scholarly journals The Challenge of Diagnosing and TreatingStaphylococcus aureusInvasive Infections in a Resource-limited Sub-Saharan Africa Setting: A Case Report

2015 ◽  
Vol 61 (5) ◽  
pp. 397-402 ◽  
Author(s):  
Gemma Rovira ◽  
Elisa F. Cooke ◽  
Helio Mucavele ◽  
Antonio Sitoe ◽  
Lola Madrid ◽  
...  
Keyword(s):  
Case Report ◽  
Sub Saharan Africa ◽  
Resource Limited ◽  
Sub Saharan

scholarly journals Building sustainable research capacity at higher learning institutions in Tanzania through mentoring of the Young Research Peers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emmanuel Balandya ◽  
Bruno Sunguya ◽  
Daniel W. Gunda ◽  
Benson Kidenya ◽  
Tumaini Nyamhanga ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
Professional Education ◽  
Research Training ◽  
Peer To Peer ◽  
Sub Saharan Africa ◽  
Ongoing Research ◽  
Scientific Presentation ◽  
Resource Limited ◽  
Sub Saharan ◽  
Young Researchers

Abstract Background Sustainability of research culture in Sub-Saharan Africa is threatened in part by the lack of a critical mass of young researchers with the requisite skills and interest to undertake research careers. This paper describes an intensive mentorship programme combining hierarchical (vertical) and peer-to-peer (horizontal) mentoring strategies among young researchers in a resource limited setting in Sub-Saharan Africa. Methods A consortium of three partnering large Tanzanian health training institutions (MUHAS, CUHAS and KCMUCo) and two collaborating US institutions (UCSF and Duke University) was formed as part of the five-year Transforming Health Professions Education in Tanzania (THET) project, funded by the NIH through Health Professional Education Partnership Initiative (HEPI). Within THET, the Community of Young Research Peers (CYRP) was formed, comprising of inter-professional and cross-institutional team of 12 Master-level Young Research Peers and 10 co-opted fellows from the former MEPI-Junior Faculty (MEPI-JF) project. The Young Peers received mentorship from senior researchers from the consortium through mentored research awards and research training, and in turn provided reciprocal peer-to-peer mentorship as well as mentorship to undergraduate students. Results At the end of the first 2 years of the project, all 12 Young Peers were proceeding well with mentored research awards, and some were at more advanced stages. For example, three articles were already published in peer reviewed journals and two other manuscripts were in final stages of preparation. All 12 Young Peers participated in CYRP-wide thematic training workshops on mentoring and secondary data analysis; 11 had undertaken at least three research training short courses in identified areas of need; 9 joined at least one other ongoing research project; 5 made at least one scientific presentation, and 5 participated in at least one submitted grant application. Half of the Young Peers have enrolled in PhD programmes. A collective total of 41 undergraduate students were actively mentored by the Young Peers in research. Conclusion The CYRP has demonstrated to be an effective model for dual vertical and horizontal mentorship in research to young investigators in resource-limited settings. This model is recommended to educators working on developing research competence of early career researchers, particularly in Sub-Saharan Africa.

scholarly journals Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

2019 ◽  
Vol 31 (3) ◽  
pp. 202-211
Author(s):  
Onyinye Hope Chime
Keyword(s):  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Related Factors ◽  
Art Programs ◽  
Adherence To Medication ◽  
Behavioural Modification ◽  
Resource Limited ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Predictors Of Adherence

BackgroundHIV infection and AIDS are majorpublic health challenges in Nigeria, a country with one of the highest rates of new infection in sub-Saharan Africa and the second largest HIV epidemic in the world.Non-adherence to medication and defaulting from treatment are the two major challenges faced by anti-retroviral therapy (ART) programs in resource-constrained settings. This study was undertaken to determine the rate and predictors of adherence to medication and retention among people living with HIVin Enugu State, Nigeria.MethodsThis was a cross-sectionalretrospective study conducted among adults living with HIV(PLHIV) receiving ARTs in eightcomprehensive health facilities in Enugu, Nigeria. We used self-reported adherence and recorded clinic visits to assess adherence and retention, respectively. Descriptive statistics (frequencies, proportions, mean and standard deviation) and regression analysis were then conducted to identify the association between adherence, retention and demographic and health-related factors. ResultsThe mean age of respondents was 38.5±9.8 years. Predictors of good adherence to medication includedbeing male(adjusted odds ratio [AOR]:2.08; 95% confidence interval [CI]:1.12–3.85), having been on anti-retroviral medications for more than 5 years (AOR:1.92; 95% CI: 1.17–3.16), the non-consumption of alcohol(AOR: 3.67; 95% CI: 2.01–6.70),not usingtraditional medicine (AOR: 2.76; 95% CI:1.33–5.73) and having a baseline CD4count exceeding 500 cells/μl (AOR: 5.67; 95% CI: 1.32–24.32).Adequate retention was predicted by being resident in the urban area (AOR: 1.90; 95% CI: 1.17–3.06). Being away from home (41.8%) and forgetfulness (35.0%) were reported as the major reasons for missing medication.ConclusionThe rates of adherence and retention found in this study were similar to those reported forother resource-limited settings. Health education and behavioural modification interventions should be intensified to reduce the consumption of alcohol and the use of traditional medicine by people living with HIV. Identifying other factors may help to design effective strategies to ensure that people living with HIV adhere to their medications and remain in care.

scholarly journals Frequency of Pneumocystis jirovecii in sputum from HIV and TB patients in Namibia

2014 ◽  
Vol 8 (03) ◽  
pp. 349-357 ◽  
Author(s):  
Vincent Nowaseb ◽  
Esegiel Gaeb ◽  
Marcin G Fraczek ◽  
Malcolm D Richardson ◽  
David W Denning
Keyword(s):  
Pneumocystis Pneumonia ◽  
Sub Saharan Africa ◽  
Pneumocystis Jirovecii ◽  
Aids Patients ◽  
Limited Region ◽  
Minimum Frequency ◽  
Resource Limited ◽  
Smear Negative ◽  
Sub Saharan ◽  
Hiv Aids

Introduction: The opportunistic fungus Pneumocystis jirovecii causes Pneumocystis pneumonia (PcP), which is a life-threatening infection in HIV/AIDS patients. The seemingly low prevalence of P. jirovecii pneumonia in sub-Saharan Africa has been a matter of great debate because many HIV/AIDS patients reside in this region. The lack of suitable diagnostic practices in this resource limited-region has been added to the uncertainty of PcP prevalence. Only a few studies have evaluated the utility of easily obtainable samples such as expectorated sputum for diagnosis of PcP. Thus, the aim of the current study was to evaluate the effectiveness of expectorated sputum for the routine diagnosis of PcP in a resource-limited sub-Saharan African setting. Methodology: Randomly collected sputum samples were analysed by microscopy after Grocott’s methenamine silver (GMS) stain staining and by qPCR to determine the minimum frequency of detectable P. jirovecii. Results: A total of 475 samples were analysed. Twenty five (5.3%) samples were positive for P. jirovecii, i.e., 17 (3.6%) using both qPCR and GMS staining and eight (1.7%) using qPCR only. P. jirovecii was present in 8/150 (5.3%) HIV-positive and tuberculosis (TB) smear-negative patients, and in 12/227 (5.3%) TB smear-negative patients with an unknown HIV status. The minimum frequency of PcP was 3.6% in Namibian HIV and TB patients, while the actual frequency is likely to be 5.3%. Conclusion: This study demonstrated that expectorated sputum can be used routinely for the diagnosis of PcP by GMS, although qPCR is more sensitive, and it requires less time and skill.

scholarly journals International Radiotherapy Referrals From Rural Rwanda: Implementation Processes and Early Clinical Outcomes

2018 ◽  
pp. 1-12
Author(s):  
Maud Hanappe ◽  
Lowell T. Nicholson ◽  
Shekinah N.C. Elmore ◽  
Alexandra E. Fehr ◽  
Jean Bosco Bigirimana ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Head And Neck ◽  
Low Income ◽  
Cancer Care ◽  
Sub Saharan Africa ◽  
Resource Limited Settings ◽  
Cancer Centre ◽  
Resource Limited ◽  
Centre Of Excellence ◽  
Sub Saharan

Purpose Low- and middle-income countries disproportionately comprise 65% of cancer deaths. Cancer care delivery in resource-limited settings, especially low-income countries in sub-Saharan Africa, is exceedingly complex, requiring multiple modalities of diagnosis and treatment. Given the vast human, technical, and financial resources required, access to radiotherapy remains limited in sub-Saharan Africa. Through 2017, Rwanda has not had in-country radiotherapy services. The aim of this study was to describe the implementation and early outcomes of the radiotherapy referral program at the Butaro Cancer Centre of Excellence and to identify both successful pathways and barriers to care. Methods Butaro District Hospital is located in a rural area of the Northern Province and is home to the Butaro Cancer Centre of Excellence. We performed a retrospective study from routinely collected data of all patients with a diagnosis of cervical, head and neck, or rectal cancer between July 2012 and June 2015. Results Between 2012 and 2015, 580 patients were identified with these diagnoses and were potential candidates for radiation. Two hundred eight (36%) were referred for radiotherapy treatment in Uganda. Of those referred, 160 (77%) had cervical cancer, 31 (15%) had head and neck cancer, and 17 (8%) had rectal cancer. At the time of data collection, 101 radiotherapy patients (49%) were alive and had completed treatment with no evidence of recurrence, 11 (5%) were alive and continuing treatment, and 12 (6%) were alive and had completed treatment with evidence of recurrence. Conclusion This study demonstrates the feasibility of a rural cancer facility to successfully conduct out-of-country radiotherapy referrals with promising early outcomes. The results of this study also highlight the many challenges and lessons learned in providing comprehensive cancer care in resource-limited settings.

Brain drain in sub-Saharan Africa: contributing factors, potential remedies and the role of academic medical centres

2012 ◽  
Vol 97 (11) ◽  
pp. 973-979 ◽  
Author(s):  
Jennifer Kasper ◽  
Francis Bajunirwe
Keyword(s):  
Clinical Skills ◽  
Codes Of Conduct ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Contributing Factors ◽  
Optimal Care ◽  
Poor Countries ◽  
Resource Limited ◽  
Sub Saharan ◽  
And Migration

A double jeopardy exists in resource-limited settings (RLS) in sub-Saharan Africa (SSA): there are a disproportionately greater number of acutely ill patients, but a paucity of healthcare workers (HCW) to care for them. SSA has 25% of the global disease burden but only 3% of the world's HCW. Thirty-two SSA countries do not meet the WHO minimum of 23 HCW per 10000 population. Contributing factors include insufficient supply, inadequate distribution and migration. Potential remedies include international workforce policies, non-governmental organisations, national and international medical organisations’ codes of conduct, inter-country collaborations, donor-directed policies and funding to train more people in-country, and health system strengthening and task-shifting. Collaborations among academic institutions from resource-rich and poor countries can help address HCW supply, distribution and migration. It is now opportune to harness bright, committed people from academic centres in resource-rich and poor settings to create long-term, collaborative relationships focused on training, clinical skills and locally relevant research endeavours, who mutually strive for HCW retention, less migration, and ultimately sufficient HCW to provide optimal care in all RLS.

scholarly journals HIV-Associated Tuberculosis in the Newborn and Young Infant

2011 ◽  
Vol 2011 ◽  
pp. 1-10 ◽  
Author(s):  
M. Adhikari ◽  
P. Jeena ◽  
R. Bobat ◽  
M. Archary ◽  
K. Naidoo ◽  
...  
Keyword(s):  
Vertical Transmission ◽  
Social Impact ◽  
Social Issues ◽  
Transmission Rate ◽  
Young Infant ◽  
Perinatal Outcomes ◽  
Sub Saharan Africa ◽  
Resource Limited ◽  
Vertical Transmission Rate ◽  
Sub Saharan

Each year, approximately 250 000 women die during pregnancy, delivery, or postpartum. Maternal mortality rates due to tuberculosis (TB) and HIV in Sub-Saharan Africa now supersede obstetric-related causes of mortality. The majority of cases occur in population-dense regions of Africa and Asia where TB is endemic. The vertical transmission rate of tuberculosis is 15%, the overall vertical transmission rate of HIV in resource-limited settings with mono- or dual-ARV therapy varies from 1.9% to 10.7%. If the millennium development goals are to be achieved, both HIV and TB must be prevented. The essential aspect of TB prevention and detection in the newborn is the maternal history and a positive HIV status in the mother. Perinatal outcomes are guarded even with treatment of both diseases. Exclusive breast feeding is recommended. The community and social impact are crippling. The social issues aggravate the prognosis of these two diseases.

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