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https://www.readbyqxmd.com/read/28436276/should-trained-lay-providers-perform-hiv-testing-a-systematic-review-to-inform-world-health-organization-guidelines
#1
C E Kennedy, P T Yeh, C Johnson, R Baggaley
New strategies for HIV testing services (HTS) are needed to achieve UN 90-90-90 targets, including diagnosis of 90% of people living with HIV. Task-sharing HTS to trained lay providers may alleviate health worker shortages and better reach target groups. We conducted a systematic review of studies evaluating HTS by lay providers using rapid diagnostic tests (RDTs). Peer-reviewed articles were included if they compared HTS using RDTs performed by trained lay providers to HTS by health professionals, or to no intervention...
April 24, 2017: AIDS Care
https://www.readbyqxmd.com/read/28435343/london-measure-of-unplanned-pregnancy-guidance-for-its-use-as-an-outcome-measure
#2
Jennifer A Hall, Geraldine Barrett, Andrew Copas, Judith Stephenson
BACKGROUND: The London Measure of Unplanned Pregnancy (LMUP) is a psychometrically validated measure of the degree of intention of a current or recent pregnancy. The LMUP is increasingly being used worldwide, and can be used to evaluate family planning or preconception care programs. However, beyond recommending the use of the full LMUP scale, there is no published guidance on how to use the LMUP as an outcome measure. Ordinal logistic regression has been recommended informally, but studies published to date have all used binary logistic regression and dichotomized the scale at different cut points...
2017: Patient related Outcome Measures
https://www.readbyqxmd.com/read/28428243/genome-wide-transcription-and-functional-analyses-reveal-heterogeneous-molecular-mechanisms-driving-pyrethroids-resistance-in-the-major-malaria-vector-anopheles-funestus-across-africa
#3
Jacob M Riveron, Sulaiman S Ibrahim, Charles Mulamba, Rousseau Djouaka, Helen Irving, Murielle J Wondji, Intan H Ishak, Charles S Wondji
Pyrethroid resistance in malaria vector, An. Funestus is increasingly reported across Africa, threatening the sustainability of pyrethroid-based control interventions including long lasting insecticidal Nets (LLINs). Managing this problem requires understanding of the molecular basis of the resistance from different regions of the continent, to establish whether it is being driven by a single or independent selective events. Here, using a genome-wide transcription profiling of pyrethroid resistant populations from Southern (Malawi), East (Uganda) and West Africa (Benin), we investigated the molecular basis of resistance, revealing strong differences between the different African regions...
April 19, 2017: G3: Genes—Genomes—Genetics
https://www.readbyqxmd.com/read/28426678/nutrition-education-improves-dietary-diversity-of-children-6-23-months-at-community-level-results-from-a-cluster-randomized-controlled-trial-in-malawi
#4
Judith Kuchenbecker, Anika Reinbott, Beatrice Mtimuni, Michael B Krawinkel, Irmgard Jordan
BACKGROUND: Low dietary quality and quantity and inappropriate feeding practices can cause undernutrition. Poor nutritional status in early childhood is associated with growth faltering. The objective of the study was to assess the potential of community-based nutrition education to improve height-for-age z-scores in children 6-23 months of age. METHODS AND FINDINGS: We carried out a cluster-randomized-controlled trial to assess the effectiveness of nutrition education...
2017: PloS One
https://www.readbyqxmd.com/read/28426440/the-impact-of-couple-hiv-testing-and-counseling-on-consistent-condom-use-among-pregnant-women-and-their-male-partners-an-observational-study
#5
Nora E Rosenberg, Lauren A Graybill, Austin Wesevich, Nuala McGrath, Carol E Golin, Suzanne Maman, Nivedita Bhushan, Mercy Tsidya, Limbikani Chimndozi, Irving F Hoffman, Mina C Hosseinipour, William C Miller
BACKGROUND: In sub-Saharan Africa couple HIV testing and counseling (CHTC) has been associated with substantial increases in safe sex, especially when at least one partner is HIV-infected. However, this relationship has not been characterized in an Option B+ context. SETTING: The study was conducted at the antenatal clinic at Bwaila District Hospital in Lilongwe, Malawi in 2016 under an Option B+ program. METHODS: Ninety heterosexual couples with an HIV-infected pregnant woman (female-positive couples) and 47 couples with an HIV-uninfected pregnant woman (female-negative couples) were enrolled in an observational study...
April 18, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28419352/dermatophytes-and-dermatophytosis-in-the-eastern-and-southern-parts-of-africa
#6
E I Nweze, I E Eke
Dermatophytosis is currently a disease of global importance and a public health burden. It is caused by dermatophytes, which attack and grow on dead animal keratin. Dermatophytes belong to three genera, namely, Epidermophyton, Microsporum, and Trichophyton. The predominant clinical forms and causative agents vary from one region of the world to another. Poor socioeconomic status, high population densities, and poor sanitary conditions are some of the factors responsible for the high prevalence of dermatophytosis in many developing countries, which include countries in southern and eastern Africa, the focus of this review...
April 17, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28419126/availability-and-affordability-of-antimalarial-and-antibiotic-medicines-in-malawi
#7
Felix Khuluza, Lutz Heide
BACKGROUND: Availability and affordability of medicines are key determinants of universal health coverage, yet achieving them presents a major challenge especially in low-income countries. We here present an analysis of availability and prices of antimalarial and antibiotic medicines in public, faith-based and private health facilities in Malawi. Medicines are provided free of charge in the public health care system of Malawi. In contrast, facilities of the Christian Health Association of Malawi (CHAM) usually charge their patients for medicines, as do private for-profit facilities...
2017: PloS One
https://www.readbyqxmd.com/read/28414783/acceptability-and-feasibility-of-early-infant-male-circumcision-for-hiv-prevention-in-malawi
#8
Charles Chilimampunga, Simeon Lijenje, Judith Sherman, Kelvin Nindi, Webster Mavhu
BACKGROUND: Voluntary medical male circumcision (VMMC) has been successfully implemented in 14 countries as an additional HIV prevention intervention. As VMMC programs mature in most countries, the focus is now on how to sustain the HIV prevention gains realised from VMMC. As part of preparations for the sustainability phase, countries are either piloting or preparing to pilot early infant male circumcision (EIMC). This qualitative study explored the acceptability and feasibility of EIMC in Malawi in order to inform pilot implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28413251/food-price-seasonality-in-africa-measurement-and-extent
#9
Christopher L Gilbert, Luc Christiaensen, Jonathan Kaminski
Everyone knows about seasonality. But what exactly do we know? This study systematically measures seasonal price gaps at 193 markets for 13 food commodities in seven African countries. It shows that the commonly used dummy variable or moving average deviation methods to estimate the seasonal gap can yield substantial upward bias. This can be partially circumvented using trigonometric and sawtooth models, which are more parsimonious. Among staple crops, seasonality is highest for maize (33 percent on average) and lowest for rice (16½ percent)...
February 2017: Food Policy
https://www.readbyqxmd.com/read/28413246/how-much-of-the-labor-in-african-agriculture-is-provided-by-women
#10
Amparo Palacios-Lopez, Luc Christiaensen, Talip Kilic
The contribution of women to labor in African agriculture is regularly quoted in the range of 60-80%. Using individual, plot-level labor input data from nationally representative household surveys across six Sub-Saharan African countries, this study estimates the average female labor share in crop production at 40%. It is slightly above 50% in Malawi, Tanzania, and Uganda, and substantially lower in Nigeria (37%), Ethiopia (29%), and Niger (24%). There are no systematic differences across crops and activities, but female labor shares tend to be higher in households where women own a larger share of the land and when they are more educated...
February 2017: Food Policy
https://www.readbyqxmd.com/read/28413243/ten-striking-facts-about-agricultural-input-use-in-sub-saharan-africa
#11
Megan Sheahan, Christopher B Barrett
Conventional wisdom holds that Sub-Saharan African farmers use few modern inputs despite the fact that most poverty-reducing agricultural growth in the region is expected to come largely from expanded use of inputs that embody improved technologies, particularly improved seed, fertilizers and other agro-chemicals, machinery, and irrigation. Yet following several years of high food prices, concerted policy efforts to intensify fertilizer and hybrid seed use, and increased public and private investment in agriculture, how low is modern input use in Africa really? This article revisits Africa's agricultural input landscape, exploiting the unique, recently collected, nationally representative, agriculturally intensive, and cross-country comparable Living Standard Measurement Study-Integrated Surveys on Agriculture (LSMS-ISA) covering six countries in the region (Ethiopia, Malawi, Niger, Nigeria, Tanzania, and Uganda)...
February 2017: Food Policy
https://www.readbyqxmd.com/read/28410374/factors-influencing-postnatal-option-b-participation-and-breastfeeding-duration-among-hiv-positive-women-in-lilongwe-district-malawi-a-qualitative-study
#12
Valerie L Flax, Gloria Hamela, Innocent Mofolo, Mina C Hosseinipour, Irving F Hoffman, Suzanne Maman
To ensure the health of mothers and children, prevention of mother-to-child HIV transmission (PMTCT) programs test women for HIV, engage HIV-positive women in care, and promote recommended breastfeeding practices. Under Malawi's Option B+ PMTCT program, ~20% of women are lost-to-follow-up (LTFU) and little is known about their breastfeeding practices. The purpose of this study is to describe facilitators and barriers to Option B+ participation and how participation influences breastfeeding duration. We conducted in-depth interviews with HIV-positive women in Option B+ (n = 32) or LTFU from Option B+ (n = 32)...
2017: PloS One
https://www.readbyqxmd.com/read/28407813/adapting-an-adherence-support-workers-intervention-engaging-traditional-healers-as-adherence-partners-for-persons-enrolled-in-hiv-care-and-treatment-in-rural-mozambique
#13
Carolyn M Audet, José Salato, Sten H Vermund, K Rivet Amico
BACKGROUND: Systematic adaptation of evidence-informed interventions that increase retention in care and improve adherence to antiretroviral therapy (ART) are essential to ending the HIV epidemic in rural sub-Saharan Africa. We selected and adapted an adherence support worker intervention employed in Malawi for use by traditional healers in rural Mozambique. Given the levels of trust and dependence previously expressed by persons living with HIV (PLHIV) for traditional medicine, we adapted the program to engage traditional healers within the allopathic health system...
April 13, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28406275/high-self-reported-non-adherence-to-antiretroviral-therapy-amongst-adolescents-living-with-hiv-in-malawi-barriers-and-associated-factors
#14
Maria H Kim, Alick C Mazenga, Xiaoying Yu, Saeed Ahmed, Mary E Paul, Peter N Kazembe, Elaine J Abrams
INTRODUCTION: Globally adolescents and young adults account for more than 40% of new HIV infections, and HIV-related deaths amongst adolescents increased by 50% from 2005 to 2012. Adherence to antiretroviral therapy (ART) is critical to control viral replication and preserve health; however, there is a paucity of research on adherence amongst the growing population of adolescents living with HIV/AIDS (ALHIV) in Southern Africa. We examined levels of self-reported ART adherence, barriers to adherence, and factors associated with non-adherence amongst ALHIV in Malawi...
March 30, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28406273/-we-are-part-of-a-family-benefits-and-limitations-of-community-art-groups-cags-in-thyolo-malawi-a-qualitative-study
#15
Umberto Pellecchia, Saar Baert, Spencer Nundwe, Andy Bwanali, Bote Zamadenga, Carol A Metcalf, Helen Bygrave, Sarah Daho, Liesbet Ohler, Brown Chibwandira, Kennedy Kanyimbo
INTRODUCTION: In 2012 Community ART Groups (CAGs), a community-based model of antiretroviral therapy (ART) delivery were piloted in Thyolo District, Malawi as a way to overcome patient barriers to accessing treatment, and to decrease healthcare workers' workload. CAGs are self-formed groups of patients on ART taking turns to collect ART refills for all group members from the health facility. We conducted a qualitative study to assess the benefits and challenges of CAGs from patients' and healthcare workers' (HCWs) perspectives...
March 28, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28405052/estimating-the-enduring-effects-of-fertiliser-subsidies-on-commercial-fertiliser-demand-and-maize-production-panel-data-evidence-from-malawi
#16
Jacob Ricker-Gilbert, T S Jayne
Most studies of input subsidy programmes confine their analyses to measuring programme effects over a one-year period. This article estimates the potential longer-run or enduring effects of fertiliser subsidy programmes on smallholder farm households' demand for commercial fertiliser and maize production over time. We use four waves of panel data on 462 farm households in Malawi for whom fertiliser use can be tracked for eight consecutive seasons between 2003/2004 and 2010/2011. Panel estimation methods are used to control for potential endogeneity of subsidised fertiliser acquisition...
February 2017: J Agric Econ
https://www.readbyqxmd.com/read/28399800/tst-positivity-in-household-contacts-of-tuberculosis-patients-a-case-contact-study-in-malawi
#17
Jonas Hector, Suzanne T Anderson, Gertrude Banda, Mercy Kamdolozi, Laura F Jefferys, Doris Shani, Natalie J Garton, Agnes Mwale, Annie Jobe, Geraint R Davies, Derek J Sloan
BACKGROUND: Screening household contacts of active tuberculosis (TB) patients is recommended for TB control. Due to resource constraints this rarely occurs in lower income countries. Demographic and clinical features of index cases may influence the likelihood of onwards TB transmission. It has also been proposed that accumulation of intracellular lipid bodies within M. tuberculosis cells may also enhance bacterial transmissibility. This study explored whether clinical and bacteriological observations recorded at baseline in TB cases in Malawi could help identify those with the highest risk of onwards transmission, to prioritise contact tracing...
April 11, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28399179/prevalence-and-factors-associated-with-malaria-parasitaemia-in-children-under-the-age-of-five-years-in-malawi-a-comparison-study-of-the-2012-and-2014-malaria-indicator-surveys-miss
#18
Maggie Zgambo, Balwani Chingatichifwe Mbakaya, Fatch Welcome Kalembo
BACKGROUND: Malaria is the main cause of morbidity and mortality among children under the age of five years in Malawi. The aim of this study was to compare the prevalence and factors associated with malaria parasitaemia among children under the age of five years in Malawi between the 2014 and 2012 Malaria Indicator Surveys (MISs). METHODOLOGY: Data on demographic factors, vector control interventions, and blood for malaria test were collected from a representative sample of children under the age of five years in Malawi through multistage cluster sampling method...
2017: PloS One
https://www.readbyqxmd.com/read/28398996/lessons-learned-from-option-b-in-the-evolution-toward-test-and-start-from-malawi-cameroon-and-the-united-republic-of-tanzania
#19
Thokozani Kalua, Beth A Tippett Barr, Joep J van Oosterhout, Dorothy Mbori-Ngacha, Erik J Schouten, Sundeep Gupta, Amakobe Sande, Gerald Zomba, Hannock Tweya, Edgar Lungu, Deborah Kajoka, Pius Tih, Andreas Jahn
The acceleration of prevention of mother-to-child transmission (PMTCT) activities, coupled with the rollout of 2010 World Health Organization (WHO) guidelines, led to important discussions and innovations at global and country levels. One paradigm-shifting innovation was Option B+ in Malawi. It was later included in WHO guidelines and eventually adopted by all 22 Global Plan priority countries. This article presents Malawi's experience with designing and implementing Option B+ and provides complementary narratives from Cameroon and Tanzania...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28398954/moving-towards-test-and-start-learning-from-the-experience-of-universal-art-programs-for-hiv-infected-pregnant-breastfeeding-women
#20
Sara E Forhan, Surbhi Modi, James C Houston, Laura N Broyles
: In 2015, the World Health Organization (WHO) recommended universal antiretroviral therapy (ART) for all people living with HIV (PLHIV) after two randomized controlled trials revealed lower rates of mortality and serious illnesses among PLHIV receiving immediate ART compared to those receiving deferred ART. Many countries in sub-Saharan Africa rapidly adopted this guidance and are implementing "test and start" programs.As this work begins, lessons learned from prevention of mother-to-child transmission (PMTCT) Option B+ programs can inform decisions for new universal HIV treatment programs...
April 10, 2017: AIDS
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