diff --git "a/data/zotero-collection-pastan_zotero_items.json" "b/data/zotero-collection-pastan_zotero_items.json" new file mode 100644--- /dev/null +++ "b/data/zotero-collection-pastan_zotero_items.json" @@ -0,0 +1,945 @@ +[ + { + "key": "BUUB8KJG", + "title": "High acceptability for cell phone text messages to improve communication of laboratory results with HIV-infected patients in rural Uganda: a cross-sectional survey study", + "abstract": "Background: Patient-provider communication is a major challenge in resource-limited settings with large catchment areas. Though mobile phone usership increased 20-fold in Africa over the past decade, little is known about acceptability of, perceptions about disclosure and confidentiality, and preferences for cell phone communication of health information in the region.Methods: We performed structured interviews of fifty patients at the Immune Suppression Syndrome clinic in Mbarara, Uganda to assess four domains of health-related communication: a) cell phone use practices and literacy, b) preferences for laboratory results communication, c) privacy and confidentiality, and d) acceptability of and preferences for text messaging to notify patients of abnormal test results.Results: Participants had a median of 38 years, were 56% female, and were residents of a large catchment area throughout southwestern Uganda. All participants expressed interest in a service to receive information about laboratory results by cell phone text message, stating benefits of increased awareness of their health and decreased transportation costs. Ninety percent reported that they would not be concerned for unintended disclosure. A minority additionally expressed concerns about difficulty interpreting messages, discouragement upon learning bad news, and technical issues. Though all respondents expressed interest in password protection of messages, there was also a strong desire for direct messages to limit misinterpretation of information.Conclusions: Cell phone text messaging for communication of abnormal laboratory results is highly acceptable in this cohort of HIV-infected patients in rural Uganda. The feasibility of text messaging, including an optimal balance between privacy and comprehension, should be further studied.", + "full_text": "", + "authors": [ + "MJ Siedner", + "JE Haberer", + "MB Bwana", + "NC Ware", + "DR Bangsberg" + ], + "doi": "10.1186/1472-6947-12-56", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "T3WT7IU5", + "title": "Provider love in an informal settlement: Men's relationships with providing women and implications for HIV in Kampala, Uganda", + "abstract": "Uganda has made progress in controlling the HIV epidemic since it first emerged in the 1980s. While new infections in the country are higher among women, men in urban areas face a higher risk of AIDS-related mortality due to starting treatment later and taking medication inconsistently. While gender analyses have been used to describe women?s HIV vulnerability, less is known about how masculinity, and especially different forms of masculinity, affect men?s vulnerability. This study reports on data from an ethnography (2016?2019) with lowincome men in urban Uganda. This study uses gender and power theory to describe how men?s relationships with female sex workers in an informal settlement in urban Kampala, Uganda are characterized by female providers (?provider love?) and male dependents. Young men in this sample, largely jobless, rely on their relationships for daily survival. As gender roles reverse, young men find themselves unable to attain masculine ideals as expected of Baganda men. Instead, men in this sample face less power in their relationships, a loss of masculine respectability, and diminished reputations in the community. These intersections of gender, economic struggle, power, and intimacy reconfigure men?s HIV vulnerability in this setting. Public health programming on HIV/ AIDS for men should consider different patterns of masculinity, power, and economic struggle and how they impact HIV outcomes.", + "full_text": "", + "authors": [ + "MM Schmidt-Sane" + ], + "doi": "10.1016/j.socscimed.2021.113847", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "XHYQCB2E", + "title": "Effect of HIV Subtype and Antiretroviral Therapy on HIV-Associated Neurocognitive Disorder Stage in Rakai, Uganda", + "abstract": "Background: Combination antiretroviral therapy (ART) improves HIV-associated neurocognitive disorder (HAND) stage in the United States where subtype B predominates, but the effect of ART and subtype on HAND stage in individuals in Uganda with subtypes D and A is largely unknown.Setting: A community-based cohort of participants residing in Rakai, Uganda.Methods: Three hundred ninety-nine initially ART-naive HIV-seropositive (HIV+) individuals were followed up over 2 years. Neurological and neuropsychological tests and functional assessments were used to determine HAND stage. Frequency and predictors of HAND and HIV-associated dementia (HAD) were assessed at baseline and at follow-up after ART initiation in 312 HIV+ individuals. HIV subtype was determined from gag and env sequences.Results: At 2-year follow-up, HAD frequency among HIV+ individuals on ART (n = 312) decreased from 13% to 5% (P < 0.001), but the overall frequency of HAND remained unchanged (56%-51%). Subtype D was associated with higher rates of impaired cognition (global deficit score >= 0.5) compared with HIV+ individuals with subtype A (55% vs. 24%) (P = 0.008). Factors associated with HAD at baseline were older age, depression, and plasma HIV viral load >100,000 copies/mL. At follow-up, age and depression remained significantly associated with HAD.Conclusions: HIV+ individuals on ART in rural Uganda had a significant decrease in the frequency of HAD, but HAND persists after 2 years on ART. The current guideline of immediate ART initiation after HIV diagnosis is likely to greatly reduce HAD in sub-Saharan Africa. Further studies of the effect of HIV subtype and neurocognitive performance are warranted.", + "full_text": "", + "authors": [ + "N Sacktor", + "D Saylor", + "G Nakigozi", + "N Nakasujja", + "K Robertson", + "MK Grabowski", + "A Kisakye", + "J Batte", + "R Mayanja", + "A Anok", + "RH Gray", + "MJ Wawer" + ], + "doi": "10.1097/QAI.0000000000001992", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "HPR5BWSJ", + "title": "Linking data sources for measurement of effective coverage in maternal and newborn health: what do we learn from individual- vs ecological-linking methods?", + "abstract": "Background Improving maternal and newborn health requires improvements in the quality of facility-based care. This is challenging to measure: routine data may be unreliable; respondents in population surveys may be unable to accurately report on quality indicators; and facility assessments lack population level denominators. We explored methods for linking access to skilled birth attendance (SBA) from household surveys to data on provision of care from facility surveys with the aim of estimating population level effective coverage reflecting access to quality care.Methods We used data from Mayuge District, Uganda. Data from household surveys on access to SBA were linked to health facility assessment census data on readiness to provide basic emergency obstetric and newborn care (BEmONC) in the same district. One individual- and two ecological-linking methods were applied. All methods used household survey reports on where care at birth was accessed. The individual- linking method linked this to data about facility readiness from the specific facility where each woman delivered. The first ecological-linking approach used a district-wide mean estimate of facility readiness. The second used an estimate of facility readiness adjusted by level of health facility accessed. Absolute differences between estimates derived from the different linking methods were calculated, and agreement examined using Lin's concordance correlation coefficient.Results A total of 1177 women resident in Mayuge reported a birth during 2012-13. Of these, 664 took place in facilities within Mayuge, and were eligible for linking to the census of the district's 38 facilities. 55% were assisted by an SBA in a facility. Using the individual-linking method, effective coverage of births that took place with a SBA in a facility ready to provide BEmONC was just 10% (95% confidence interval CI 3-17). The absolute difference between the individual-and ecological-level linking method adjusting for facility level was one percentage point (11%), and tests suggested good agreement. The ecological method using the district-wide estimate demonstrated poor agreement.Conclusions The proportion of women accessing appropriately equipped facilities for care at birth is far lower than the coverage of facility delivery. To realise the life-saving potential of health services, countries need evidence to inform actions that address gaps in the provision of quality care. Linking household and facility-based information provides a simple but innovative method for estimating quality of care at the population level. These encouraging findings suggest that linking data sets can result in meaningful evidence even when the exact location of care seeking is not known.", + "full_text": "", + "authors": [ + "B Willey", + "P Waiswa", + "D Kajjo", + "M Munos", + "J Akuze", + "E Allen", + "T Marchant" + ], + "doi": "10.7189/jogh.08.010601", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "YR6N3YXI", + "title": "Using baseline and formative evaluation data to inform the Uganda Helmet Vaccine Initiative", + "abstract": "Motorcycles are an important form of transportation in Uganda, and are involved in more road traffic injuries than any other vehicle. The majority of motorcycles in Uganda are used as motorcycle taxis, better known locally as boda bodas. Research shows that a motorcycle helmet is effective at reducing a rider's risk of death and head injury. As part of the Uganda Helmet Vaccine Initiative (UHVI), researchers collected baseline and formative evaluation data on boda boda operators' helmet attitudes, beliefs, and behaviors to inform UHVI activities. Researchers collected data on motorcycle helmet-related attitudes and beliefs through focus group discussions and structured roadside interviews, and researchers conducted roadside observations to collect data on helmet-wearing behaviors. Of the 12,189 motorcycle operators and passengers observed during roadside observations, 30.8% of drivers and <1% of passengers were wearing helmets. The most commonly reported helmet-wearing barriers from the focus group discussions and structured roadside interviews were: (1) Helmet is uncomfortable', (2) Helmet is too hot', (3) Helmet is too expensive', and (4) Helmet is of low quality'. Researchers incorporated findings from the formative research into the UHVI campaign to increase motorcycle helmet use. Radio messages addressing helmet comfort and cost were widely aired throughout Kampala, Uganda. In addition, campaign staff held nine boda boda operator workshops, covering approximately 900 operators, in which the facilitator addressed barriers and facilitators to helmet use. Each workshop participant received a high-quality tropical motorcycle helmet. UHVI will continue to use a data-driven approach to future campaign activities.", + "full_text": "", + "authors": [ + "DR Roehler", + "RB Naumann", + "B Mutatina", + "M Nakitto", + "B Mwanje", + "L Brondum", + "C Blanchard", + "GT Baldwin", + "AM Dellinger" + ], + "doi": "10.1177/1757975913509657", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "QHFH2YD6", + "title": "Social norms regarding alcohol use, perceptions of alcohol advertisement and intent to drink alcohol among youth in Uganda", + "abstract": "The objective of this paper is to address the scarcity of research on alcohol marketing exposure and underage drinking in sub-Saharan Africa. This study examines perceptions of alcohol advertisements and perceived peer, adult, and parental attitudes regarding alcohol use and intentions to drink among vulnerable youth. The Kampala Youth Survey is a cross-sectional study conducted in 2014 with service-seeking youth (ages 12-18 years) living in the slums of Kampala (n = 1,134) who were participating in Uganda Youth Development Link drop-in centers. Survey measures assessed perceptions of alcohol ads, social norms regarding alcohol use, and intentions to drink alcohol. Chi-square tests and structural equation modeling analyses were computed. Among participants, 32% reported intentions to drink alcohol. In fully adjusted multivariable models, current drinking status (AdjOR = 5.13; 95% CI:3.93, 6.72) and perceived attractive alcohol ads (AdjOR = 3.71; 95%CI: 2.88, 4.78) were most strongly associated with the intention to drink. Analyses examining social norms as a moderator between perceptions of alcohol ads and intention to drink found that peer networks that disapproved of drinking were protective against intent to drink. Perceived alcohol advertisement effectiveness and peer networks supportive of alcohol use were associated with intentions to drink among both boys and girls in Kampala and were not buffered by parental disapproval of drinking. Reducing exposure to alcohol marketing and developing prevention programs that strengthen peer networks disapproving of underage alcohol use and reduce exposure to alcohol marketing may be promising strategies among these vulnerable youth.", + "full_text": "", + "authors": [ + "MH Swahn", + "R Culbreth", + "C Cottrell-Daniels", + "NM Tumwesigye", + "D Jernigan", + "R Kasilye", + "I Obot" + ], + "doi": "10.1080/14635240.2022.2047093", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "P9LSFH7D", + "title": "Trichophyton violaceum Leading cause of tinea capitis in children in the Mbarara Regional Referral Hospital in Uganda", + "abstract": "Tinea capitis is caused by anthropophilic, zoophilic or geophilic dermatophytes of the genera Microsporum or Trichophyton.The aim of this study was to analyze the clinical presentation of tinea capitis among children in western Uganda.From February to June 2012, skin and hair samples were obtained from 115 patients aged from 1 to 16 years presenting at Mbarara Regional Referral Hospital (MUSC) with clinically suspected tinea capitis. Conventional mycological diagnostics comprised Blancophor preparation and cultivation of fungi for species identification.Tinea capitis among the children included in the MUSC study was mainly noninflammatory showing mostly a seborrhoeic pattern or \"black dot\" and \"gray patch\" form and highly inflammatory kerion celsi. Blancophor preparation identified 82.6 % positive and 17.4 % negative samples. Cultural species differentiation showed Trichophyton (T.) violaceum as the causative agent for tinea capitis in 56.6 % of the patients. In 13 %, Microsporum (M.) audouinii was isolated followed by T. soudanense (2.6 %), and T. rubrum (1.7 %). In addition, moulds (contamination?) such as Scopulariopsis brevicaulis, Aspergillus niger, and Fusarium oxysporum were found as well as mixed infections.The anthropophilic dermatophyte T. violaceum represents the most frequent cause of tinea capitis in western Uganda. For successful management oral antifungal therapy is necessary together with supportive topical treatment.", + "full_text": "", + "authors": [ + "C Wiegand", + "P Mugisha", + "GK Mulyowa", + "P Elsner", + "UC Hipler", + "Y Graser", + "S Uhrlass", + "P Nenoff" + ], + "doi": "10.1007/s00105-016-3831-1", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "C9FKBKS3", + "title": "Rifampicin susceptibility discordance between Xpert MTB/RIF G4 and Xpert Ultra before MDRT-TB treatment initiation: A case report from Uganda", + "abstract": "Tuberculosis (TB) resistance to rifampicin, the most powerful drug leads to increase in mortality. Globally, half a million new patients develop such resistant TB each year, coupled with both inappropriate diagnosis and treatment initiation.We report a case of rifampicin resistant Mycobacterium tuberculosis whose rifampicin resistance was missed by Xpert MTB/RIF Assay G4 but detected by the Xpert MTB/RIF Ultra assay at different time points leading to increased delays for MDR-TB treatment initiation at Mulago Hospital, Kampala, Uganda. Our case report compels greater urgency in accelerating the transition to the newer assay, Ultra, to benefit from higher sensitivity of rifampicin resistance detection.", + "full_text": "", + "authors": [ + "W Ssengooba", + "K Komakech", + "S Namiiro", + "H Byabajungu", + "J Nalunjogi", + "W Katagira", + "I Kimuli", + "ML Joloba", + "S Adakun", + "L Nakiyingi", + "G Torrea", + "BJ Kirenga" + ], + "doi": "10.1016/j.jctube.2021.100286", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "U9HAASQR", + "title": "High Prevalence of Ciprofloxacin-Resistant Gonorrhea Among Female Sex Workers in Kampala, Uganda (2008-2009)", + "abstract": "BackgroundRecent antimicrobial resistance data for Neisseria gonorrhoeae are lacking in Uganda, where, until 2010, ciprofloxacin was the nationally recommended first-line treatment of presumptive gonorrhea. This study assessed the antimicrobial susceptibility patterns of N. gonorrhoeae isolates cultured from female sex workers (FSWs) in Kampala.MethodsGonococci were isolated from endocervical specimens collected from women enrolled in a FSW cohort for 18 months (2008-2009). Minimum inhibitory concentrations for 7 antibiotics (ciprofloxacin, cefixime, ceftriaxone, azithromycin, spectinomycin, penicillin, and tetracycline) were determined for 148 isolates using Etest strips. The European Committee on Antimicrobial Susceptibility Testing version 1.3 clinical breakpoints were used to assign susceptibility categories. The 2008 World Health Organization N. gonorrhoeae panel was used for quality assurance purposes.ResultsFor ciprofloxacin, 123 (83.1%) gonococcal isolates were resistant, 2 (1.4%) had intermediate susceptibility, and 23 (15.6%) were fully susceptible. All isolates were susceptible to ceftriaxone and spectinomycin, whereas 1 isolate (0.7%) was resistant to cefixime. For azithromycin, 124 isolates (83.8%) were susceptible, 20 (13.5%) had decreased susceptibility, and 4 (2.7%) were resistant. Most isolates were resistant to penicillin (101; 68.2%) and tetracycline (144; 97.3%). The minimum inhibitory concentration ranges for each antibiotic were as follows: ciprofloxacin (0.002-32 mg/L), ceftriaxone (<= 0.002-0.064 mg/L), cefixime (<= 0.016-0.38 mg/L), spectinomycin (2-24 mg/L), azithromycin (0.023-1 mg/L), penicillin (0.094-32 mg/L), and tetracycline (0.019-256 mg/L).ConclusionsThe high prevalence of ciprofloxacin-resistant gonorrhea observed in Kampala-based FSW emphasizes the need for sustainable gonococcal antimicrobial resistance surveillance programs in Uganda and, in general, Africa.", + "full_text": "", + "authors": [ + "J Vandepitte", + "P Hughes", + "G Matovu", + "J Bukenya", + "H Grosskurth", + "DA Lewis" + ], + "doi": "10.1097/OLQ.0000000000000099", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "FRKZKY4Z", + "title": "The Social Legacy of AIDS: Fertility Aspirations Among HIV-Affected Women in Uganda", + "abstract": "Objectives. We investigated the impact of HIV status on fertility desires in Uganda.Methods. We surveyed 1594 women aged 18 to 49 years visiting outpatient services at Mbarara Regional Hospital, from May through August 2010. Of these, 59.7% were HIV-positive; 96.4% of HIV-positive women were using antiretroviral therapy (ART). We used logistic regression models to examine relationships between HIV status and fertility desires, marital status, household structure, educational attainment, and household income.Results. Among married women, HIV-positive status was significantly associated with a lower likelihood of desiring more children (27.7% vs 56.4% of HIV-negative women; chi(2) = 39.97; P<.001). The difference remained highly significant net of age, parity, son parity, foster children, education, or household income. HIV-positive women were more likely to be poor, unmarried, single heads of household, in second marriages (if married), living with an HIV-positive spouse, and supporting foster children.Conclusions. We found a strong association between positive HIV status and lower fertility aspirations among married women in Uganda, irrespective of ART status. Although the increasing availability of ART is a tremendous public health achievement, women affected by HIV have numerous continuing social needs. (Am J Public Health. 2013;103:278-285. doi:10.2105/AJPH.2012.300892)", + "full_text": "", + "authors": [ + "RC Snow", + "M Mutumba", + "K Resnicow", + "G Mugyenyi" + ], + "doi": "10.2105/AJPH.2012.300892", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "QW4NZVWC", + "title": "Training, employee engagement and employee performance: Evidence from Uganda's health sector", + "abstract": "The purpose of this study was to investigate the contribution of training and employee engagement on employee performance using evidence from Uganda's health sector. This study is cross sectional and correlational. Usable questionnaires were received from 150 respondents from four Catholic founded hospitals that is Kamuli Mission Hospital, Buluba Mission Hospital, St. Benedict Mission Hospital and Budini Mission Hospital. Data were analyzed using SPSS. Regression analysis results indicate that training and employee engagement significantly predict employee performance by 44.7% and employee engagement was found to be a major predictor of employee performance as compared to training. Correlation analysis results indicate that there is a significant positive relationship between training and employee performance. Correlation analysis results further indicate that there is a significant positive relationship between employee engagement and employee performance. A partial mediation effect of employee engagement in the relationship between training and employee performance was also established. This research is important to managers, policy makers and Government in improving employee performance in the health sector. Given that this study was cross sectional, monitoring changes in behavior could not be possible. To the researchers' knowledge, this is the first study to establish the contribution of training and employee engagement on employee performance and at the same time provide an initial empirical evidence on the mediation effect of employee engagement in the relationship between training and employee performance using evidence from Uganda's health sector.", + "full_text": "", + "authors": [ + "K Sendawula", + "SN Kimuli", + "J Bananuka", + "GN Muganga" + ], + "doi": "10.1080/23311975.2018.1470891", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "T3F6J82V", + "title": "Availability of post-hospital services supporting community reintegration for children with identified surgical need in Uganda", + "abstract": "Background: Community services and supports are essential for children transitioning home to recover from the hospital after surgery. This study assessed the availability and geographic capacity of rehabilitation, assistive devices, familial support, and school reintegration programs for school-aged children in Uganda with identified surgical need.Methods: This study assessed the geographic epidemiology and spatial analysis of resource availability in communities in Uganda. Participants were children with identified surgical need using the Surgeons OverSeas Assessment of Surgical need (SOSAS). Community-based resources available to children and adolescents after surgery in Uganda were identified using publicly available data sources and searching for resources through consultation with in-country collaborators We sought resources available in all geographic regions for a variety of services.Results: Of 1082 individuals surveyed aged 5 to 14 yearsr, 6.2% had identified surgical needs. Pediatric surgical conditions were most prevalent in the Northern and Central regions of Uganda. Of the 151 community-based services identified, availability was greatest in the Central region and least in the Northern region, regardless of type. Assuming 30% of children with surgical needs will need services, a maximum of 50.1% of these children would have access to the needed services in the extensive capacity estimates, while only 10.0% would have access in the minimal capacity estimates. The capacity varied dramatically by region with the Northern region having much lower capacity in all scenarios as compared to the Central, Eastern, or Western regions.Conclusions: Our study found that beyond the city of Kampala in the Central region, community-based services were severely lacking for school-aged children in Uganda. Increased pediatric surgical capacity to additional hospitals in Uganda will need to be met with increased availability and access to community-based services to support recovery and community re-integration.", + "full_text": "", + "authors": [ + "ER Smith", + "BJ van de Water", + "A Martin", + "SJ Barton", + "J Seider", + "C Fitzgibbon", + "MM Bility", + "N Ekeji", + "JRN Vissoci", + "MM Haglund", + "JP Bettger" + ], + "doi": "10.1186/s12913-018-3510-2", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "MZK42KJW", + "title": "Class-Based Chronicities of Suffering and Seeking Help: Comparing Addiction Treatment Programs in Uganda", + "abstract": "Based on ethnographic fieldwork, this article looks at changing discourses and practices in the field of mental health care in Uganda. In particular, it analyzes two psychotherapeutic institutions designed to treat drug- and alcohol-addiction, and their accessibility and affordability for people from different class backgrounds. The first center is a high-class residential facility near Kampala which offers state-of-the-art addiction therapy, but is affordable only for the rich. The second center, a church-funded organization in Northern Uganda, cares mainly for people from poor, rural families who cannot afford exp/tensive treatment. Comparing the two centers provides important insights not only into the temporalities of mental illness, substance abuse and mental health care, but also into broader socio-economic dynamics and understandings of suffering in contemporary Uganda. The term 'class-based chronicities' refers to the way both the urgency with which people seek treatment (when has someone suffered enough?) and the length of treatment they receive (when is someone considered 'recovered'?) are highly class-dependent. On a theoretical level, the article shows how psychotherapeutic models operate as philosophical systems which not only impact on treatment practices, but also produce different addiction entities and addiction-related subjectivities. As such, it contributes to an emerging anthropology of addiction.", + "full_text": "", + "authors": [ + "J Vorholter" + ], + "doi": "10.1007/s11013-017-9541-z", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "93GUZ7YR", + "title": "The burden of HIV/AIDS among slum-dwelling school-age children in Kampala, Uganda", + "abstract": "Introduction: Adult and youthful slum dwellers have been documented to have a higher prevalence of human immunodeficiency virus (HIV) compared to the general population. However, there is paucity of information on the extent of this infection among slum-dwelling school-age (5-14 years) children in Uganda. This study explored the burden of HIV among slum-dwelling school-age children (SDSAC) of Namuwongo, Kampala, Uganda.Material and methods: We analysed data derived from HIV counselling and testing records of school-age children that tested at Kisugu HCIII between 2011 and 2016. A total of 555 anonymised records were analysed for: residence, HIV, religious, and sex status. Using STATA version 13, bi-variate analysis was conducted to obtain joint distribution, and the two-sample test of proportions test was used to elicit associations and their significance.Results: The overall study population burden of HIV was 2%, with girls (2.6%) more affected than boys (0.9%). SDSAC had a higher HIV burden (3.3%) compared to non-slum dwellers (1.2%). HIV was more prevalent among slum-dwelling girls (5.2%) compared to their non-slum dwelling counterparts (0.9%). A positive HIV result was associated with being a slum dwelling girl (95% CI: [0.3-8.3], p = 0.013) and belonging to the 10-14-year age group (95% CI: [0.002-0.065], p = 0.015).Conclusions: There is a high burden of HIV among slum-dwelling school-age girls in Kampala. SDSAC should be included among the blind spot population, and we recommend expansion of school-age-friendly, preventive, promotive, and therapeutic HIV services to these areas.", + "full_text": "", + "authors": [ + "JT Ssensamba", + "M Nakafeero", + "DM Ssemakula", + "R Ssenyonga", + "JB Nnakate" + ], + "doi": "10.5114/hivar.2019.89455", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "32GPMZ6P", + "title": "Acceptability and trust of community health workers offering maternal and newborn health education in rural Uganda", + "abstract": "When trusted, Community Health Workers (CHWs) can contribute to improving maternal and newborn health outcomes in low- and middle-income countries through education. Issues of acceptability of CHWs by communities were explored through experiences gained in a qualitative study that is part of a cluster randomized trial in East Uganda. Initially, focus group discussions with key community members and leaders were undertaken regarding preventative health and 40 CHWs were observed making home visits by supervisors during the initial 6 months of fieldwork of the trial in eight villages in the Jinja District in Uganda. The results were analyzed using the 5-SPICE framework. Observation of CHWs in the field identified a number of unanticipated issues including a general mistrust of the public health system by community members in areas that had an impact on maternal and newborn health. At the outset, CHWs often did not trust their own abilities and faced community expectations that they would provide curative rather than preventative care. Early community engagement, non-threatening home visits that enhanced friendship and supportive supervision improved the confidence of the CHWs and improved the trust and acceptance of the CHWs and the willingness of the community members to act on what was discussed.", + "full_text": "", + "authors": [ + "D Singh", + "R Cumming", + "J Negin" + ], + "doi": "10.1093/her/cyv045", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "UF8DVITP", + "title": "AFM investigation of APAC (antiplatelet and anticoagulant heparin proteoglycan)", + "abstract": "Antiplatelet and anticoagulant drugs are classified antithrombotic agents with the purpose to reduce blood clot formation. For a successful treatment of many known complex cardiovascular diseases driven by platelet and/or coagulation activity, the need of more than one antithrombotic agent is inevitable. However, combining drugs with different mechanisms of action enhances risk of bleeding. Dual anticoagulant and antiplatelet (APAC), a novel semisynthetic antithrombotic molecule, provides both anticoagulant and antiplatelet properties in preclinical studies. APAC is entering clinical studies with this new exciting approach to manage cardiovascular diseases. For a better understanding of the biological function of APAC, comprehensive knowledge of its structure is essential. In this study, atomic force microscopy (AFM) was used to characterize APAC according to its structure and to investigate the molecular interaction of APAC with von Willebrand factor (VWF), since specific binding of APAC to VWF could reduce platelet accumulation at vascular injury sites. By the optimization of drop-casting experiments, we were able to determine the volume of an individual APAC molecule at around 600 nm(3), and confirm that APAC forms multimers, especially dimers and trimers under the experimental conditions. By studying the drop-casting behavior of APAC and VWF individually, we depictured their interaction by using an indirect approach. Moreover, in vitro and in vivo conducted experiments in pigs supported the AFM results further. Finally, the successful adsorption of APAC to a flat gold surface was confirmed by using photothermal-induced resonance, whereby attenuated total reflection-Fourier transform infrared spectroscopy (ATR-FTIR) served as a reference method.", + "full_text": "", + "authors": [ + "M Winzely", + "A Jouppila", + "G Ramer", + "L Lux", + "B Lendl", + "K Barreiro", + "R Lassila", + "G Friedbacher" + ], + "doi": "10.1007/s00216-021-03765-y", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "3SVBIDEF", + "title": "Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda", + "abstract": "Global and local efforts have been devoted to increase the supply of antiretroviral therapy (ART) in sub-Saharan Africa. Recent qualitative studies suggest that even with free ART, patients may fail to adhere to medication because of socioeconomic barriers such as transportation costs to clinics. The aim of this study was to measure adherence in a population of patients receiving free ART and to examine barriers to adherence. Adherence was measured using the pill count and self-report methods among 140 HIV-positive patients at four PEPFAR-facilitated ART clinics in Kayunga, a rural district in Uganda. Self-report was also used to examine reasons for non-adherence. Pill count adherence estimates revealed that 86.4% of the patients were adherent (>= 95%) in the past six months. Self-report estimates showed that all the patients were adherent in the past six months with average adherence of 99.7% +/- 90.6. The main reasons for non-adherence were being away from medication at dose time (29.4%) and forgetting to take pills (27.5%). Lack of access to food and transportation costs accounted for 11.7% and 7.8% of non-adherence, respectively. Patients with 100% adherence reported lack of access to food as the main challenge they had to overcome to stay adherent. Patients attending the rural clinic were significantly less adherent to ART than patients at the Kayunga district capital [OR 0.046 (0.008-0.269)]. The study revealed that the greatest patient-perceived challenge to adherence in this population is the lack of access to food; however, the immediate reasons for non-adherence were found to be forgetfulness and being away from medication at dose's time. These results suggest that interventions tackling lack of access to food are necessary, but interventions addressing forgetfulness and being away from medication at dose's time would be the most effective in enhancing adherence inpatients receiving free ART.", + "full_text": "", + "authors": [ + "V Senkomago", + "D Guwatudde", + "M Breda", + "K Khoshnood" + ], + "doi": "10.1080/09540121.2011.564112", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "MHYDUMS8", + "title": "Changing Antimalarial Drug Sensitivities in Uganda", + "abstract": "Dihydroartemisinin-piperaquine (DP) has demonstrated excellent efficacy for the treatment and prevention of malaria in Uganda. However, resistance to both components of this regimen has emerged in Southeast Asia. The efficacy of artemether-lumefantrine, the first-line regimen to treat malaria in Uganda, has also been excellent, but continued pressure may select for parasites with decreased sensitivity to lumefantrine. To gain insight into current drug sensitivity patterns, ex vivo sensitivities were assessed and genotypes previously associated with altered drug sensitivity were characterized for 58 isolates collected in Tororo, Uganda, from subjects presenting in 2016 with malaria from the community or as part of a clinical trial comparing DP chemoprevention regimens. Compared to community isolates, those from trial subjects had lower sensitivities to the aminoquinolines chloroquine, monodesethyl amodiaquine, and piperaquine and greater sensitivities to lumefantrine and mefloquine, an observation consistent with DP selection pressure. Compared to results for isolates from 2010 to 2013, the sensitivities of 2016 community isolates to chloroquine, amodiaquine, and piperaquine improved (geometric mean 50% inhibitory concentrations [IC50] = 248, 76.9, and 19.1 nM in 2010 to 2013 and 33.4, 14.9, and 7.5 nM in 2016, respectively [P < 0.001 for all comparisons]), the sensitivity to lumefantrine decreased (IC50 = 3.0 nM in 2010 to 2013 and 5.4 nM in 2016 [P < 0.001]), and the sensitivity to dihydroartemisinin was unchanged (IC50 = 1.4 nM). These changes were accompanied by decreased prevalence of transporter mutations associated with aminoquinoline resistance and low prevalence of polymorphisms recently associated with resistance to artemisinins or piperaquine. Antimalarial drug sensitivities are changing in Uganda, but novel genotypes associated with DP treatment failure in Asia are not prevalent.", + "full_text": "", + "authors": [ + "SA Rasmussen", + "FG Ceja", + "MD Conrad", + "PK Tumwebaze", + "O Byaruhanga", + "T Katairo", + "SL Nsobya", + "PJ Rosenthal", + "RA Cooper" + ], + "doi": "10.1128/AAC.01516-17", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "SHZ2AABK", + "title": "The Rates of HIV Superinfection and Primary HIV Incidence in a General Population in Rakai, Uganda", + "abstract": "Background. Human immunodeficiency virus (HIV) superinfection has been documented in high-risk individuals; however, the rate of superinfection among HIV-infected individuals within a general population remains unknown.Methods. A novel next-generation ultra-deep sequencing technique was utilized to determine the rate of HIV superinfection in a heterosexual population by examining two regions of the viral genome in longitudinal samples from recent HIV seroconverters (n = 149) in Rakai District, Uganda.Results. The rate of superinfection was 1.44 per 100 person years (PYs) (95% confidence interval [CI],.4-2.5) and consisted of both inter-and intrasubtype superinfections. This was compared to primary HIV incidence in 20 220 initially HIV-negative individuals in the general population in Rakai (1.15 per 100 PYs; 95% CI, 1.1-1.2; P = .26). Propensity score matching (PS) was used to control for differences in sociodemographic and behavioral characteristics between the HIV-positive individuals at risk for superinfection and the HIV-negative population at baseline and follow-up. After PS matching, the estimated rate of primary incidence was 3.28 per 100 PYs (95% CI, 2.0-5.3; P = .07) controlling for baseline differences and 2.51 per 100 PYs (95% CI, 1.5-4.3; P = .24) controlling for follow-up differences.Conclusions. This suggests that the rate of HIV superinfection in a general population is substantial, which could have a significant impact on future public health and HIV vaccine strategies.", + "full_text": "", + "authors": [ + "AD Redd", + "CE Mullis", + "D Serwadda", + "XR Kong", + "C Martens", + "SM Ricklefs", + "AAR Tobian", + "CC Xiao", + "MK Grabowski", + "F Nalugoda", + "G Kigozi", + "O Laeyendecker", + "J Kagaayi", + "N Sewankambo", + "RH Gray", + "SF Porcella", + "MJ Wawer", + "TC Quinn" + ], + "doi": "10.1093/infdis/jis325", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "7ZQMLCLZ", + "title": "Do Community-based Livelihood Interventions Affect Sexual and Reproductive Health and Rights of Young People in Slum Areas of Uganda: a Difference-in-difference with Kernel Propensity Score Matching Analysis", + "abstract": "Slum dwellers across Africa have been targeted in interventions whose impacts remain unclear. We evaluated the impact of a livelihood intervention on the sexual and reproductive health and rights (SRHR) of young people in the slum areas of Kampala, Uganda. We carried out a repeated cross-sectional survey in 2014 and 2017 to examine the impact of community-based livelihood interventions on the SRHR of young people in the slum areas of Kampala, Uganda. Impacts were observed such as reduced sexual activity, reduction in aspects of gender-based violence attitudes and beliefs, increased access to and decision-making about contraceptive and family-planning services, increased availability and affordability of SRHR services, reduced need to seek further knowledge on SRHR, reduced barriers to HIV testing, and increased knowledge of health responsibilities. Unexpected results included: increased proportion of young people who had ever had sex, decreased mean age of sexual debut, unaffordability of contraceptives, and increased culturally shaped attitudes and social norms related to gender-based violence. We observed no impact on condom use, consensual sex and sexual assault, the number of sexual partners, knowledge about HIV/AIDS, stigma and discrimination against people living with HIV/AIDS, affordability of male and female condoms, and uptake of HIV testing services. Rights-based interventions are crucial to how we understand the SRHR of young people in complex sociocultural environments. While the livelihood interventions made significant impacts on the SRHR of young people, there are questions about how such interventions address deeply rooted sociocultural practices to maximise outcomes.", + "full_text": "", + "authors": [ + "AMN Renzaho", + "JK Kamara", + "D Doh", + "P Bukuluki", + "RA Mahumud", + "M Galukande" + ], + "doi": "10.1007/s11524-021-00596-1", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "BTRQKMJ7", + "title": "A qualitative study on alcohol consumption and HIV treatment adherence among men living with HIV in Ugandan fishing communities", + "abstract": "Ugandan fishing communities are dually burdened with high rates of HIV and alcohol use. This qualitative study explores context and motivation of alcohol consumption, and alcohol's effect on antiretroviral treatment (ART) adherence, among male fisherfolk living with HIV in Wakiso District, Uganda. We conducted in-depth semi-structured interviews with 30 men in HIV care and on ART, and used a thematic analysis approach for analysis. Alcohol use was identified as a major barrier to ART adherence through cognitive impairment and the intentional skipping of doses when drinking. Men reportedly reduced their drinking since HIV diagnosis - motivated by counseling received from providers and a newfound desire to live a healthy lifestyle. However, social, occupational, and stress-related influences that make alcohol reduction difficult were identified. Our findings suggest alcohol use may pose a challenge to ART adherence for fishermen living with HIV - and has implications for the tailoring of screening and brief intervention for alcohol reduction in HIV care for this population.", + "full_text": "", + "authors": [ + "KM Sileo", + "W Kizito", + "RK Wanyenze", + "H Chemusto", + "W Musoke", + "B Mukasa", + "SM Kiene" + ], + "doi": "10.1080/09540121.2018.1524564", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "RVLW3CI2", + "title": "Matricellular Proteins Play a Potential Role in Acute Primary Angle Closure", + "abstract": "Purpose: To quantify levels of matricellular proteins in aqueous humor samples from acute primary angle closure (APAC) and non-glaucomatous cataract eyes and investigate their correlation with intraocular pressure (IOP) fluctuation.Materials and Methods: Aqueous humor samples were collected from 63 eyes including 29 current APAC eyes, 12 previous APAC eyes, and 22 cataract eyes. Concentrations of four main matricellular proteins (SPARC, tenascin-C, thrombospondin-2, and osteopontin) were measured using multiplexed immunoassay kits. Correlations between matricellular proteins and age, sex, and IOP were then detected using Spearman's rank correlation coefficient.Results: The levels of SPARC, thrombospondin-2, and osteopontin were significantly elevated in the APAC group as compared to the cataract group (p<0.001, p<0.001, and p=0.009, respectively). Further separation of the APAC group into current and previous APAC groups showed that only the differences of SPARC and thrombospondin-2 between the current APAC and cataract groups were significant (both p<0.001). All four matricellular proteins were found to have a positive correlation with IOP in the current APAC group but no correlation was found in the previous APAC or cataract groups.Conclusions: The levels of matricellular proteins were significantly elevated in the current APAC eyes and positively correlated to IOP. Further studies are necessary to investigate the molecular mechanisms and histological evidence of pathogenesis in matricellular proteins in APAC.", + "full_text": "", + "authors": [ + "J Wang", + "MS Fu", + "K Liu", + "N Wang", + "ZH Zhang", + "MW Zhou", + "X Xu" + ], + "doi": "10.1080/02713683.2018.1449222", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "BT84S2TI", + "title": "Surgical Release of Gluteal Fibrosis in Children Results in Sustained Benefit at 5-Year Follow-up", + "abstract": "Background: Gluteal fibrosis (GF) is a fibrotic infiltration of the gluteal muscles resulting in functionally limiting contracture of the hips and is associated with injections of medications into the gluteal muscles. It has been reported in numerous countries throughout the world. This study assesses the 5-year postoperative range of motion (ROM) and functional outcomes for Ugandan children who underwent surgical release of GF. Methods: A retrospective cohort study of children who underwent release of GF in 2013 at Kumi Hospital in Eastern Uganda. Functional outcomes, hip ROM, and scar satisfaction data were collected for all patients residing within 40 km of the hospital. Results: One hundred eighteen children ages 4 to 16 at the time of surgery were treated with surgical release of GF in 2013 at Kumi Hospital. Of those 118, 89 were included in this study (79.5%). The remaining 29 were lost to follow-up or lived outside the study's radius. Detailed preoperative ROM and functional data were available for 53 of the 89 patients. In comparison with preoperative assessment, all patients postoperatively reported ability to run normally (P<0.001), sit upright in a chair (P<0.001), sit while eating (P<0.001), and attend the entire day of school (P<0.001). Passive hip flexion (P<0.001) improved when compared with preoperative measurements. In all, 85.2% (n=75) of patients reported satisfaction with scar appearance as \"ok,\" \"good,\" or \"excellent\" 29.2% (n=26) of patients reported back or hip complaints. Conclusions: Overall, the 5-year postoperative outcomes suggest that surgical release of GF improves ROM and functional quality of life with sustained effect.", + "full_text": "", + "authors": [ + "AL Reilly", + "FR Owori", + "R Obaikol", + "E Asige", + "H Aluka", + "N Penny", + "R Olupot", + "CS Sabatini" + ], + "doi": "10.1097/BPO.0000000000001735", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "TARV443S", + "title": "Impact of Anticoagulant and Antiplatelet Use on Outcomes in Blunt Chest Injury", + "abstract": "The aim of this study was to evaluate the impact of prehospital antiplatelet and/or anticoagulant (APAC) use on treatment and outcomes in patients with severe blunt chest injury. Patients with three or more rib fractures and a hospital length of stay (LOS) > three days admitted from 2014 to 2015 were included. Demographics, mortality, complications, injuries, hospital and ICU LOS, use of blood products, and thoracostomy were studied. Of 383 patients, 27.4 per cent were on APAC medication. Patients on APAC were older (P < 0.0001), had higher Glasgow Coma Score (P < 0.0001), and had lower Injury Severity Score (P < 0.0001) and total number of fractures (P = 0.0013) than the non-APAC group. APAC was not a predictor of mortality with or without age adjustment. In multiple linear regressions, APAC did not predict an increased LOS. APAC patients did not demonstrate an increase in admission diagnosis or complication of hemothorax, blood transfusions, tube thoracostomy, tracheostomy, LOS, or mortality rates. Similar findings are present in the subgroup of patients studied with high kinetic energy mechanism of injury. Our study does not support the perceived morbidity of APAC therapy in patients with severe blunt chest injury.", + "full_text": "", + "authors": [ + "P Udekwu", + "S Roy", + "A Stiles", + "A Dibbert", + "M Nguyen", + "V Rice" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "J2QRY9BR", + "title": "Mobility among youth in Rakai, Uganda: Trends, characteristics, and associations with behavioural risk factors for HIV", + "abstract": "Mobility, including migration and travel, influences risk of HIV. This study examined time trends and characteristics among mobile youth (15-24 years) in rural Uganda, and the relationship between mobility and risk factors for HIV. We used data from an annual household census and population-based cohort study in the Rakai district, Uganda. Data on in-migration and out-migration were collected among youth (15-24 years) from 43 communities from 1999 to 2011 (N = 112,117 observations) and travel among youth residents from 2003 to 2008 (N = 18,318 observations). Migration and travel were more common among young women than young men. One in five youth reported out-migration. Over time, out-migration increased among youth and in-migration remained largely stable. Primary reasons for migration included work, living with friends or family, and marriage. Recent travel within Uganda was common and increased slightly over time in teen women (15-19 years old), and young adult men and women (20-24 years old). Mobile youth were more likely to report HIV-risk behaviours including: alcohol use, sexual experience, multiple partners, and inconsistent condom use. Our findings suggest that among rural Ugandan youth, mobility is increasingly common and associated with HIV-risk factors. Knowledge of patterns and characteristics of a young, high-risk mobile population has important implications for HIV interventions.", + "full_text": "", + "authors": [ + "AC Schuyler", + "ZR Edelstein", + "S Mathur", + "J Sekasanvu", + "F Nalugoda", + "R Gray", + "MJ Wawer", + "DM Serwadda", + "JS Santelli" + ], + "doi": "10.1080/17441692.2015.1074715", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "87HKHYQB", + "title": "Nutritional and Immunological Correlates of Memory and Neurocognitive Development Among HIV-Infected Children Living in Kayunga, Uganda", + "abstract": "Objective:To identify the nutritional and immunological correlates of memory and neurocognitive development as measured by the Mullen Scales of Early Learning (MSEL) and by the Color Object Association Test (COAT) among children in Uganda.Design:This analysis uses baseline data collected between 2008 and 2010 from 119 HIV-infected children aged 1-6 years, participating in a randomized controlled trial of an interventional parenting program in Kayunga, Uganda.Methods:Peripheral blood draws were performed to determine immunological biomarkers. Unadjusted and adjusted linear regression models were used to relate MSEL and COAT scores to sociodemographic characteristics, weight-for-age Z scores (WAZs), antiretroviral therapy status, and immunological biomarkers.Results:In the final analysis, 111 children were included. Lower levels of CD4(+) CD38(+) T cells (P = 0.04) were associated to higher immediate and total recall scores (P = 0.04). Higher levels of CD8(+) HLA-DR+ T cells were associated with higher total recall score (P = 0.04) of the COAT. Higher CD4(+) CD38(+) HLA-DR+ T cells levels were associated with higher gross motor scores of the MSEL (P = 0.02). WAZ was positively correlated to visual reception, fine motor, expressive language, and composite score of the MSEL.Conclusions:Overall, WAZ was a stronger predictor of neurocognitive outcomes assessed by the MSEL. CD4(+) CD38(+) T cells were more specifically associated with memory-related outcomes. Future research should include immunological markers and standardized neurocognitive tests to further understand this relationship.", + "full_text": "", + "authors": [ + "H Ruisenor-Escudero", + "I Familiar-Lopez", + "A Sikorskii", + "N Jambulingam", + "N Nakasujja", + "R Opoka", + "J Bass", + "M Boivin" + ], + "doi": "10.1097/QAI.0000000000000905", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "9TPHBQ5J", + "title": "Profiling the Native Specific Human Humoral Immune Response to Sudan Ebola Virus Strain Gulu by Chemiluminescence Enzyme-Linked Immunosorbent Assay", + "abstract": "Ebolavirus, a member of the family Filoviridae, causes high lethality in humans and nonhuman primates. Research focused on protection and therapy for Ebola virus infection has investigated the potential role of antibodies. Recent evidence suggests that antibodies can be effective in protection from lethal challenge with Ebola virus in nonhuman primates. However, despite these encouraging results, studies have not yet determined the optimal antibodies and composition of an antibody cocktail, if required, which might serve as a highly effective and efficient prophylactic. To better understand optimal antibodies and their targets, which might be important for protection from Ebola virus infection, we sought to determine the profile of viral protein-specific antibodies generated during a natural cycle of infection in humans. To this end, we characterized the profile of antibodies against individual viral proteins of Sudan Ebola virus (Gulu) in human survivors and nonsurvivors of the outbreak in Gulu, Uganda, in 2000-2001. We developed a unique chemiluminescence enzyme-linked immunosorbent assay (ELISA) for this purpose based on the full-length recombinant viral proteins NP, VP30, and VP40 and two recombinant forms of the viral glycoprotein (GP(1-294) and GP(1-649)) of Sudan Ebola virus (Gulu). Screening results revealed that the greatest immunoreactivity was directed to the viral proteins NP and GP(1-649), followed by VP40. Comparison of positive immunoreactivity between the viral proteins NP, GP(1-649), and VP40 demonstrated a high correlation of immunoreactivity between these viral proteins, which is also linked with survival. Overall, our studies of the profile of immunorecognition of antibodies against four viral proteins of Sudan Ebola virus in human survivors may facilitate development of effective monoclonal antibody cocktails in the future.", + "full_text": "", + "authors": [ + "A Sobarzo", + "E Perelman", + "A Groseth", + "O Dolnik", + "S Becker", + "JJ Lutwama", + "JM Dye", + "V Yavelsky", + "L Lobel", + "RS Marks" + ], + "doi": "10.1128/CVI.00363-12", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "E3UVIVP2", + "title": "\"Telling my husband I have HIV is too heavy to come out of my mouth\": pregnant women's disclosure experiences and support needs following antenatal HIV testing in eastern Uganda", + "abstract": "Introduction: Disclosure of HIV serostatus by women to their sexual partners is critical for the success of the prevention of mother-to-child transmission of HIV (PMTCT) programme as an integrated service in antenatal care. We explored pregnant HIV-positive and HIV-negative women's partner disclosure experiences and support needs in eastern Uganda.Methods: This was a qualitative study conducted at Mbale Regional Referral Hospital in eastern Uganda between January and May 2010. Data collection was through in-depth interviews with 15 HIV-positive and 15 HIV-negative pregnant women attending a follow up antenatal clinic (ANC) at Mbale Hospital, and six key informant interviews with health workers at the clinic. Data management was done using NVivo version 9, and a content thematic approach was used for analysis.Results: All HIV-negative women had disclosed their HIV status to their sexual partners but expressed need for support to convince their partners to also undergo HIV testing. Women reported that their partners often assumed that they were equally HIV-negative and generally perceived HIV testing in the ANC as a preserve for women. Most of the HIV-positive women had not disclosed their HIV status to sexual partners for fear of abandonment, violence and accusation of bringing HIV infection into the family. Most HIV-positive women deferred disclosure and requested health workers' support in disclosure. Those who disclosed their positive status generally experienced positive responses from their partners.Conclusions: Within the context of routine HIV testing as part of the PMTCT programme, most women who test HIV-positive find disclosure of their status to partners extremely difficult. Their fear of disclosure was influenced by the intersection of gender norms, economic dependency, women's roles as mothers and young age. Pregnant HIV-negative women and their unborn babies remained at risk of HIV infection owing to the resistance of their partners to go for HIV testing. These findings depict a glaring need to strengthen support for both HIV-positive and HIV-negative women to maximize opportunities for HIV prevention.", + "full_text": "", + "authors": [ + "J Rujumba", + "S Neema", + "R Byamugisha", + "T Tylleskar", + "JK Tumwine", + "HK Heggenhougen" + ], + "doi": "10.7448/IAS.15.2.17429", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "JYZWFPDI", + "title": "Breast Carcinoma in Uganda Microscopic Study and Receptor Profile of 45 Cases", + "abstract": "Context-Histologic and receptor data on breast carcinoma in Uganda are scarce. Estrogen receptor status is not routinely available. Breast cancer blocks from Uganda were studied in Montreal, Canada, and clinical correlations subsequently discussed in Kampala, Uganda.Objective-To correlate histologic features (tumor type, histologic grade), receptor profile (estrogen receptor, progesterone receptor, and HER2/neu), and age in Ugandan women.Design-Pathology reports for 2000-2004 from Nsambya Hospital, reporting invasive breast carcinoma, provided 45 microscopically confirmed cases.Results-Seventy-three percent of patients were 50 years or younger. Histologic types were invasive ductal carcinoma (78%) and \"good\" prognosis types (11%). Overall 40% were grade 3, but 48% of invasive ductal carcinomas were grade 3. Estrogen receptor was positive in 60% overall and in 51% of invasive ductal carcinomas. HER2/neu was overexpressed in 11%; 36% were \"triple\" negative (estrogen receptor, progesterone receptor, HER2/neu negative).Conclusions-Breast carcinoma in Ugandan women presents at a younger age and is histologically and by receptor profile more aggressive than carcinoma in Caucasian women. (Arch Pathol Lab Med. 2011;135:194-199)", + "full_text": "", + "authors": [ + "I Roy", + "E Othieno" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "NAT9CYAV", + "title": "Attitudes, Norms and Self-Efficacy: Examining Socio-Cognitive Correlates and Sexual Abstinence Among Ugandan Youth Ages 16-18 years, in the Slums of Kampala, Uganda", + "abstract": "Sex-related beliefs, attitudes, and perceptions have been shown to be associated with HIV-related behaviors. However, little is known about the factors associated with delayed sexual activity among older adolescents in sub-Saharan Africa. This study examined potentially protective beliefs, attitudes, and perceptions associated with delayed sexual initiation among Ugandan youth. Secondary analyses were based on data from the 2014 Kampala Youth Survey, in which 1137 youth aged 12-18, living in 6 slum communities throughout Kampala, Uganda, were surveyed about sociodemographic factors and various health outcomes including drinking patterns, sexual behavior, HIV status, and violence exposure. Participants were recruited, consented, and interviewed by trained by Uganda Youth Development Link staff. After controlling for significant sociodemographic factors, older adolescent (aged 15-18 years old, n = 757, males = 44%, female 56%) sexual abstainers (never had sexual intercourse) were more likely than sexually active youth to (1) perceive HIV as a serious health issue; (2) have positive perceptions of condom use; (3) believe that their friends planned to delay sex and; (4) be confident in their ability to avoid or refuse sex. Sexual abstinence was also associated with lower odds of reporting drunkenness. Study findings revealed that abstainers held more protective beliefs and attitudes for HIV-related risk, compared to sexually active youth. Identifying predictors for early sexual activity provides opportunities for the development of HIV prevention strategies that encourage the delay of sexual debut.", + "full_text": "", + "authors": [ + "M Waajid", + "MH Swahn", + "L Salazar", + "K Ramsey-White", + "R Kasirye" + ], + "doi": "10.1007/s12119-021-09844-7", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "TZT5NH3E", + "title": "Trends in the incidence of cancer in Kampala, Uganda 1991-2010", + "abstract": "The Kampala cancer registry is the longest established in Africa. Trends in incidence rates for a 20-year period (1991-2010) for Kyadondo County (Kampala city and a rural hinterland) illustrate the effects of changing lifestyles in urban Africa, and the effects of the epidemic of HIV-AIDS. There has been an overall increase in the risk of cancer during the period in both sexes, with incidence rates of major cancers such as breast and prostate showing particularly marked increases (3.7% and 5.2% annually, respectively). In the 1960s cancer of the oesophagus was the most common cancer of men (and second in women), and incidence in the last 20 years has not declined. Cancer of the cervix, always the most frequent cancer of women, has shown an increase over the period (1.8% per year), although the rates appear to have declined in the last 4 years. HIV prevalence in adults in Uganda fell from a maximum in 1992 to a minimum (about 6%) in 2004, and has risen a little subsequently, while availability of antiretroviral drugs has risen sharply in recent years. Incidence of Kaposi sarcoma in men fell until about 2002, and has been relatively constant since then, while in women there has been a continuing decline since 2000. Other HIV related cancersnon-Hodgkin lymphoma of younger adults, and squamous cell carcinoma of conjunctivahave shown major increases in incidence, although the former (NHL) has shown a small decline in incidence in the most recent 2 years.What's new? Little information is available on trends in cancer incidence from sub-Saharan Africa. To help rectify that situation, the authors of the present study examined cancer incidence trends over a 20-year period in Kyadondo County, which includes Kampala, the capital of Uganda, using data from the Kampala Cancer Registry. Some trends were expected, such as an increase in cancers associated with Western lifestyles. Other trends, however, such as a lack of decline in cancers of the cervix, esophagus, and stomach, which are associated with poverty, were surprising. In addition, HIV-related cancers showed only modest or no recent decline.", + "full_text": "", + "authors": [ + "HR Wabinga", + "S Nambooze", + "PM Amulen", + "C Okello", + "L Mbus", + "DM Parkin" + ], + "doi": "10.1002/ijc.28661", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "6TD7KJFG", + "title": "HIV Type 1 Genetic Variation in Foreskin and Blood from Subjects in Rakai, Uganda", + "abstract": "The foreskin contains a subset of dendritic cells, macrophages, and CD4(+) and CD8(+) T cells that may be targets for initial HIV infection in female-to-male sexual transmission of HIV-1. We present analyses comparing HIV-1 sequences isolated from foreskin DNA and serum RNA in 12 heterosexual men enrolled in an adult male circumcision trial performed in Rakai, Uganda. Phylogenetic analysis demonstrated three topologies: (1) little divergence between foreskin and serum, (2) multiple genetic bottlenecks occurring in both foreskin and serum, and (3) complete separation of foreskin and serum populations. The latter tree topology provided evidence that foreskin may serve as a reservoir for distinct HIV-1 strains. Distance and recombination analysis also demonstrated that viral genotypes in the foreskin might segregate independently from the circulating pool of viruses.", + "full_text": "", + "authors": [ + "Rakai Hlth Sci Program", + "RM Galiwango", + "SL Lamers", + "AD Redd", + "J Manucci", + "AAR Tobian", + "N Sewankambo", + "G Kigozi", + "G Nakigozi", + "D Serwadda", + "I Boaz", + "F Nalugoda", + "DJ Sullivan", + "XR Kong", + "MJ Wawer", + "RH Gray", + "TC Quinn", + "O Laeyendecker" + ], + "doi": "10.1089/aid.2011.0176", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "9LBJ65B6", + "title": "Comparison of pretreatment measurements of anterior segment parameters in eyes with acute and chronic primary angle closure", + "abstract": "PurposeTo compare pretreatment anterior segment parameters between eyes with acute primary angle closure (APAC) and chronic primary angle closure (CPAC), and to identify the characteristics of eyes with APAC.Study designRetrospective.MethodsWe measured pretreatment anterior chamber depth (ACD), iris convexity (IC), and pupil diameter in eyes with APAC and CPAC using anterior segment optical coherence tomography. The risk of APAC associated with anterior segment parameters was investigated using multiple logistic regression. Eyes with APAC were discriminated from eyes with CPAC using the receiver-operating characteristic (ROC) curve and area under the curve (AUC). The best cutoff for these variables was determined.ResultsThirty-four eyes with APAC and 60 eyes with CPAC were included. The mean intraocular pressure was 52.312.6mmHg in APAC and 15.5 +/- 3.5mmHg in CPAC (P<.001). Eyes with APAC had a shallower ACD (1.407 +/- 0.301mm vs. 1.960 +/- 0.205mm, P<.001) and less IC (0.233 +/- 0.087mm vs. 0.294 +/- 0.068mm, P<.001) than eyes with CPAC. In multivariate analysis, significant variables associated with APAC were ACD (P<.001) and IC (P=.001). The AUC for ACD was 0.931 and for IC, 0.742. The best cutoff for ACD was 1.699mm (sensitivity 0.824, specificity 0.917) and for IC, 0.282mm (sensitivity 0.853, specificity 0.533).Conclusions Eyes with APAC had a shallower ACD and less IC. Eyes with an ACD<1.7mm may be at risk for APAC.", + "full_text": "", + "authors": [ + "S Yoshimizu", + "F Hirose", + "S Takagi", + "M Fujihara", + "Y Kurimoto" + ], + "doi": "10.1007/s10384-019-00651-0", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "AABBH2SV", + "title": "Preference for Sayana (R) Press versus intramuscular Depo-Provera among HIV-positive women in Rakai, Uganda: a randomized crossover trial", + "abstract": "Introduction: Sayana Press (SP), a subcutaneous formulation of depot medroxyprogesterone acetate (DMPA) prefilled in a Uniject injection system, could potentially improve and expand contraceptive injection services, but acceptability of SP is unknown. HIV-positive women need contraception to avoid unintended pregnancy and risk of vertical HIV transmission. We assessed acceptability of SP versus intramuscular DMPA (DMPA-IM) among HIV-positive women and their care providers in Rakai, Uganda.Methods: Women were randomized to DMPA-IM or SP at baseline, received the alternate product at 3 months, and chose their preferred method at 6 months. We determined preferences among new and experienced contraceptive injectable users who had tried both types of injection during the trial, and from providers before and after providing both types of injectables to clients.Results: Among 357 women randomized, 314 were followed up at 6 months (88%). Although SP caused more skin irritation than DMPA-IM (3.8% vs. 0% at 6 months, p=.03), it was associated with marginally fewer side effects (30.4% vs. 40.4% at 6 months, p=.06). Participants reported high levels of willingness to recommend the DMPA contraception to a friend and satisfaction with the injection received, and these did not differ by injection type. Sixty-four percent of women and 73% of providers preferred SP to DMPA-IM at 6 months; women's preferences did not differ by previous experience with injectable contraception.Conclusions: SP is acceptable to HIV-positive women and health care providers in this rural Ugandan population.Implications: SP appears to be acceptable to HIV-positive women and their care providers in Rakai, Uganda, and strategies for appropriate rollout of this innovative technology should be explored. Published by Elsevier Inc.", + "full_text": "", + "authors": [ + "Rakai Hlth Sci Program Sayana", + "CB Polis", + "GF Nakigozi", + "H Nakawooya", + "G Mondo", + "F Makumbi", + "RH Gray" + ], + "doi": "10.1016/j.contraception.2013.11.008", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "DEIHXF3K", + "title": "Traditional healer-delivered point-of-care HIV testing versus referral to clinical facilities for adults of unknown serostatus in rural Uganda: a mixed-methods, cluster-randomised trial", + "abstract": "Background HIV counselling and testing are essential to control the HIV epidemic. However, HIV testing uptake is low in sub-Saharan Africa, where many people use informal health-care resources such as traditional healers. We hypothesised that uptake of HIV tests would increase if provided by traditional healers. We aimed to determine the effectiveness of traditional healers delivering HIV testing at point of care compared with referral to local clinics for HIV testing in rural southwestern Uganda.Methods We did a mixed-methods study that included a cluster-randomised trial followed by individual qualitative interviews among a sample of participants in Mbarara, Uganda. Traditional healers aged 18 years or older who were located within 8 km of the Mbarara District HIV clinic, were identified in the 2018 population-level census of traditional healers in Mbarara District, and delivered care to at least seven clients per week were randomly assigned (1:1) as clusters to an intervention or a control group. Healers screened their clients for eligibility, and research assistants confirmed eligibility and enrolled clients who were aged 18 years or older, were receiving care from a participating healer, were sexually active (ever had intercourse), self-reported not having received an HIV test in the previous 12 months (and therefore considered to be of unknown serostatus), and had not previously been diagnosed with HIV infection. Intervention group healers provided counselling and offered point-of-care HIV tests to adult clients. Control group healers provided referral for HIV testing at nearby clinics. The primary outcome was the individual receipt of an HIV test within 90 days of study enrolment. Safety and adverse events were recorded and defined on the basis of prespecified criteria. This study is registered with ClinicalTrials.gov, NCT03718871.Findings Between Aug 2, 2019, and Feb 7, 2020, 17 traditional healers were randomly assigned as clusters (nine to intervention and eight to control), with 500 clients of unknown HIV serostatus enrolled (250 per group). In the intervention group, 250 clients (100%) received an HIV test compared with 57 (23%) in the control group, a 77% (95% CI 73-82) increase in testing uptake, after adjusting for the effect of clustering (p<0.0001). Ten (4%) of 250 clients in the intervention group tested HIV positive, seven of whom self-reported linkage to HIV care. No new HIV cases were identified in the control group. Qualitative interviews revealed that HIV testing delivered by traditional healers was highly acceptable among both providers and clients. No safety or adverse events were reported.Interpretation Delivery of point-of-care HIV tests by traditional healers to adults of unknown serostatus significantly increased rates of HIV testing in rural Uganda. Given the ubiquity of healers in Africa, this approach holds promise as a new pathway to provide community-based HIV testing, and could have a dramatic effect on uptake of HIV testing in sub-Saharan Africa. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.", + "full_text": "", + "authors": [ + "R Sundararajan", + "M Ponticiello", + "MH Lee", + "SA Strathdee", + "W Muyindike", + "D Nansera", + "R King", + "D Fitzgerald", + "J Mwanga-Amumpaire" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "N9GVI6HF", + "title": "Clinical correlates of suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda", + "abstract": "The association between suicidality and HIV/AIDS has been demonstrated for three decades, but little is know about risk factors that can help understand this association and help identify who is most at risk. Few research studies have been conducted in sub-Saharan Africa, a region that accounts for more than 70% of the HIV global burden. This paper describes clinical risk factors for suicidality among individuals with HIV infection and AIDS disease in Mbarara, Uganda. In this study, suicidality includes both suicidal ideation and suicidal attempts. A cross-sectional survey was conducted with 543 HIV-positive individuals aged 15 years and above, recruited from 2 HIV specialised clinics in Mbarara. Using logistic regression analysis, factors significantly associated with suicidality at 95% confidence interval were identified. The rate of suicidality was 10% (n = 54; 95% CI: 5.00-15.00). Risk factors for suicidality were: perception of poor physical health (OR 2.22, 95% CI 1.23-3.99, p = 0.007), physical pain (OR 1.83, 95% CI 1.01-3.30, p = 0.049), reducing work due to illness (OR = 2.22, 95% CI 1.23-3.99, p = 0.004) and recent HIV diagnosis (OR 1.02, 95% CI 1.01-1.03, p = 0.001). These findings suggest that HIV/AIDS in south-western Uganda is associated with a considerable burden of suicidality. HIV is associated with several clinical factors that increase vulnerability to suicidality. There is need for more appropriate interventions targeting these clinical risk factors, systematic suicide risk assessment and management of suicidal ideation and behaviours in HIV care.", + "full_text": "", + "authors": [ + "GZ Rukundo", + "E Kinyanda", + "B Mishara" + ], + "doi": "10.2989/16085906.2016.1182035", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "5X7YZUWI", + "title": "A life of fear: Sex workers and the threat of HIV in Uganda", + "abstract": "Schoemaker J, Twikirize J. A life of fear: sex workers and the threat of HIV in UgandaThe way individuals perceive their risk to certain threats influences their adoption of preventive behaviour. This study explored sex workers' perception of risk of HIV infection within the context of other serious threats. The study was carried out in Kampala, Uganda, using peer ethnography. Sex workers were well aware of their risk of HIV infection but this risk was eclipsed by other more immediate and frightening threats. Sex workers' willingness to gamble with HIV is explained by the fact that their existence is already very dangerous, and taking risks is an inherent part of their trade. Decriminalising sex work could make their lives somewhat safer, motivating them to better protect themselves, but this is unlikely to happen in Uganda. Attempting to enforce some coercive control mechanisms would not work, given the pervasive corruption in law enforcement and the judiciary, the institutions that would be responsible for implementing such control.", + "full_text": "", + "authors": [ + "J Schoemaker", + "J Twikirize" + ], + "doi": "10.1111/j.1468-2397.2010.00770.x", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "4FGQDQDB", + "title": "Pregnant women's experiences of routine counselling and testing for HIV in Eastern Uganda: a qualitative study", + "abstract": "Background: Routine HIV counselling and testing as part of antenatal care has been institutionalized in Uganda as an entry point for pregnant women into the prevention of mother-to-child transmission of HIV (PMTCT) programme. Understanding how women experience this mode of HIV testing is important to generate ideas on how to strengthen the PMTCT programme. We explored pregnant HIV positive and negative women's experiences of routine counselling and testing in Mbale District, Eastern Uganda and formulated suggestions for improving service delivery.Methods: This was a qualitative study conducted at Mbale Regional Referral Hospital in Eastern Uganda between January and May 2010. Data were collected using in-depth interviews with 30 pregnant women (15 HIV positive and 15 HIV negative) attending an antenatal clinic, six key informant interviews with health workers providing antenatal care and observations. Data were analyzed using a content thematic approach.Results: Prior to attending their current ANC visit, most women knew that the hospital provided HIV counselling and testing services as part of antenatal care (ANC). HIV testing was perceived as compulsory for all women attending ANC at the hospital but beneficial, for mothers, especially those who test HIV positive and their unborn babies. Most HIV positive women were satisfied with the immediate counselling they received from health workers, but identified the need to provide follow up counselling and support after the test, as areas for improvement. However, most HIV negative women mentioned that they were given inadequate attention during post-test counselling. This left them with unanswered questions and, for some, doubts about the negative test results.Conclusions: In this setting, routine HIV counselling and testing services are known and acceptable to mothers. There is need to strengthen post-test and follow up counselling for both HIV positive and negative women in order to maximize opportunities for primary and post exposure HIV prevention. Partnerships and linkages with people living with HIV, especially those in existing support groups such as those at The AIDS Support Organization (TASO), may help to strengthen counselling and support for pregnant women. For effective HIV prevention, women who test HIV negative should be supported to remain negative.", + "full_text": "", + "authors": [ + "J Rujumba", + "S Neema", + "JK Tumwine", + "T Tylleskar", + "HK Heggenhougen" + ], + "doi": "10.1186/1472-6963-13-189", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "2TCEH9T7", + "title": "Practice and prospects of indigenous homestead based approaches to prevention of malaria; a case study of a high malaria transmission area in Uganda", + "abstract": "Environmental sanitation and indigenous practices based on homestead characteristics have not been emphasized in national malaria control strategies. This study explored homestead characteristics, housing attributes, indigenous practices and knowledge of malaria in a rural high malaria transmission community in Uganda. Structured interviews and direct observations of housing attribute and homestead characteristics were carried out in 100 randomly selected homesteads in Kaliro District, Uganda. Plants believed to be mosquito repellants were observed in a number of homesteads and most respondents correctly described malaria symptoms. Almost all homesteads (99%) had large crops grown around them and were close to kraals (within 50 m, 88%). A number of homesteads were in easy reach of un-protected water springs (49%), 32% had material that could harbour mosquitoes (e.g. tins or ditches). The community had good knowledge of malaria and its prevention. Homesteads had modifications aimed at reducing malaria transmission. Despite this knowledge, the environment of most homesteads was conducive for the survival and faster multiplication of malaria vectors and this collaborates with the high prevalence of malaria found in the study area. There is need to develop and pilot interventions focusing on modifications of homestead characteristics and housing attributes for sustainable control of malaria.", + "full_text": "", + "authors": [ + "PJ Waako", + "RN Nsubuga", + "P Sebulime", + "JRS Tabuti" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "MXLKGQAE", + "title": "Effectiveness of group discussions and commitment in improving cleaning behaviour of shared sanitation users in Kampala, Uganda slums", + "abstract": "Rationale and objective: Access to and use of hygienic shared sanitation facilities is fundamental in reducing the high risk of diseases such as diarrhoea and respiratory infections. We evaluated the effectiveness of group discussions and commitment in improving the cleaning behaviour of shared sanitation users in three urban slums in Kampala, Uganda. The study follows the risk, attitudes, norms, abilities and self-regulation (RANAS) model of behaviour change and some factors of the social dilemma theory.Methods: A pre-versus post-intervention survey was conducted in three slums of Kampala, Uganda, between December 2012 and September 2013. From the pre-intervention findings, users of dirty sanitation facilities were randomly assigned to discussions, discussions + commitment and control interventions. The interventions were implemented for 3 months with the aim of improving cleaning behaviour. This paper provides an analysis of 119 respondents who belonged to the intervention discussion-only (n = 38), discussions + commitment (n = 41) and the control (no intervention, n = 40) groups.Results: Compared to the control, discussions and discussions + commitment significantly improved shared toilet users' cleaning behaviour. The rate of improvement was observed through behavioural determinants such as cleaning obligation, cleaning ease, cleaning approval and affective beliefs.Conclusion: Our study findings show that group discussions and commitment interventions derived from RANAS model of behaviour change are effective in improving the shared sanitation users' cleaning behaviour. (C) 2015 Elsevier Ltd. All rights reserved.", + "full_text": "", + "authors": [ + "IK Tumwebaze", + "HJ Mosler" + ], + "doi": "10.1016/j.socscimed.2015.10.059", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "6QCU2PSS", + "title": "The diagnostic impact of limited, screening obstetric ultrasound when performed by midwives in rural Uganda", + "abstract": "OBJECTIVE: To evaluate the diagnostic impact of limited obstetric ultrasound (US) in identifying high-risk pregnancies when used as a screening tool by midwives in rural Uganda.STUDY DESIGN: This was an institutional review board-approved prospective study of expecting mothers in rural Uganda who underwent clinical and US exams as part of their standard antenatal care visit in a local health center in the Isingiro district of Uganda. The midwives documented clinical impressions before performing a limited obstetric US on the same patient. The clinical findings were then compared with the subsequent US findings to determine the diagnostic impact. The midwives were US-naive before participating in the 6-week training course for limited obstetric US.RESULT: Midwife-performed screening obstetric US altered the clinical diagnosis in up to 12% clinical encounters. This diagnostic impact is less (6.7 to 7.4%) if the early third trimester diagnosis of malpresentation is excluded. The quality assurance review of midwives' imaging demonstrated 100% sensitivity and specificity in the diagnosing gestational number, and 90% sensitivity and 96% specificity in the diagnosis of fetal presentation.CONCLUSION: Limited, screening obstetric US performed by midwives with focused, obstetric US training demonstrates the diagnostic impact for identifying conditions associated with high-risk pregnancies in 6.7 to 12% of patients screened. The limited obstetric US improved diagnosis of early pregnancy complication as well as later gestation twins and malpresentation. Midwives who have undergone focused 6-week limited obstetric US training proved capable of diagnosing twins and fetal presentation with high sensitivity and specificity.", + "full_text": "", + "authors": [ + "JO Swanson", + "MG Kawooya", + "DL Swanson", + "DS Hippe", + "P Dungu-Matovu", + "R Nathan" + ], + "doi": "10.1038/jp.2014.54", + "year": null, + "item_type": "journalArticle", + "url": "" + }, + { + "key": "AV6UTUMW", + "title": "Dengue", + "abstract": "La dengue est une maladie susceptible d`etre confondue a ses debuts au paludisme. C`est une maladie virale d`evolution parfois grave. Elle est transmise par un moustique vivant dans les zones urbaines des pays tropicaux (1).", + "full_text": "", + "authors": [], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.remed.org/LDC_Mars_2010.pdf" + }, + { + "key": "5R4UPGFC", + "title": "Les contraceptifs oraux", + "abstract": "Les contraceptifs (alias anticonceptionnels) sont des moyens qui empechent la fecondation; ou plus generalement la grossesse. Les raisons de recourir a une contraception sont variees; et les contraceptifs estroprogestatifs oraux font partie des moyens de contraception les plus efficaces pour les femmes (1 a 3). Quelles associations estroprogestatives retenir en priorite ?", + "full_text": "", + "authors": [], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.remed.org/LDC_Mars_2010.pdf" + }, + { + "key": "U64JA4MK", + "title": "Behaviour change and motivational interviewing in the patient with diabetes", + "abstract": "Motivational Interviewing (MI) is designed to motivate people to change by helping them to recognise and resolve the difference between a behaviour problem and personal goals and values. There are several challenges of health behaviour change in MI; as well as traps that the health care provider and patient can easily fall into. During the MI approach; a patient should be guided through the change model; providing him the chance to participate. There are several general principles in the MI approach as well as different interaction techniques. The efficacy of MI has been widely published in the literature", + "full_text": "", + "authors": [ + "M Young" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "https://search.bvsalud.org/gim/resource/en/biblio-1263739" + }, + { + "key": "57YZMTMW", + "title": "Traitement de l`erysipele de jambe", + "abstract": "La prise en charge d`un erysipele de jambe est a adapter en fonction de la severite de l`atteinte cutanee; du retentissement de l`infection sur l`etat general; et des antecedents du patient. L`antibiotherapie reduit la mortalite; les complications; la duree de l`infection et les douleurs de l`erysipele", + "full_text": "", + "authors": [], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.remed.org/LDC_Mars_2010.pdf" + }, + { + "key": "EBBX46NC", + "title": "A Model for Higher Education Campus Health Services", + "abstract": "This study was undertaken in order to develop a holistic healthcare model that would assist registered nurses who are employed at a higher education campus' health service to render a healthcare service relevant to the healthcare needs of the campus healthcare consumers. A theory-generative; qualitative; explorative; descriptive and contextual research design for theory generation was used to develop a holistic healthcare model for a higher education campus' health service. It became evident throughout the study that the participants experienced a need for a more comprehensive healthcare service on campus. The main concepts of holistic healthcare were identified from the information obtained from the in-depth; focus group interviews that were conducted with the participants. The process of theoretical model generation was conducted according to the steps of theory generation as proposed by Walker and Avant (1995:39); namely that of concept analysis; the placing of concepts in relationships; a description of the model and guidelines to operationalise the model. This model provides a structured holistic healthcare frame of reference for registered nurses employed in a campus health service at a Higher Education Institution (HEI) and could be used to assist all campus healthcare consumers to become balanced whole persons who are able to realise their dreams and maintain consistency with regard to optimal health and capacity", + "full_text": "", + "authors": [ + "E. J Ricks", + "D. Van Rooyen", + "J Strumpher" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.hsag.co.za/index.php/HSAG/article/view/508/503" + }, + { + "key": "Q9NUK3KE", + "title": "Tumeur de Pancoast-Tobias : a propos d'un cas", + "abstract": "La tumeur de Pancoast-Tobias est rare. Les auteurs rapportent un cas chez un homme de 50 ans presentant une tumefaction cervicale et thoracique droite associee a une douleur de l'epaule droite; une nevralgie du membre superieur droit et un syndrome de Claude Bernard Horner evoquant le syndrome de Pancoast-Tobias. La radiographie et le scanner thoraciques confirmaient le diagnostic d'une tumeur apicale droite. Une exerese large etait pratiquee suivie d'une chimiotherapie. Aucune recidive n'etait observee apres un recul de deux ans. Les particularites de cette pathologie rare sont discutees a travers une revue de la litterature", + "full_text": "", + "authors": [ + "A. J. C Rakotoarisoa", + "A. A Rakotovao", + "V. H Randriambololona", + "N. N. M Razafimanjato" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://revuetropicale-chirurgie.ifrance.com/vol4num12010/pancoast.pdf" + }, + { + "key": "X367LSGE", + "title": "Toxicite grave des locaux aux chez un nourrisson de 16 mois", + "abstract": "L'anesthesie caudale trouve actuellement sa place dans les interventions chirurgicales pediatriques en raison de ses avantages par rapport a l'anesthesie generale. Pourtant; ce type d'anesthesie peut etre egalement a l'origine d'une toxicite grave qui met en jeu le pronostic vital des enfants. Les auteurs rapportent un cas de toxicite grave du au surdosage d'un melange de lidocaine et de bupivacaine chez un nourrisson de 16 mois. Les caracteristiques cliniques de cette toxicite; ses etiologies et sa prise en charge seront discutees par rapport a la litterature", + "full_text": "", + "authors": [ + "S. T Rakotoarivony", + "H. M Rakotonirina", + "J. A. C Ramorasata", + "J. M Randriamiarana", + "N. E Raveloson", + "F Sztark" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.rarmu.com/publications/2(2)/full_text/2(2)_12-15.pdf" + }, + { + "key": "85JRL7DR", + "title": "The Full Blood Count and Blood film (Haemogram)", + "abstract": "\"Wherever we are in the world there never seems to be enough money for healthcare provision. So the key is to make what resources we have go as far as possible. Any laboratory test that we request should always be preceded by the questions \"\"Why are we making the request; what are the possible results and what decisions might those results lead us to make?\"\" Then we should ask \"\"Have we gained all possible information from that test? A simple examination of the blood (with an Erythrocyte Sedimentation Rate / ESR) is probably the best example of this approach. It may appear very limited but a great deal of information can be obtained about systemic disease. Most hospitals and health centres have the facilities for these tests. The commoner blood count and blood film abnormalities can be considered under the headings of chronic disorders; infections and diseases of the various systems. (Primary haematological diseases are excluded from the present discussion).\"", + "full_text": "", + "authors": [ + "T Tibbutt" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.southsudanmedicaljournal.com/assets/files/Journals/vol_4_iss_3_aug_11/SSMJ_4_3.pdf" + }, + { + "key": "NXC82FPI", + "title": "Le traitement de la goutte", + "abstract": "La goutte est une arthrite aigue recidivante ou chronique des articulations peripheriques provoquee par le depot a l'interieur et au voisinage des articulations et des tendons de cristaux d'urate monosodique. La goutte touche environ 1des hommes dans les pays developpes; avec un sex-ratio de 7 a 9 hommes pour 1 femme. Le pic d'incidence maximale se situe chez l'homme entre 50 et 60 ans. Chez la femme; la goutte est rare avant la menopause. Apres la menopause; il s'agit souvent d'une goutte liee a une hyperuricemie secondaire", + "full_text": "", + "authors": [], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.repere-medical.com/article-344.html" + }, + { + "key": "Q64CHUS8", + "title": "Review Diagnosis; Aetiology; and Severity in Adult Community-Acquired Pneumonia", + "abstract": "N/A", + "full_text": "", + "authors": [ + "D Wootton" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.africanjournalofrespiratorymedicine.com/articles/march_2010/AJRM%20MARCH%20pp%205-7.pdfhttp://indexmedicus.afro.who.int/iah/fulltext/AJRM/vol 5 n 2/Review diagnosis.pdf" + }, + { + "key": "8USRZUNE", + "title": "Nosocomial infections and the challenges of control in developing countries", + "abstract": "Nosocomial infection is a recognized public health problem world-wide with a prevalence rate of 3.0-20.7and an incidence rate of 5-10. It has become increasingly obvious that infections acquired in the hospital lead to increased morbidity and mortality which has added noticeably to economic burden. However; after about three decades of nosocomial infection surveillance and control world-wide; it still remains an important problem for hospitals today. Studies have shown that most hospitals in developing countries especially Africa; have no effective infection control programme due to lack of awareness of the problem; lack of personnel; poor water supply; erratic electricity supply; ineffective antibiotic policies with emergence of multiply antibiotic resistant microbes; poor laboratory backup; poor funding and non-adherence to safe practices by health workers. It is recommended that the cost of hospital infection control programme should be included in the health budget of the country and fund allocated for the infection control committee for routine control purposes and to bear the cost of outbreaks. There is need for adequate staffing and continuous education of staff on the principles of infection control; especially hand washing which is the single most important effective measure to reduce the risks of cross infection", + "full_text": "", + "authors": [ + "S. O Samuel", + "O. O Kayode", + "O. I Musa", + "G. C Nwigwe", + "O. A Aboderin", + "T. A. T Salami", + "S. S Taiwo" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "https://search.bvsalud.org/gim/resource/en/biblio-1256053" + }, + { + "key": "6L9U8NCH", + "title": "Coping with Cholera: the Importance of Coordinated Planning", + "abstract": "Cholera epidemics in Zimbabwe; Haiti; and Nigeria have grabbed worldwide headlines in the last couple of years as beleagured health agencies battled to contain a rising tide of patients. Is this resurgence a pathological issue; or simply the consequence of poor public health provision? Superficially there should be little excuse for the epidemics of the size we have witnessed recently (more than 1500 died in the outbreak in Nigeria in 2010); cholera is not a mystery illness; and measures to contain an outbreak are known. But the logistics can be daunting and if health systems are weak; they can quickly become overwhelmed. Can one prepare? Of course. and in fact it is a must. As with all infectious diseases; lessons from one campaign will educate and illuminate actions for another. Hospitals and communities should be undertaking regular risk assessments; and providing quality training and resources to enable swift and decisive action the moment a problem is identified. Until the 1980s most outbreaks were managed at the local level using the best available common sense. Apart from in the most densely populated areas; this was largely successful. Slowly; public health experts started comparing notes and the compilation of guidelines for the control of cholera outbreaks started to emerge with epidemiologists from WHO helping to `join up the dots' between experiences in different continents and countries", + "full_text": "", + "authors": [], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "http://www.africa-health.com/articles/january_2011/Cholera.pdf" + }, + { + "key": "5ZGXH5IX", + "title": "Prevalence and Analysis of Factors Related to Occurrence of Pulp Stone in Adult Restorative Patients", + "abstract": "Background: Pulp stone; though of an unclear aetiology; is clinically common. It potentially poses procedural difficulty to the endodontist and may also be a marker of an underlying systemic condition. Objectives: The study investigated pulp stone occurrence in adult restorative patients. It also highlighted the relationship between pulp stone and pristine posterior teeth; chronic periodontitis and posterior teeth with abrasion; as well as the effect of age and gender on pulp stone occurrence. Method: Three hundred subjects; aged 18-60 years participated in the cross sectional study. Pristine teeth; teeth with chronic periodontitis and those with abrasion were recruited. Result: Pulp stone was seen more often in the 41-50 years age band; in molars and in teeth with chronic periodontitis but less often in teeth with abrasion. In addition; coronal and free form of pulp stone were more popular. Conclusion: It is recommended that researchers should pay special care in case selections; and during biomechanical coronal instrumentation", + "full_text": "", + "authors": [ + "C. I Udoye", + "M. A Sede" + ], + "doi": "", + "year": null, + "item_type": "journalArticle", + "url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507086/http://amhsr.org/Articles/Udoye et al(2).pdf" + } +] \ No newline at end of file