scholarly journals Acceptability, Effect and Cost of Mobile-Health on Art Adherence and Assessment of Covid-19 Knowledge Among Youths: A Mixed Methods Sequential Study in Kiryandongo. A Study Protocol Youth Trial

2021 ◽  
Author(s):  
Agnes Bwanika Naggirinya ◽  
David B Meya ◽  
Joseph Rujumba ◽  
Peter Waiswa ◽  
Rosalind Parkes-Ratanshi
Keyword(s):  
Qualitative Study ◽  
Randomized Control Trial ◽  
Standard Of Care ◽  
Sub Saharan Africa ◽  
Trial Registration ◽  
World Health ◽  
Art Adherence ◽  
Clinic Appointment ◽  
Resource Limited ◽  
Randomized Control

Abstract Background: AIDS is the leading cause of death among young people in sub-Saharan Africa. Adherence to antiretroviral therapy is the principal determinant for achieving and sustaining viral suppression, which decreases progression to AIDS and reduces risk of mortality. Few studies have evaluated mHealth adherence tools among youths in resource-limited settings.We aim to evaluate whethermHealth tool improves ART adherence outcomes among youth receiving ART at a rural district in Western Uganda. The Corona virus disease outbreak was announced a Public Health Emergency of International concern on Jan 2020; and declared a global pandemic by World Health Organization on Mar, 2020.In rural areas, there is little data on knowledge and myths on COVID among youths.General objective:To assessacceptability, effect and cost of themHealth tool on ART adherence, knowledge and myths on COVID-19among youth initiating and on ART at KiryandongoDistrict.Methods: This is a mixed methodsequential exploratory study, with the qualitative study conducted first followed by a randomized control trial and healthcare cost evaluation.The qualitative study will assess barriers, enablers of adherence and acceptability of mHealth among youths receiving care at three health facilities inKiryandongo District.The randomized control trial of 206 youth initiatingARTto either Standard of Care or mHealth tool plus Standard of care to assesseffect of mHealth tool on ART adherence and retention in care. Through a basic cell phone, participants in the intervention arm will receive pill reminders, clinic appointment reminders, health voice messages and self-reported symptoms in addition to standard of care. Collection of data on knowledge and myths on COVID-19, HIV and sexual behavior. The health care evaluationnested within randomized trial, will assess the cost of interventionin comparison to Standard of care.Discussion: This project will determine acceptability, effectiveness of mHealth, knowledge & myths on COVID-19and cost of delivering pill and clinic appointment reminders, and voice messages to a population with suboptimal ART adherence in a resource-limited setting.Trial registration: Fully registered under clinicaltrials.gov by 20th Jan 2021. The study is ongoing. Recruitment started Aug 2020.Clinical Trial registration: NCT 04718974

scholarly journals Efektivitas Klinis Ofloksasin Topikal Dibanding Ciprofloksasin Oral Pada Terapi Otitis Media Supuratif Kronik Aktif

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Deasy Mediawaty ◽  
Pujo Widodo ◽  
Dian Ayu Ruspita
Keyword(s):  
World Health Organization ◽  
Otitis Media ◽  
Randomized Control Trial ◽  
World Health ◽  
Control Group ◽  
Control Group Design ◽  
Group Design ◽  
Randomized Control ◽  
Health Organization ◽  
Per Oral

Latar belakang : Otitis media kronik atau sering disebut Otitis Media Supuratif Kronik (OMSK) adalah otitis media yang berlangsung > 12 minggu. Prevalensi OMSK di seluruh dunia sebanyak 65-330 juta dan 60% di antaranya menderita kurang pendengaran yang signifikan. Angka kejadian OMSK aktif mencapai 3,8% dari pasien THT-KL. Gejala OMSK aktif berupa banyaknya discaj, kurang pendengaran, nyeri, pusing berputar, telinga tidak nyaman. Tanda OMSK aktif berupa discaj di liang telinga, perforasi membran timpani, dan gangguan pendengaran. World Health Organization (WHO) mencanangkan strategi untuk mengatasi OMSK secara serius berkaitan dengan komplikasi yang dapat disebabkan. Pilihan terapi medikamentosa yang tepat diperlukan untuk mengatasi OMSK aktif. Ofloksasin topikal dan ciprofloksasin oral adalah antibiotik golongan fluorokuinolon yang banyak digunakan. Efektivitas diantaranya dibuktikan dengan perbaikan gejala dan tanda klinis. Tujuan : Membuktikan efektifitas ofloksasin topikal, ciprofloksasin oral dan efektifitas ofloksasin topikal dibanding ciprofloksasin oral terhadap perbaikan gejala dan tanda klinis. Metode :  Penelitian intervensi dengan rancangan pretest and posttest control group design, randomized control trial Klinik THT-KL BKIM Semarang pada bulan Juni-Agustus 2016. Penderita OMSK aktif dilakukan anamnesis lalu dilakukan pemeriksaan fisik dan pemeriksaan pendengaran dilanjutkan randomisasi. Penderita diberi ofloksasin topikal 10 tetes/12 jam atau ciprofloksasin tablet 500 mg/12 jam per oral. Hari ke 4, 10 dan 14 setelah terapi penderita kontrol. Analisis uji komparatif menggunakan uji parametrik dan non parametrik. Hasil : Jumlah subyek penelitian 108 orang ; ofloksasin topikal 54 orang (50%) dan ciprofloksasin oral 54 orang  (50 %). Gejala dan tanda klinis setelah terapi lebih rendah dibanding sebelum terapi pada kelompok ofloksasin topikal dan ciprofloksasin oral dengan nilai kemaknaan p < 0,05. Gejala klinis kelompok ofloksasin lebih baik dibanding ciproloksasin secara bermakna (p<0,05). Tanda klinis kedua kelompok terdapat perbedaan yang tidak bermakna (p>0,05). Simpulan : Ofloksasin topikal dan ciprofloksasin oral terbukti efektif memperbaiki gejala dan tanda klinis penderita OMSK aktif. Ofloksasin topikal efektif memperbaiki gejala klinis dibandingkan ciprofloksasin oral. Kata kunci : Otitis media supuratif kronik, ofloksasin, ciprofloksasin, gejala dan tanda klinis

scholarly journals Implementasi Prehospital Stroke Scale sebagai Screening Tools Serangan Stroke bagi Komunitas Risiko Tinggi

2020 ◽  
Vol 3 (2) ◽  
pp. 46
Author(s):  
Linda Widyarani ◽  
Cecilya Kustanti
Keyword(s):  
Cohort Study ◽  
Los Angeles ◽  
Qualitative Study ◽  
Literature Review ◽  
Randomized Control Trial ◽  
Screening Tools ◽  
Google Scholar ◽  
Fast Time ◽  
Speech Time ◽  
Randomized Control

Pendahuluan : Stroke merupakan penyebab kematian tertinggi di Indonesia, dengan prosentase 21,1%. Deteksi dini stroke oleh individu berisiko tinggi beserta keluarga (layperson), dengan prehospital stroke scales merupakan konsep utama chain of survivals stroke. Tujuan dari penelitian ini adalah mensintesis artikel-artikel tentang prehospital stroke scales yang dapat diajarkan pada individu berisiko tinggi beserta keluarga (layperson), agar individu berisiko tinggi beserta keluarga (layperson) terbekali dengan baik dan keberhasilan program terapi serta pengobatan dapat optimalMetode : Desain penelitian ini adalah literature review, yaitu menelaah hasil-hasil penelitian sebelumnya pada artikel yang telah terpublikasi. Penelusuran artikel dilakukan melalui PubMed, EBSCO, Science Direct dan Google Scholar. Kriteria inklusi meliputi a) publikasi artikel dalam sepuluh tahun terakhir 2010-2020, b) artikel menggunakan Bahasa Inggris dan memiliki fulltext, c) studi yang terdiri dari randomized control trial, cohort study dan qualitative study, sedangkan kriteria ekslusi meliputi artikel yang tidak memenuhi kriteria inklusi pada penelitian ini.Hasil : Hasil dari sintesis artikel yang telah ditemukan yaitu prehospital stroke scales dengan Cincinnati Prehospital Stroke Scale (CPSS), The Los Angeles Prehopsital Stroke Screen (LAPSS) dan juga Face Arm Speech Time (FAST) time dapat dikampanyekan dan diajarkan pada individu berisiko tinggi beserta keluarga (layperson) agar individu berisiko tinggi beserta keluarga (layperson) terbekali dengan baik dan keberhasilan program terapi.Kesimpulan : Pengobatan dapat optimal sehingga angka morbiditas dan mortalitas pasien stroke dalam diminimalkan.    

scholarly journals EDITORIAL: COVID-19: Rebooting pharmacy education in resource-limited settings

2021 ◽  
pp. 67-70
Author(s):  
Jennie Lates ◽  
Dan Kibuule
Keyword(s):  
Health Systems ◽  
World Health Organisation ◽  
Pharmacy Education ◽  
Sub Saharan Africa ◽  
World Health ◽  
Resource Limited Settings ◽  
Non Communicable Diseases ◽  
High Burden ◽  
Resource Limited ◽  
Sub Saharan

Globally, the COVID-19 pandemic has aggravated inequalities in access to quality pharmacy education, particularly in resource-limited settings in Africa (Engle, 2020; Fuller et al., 2020). This is a serious concern for Africa especially, given that sub-Saharan Africa ranks lowest on the global pharmaceutical workforce index and has a disproportionately high burden of infectious and non-communicable diseases, combined with weak health systems (World Health Organisation [WHO], 2013; Bates et al., 2018).

scholarly journals Effect of lactation counselling on breast feeding: randomized control trial

2017 ◽  
Vol 4 (5) ◽  
pp. 1610
Author(s):  
Ramesh Choudhary ◽  
Chetan Meena ◽  
Sunil Gothwal ◽  
S. Sitaraman ◽  
Sheela Sharma ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Randomized Control Trial ◽  
Tertiary Care ◽  
Intervention Group ◽  
Standard Of Care ◽  
Care Hospital ◽  
Feeding Rates ◽  
Counseling Intervention ◽  
Northern India ◽  
Randomized Control

Background: Breastfeeding for a newborn is a standard of care. Breast feeding rates are documented low in our country. Objective of present study was to find out the effect of lactation counselling on breast feeding rates.Methods: It was an open lable randomized control trial and conducted at Department of Pediatrics and Obstetrics of a tertiary care hospital of Northern India. Eligible subjects were 3rd trimester mothers admitted for delivery. Student t test and chi square test were used.Results: Breast feeding counseling (intervention) group resulted in early imitation, higher breast-feeding rates at discharge and follow up.Conclusions: Breast feeding counselling improves initiation, breast feeding rates at discharge and beyond. This study also emphasizes that lactation counselling is useful. Every opportunity of counselling should be availed by health care workers to promote breast feeding.

scholarly journals The conundrum of clinical trials and standard of care in sub-Saharan Africa – the research nurse perspective

2019 ◽  
Vol 24 (8) ◽  
pp. 649-660 ◽  
Author(s):  
Jane Frances Ndyetukira ◽  
Richard Kwizera ◽  
Florence Kugonza ◽  
Cynthia Ahimbisibwe ◽  
Carol Namujju ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Standard Of Care ◽  
Sub Saharan Africa ◽  
Research Nurse ◽  
Loss To Follow Up ◽  
Resource Limited ◽  
Research Nurses ◽  
Sub Saharan

Background Nurses form a very important part of the health workforce in sub-Saharan Africa. Research nurses are critical to the implementation of clinical trials. The duties and responsibilities of a research nurse are complex and continue to evolve as new practices and guidelines are formulated. Aims In this paper, we have highlighted the major contributions of research nurses in HIV clinical trials in sub-Saharan Africa from the unique perspective of Ugandan nurses. Methods The requirements and challenges of two multi-site, randomised cryptococcal meningitis clinical trials in Uganda were assessed from the perspective of research nurses conducting complex research in resource-limited settings. Results Over the course of 8 years, approximately 1739 participants were screened and 934 people were enrolled into the two trials. The nurses found that patient education and engagement were among the most important predictors of success in minimising loss to follow-up. Conclusions Research nurses played a key role in communicating clinical research goals to patients, obtaining informed consent, minimising loss to follow-up, and ensuring that research practices are translated and implemented into standard of care. However, there remains a need to integrate the same level of care provided in clinical research studies to non-study patients.

Ayurveda and Management of COVID-19 in Rural Indian Population: A pilot, double blind, randomized control trial

2021 ◽  
Author(s):  
K P Bharath Chandra ◽  
Saumya Subramanian ◽  
Rohini Wadhawan ◽  
Akhilesh Mohan Wodeyar ◽  
Alefia Zakir Marfatia ◽  
...  
Keyword(s):  
Randomized Control Trial ◽  
Standard Of Care ◽  
Rt Pcr ◽  
Early Recovery ◽  
Double Blind ◽  
Study Duration ◽  
Care Treatment ◽  
Significant Difference ◽  
Standard Of Care Treatment ◽  
Randomized Control

Abstract Background The SARS-CoV-2 virus responsible for the COVID-19 pandemic is a highly contagious and rapidly mutating virus. The COVID-19 pandemic has affected millions globally over the last 18 months and continues to overwhelm the healthcare system in several countries to date. The healthcare and scientific community has been vigorously searching for ways to manage the disease. Several solutions based on traditional systems of medicine like Ayurveda are also being explored for their effectiveness in managing COVID-19. The study explored the efficacy of a 19 ingredient Ayurvedic polyherbal formulation called NOQ19, on the recovery of mild, RT-PCR positive COVID-19 patients. Methods This was a prospective, double blind, randomized control trial that included 92 patients with a RT-PCR positive mild case of COVID-19. The patients were enrolled from rural areas of Karnataka, a state in India. The patients were randomized between the NF2 and placebo arms, in a 1:1 ratio, and were provided their respective intervention, along with the standard of care treatment (SOC). The trial took place at the Community Care Center, Konnanuru, Hassan, Karnataka. The study duration was around 2 months and the follow-up period for an individual patient was 14 days. RT-PCR analysis was done at baseline, Day 3, 7 and 10. Blood markers to track inflammation were assessed at baseline, Day 3 and 7. Result A statistically significant difference was observed between the two groups with regards to the percentage of population who turned RT-PCR negative on Day 3 and Day 10. On all three assessment time points (Day 3, 7 and 10), the NF2+SOC arm showed a greater percentage of population who were RT-PCR negative compared to the placebo+SOC arm: Day 3 (NF2 -19%, Placebo - 0%) ; Day 7 (NF2- 41%, Placebo - 19%) ; Day 10 (NF2-73%, Placebo 44%). No significant changes were observed in blood markers for both the groups. Conclusion NF2 administered along with standard of care treatment aided early recovery from COVID-19 as demonstrated by a higher percentage of population who were RT-PCR negative on Day 3, 7 and 10. No side effects were observed during the entire study duration. Early recovery of patients is essential for rational usage of limited healthcare resources in a pandemic.

scholarly journals PO 8564 WHAT IS CLINICAL TRIAL QUALITY? A QUALITATIVE STUDY BASED ON INTERVIEWS WITH DIFFERENT STAKEHOLDERS CONDUCTING CLINICAL TRIALS IN SUB-SAHARAN AFRICA

2019 ◽  
Vol 4 (Suppl 3) ◽  
pp. A54.1-A54
Author(s):  
Angela Lazarova ◽  
Claudia Fuchs ◽  
Christian Burri
Keyword(s):  
Clinical Trials ◽  
Qualitative Study ◽  
Web Search ◽  
Sub Saharan Africa ◽  
Quality Factors ◽  
Structured Interviews ◽  
Trial Quality ◽  
Resource Limited ◽  
Quality Aspects ◽  
Sub Saharan

BackgroundThere is no unified, broad definition for quality in clinical trials (CTs). Besides the explicit quality requirements in international guidelines and national legislation, however, there are broader factors to consider, including specific setting-related aspects influencing quality needs, quality perception and local implementation of guidelines. Our objective was to identify these factors from a resource-limited settings perspective (in this case, sub-Saharan Africa).MethodsIn March-April 2018, we conducted a qualitative study based on semi-structured interviews with participants from three stakeholder groups (monitors, sponsors, and investigators) conducting CTs in sub-Saharan Africa. We identified the interviewees either through CT registry platforms, a web search or by reference. We aimed to include 10–20 participants per stakeholder group. After consent, the interviews were held in person (via Skype or telephone), recorded, and transcribed verbatim. The interview questionnaire addressed a CT quality definition and quality factors during the CT process. We performed the analysis using the framework method.ResultsSo far, we included 21 participants (17 investigators, two sponsors, two monitors). Eight (8) (from sub-Saharan Africa) and 13 (not from sub-Saharan Africa) who contributed to CTs in 19 different countries in sub-Saharan Africa. Quality definitions mentioned so far were variable. A repeated statement was that the quality definition should be broad and include a system of multiple aspects and layers. We will interview more experts with sponsor and monitor experience in May 2018 and elaborate these quality aspects and layers. We will discuss these results with regards to a comprehensive quality framework for CTs currently under development for Northern countries by another Swiss research team.ConclusionCT quality was perceived in variable ways, as was the relevance of the aspects across different CT steps. Structuring the multifaceted layers of CT quality will facilitate appropriate and efficient CT quality management in sub-Saharan Africa.

scholarly journals Comparative feasibility of two World Health Organization partographs to predict prolonged labour: a randomized control trial

2019 ◽  
Vol 6 (4) ◽  
pp. 167
Author(s):  
Mohini Rajoriya ◽  
Ruchi Kalra
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Randomized Control Trial ◽  
Controlled Trial ◽  
World Health ◽  
P Value ◽  
Obstructed Labor ◽  
Prolonged Labor ◽  
Randomized Control ◽  
Latent Phase

<p class="abstract"><strong>Background:</strong> One of the major causes of maternal mortality is obstructed labor. Identification of abnormal labor at earliest and timely management can prevent prolonged labor and significantly reduce its sequel. Partograph is a useful tool in hands of labor care givers to monitor labor course. The study was done to compare feasibility of two WHO partographs a composite partograph including the latent phase with a simplified one without the latent phase to predict prolonged labor in randomized control trial.</p><p class="abstract"><strong>Methods:</strong> A randomized controlled trial, with parallel arm design was conducted. Sample size was calculated as 404 pregnant women .They were randomly categorized in two groups, each group having 202 participants.</p><p class="abstract"><strong>Results:</strong> labor had crossed the alert line in 108 (53.4%) cases monitored by composite partograph and 38(18.8%) cases monitored with simplified partograph. The calculated P value was &lt;0.0001. The odds ratio calculate was 4.95 and 95% confidence interval was 3.16 to 7.76. Labor crossing the action line was found in 16 (7.9%) in composite partograph whereas in simplified partograph, labor had crossed the action line in 18 cases in simplified group. Calculated P value was 0.72 (&gt;0.05). The odds ratio was 0.8793 and 95% confidence interval 0.43 to 1.77 which was not significant statistically .Most participants (70%) experienced difficulty with the composite partograph, but no participant reported difficulty while plotting the simplified partograph.</p><p class="abstract"><strong>Conclusions: </strong>WHO simplified partograph was found to be as good as WHO composite partograph in identifying maternal and perinatal outcomes and was more user friendly.</p>

scholarly journals The 4MOTHERS trial of the impact of a mobile money-based intervention on maternal and neonatal health outcomes in Madagascar: study protocol of a cluster-randomized hybrid effectiveness-implementation trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Etienne Lacroze ◽  
Till Bärnighausen ◽  
Jan Walter De Neve ◽  
Sebastian Vollmer ◽  
Rolland Marie Ratsimbazafy ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Outcomes ◽  
Sub Saharan Africa ◽  
Trial Registration ◽  
World Health ◽  
Neonatal Health ◽  
Mobile Money ◽  
Maternal And Neonatal Health ◽  
Cluster Randomized ◽  
The Impact

Abstract Background Mobile money—a service enabling users to receive, store, and send electronic money using mobile phones—has been widely adopted across low- and middle-income economies to pay for a variety of services, including healthcare. However, evidence on its effects on healthcare access and health outcomes are scarce and the possible implications of using mobile money for financing and payment of maternal healthcare services—which generally require large one-time out-of-pocket payments—have not yet been systematically assessed in low-resource settings. The aim of this study is to determine the impact on health outcomes, cost-effectiveness, feasibility, acceptability, and usefulness of mobile phone-based savings and payment service, the Mobile Maternal Health Wallet (MMHW), for skilled healthcare during pregnancy and delivery among women in Madagascar. Methods This is a hybrid effectiveness-implementation type-1 trial, determining the effectiveness of the intervention while evaluating the context of its implementation in Madagascar’s Analamanga region, containing the capital, Antananarivo. Using a stratified cluster randomized design, 61 public-sector primary-care health facilities were randomized within 6 strata to either receive the intervention or not (29 intervention vs. 32 control facilities). The strata were defined by a health facility’s antenatal care visit volume and its capacity to offer facility-based deliveries. The registered pre-specified primary outcomes are (i) delivery at a health facility, (ii) antenatal care visits, and (iii) total healthcare expenditure during pregnancy, delivery, and neonatal period. The registered pre-specified secondary outcomes include additional health outcomes, economic outcomes, and measurements of user experience and satisfaction. Our estimated enrolment number is 4600 women, who completed their pregnancy between July 1, 2020, and December 31, 2021. A series of nested mixed-methods studies will elucidate client and provider perceptions on feasibility, acceptability, and usefulness of the intervention to inform future implementation efforts. Discussion A cluster-randomized, hybrid effectiveness-implementation design allows for a robust approach to determine whether the MMHW is a feasible and beneficial intervention in a resource-restricted public healthcare environment. We expect the results of our study to guide future initiatives and health policy decisions related to maternal and neonatal health and universal healthcare coverage through technology in Madagascar and other countries in sub-Saharan Africa. Trial registration This trial was registered on March 12, 2021: Deutsches Register Klinischer Studien (German Clinical Trials Register), identifier: DRKS00014928. For World Health Organization Trial Registration Data Set see Additional file 1.

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