-of-hiv-option-b-guidelines
#13
Pamela Marinda, Nkandu Chibwe, Ernest Tambo, Sidney Lulanga, Christopher Khayeka-Wandabwa
BACKGROUND: In 2013, the World Health Organization released a new set of guidelines widely known as Option B+. Prior to that there were guidelines released in 2010. Option B+ recommends lifelong antiretroviral treatment for all pregnant and breastfeeding women living with Human Immunodeficiency Virus. The study aimed at investigating challenges and opportunities in implementing Infant and Young Child Feeding in the context of Prevention of Mother To Child Transmission (PMTCT) guidelines among HIV positive mothers of children aged 0-24 months...
June 2, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28575365/density-of-upper-respiratory-colonization-with-streptococcus-pneumoniae-and-its-role-in-the-diagnosis-of-pneumococcal-pneumonia-among-children-aged-5-years-in-the-perch-study
#14
Henry C Baggett, Nora L Watson, Maria Deloria Knoll, W Abdullah Brooks, Daniel R Feikin, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, J Anthony G Scott, Donald M Thea, Martin Antonio, Juliet O Awori, Vicky L Baillie, Andrea N DeLuca, Amanda J Driscoll, Julie Duncan, Bernard E Ebruke, Doli Goswami, Melissa M Higdon, Ruth A Karron, David P Moore, Susan C Morpeth, Justin M Mulindwa, Daniel E Park, Wantana Paveenkittiporn, Barameht Piralam, Christine Prosperi, Samba O Sow, Milagritos D Tapia, Khalequ Zaman, Scott L Zeger, Katherine L O'Brien
Background.: Previous studies suggested an association between upper airway pneumococcal colonization density and pneumococcal pneumonia, but data in children are limited. Using data from the Pneumonia Etiology Research for Child Health (PERCH) study, we assessed this potential association. Methods.: PERCH is a case-control study in 7 countries: Bangladesh, The Gambia, Kenya, Mali, South Africa, Thailand, and Zambia. Cases were children aged 1-59 months hospitalized with World Health Organization-defined severe or very severe pneumonia...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28575361/chest-radiograph-findings-in-childhood-pneumonia-cases-from-the-multisite-perch-study
#15
Nicholas Fancourt, Maria Deloria Knoll, Henry C Baggett, W Abdullah Brooks, Daniel R Feikin, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, J Anthony G Scott, Donald M Thea, Juliet O Awori, Breanna Barger-Kamate, James Chipeta, Andrea N DeLuca, Mahamadou Diallo, Amanda J Driscoll, Bernard E Ebruke, Melissa M Higdon, Yasmin Jahan, Ruth A Karron, Nasreen Mahomed, David P Moore, Kamrun Nahar, Sathapana Naorat, Micah Silaba Ominde, Daniel E Park, Christine Prosperi, Somwe Wa Somwe, Somsak Thamthitiwat, Syed M A Zaman, Scott L Zeger, Katherine L O'Brien
Background.: Chest radiographs (CXRs) are frequently used to assess pneumonia cases. Variations in CXR appearances between epidemiological settings and their correlation with clinical signs are not well documented. Methods.: The Pneumonia Etiology Research for Child Health project enrolled 4232 cases of hospitalized World Health Organization (WHO)-defined severe and very severe pneumonia from 9 sites in 7 countries (Bangladesh, the Gambia, Kenya, Mali, South Africa, Thailand, and Zambia)...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28575355/standardization-of-clinical-assessment-and-sample-collection-across-all-perch-study-sites
#16
Jane Crawley, Christine Prosperi, Henry C Baggett, W Abdullah Brooks, Maria Deloria Knoll, Laura L Hammitt, Stephen R C Howie, Karen L Kotloff, Orin S Levine, Shabir A Madhi, David R Murdoch, Katherine L O'Brien, Donald M Thea, Juliet O Awori, Charatdao Bunthi, Andrea N DeLuca, Amanda J Driscoll, Bernard E Ebruke, Doli Goswami, Melissa M Hidgon, Ruth A Karron, Sidi Kazungu, Nana Kourouma, Grant Mackenzie, David P Moore, Azwifari Mudau, Magdalene Mwale, Kamrun Nahar, Daniel E Park, Barameht Piralam, Phil Seidenberg, Mamadou Sylla, Daniel R Feikin, J Anthony G Scott
Background.: Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods.: Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website...
June 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28575193/the-cost-structure-of-routine-infant-immunization-services-a-systematic-analysis-of-six-countries
#17
Fangli Geng, Christian Suharlim, Logan Brenzel, Stephen C Resch, Nicolas A Menzies
Little information exists on the cost structure of routine infant immunization services in low- and middle-income settings. Using a unique dataset of routine infant immunization costs from six countries, we estimated how costs were distributed across budget categories and programmatic activities, and investigated how the cost structure of immunization sites varied by country and site characteristics. The EPIC study collected data on routine infant immunization costs from 319 sites in Benin, Ghana, Honduras, Moldova, Uganda, Zambia, using a standardized approach...
May 31, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28573009/characterizing-and-quantifying-human-movement-patterns-using-gps-data-loggers-in-an-area-approaching-malaria-elimination-in-rural-southern-zambia
#18
Kelly M Searle, Jailos Lubinda, Harry Hamapumbu, Timothy M Shields, Frank C Curriero, David L Smith, Philip E Thuma, William J Moss
In areas approaching malaria elimination, human mobility patterns are important in determining the proportion of malaria cases that are imported or the result of low-level, endemic transmission. A convenience sample of participants enrolled in a longitudinal cohort study in the catchment area of Macha Hospital in Choma District, Southern Province, Zambia, was selected to carry a GPS data logger for one month from October 2013 to August 2014. Density maps and activity space plots were created to evaluate seasonal movement patterns...
May 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28558800/the-influence-of-quality-maternity-waiting-homes-on-utilization-of-facilities-for-delivery-in-rural-zambia
#19
Elizabeth G Henry, Katherine Semrau, Davidson H Hamer, Taryn Vian, Mary Nambao, Kaluba Mataka, Nancy A Scott
BACKGROUND: Residential accommodation for expectant mothers adjacent to health facilities, known as maternity waiting homes (MWH), is an intervention designed to improve access to skilled deliveries in low-income countries like Zambia where the maternal mortality ratio is estimated at 398 deaths per 100,000 live births. Our study aimed to assess the relationship between MWH quality and the likelihood of facility delivery in Kalomo and Choma Districts in Southern Province, Zambia. METHODS: We systematically assessed and inventoried the functional capacity of all existing MWH using a quantitative facility survey and photographs of the structures...
May 30, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28542166/indoor-secondhand-tobacco-smoke-and-risk-of-under-five-mortality-in-23-sub-saharan-africa-countries-a-population-based-study-and-meta-analysis
#20
Patrick Opiyo Owili, Miriam Adoyo Muga, Wen-Chi Pan, Hsien-Wen Kuo
BACKGROUND: Inhalation of secondhand smoke from tobacco results in serious health outcomes among under-five children, and yet, few studies have assessed its effect on under-five mortality. We investigated the association between frequency of exposure to household tobacco smoke and risk of under-five mortality in sub-Saharan Africa (SSA). METHODS: Demographic Health Survey data of under-five children from 23 SSA countries (n = 787,484) were used. Cox proportional hazard models described the association between exposure to tobacco smoke and the risk of under-five mortality in each country, with age as the time-to-event indicator...
2017: PloS One
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