scholarly journals Experiences of women seeking care for abortion complications in health facilities: Secondary analysis of the WHO Multi‐Country Survey on Abortion in 11 African countries

2021 ◽  
Author(s):  
Philip Govule ◽  
Sasha Baumann ◽  
Jean‐Paul Dossou ◽  
Clara Calvert ◽  
Sourou Goufodji ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Health Facilities ◽  
African Countries ◽  
Abortion Complications ◽  
Experiences Of Women

scholarly journals High prevalence of non-dipping patterns among Black Africans with uncontrolled hypertension: a secondary analysis of the CREOLE trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Prossie Merab Ingabire ◽  
◽  
Dike B. Ojji ◽  
Brian Rayner ◽  
Elijah Ogola ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Monitoring ◽  
Secondary Analysis ◽  
Uncontrolled Hypertension ◽  
African Countries ◽  
Night Time ◽  
Black Africans ◽  
Long Term Outcome ◽  
Black African ◽  
High Prevalence

Abstract Background Dipping of blood pressure (BP) at night is a normal physiological phenomenon. However, a non-dipping pattern is associated with hypertension mediated organ damage, secondary forms of hypertension and poorer long-term outcome. Identifying a non-dipping pattern may be useful in assessing risk, aiding the decision to investigate for secondary causes, initiating treatment, assisting decisions on choice and timing of antihypertensive therapy, and intensifying salt restriction. Objectives To estimate the prevalence and factors associated with non-dipping pattern and determine the effect of 6 months of three antihypertensive regimens on the dipping pattern among Black African hypertensive patients. Methods This was a secondary analysis of the CREOLE Study which was a randomized, single blind, three-group trial conducted in 10 sites in 6 Sub-Saharan African countries. The participants were 721 Black African patients, aged between 30 and 79 years, with uncontrolled hypertension and a baseline 24-h ambulatory blood pressure monitoring (ABPM). Dipping was calculated from the average day and average night systolic blood pressure measures. Results The prevalence of non-dipping pattern was 78% (564 of 721). Factors that were independently associated with non-dipping were: serum sodium > 140 mmol/l (OR = 1.72, 95% CI 1.17–2.51, p-value 0.005), a higher office systolic BP (OR = 1.03, 95% CI 1.01–1.05, p-value 0.003) and a lower office diastolic BP (OR = 0.97, 95% CI 0.95–0.99, p-value 0.03). Treatment allocation did not change dipping status at 6 months (McNemar’s Chi2 0.71, p-value 0.40). Conclusion There was a high prevalence of non-dipping among Black Africans with uncontrolled hypertension. ABPM should be considered more routinely in Black Africans with uncontrolled hypertension, if resources permit, to help personalise therapy. Further research is needed to understand the mechanisms and causes of non-dipping pattern and if targeting night-time BP improves clinical outcomes. Trial registration ClinicalTrials.gov (NCT02742467).

scholarly journals Protocol for establishing an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) for integrating care of communicable and non-communicable diseases using tuberculosis and diabetes as a case study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e041521
Author(s):  
Stellah G Mpagama ◽  
Kaushik Ramaiya ◽  
Troels Lillebæk ◽  
Blandina T Mmbaga ◽  
Marion Sumari-de Boer ◽  
...  
Keyword(s):  
Operational Research ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Learning System ◽  
Management Approach ◽  
African Countries ◽  
Non Communicable Diseases ◽  
Research Outcomes ◽  
The Government

IntroductionMost sub-Saharan African countries endure a high burden of communicable infections but also face a rise of non-communicable diseases (NCDs). Interventions targeting particular epidemics are often executed within vertical programmes. We establish an Adaptive Diseases control Expert Programme in Tanzania (ADEPT) model with three domains; stepwise training approach, integration of communicable and NCDs and a learning system. The model aims to shift traditional vertical programmes to an adaptive diseases management approach through integrating communicable and NCDs using the tuberculosis (TB) and diabetes mellitus (DM) dual epidemic as a case study. We aim to describe the ADEPT protocol with underpinned implementation and operational research on TB/DM.Methods and analysisThe model implement a collaborative TB and DM services protocol as endorsed by WHO in Tanzania. Evaluation of the process and outcomes will follow the logic framework. A mixed research design with both qualitative and quantitative approaches will be used in applied research action. Anticipated implementation research outcomes include at the health facilities level for organising TB/DM services, pathways of patients with TB/DM seeking care in different health facilities, factors in service delivery that need deimplementation and the ADEPT model implementation feasibility, acceptability and fidelity. Expected operational research outcomes include additional identified patients with dual TB/DM, the prevalence of comorbidities like hypertension in patients with TB/DM and final treatment outcomes of TB/DM including treatment-related complications. Findings will inform the future policies and practices for integrating communicable and NCDs services.Ethics and disseminationEthical approval was granted by The National Research Health Ethical Committee (Ref-No. NIMR/HQ/R.8a/Vol.IX/2988) and the implementation endorsed by the government authorities. Findings will be proactively disseminated through multiple mechanisms including peer-reviewed journals, and engagement with various stakeholders’ example in conferences and social media.

scholarly journals Molecular detection of viral pathogens from suspected viral hemorrhagic fever patients in Ghana

2020 ◽  
pp. 31-35
Author(s):  
Joseph HK Bonney ◽  
Theodore W Asigbee ◽  
Erasmus Kotey ◽  
Keren Attiku ◽  
Franklin Asiedu-Bekoe ◽  
...  
Keyword(s):  
Influenza A ◽  
Virus Disease ◽  
Health Facilities ◽  
African Countries ◽  
Case Definitions ◽  
Viral Pathogens ◽  
Standard Case ◽  
Clinical Specimens ◽  
Influenza A H1n1 ◽  
Case Based

Background: Viral hemorrhagic fevers (VHFs) are infectious illnesses that can cause serious morbidity and mortality to infected persons. During the 2014 Ebola virus disease outbreak in some West African countries, Ghana revamped its surveillance system across the country to prepare, effectively respond and pre-empt any public health concerns Objective: We report on suspected VHF clinical specimens submitted to the Noguchi Memorial Institute for Medical Research (NMIMR) from health facilities across the country for diagnosis within the period under review. This was partly to provide rapid response and to alert the health system to prevent outbreaks and its spread. Methods: From January 2017 to December 2018 clinical specimens of blood from 149 cases of suspected VHFs were collected at health facilities across the country and sent to NMIMR. Patient specimens were tested for viral pathogens including Lassa fever, Yellow fever, Dengue fever, Chikungunya, Zika, Ebola and Marburg by real-time reverse transcription-polymerase chain reaction. A case was however tested for influenza as the patient exhibited respiratory distress symptoms as well. Demographic and clinical information collected on a structured case-based forms were analyzed for each patient. Results: Out of the 149 clinical specimens tested, three (3) were found to be positive, with two (2) being Dengue and one (1) seasonal Influenza A H1N1. Analysis of the case-based forms revealed shortcomings with regards to standard case definitions used to enroll suspected cases. Conclusion: Our results buttress the need for a routine surveillance activity for VHFs to minimize spread and possibly forestall outbreaks. Moreover, febrile illnesses can be caused by a host of pathogens hence there is a need for enhanced diagnosis to help in patient management.

scholarly journals Integrated Family Planning and Immunization Service Delivery at Health Facility and Community Sites in Dowa and Ntchisi Districts of Malawi: A Mixed Methods Process Evaluation

2020 ◽  
Vol 17 (12) ◽  
pp. 4530
Author(s):  
Chelsea M. Cooper ◽  
Jacqueline Wille ◽  
Steven Shire ◽  
Sheila Makoko ◽  
Asnakew Tsega ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Family Planning ◽  
Service Providers ◽  
Service Integration ◽  
Secondary Analysis ◽  
Health Sector ◽  
Health Facilities ◽  
Immunization Service ◽  
Mothers And Fathers ◽  
The Government

The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services in all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.

scholarly journals Quality of basic maternal care functions in health facilities of five African countries: an analysis of national health system surveys

2016 ◽  
Vol 4 (11) ◽  
pp. e845-e855 ◽  
Author(s):  
Margaret E Kruk ◽  
Hannah H Leslie ◽  
Stéphane Verguet ◽  
Godfrey M Mbaruku ◽  
Richard M K Adanu ◽  
...  
Keyword(s):  
Health System ◽  
National Health ◽  
Maternal Care ◽  
National Health System ◽  
Health Facilities ◽  
African Countries

scholarly journals Quality of Sulfadoxine-Pyrimethamine Given as Antimalarial Prophylaxis in Pregnant Women in Selected Health Facilities in Central Region of Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Danny F. Yeboah ◽  
Richmond Afoakwah ◽  
Ekene K. Nwaefuna ◽  
Orish Verner ◽  
Johnson N. Boampong
Keyword(s):  
Pregnant Women ◽  
Central Region ◽  
Malaria Infection ◽  
High Performance ◽  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
Health Facilities ◽  
African Countries ◽  
Malaria During Pregnancy

The use of sulfadoxine-pyrimethamine (SP) as an intermittent preventive treatment (IPT) against malaria during pregnancy has become a policy in most sub-Sahara African countries and crucially depends on the efficacy of SP. This study sets out to evaluate the effectiveness of the SP given to the pregnant women in some selected health facilities in the Central Region of Ghana to prevent maternal malaria in pregnant women. A total of 543 pregnant women recruited from 7 selected health centres in Central Region of Ghana participated in the study. Parasite density ofPlasmodium falciparumwas determined from peripheral blood of the pregnant women using microscopy. High performance liquid chromatography (HPLC) and dissolution tester were used to determine the quality of the SP. Malaria infection was recorded in 11.2% of pregnant women who had a history of SP consumption. SP failed the dissolution test. Pregnant women who did not receive IPT-SP were 44%. Low haemoglobin level was recorded in 73.5% of the pregnant women. The results indicated that SP was substandard. IPT-SP is ineffective in preventing malaria infection.

scholarly journals Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

BMJ Open ◽  
2017 ◽  
Vol 7 (3) ◽  
pp. e014680 ◽  
Author(s):  
Joseph de Graft-Johnson ◽  
Linda Vesel ◽  
Heather E Rosen ◽  
Barbara Rawlins ◽  
Stella Abwao ◽  
...  
Keyword(s):  
Newborn Care ◽  
Health Facilities ◽  
Observational Assessment ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Assessing vaccine cold chain storage quality: a cross-sectional study of health facilities in three African countries

The Lancet ◽  
2013 ◽  
Vol 381 ◽  
pp. S25 ◽  
Author(s):  
Roy Burstein ◽  
Emily A Dansereau ◽  
Ruben O Conner ◽  
Brendan M DeCenso ◽  
Kristen P Delwiche ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Health Facilities ◽  
Cold Chain ◽  
Sectional Study ◽  
Storage Quality ◽  
African Countries ◽  
Cross Sectional
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