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https://www.readbyqxmd.com/read/28736466/spatiotemporal-aggregation-for-temporally-extensive-international-microdata
#1
Tracy A Kugler, Steven M Manson, Joshua R Donato
We describe a strategy for regionalizing subnational administrative units in conjunction with harmonizing changes in unit boundaries over time that can be applied to provide small-area geographic identifiers for census microdata. The availability of small-area identifiers blends the flexibility of individual microdata with the spatial specificity of aggregate data. Regionalizing microdata by administrative units poses a number of challenges, such as the need to aggregate individual scale data in a way that ensures confidentiality and issues arising from changing spatial boundaries over time...
May 2017: Computers, Environment and Urban Systems
https://www.readbyqxmd.com/read/28736395/understanding-the-relationship-between-couple-dynamics-and-engagement-with-hiv-care-services-insights-from-a-qualitative-study-in-eastern-and-southern-africa
#2
Joyce Wamoyi, Jenny Renju, Mosa Moshabela, Estelle McLean, Daniel Nyato, Doris Mbata, Oliver Bonnington, Janet Seeley, Kathryn Church, Basia Zaba, Alison Wringe
OBJECTIVE: To explore the interplay between couple dynamics and the engagement of people living with HIV (PLHIV) with HIV care and treatment services in three health and demographic surveillance sites in Tanzania, Malawi and South Africa. METHODS: A qualitative study was conducted involving 107 in-depth interviews with PLHIV with a range of HIV care and treatment histories, including current users of HIV clinics, and people not enrolled in HIV care. Interviews explored experiences of living with HIV and how and why they chose to engage or not with HIV services...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736393/traditional-healers-faith-healers-and-medical-practitioners-the-contribution-of-medical-pluralism-to-bottlenecks-along-the-cascade-of-care-for-hiv-aids-in-eastern-and-southern-africa
#3
Mosa Moshabela, Dominic Bukenya, Gabriel Darong, Joyce Wamoyi, Estelle McLean, Morten Skovdal, William Ddaaki, Kenneth Ondeng'e, Oliver Bonnington, Janet Seeley, Victoria Hosegood, Alison Wringe
OBJECTIVES: There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade. METHODS: We conducted a multicountry exploratory qualitative study in seven health and demographic surveillance sites in six eastern and southern African countries: Uganda, Kenya, Tanzania, Malawi, Zimbabwe and South Africa...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736392/-i-am-treated-well-if-i-adhere-to-my-hiv-medication-putting-patient-provider-interactions-in-context-through-insights-from-qualitative-research-in-five-sub-saharan-african-countries
#4
Ken Ondenge, Jenny Renju, Oliver Bonnington, Mosa Moshabela, Joyce Wamoyi, Constance Nyamukapa, Janet Seeley, Alison Wringe, Morten Skovdal
OBJECTIVES: The nature of patient-provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient-provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, we seek to unpack local dynamics that serve to hinder or facilitate productive patient-provider interactions...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736391/-i-wanted-to-safeguard-the-baby-a-qualitative-study-to-understand-the-experiences-of-option-b-for-pregnant-women-and-the-potential-implications-for-test-and-treat-in-four-sub-saharan-african-settings
#5
Estelle McLean, Jenny Renju, Joyce Wamoyi, Dominic Bukenya, William Ddaaki, Kathryn Church, Basia Zaba, Alison Wringe
OBJECTIVE: To explore what influences on engagement with Option B+ in four sub-Saharan African settings. METHODS: In-depth interviews were conducted in 2015, with 22 HIV-positive women who had been pregnant since Option B+ was available, and 15 healthcare workers (HCWs) involved in HIV service delivery. Participants were purposely selected from four health and demographic surveillance sites in Malawi, Tanzania and Uganda. A thematic content analysis was conducted to investigate what influenced engagement with Option B+...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#6
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736389/hiv-testing-experiences-and-their-implications-for-patient-engagement-with-hiv-care-and-treatment-on-the-eve-of-test-and-treat-findings-from-a-multicountry-qualitative-study
#7
Alison Wringe, Mosa Moshabela, Constance Nyamukapa, Dominic Bukenya, Ken Ondenge, William Ddaaki, Joyce Wamoyi, Janet Seeley, Kathryn Church, Basia Zaba, Victoria Hosegood, Oliver Bonnington, Morten Skovdal, Jenny Renju
OBJECTIVE: In view of expanding 'test and treat' initiatives, we sought to elicit how the experience of HIV testing influenced subsequent engagement in HIV care among people diagnosed with HIV. METHODS: As part of a multisite qualitative study, we conducted in-depth interviews in Uganda, South Africa, Tanzania, Kenya, Malawi and Zimbabwe with 5-10 health workers and 28-59 people living with HIV, per country. Topic guides covered patient and provider experiences of HIV testing and treatment services...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28726532/local-to-global-working-together-to-meet-the-needs-of-vulnerable-communities
#8
Anne Dressel, Lucy Mkandawire-Valhmu, Ann Dietrich, Ellen Chirwa, Florence Mgawadere, Sylvia Kambalametore, Peninnah Kako
Since 2012, the University of Wisconsin-Milwaukee (UWM) faculty from nursing and physical therapy (PT) have been working together towards a common goal: to meet the healthcare needs of vulnerable populations in Malawi and Milwaukee. Sharing valuable knowledge and understanding one another's professions have allowed us to develop interprofessional education (IPE) learning experiences for students to help identify how quality of life could be improved or enhanced for children and their families across two different geographic spaces, one in rural Malawi and the other in urban Milwaukee...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28723333/enhanced-prophylaxis-plus-antiretroviral-therapy-for-advanced-hiv-infection-in-africa
#9
James Hakim, Victor Musiime, Alex J Szubert, Jane Mallewa, Abraham Siika, Clara Agutu, Simon Walker, Sarah L Pett, Mutsa Bwakura-Dangarembizi, Abbas Lugemwa, Symon Kaunda, Mercy Karoney, Godfrey Musoro, Sheila Kabahenda, Kusum Nathoo, Kathryn Maitland, Anna Griffiths, Margaret J Thomason, Cissy Kityo, Peter Mugyenyi, Andrew J Prendergast, A Sarah Walker, Diana M Gibb
BACKGROUND: In sub-Saharan Africa, among patients with advanced human immunodeficiency virus (HIV) infection, the rate of death from infection (including tuberculosis and cryptococcus) shortly after the initiation of antiretroviral therapy (ART) is approximately 10%. METHODS: In this factorial open-label trial conducted in Uganda, Zimbabwe, Malawi, and Kenya, we enrolled HIV-infected adults and children 5 years of age or older who had not received previous ART and were starting ART with a CD4+ count of fewer than 100 cells per cubic millimeter...
July 20, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#10
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28717764/comprehensive-human-papillomavirus-genotyping-in-cervical-squamous-cell-carcinomas-and-its-relevance-to-cervical-cancer-prevention-in-malawian-women
#11
Brooke E Howitt, Michael Herfs, Tamiwe Tomoka, Steve Kamiza, Tarik Gheit, Massimo Tommasino, Philippe Delvenne, Christopher P Crum, Danny Milner
PURPOSE: Cervical squamous cell carcinoma (SCC) continues to be a significant cause of cancer morbidity and is the third leading cause of cancer-related death in women worldwide. In sub-Saharan Africa, cervical cancer is not only the most common female cancer but also the leading cause of cancer-related deaths in women. Malawi, in particular, has the highest burden of cervical cancer. With the increasing use of human papillomavirus (HPV) vaccination, documenting the prevalent HPV types in those high-risk populations is necessary to both manage expectations of HPV vaccination and guide future vaccine development...
June 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/28713803/the-institute-for-global-orthopedics-and-traumatology-a-model-for-academic-collaboration-in-orthopedic-surgery
#12
Devin James Conway, Richard Coughlin, Amber Caldwell, David Shearer
In 2006, surgeons at the University of California, San Francisco (UCSF) established the Institute for Global Orthopedics and Traumatology (IGOT), an initiative within the department of orthopedic surgery. The principal aim of IGOT is to create long-term, sustainable solutions to the growing burden of musculoskeletal injury in low- and middle-income countries (LMICs) through academic partnership. IGOT currently has relationships with teaching hospitals in Ghana, Malawi, Tanzania, Nicaragua, and Nepal. The organizational structure of IGOT is built on four pillars: Global Surgical Education (GSE), Global Knowledge Exchange (GKE), Global Research Initiative (GRI), and Global Leadership and Advocacy...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28711389/population-genetic-structure-antibiotic-resistance-capsule-switching-and-evolution-of-invasive-pneumococci-before-conjugate-vaccination-in-malawi
#13
Chrispin Chaguza, Jennifer E Cornick, Cheryl P Andam, Rebecca A Gladstone, Maaike Alaerts, Patrick Musicha, Chikondi Peno, Naor Bar-Zeev, Arox W Kamng'ona, Anmol M Kiran, Chisomo L Msefula, Lesley McGee, Robert F Breiman, Aras Kadioglu, Neil French, Robert S Heyderman, William P Hanage, Stephen D Bentley, Dean B Everett
INTRODUCTION: Pneumococcal infections cause a high death toll in Sub Saharan Africa (SSA) but the recently rolled out pneumococcal conjugate vaccines (PCV) will reduce the disease burden. To better understand the population impact of these vaccines, comprehensive analysis of large collections of pneumococcal isolates sampled prior to vaccination is required. Here we present a population genomic study of the invasive pneumococcal isolates sampled before the implementation of PCV13 in Malawi...
July 12, 2017: Vaccine
https://www.readbyqxmd.com/read/28702463/supporting-quality-data-systems-lessons-learned-from-early-implementation-of-routine-viral-load-monitoring-at-a-large-clinic-in-lilongwe-malawi
#14
Jean Gibb, Jimmy Chitsulo, Chifundo Chipungu, Mackenzie Chivwara, Alan Schooley, Risa M Hoffman
Successful viral load programs rely on the presence of data systems and high quality of patient data. Using a cohort of 49 patients at Partners in Hope, a large, urban HIV clinic in Malawi, we performed a quality improvement assessment of a new viral load program with a focus on accuracy of data collected from patients as well as adherence to Malawi HIV Guidelines in regard to response to elevated viral loads (≥1,000 copies/mL). Data were obtained from three parallel medical record systems to investigate the proportion of patients with a repeat viral load and whether the three data systems agreed in regard to sociodemographic and clinical data...
2017: Journal of Clinical Research in HIV AIDS and Prevention
https://www.readbyqxmd.com/read/28702174/costs-of-implementing-integrated-community-case-management-iccm-in-six-african-countries-implications-for-sustainability
#15
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/28701847/melioidosis-an-emerging-infection-with-fatal-outcomes
#16
Isabella Princess, R Ebenezer, Nagarajan Ramakrishnan, Arun Kumar Daniel, S Nandini, M A Thirunarayan
According to the Centers for Disease Control and Prevention, from being nonendemic for melioidosis, India has now become endemic for the disease since 2012. Until then, melioidosis cases were being reported sporadically from India. There have been isolated case reports from few states across the country for the past few years. Most of the times, Burkholderia pseudomallei may be misreported as Pseudomonas species, especially in resource-poor laboratories. Due to its varied clinical presentation, the specific clinical diagnosis can be difficult, thereby making laboratory diagnosis mandatory...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28700642/bacterial-communities-found-in-placental-tissues-are-associated-with-severe-chorioamnionitis-and-adverse-birth-outcomes
#17
Ronan M Doyle, Kathryn Harris, Steve Kamiza, Ulla Harjunmaa, Ulla Ashorn, Minyanga Nkhoma, Kathryn G Dewey, Kenneth Maleta, Per Ashorn, Nigel Klein
Preterm birth is a major cause of neonatal mortality and morbidity worldwide. Bacterial infection and the subsequent inflammatory response are recognised as an important cause of preterm birth. It is hypothesised that these organisms ascend the cervical canal, colonise placental tissues, cause chorioamnionitis and in severe cases infect amniotic fluid and the foetus. However, the presence of bacteria within the intrauterine cavity does not always precede chorioamnionitis or preterm birth. Whereas previous studies observing the types of bacteria present have been limited in size and the specificity of a few predetermined organisms, in this study we characterised bacteria found in placental tissues from a cohort of 1391 women in rural Malawi using 16S ribosomal RNA gene sequencing...
2017: PloS One
https://www.readbyqxmd.com/read/28698327/bubble-continuous-positive-airway-pressure-in-the-treatment-of-severe-paediatric-pneumonia-in-malawi-a-cost-effectiveness-analysis
#18
Teresa Bleakly Kortz, Benjamin Herzel, Elliot Marseille, James G Kahn
OBJECTIVES: Pneumonia is the largest infectious cause of death in children under 5 years globally, and limited resource settings bear an overwhelming proportion of this disease burden. Bubble continuous positive airway pressure (bCPAP), an accepted supportive therapy, is often thought of as cost-prohibitive in these settings. We hypothesise that bCPAP is a cost-effective intervention in a limited resource setting and this study aims to determine the cost-effectiveness of bCPAP, using Malawi as an example...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697794/factors-associated-with-maternal-mortality-in-malawi-application-of-the-three-delays-model
#19
Florence Mgawadere, Regine Unkels, Abigail Kazembe, Nynke van den Broek
BACKGROUND: The three delays model proposes that maternal mortality is associated with delays in: 1) deciding to seek care; 2) reaching the healthcare facility; and 3) receiving care. Previously, the majority of women who died were reported to have experienced type 1 and 2 delays. With increased coverage of healthcare services, we sought to explore the relative contribution of each type of delay. METHOD: 151 maternal deaths were identified during a 12-month reproductive age mortality survey (RAMOS) conducted in Malawi; verbal autopsy and facility-based medical record reviews were conducted to obtain details about the circumstances surrounding each death...
July 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28696787/reduced-morbidity-motivated-adoption-of-infant-and-young-child-feeding-practices-after-nutrition-education-intervention-in-rural-malawi
#20
Gabriella Chiutsi-Phiri, Eleonore Heil, Alexander A Kalimbira, Charles Masangano, Beatrice M Mtimuni, Michael B Krawinkel, Irmgard Jordan
This study assessed caregivers' knowledge and practices and factors that influence the adoption of improved infant and young child feeding (IYCF) practices after nutrition education in Kasungu and Mzimba districts among 198 caregivers. Mixed-methods convergent-parallel design, including knowledge tests, focus group discussions, and in-depth interviews in the intervention areas, was used to collect quantitative and qualitative data. Data were analyzed using count regression and content analysis, which showed that knowledge increased among caregivers after nutrition education...
July 11, 2017: Ecology of Food and Nutrition
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