scholarly journals Availability of nutritional support services in HIV care and treatment sites in sub-Saharan African countries

2011 ◽  
Vol 15 (5) ◽  
pp. 938-947 ◽  
Author(s):  
Aranka Anema ◽  
Wendy Zhang ◽  
Yingfeng Wu ◽  
Batya Elul ◽  
Sheri D Weiser ◽  
...  
Keyword(s):  
Support Services ◽  
Nutritional Support ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Severe Malnutrition ◽  
Micronutrient Supplementation ◽  
African Countries ◽  
Nutritional Counselling ◽  
Care And Treatment ◽  
Sub Saharan

AbstractObjectiveTo examine the availability of nutritional support services in HIV care and treatment sites across sub-Saharan Africa.DesignIn 2008, we conducted a cross-sectional survey of sites providing antiretroviral therapy (ART) in nine sub-Saharan African countries. Outcomes included availability of: (i) nutritional counselling; (ii) micronutrient supplementation; (iii) treatment for severe malnutrition; and (iv) food rations. Associations with health system indicators were explored using bivariate and multivariate methods.SettingPresident's Emergency Plan for AIDS Relief-supported HIV treatment and care sites across nine sub-Saharan African countries.SubjectsA total of 336 HIV care and treatment sites, serving 467 175 enrolled patients.ResultsOf the sites under study, 303 (90 %) offered some form of nutritional support service. Nutritional counselling, micronutrient supplementation, treatment for severe acute malnutrition and food rations were available at 98 %, 64 %, 36 % and 31 % of sites, respectively. In multivariate analysis, secondary or tertiary care sites were more likely to offer nutritional counselling (adjusted OR (AOR): 2·2, 95 % CI 1·1, 4·5). Rural sites (AOR: 2·3, 95 % CI 1·4, 3·8) had increased odds of micronutrient supplementation availability. Sites providing ART for >2 years had higher odds of availability of treatment for severe malnutrition (AOR: 2·4, 95 % CI 1·4, 4·1). Sites providing ART for >2 years (AOR: 1·6, 95 % CI 1·3, 1·9) and rural sites (AOR: 2·4, 95 % CI 1·4, 4·4) had greater odds of food ration availability.ConclusionsAvailability of nutritional support services was high in this large sample of HIV care and treatment sites in sub-Saharan Africa. Further efforts are needed to determine the uptake, quality and effectiveness of these services and their impact on patient and programme outcomes.

scholarly journals Changing forms of HIV-related stigma along the HIV care and treatment continuum in sub-Saharan Africa: a temporal analysis

2017 ◽  
Vol 93 (Suppl 3) ◽  
pp. e052975 ◽  
Author(s):  
O Bonnington ◽  
J Wamoyi ◽  
W Ddaaki ◽  
D Bukenya ◽  
K Ondenge ◽  
...  
Keyword(s):  
Temporal Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Related Stigma ◽  
Care And Treatment ◽  
Sub Saharan

scholarly journals Implementation of differentiated service delivery for paediatric HIV care and treatment: opportunities, challenges and experience from seven sub-Saharan African countries

2020 ◽  
Vol 8 (3) ◽  
pp. e000393
Author(s):  
Rebecca Abelman ◽  
Catharina Alons ◽  
Jeni Stockman ◽  
Ivan Teri ◽  
Anna Grimsrud ◽  
...  
Keyword(s):  
Service Delivery ◽  
Children And Adolescents ◽  
Care Delivery ◽  
Hiv Care ◽  
Differentiated Service ◽  
Viral Load Suppression ◽  
African Countries ◽  
Care And Treatment ◽  
Sub Saharan ◽  
Living With Hiv

Differentiated service delivery (DSD) models for HIV often exclude children and adolescents. Given that children and adolescents have lower rates of HIV diagnosis, treatment and viral load suppression, there is a need to use DSD to meet the needs of children and adolescents living with HIV. This commentary reviews the concept of DSD, examines the application of DSD to the care of children and adolescents living with HIV, and describes national guidance on use of DSD for children and adolescents and implementation of DSD for HIV care and treatment in children and adolescents in Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)–supported programmes in seven sub-Saharan countries between 2017 and 2019. Programme descriptions include eligibility criteria, location and frequency of care delivery, healthcare cadre delivering the care, as well as the number of EGPAF-supported facilities supporting each type of DSD model. A range of DSD models were identified. While facility-based models predominate, several countries support community-based models. Despite significant uptake of various DSD models for children and adolescents, there was variable coverage within countries and variability in age criteria for each model. While the recent uptake of DSD models for children and adolescents suggests feasibility, more can be done to optimise and extend the use of DSD models for children and adolescents living with HIV. Barriers to further DSD uptake are described and solutions proposed. DSD models for children and adolescents are a critical tool that can be optimised to improve the quality of HIV care and outcomes for children and adolescents.

scholarly journals Decentralization of Pediatric HIV Care and Treatment in Five Sub-Saharan African Countries

2013 ◽  
Vol 62 (5) ◽  
pp. e124-e130 ◽  
Author(s):  
Ruby N. Fayorsey ◽  
Suzue Saito ◽  
Rosalind J. Carter ◽  
Eduarda Gusmao ◽  
Koen Frederix ◽  
...  
Keyword(s):  
Pediatric Hiv ◽  
Hiv Care ◽  
African Countries ◽  
Care And Treatment ◽  
Sub Saharan ◽  
Pediatric Hiv Care

scholarly journals Strengthening Health Systems for Chronic Care: Leveraging HIV Programs to Support Diabetes Services in Ethiopia and Swaziland

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Miriam Rabkin ◽  
Zenebe Melaku ◽  
Kerry Bruce ◽  
Ahmed Reja ◽  
Alison Koler ◽  
...  
Keyword(s):  
Chronic Care ◽  
Rapid Assessment ◽  
Scale Up ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
The Status ◽  
Care Systems ◽  
Care And Treatment ◽  
Sub Saharan ◽  
Hiv Programs

The scale-up of HIV services in sub-Saharan Africa has catalyzed the development of highly effective chronic care systems. The strategies, systems, and tools developed to support life-long HIV care and treatment are locally owned contextually appropriate resources, many of which could be adapted to support continuity care for noncommunicable chronic diseases (NCD), such as diabetes mellitus (DM). We conducted two proof-of-concept studies to further the understanding of the status of NCD programs and the feasibility and effectiveness of adapting HIV program-related tools and systems for patients with DM. In Swaziland, a rapid assessment illustrated gaps in the approaches used to support DM services at 15 health facilities, despite the existence of chronic care systems at HIV clinics in the same hospitals, health centers, and clinics. In Ethiopia, a pilot study found similar gaps in DM services at baseline and illustrated the potential to rapidly improve the quality of care and treatment for DM by adapting HIV-specific policies, systems, and tools.

scholarly journals Bottlenecks to HIV care and treatment in sub-Saharan Africa: a multi-country qualitative study

2017 ◽  
Vol 93 (Suppl 3) ◽  
pp. e053172 ◽  
Author(s):  
Alison Wringe ◽  
Jenny Renju ◽  
Janet Seeley ◽  
Mosa Moshabela ◽  
Morten Skovdal
Keyword(s):  
Qualitative Study ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care And Treatment ◽  
Sub Saharan

scholarly journals Age-dependent inequalities in HIV/STI burden and care receipt among men and transgender persons who have sex with men in Nairobi

2021 ◽  
Author(s):  
Adrian Smith ◽  
Elizabeth Fearon ◽  
Rhoda Kibuti ◽  
Erastus Irungu ◽  
Mary Kungu ◽  
...  
Keyword(s):  
Viral Load ◽  
Self Report ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
African Countries ◽  
Hiv Viral Load ◽  
Transgender Persons ◽  
Sub Saharan ◽  
Sex With Men

Background Gay, bisexual and other men who have sex with men (GBMSM) and transgender persons (TP) bear high burdens of HIV and other sexually transmitted infections (STIs) in sub-Saharan Africa, yet evidence of HIV care coverage for these groups is sparse from the region despite prevailing stigma and discrimination towards these groups. Methods 618 GBMSM/TP were recruited in Nairobi between May to December 2017 using respondent-driven sampling. Participants reported recent sexual behaviour, HIV testing and care receipt, and symptoms of STIs. Participants tested for HIV using Kenyan testing algorithms and GeneXpert methods, syphilis, viral hepatitis and ano-genital gonorrhoea and chlamydia. We assessed associations with HIV status and detectable HIV viral load using multivariable robust Poisson regression models. Findings 26.4% (286/618) were HIV positive of whom 76.5% were status aware, 65.3% were on ART, and 47.4% were virally suppressed (<50 copies/ml). Participants 18-22 years old were less likely to be status aware, be receiving ART or to have achieved viral suppression. Mean log viral load was 3.14 log higher in 18-22 year olds compared to older participants. Bacterial STIs were frequently detected at both urethral and rectal sites and a majority of infections at both sites were asymptomatic by self-report (rectal 82.2%, urethral 90.8%). Interpretation Engagement in the HIV diagnosis and care cascade among GBMSM/TP in Kenya is markedly better than in most sub-Saharan African countries. However it falls short of achievements among the general population in the country and cascades achieved in GBMSM in high income settings. Young men and transgender persons who have sex with men are least well served by the current configuration of adult key population services, and programmes should identify and address the sexual, social and developmental needs of adolescent and young key populations

Crowdsourcing Covid-19 signals in sub-Saharan Africa: Leveraging digital contributor networks for participatory surveillance of Covid-19 symptoms and deaths (Preprint)

2020 ◽  
Author(s):  
Ngozi A Erondu ◽  
Sagal A Ali ◽  
Mohamed Ali ◽  
Schadrac C Agbla
Keyword(s):  
Public Health ◽  
Sub Saharan Africa ◽  
Specific Information ◽  
Surveillance Systems ◽  
Health Seeking ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Local Networks ◽  
The World ◽  
Sub Saharan

BACKGROUND In sub-Saharan Africa, underreporting of cases and deaths has been attributed to various factors including, weak disease surveillance, low health-seeking behaviour of flu like symptoms, and stigma of Covid-19. There is evidence that SARS-CoV-2 spread mimics transmission patterns of other countries across the world. Since the Covid-19 pandemic has changed the way research can be conducted and in light of restrictions on travel and risks to in-person data collection, innovative approaches to collecting data must be considered. Nearly 50% of Africa’s population is a unique mobile subscriber and it is one of the fastest growing smart-phone marketplaces in the world; hence, mobile phone platforms should be considered to monitor Covid-19 trends in the community. OBJECTIVE We demonstrate the use of digital contributor platforms to survey individuals about cases of flu-like symptoms and instances of unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia, and Zimbabwe. METHODS Rapid cross-sectional survey of individuals with severe flu and pneumonia symptoms and unexplained deaths in Ethiopia, Kenya, Nigeria, Somalia and Zimbabwe RESULTS Using a non-health specific information platform, we found COVID-19 signals in five African countries, specifically: •Across countries, nearly half of the respondents (n=739) knew someone who had severe flu or pneumonia symptoms in recent months. •One in three respondents from Somalia and one in five from Zimbabwe respondents said they knew more than five people recently displaying flu and/or pneumonia symptoms. •In Somalia there were signals that a large number of people might be dying outside of health facilities, specifically in their homes or in IDP or refugee camps. CONCLUSIONS Existing digital contributor platforms with local networks are a non-traditional data source that can provide information from the community to supplement traditional government surveillance systems and academic surveys. We demonstrate that using these distributor networks to for community surveys can provide periodic information on rumours but could also be used to capture local sentiment to inform public health decision-making; for example, these insights could be useful to inform strategies to increase confidence in Covid19 vaccine. As Covid-19 continues to spread somewhat silently across sub-Saharan Africa, regional and national public health entities should consider expanding event-based surveillance sources to include these systems.

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