scholarly journals A Smartphone Game to Prevent HIV Among Young Africans: Protocol for a Randomized Pilot Study of a Mobile Intervention (Preprint)

2018 ◽  
Author(s):  
Gaëlle Sabben ◽  
Victor Akelo ◽  
Victor Mudhune ◽  
Ken Ondeng'e ◽  
Richard Ndivo ◽  
...  
Keyword(s):  
Young People ◽  
Controlled Trial ◽  
Hiv Infections ◽  
Geographic Area ◽  
Sub Saharan Africa ◽  
Hiv Prevention Intervention ◽  
Randomized Controlled ◽  
Sub Saharan ◽  
Lost To Follow Up

BACKGROUND Young people aged under 25 years make up an increasing proportion of the population in emerging economies such as Kenya, where half of new adult HIV infections are among 15- to 24-year olds. Interventions targeting this age group have the potential to avert HIV infections among an increasingly large at-risk population. Interactive communication technologies offer a promising platform for reaching young people in engaging ways. OBJECTIVE Tumaini is a narrative-based smartphone game designed to help young Africans protect themselves from HIV. The objective of this study was to pilot test the game, focusing on the data needed to inform a future randomized controlled efficacy trial, including assessments of study feasibility and safety. METHODS The study took place in Kisumu Town, western Kenya, in spring 2017. The game-based intervention was pilot tested for 16 days with a sample of 60 preadolescents aged 11 to 14 years. Participant recruitment was initiated through schools. Participants were randomly assigned to the control or intervention arms of the study. One parent for each of the intervention arm participants was also recruited (n=30). The intervention arm participants were provided with smartphones on which Tumaini was loaded so that they could play the game at home. Youth completed behavioral surveys at baseline, posttest, and 6-week follow-up. The intervention arm participants provided quantitative feedback on their experience of the game-based intervention at posttest. They and their parents further participated in postintervention focus group discussions. Feasibility-related study metrics were collected on recruitment, enrollment, attrition, safety of participants, and return of phones. RESULTS Recruitment and enrollment of the 60 preadolescents and parents were successfully completed within 18 days. No participants were lost to follow-up: all youth completed all 3 waves of the survey and 27 intervention arm youth and 22 parents and caregivers participated in the focus groups. No safety concerns were reported. All phones were returned after the intervention period; none were damaged or lost. All intervention arm participants initiated gameplay, recording a mean exposure time just under 27 hours. CONCLUSIONS Findings indicate that it is feasible and safe to test a smartphone-based HIV prevention intervention for very young adolescents in urban and peri-urban sub-Saharan Africa by initiating recruitment in schools and temporarily providing youth participants with smartphones on which the game is loaded. A randomized controlled trial powered to assess the efficacy of the game-based intervention is being designed to be carried out in the same geographic area as the pilot, using similar methods. CLINICALTRIAL ClinicalTrials.gov NCT03054051; https://clinicaltrials.gov/ct2/show/NCT03054051 (Archived by WebCite at http://www.webcitation.org/6wjwpX8Bg.) INTERNATIONAL REGISTERED REPOR RR1-10.2196/11209

scholarly journals Effect of a single dose of oral azithromycin on malaria parasitaemia in children: a randomized controlled trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Boubacar Coulibaly ◽  
Ali Sié ◽  
Clarisse Dah ◽  
Mamadou Bountogo ◽  
Mamadou Ouattara ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Childhood Mortality ◽  
Sub Saharan Africa ◽  
Tympanic Temperature ◽  
Malaria Parasitaemia ◽  
Randomized Controlled ◽  
Sub Saharan ◽  
Oral Azithromycin ◽  
Thick Smear

Abstract Background Azithromycin has recently been shown to reduce all-cause childhood mortality in sub-Saharan Africa. One potential mechanism of this effect is via the anti-malarial effect of azithromycin, which may help treat or prevent malaria infection. This study evaluated short- and longer-term effects of azithromycin on malaria outcomes in children. Methods Children aged 8 days to 59 months were randomized in a 1:1 fashion to a single oral dose of azithromycin (20 mg/kg) or matching placebo. Children were evaluated for malaria via thin and thick smear and rapid diagnostic test (for those with tympanic temperature ≥ 37.5 °C) at baseline and 14 days and 6 months after treatment. Malaria outcomes in children receiving azithromycin versus placebo were compared at each follow-up timepoint separately. Results Of 450 children enrolled, 230 were randomized to azithromycin and 220 to placebo. Children were a median of 26 months and 51% were female, and 17% were positive for malaria parasitaemia at baseline. There was no evidence of a difference in malaria parasitaemia at 14 days or 6 months after treatment. In the azithromycin arm, 20% of children were positive for parasitaemia at 14 days compared to 17% in the placebo arm (P = 0.43) and 7.6% vs. 5.6% in the azithromycin compared to placebo arms at 6 months (P = 0.47). Conclusions Azithromycin did not affect malaria outcomes in this study, possibly due to the individually randomized nature of the trial. Trial registration This study is registered at clinicaltrials.gov (NCT03676751; registered 19 September 2018).

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

Manganese and Lipoflavonoid Plus® to Treat Tinnitus: A Randomized Controlled Trial

2016 ◽  
Vol 27 (08) ◽  
pp. 661-668 ◽  
Author(s):  
Eveling Rojas-Roncancio ◽  
Richard Tyler ◽  
Hyung-Jin Jun ◽  
Tang-Chuan Wang ◽  
Haihong Ji ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Control Group ◽  
Randomized Controlled ◽  
Data Collection And Analysis ◽  
Loudness Match ◽  
Minimal Masking Level ◽  
Lost To Follow Up ◽  
To Receive

Background: Several tinnitus sufferers suggest that manganese has been helpful with their tinnitus. Purpose: We tested this in a controlled experiment where participants were committed to taking manganese and Lipoflavonoid Plus® to treat their tinnitus. Research Design: Randomized controlled trial. Study Sample: 40 participants were randomized to receive both manganese and Lipoflavonoid Plus® for 6 months, or Lipoflavonoid Plus® only (as the control). Data Collection and Analysis: Pre- and postmeasures were obtained with the Tinnitus Handicap Questionnaire, Tinnitus Primary Functions Questionnaire, and tinnitus loudness and annoyance ratings. An audiologist performed the audiogram, the tinnitus loudness match, and minimal masking level. Results: Twelve participants were dropped out of the study because of the side effects or were lost to follow-up. In the manganese group, 1 participant (out of 12) showed a decrease in the questionnaires, and another showed a decrease in the loudness and annoyance ratings. No participants from the control group (total 16) showed a decrease in the questionnaires ratings. Two participants in the control group reported a loudness decrement and one reported an annoyance decrement. Conclusions: We were not able to conclude that either manganese or Lipoflavonoid Plus® is an effective treatment for tinnitus.

scholarly journals Does undernutrition increase the risk of lost to follow-up in adults living with HIV in sub-Saharan Africa? Protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e048022
Author(s):  
Animut Alebel ◽  
Daniel Demant ◽  
Pammla Petrucka ◽  
David Sibbritt
Keyword(s):  
Systematic Review ◽  
Effect Size ◽  
Grey Literature ◽  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Significance Level ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Lost To Follow Up

IntroductionUndernutrition is considered a marker for poor prognosis among people living with HIV (PLHIV), particularly in sub-Saharan Africa (SSA), where undernutrition and HIV are both highly prevalent. Evidence suggests that undernutrition (body mass index <18.5 kg/m2) is one of the main factors that significantly increases the risk of lost to follow-up (LTFU) in PLHIV. However, primary studies in SSA have reported inconsistent findings on the relationship between undernutrition and LTFU among adults living with HIV. To the best of our knowledge, no systematic review which aimed to summarise the available evidence. Hence, this review aims to determine the pooled effect of undernutrition on LTFU among adults living with HIV in SSA.Methods and analysisPubMed, EMBASE, Web of Science, Scopus, and, for grey literature, Google Scholar will be systematically searched to include relevant articles published since 2005. Studies reporting the effect of undernutrition on LTFU in adults living with HIV in SSA will be included. The Newcastle-Ottawa Scale will be used for quality assessment. Data from eligible studies will be extracted using a standardised data extraction tool. Heterogeneity between included studies will be assessed using Cochrane Q-test and I2 statistics. The Egger’s and Begg’s tests at a 5% significance level will be used to evaluate publication bias. As heterogeneity is anticipated, the pooled effect size will be estimated using a random-effects model. The final effect size will be reported using the adjusted HR with a 95% CI.Ethics and disseminationEthical approval is not required for a protocol for a systematic review. The results of this systematic review will be published in a peer-reviewed journal and will be publicly available.PROSPERO registration numberCRD42021277741.

scholarly journals Effectiveness of preoperative bath using Chloroxylenol antiseptic soap on the incidence of post emergency Cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a Randomized Controlled trial

2020 ◽  
Author(s):  
Henry Lukabwe ◽  
Rogers Kajabwangu ◽  
Dale Mugisha ◽  
Horace Kizito ◽  
Baraka Munyanderu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Surgical Site Infections ◽  
Referral Hospital ◽  
Sub Saharan Africa ◽  
Regional Referral Hospital ◽  
Randomized Controlled ◽  
Emergency Cesarean ◽  
Sub Saharan

Abstract Introduction: Surgical Site Infections (SSIs) are infections that occur at or near the surgical incision within 30 days of the surgery. SSIs are the commonest form of hospital acquired infections in sub Saharan Africa with estimates between 15%-45%. Cesarean section (CS) is the single most important risk factor for postpartum infections, carrying a 5 to 20-fold increase in the risk of developing sepsis, with an even higher risk when the operation is an emergency. In sub Saharan Africa, the leading cause of maternal mortality is puerperal sepsis. There is a need for simple interventions that can reduce this burden of SSI in the limited resource settings. Therefore, the purpose of this study was to measure the effectiveness of chloroxylenol in reducing the incidence of post Cesarean section surgical site infections at Mbarara Regional Referral Hospital (MRRH).Methods: We conducted a single blinded randomized controlled trial at MRRH maternity ward in which women due for CS were randomized into either control or intervention arms. The intervention was a complete body bath with chloroxylenol antiseptic soap before the operation, while the control arm study participants received a standard pre-operative preparation procedures according to the existing ward protocol. All participants were followed up for 30 days and assessed using a standard SSI screening tool. Results: Ninety-six women were randomized, and 48 were assigned to either arm. The overall incidence of SSI was 30.21%. The incidence of SSI was significantly lower in the intervention compared to the control arm, at 6.25% in the intervention arm versus 54.17% in the control arm (p value<0.001). Chloroxylenol bath was protective of SSI with a 90% risk reduction for SSI (95% confidence interval of 67% – 97%). Conclusion: A preoperative bath with chloroxylenol for pregnant mothers is associated with a significantly lower risk of post Cesarean section surgical site infections. Health facilities with a high burden of post SSI should consider adding this simple and effective intervention to the existing infection prevention measures. Clinical Trials.gov registration (NCT03544710).

Short-term Effects of Calcium and Vitamin D Supplementation in Postmenopausal Hypertensive Patients in sub-Saharan Africa: A Double Blinded Randomized Controlled Trial

2021 ◽  
Vol 1 (3) ◽  
pp. 59-64
Author(s):  
Chris Nadège Nganou-Gnindjio ◽  
Vicky Jocelyne Ama Moor ◽  
Constant Anatole Pieme ◽  
Guy Sadeu Wafeu ◽  
Ingrid Ngandjeu Kamtchoum ◽  
...  
Keyword(s):  
Vitamin D ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Vitamin D Supplementation ◽  
Sub Saharan Africa ◽  
Short Term ◽  
Hypertensive Patients ◽  
Randomized Controlled ◽  
Sub Saharan ◽  
Double Blinded

scholarly journals Effectiveness of preoperative bath using Chloroxylenol antiseptic soap on the incidence of post emergency Cesarean section surgical site infection at Mbarara Regional Referral hospital, Uganda: a Randomized Controlled trial

2020 ◽  
Author(s):  
Henry Lukabwe ◽  
Rodgers Kajabwangu ◽  
Dale Mugisha ◽  
Horace Mayengo ◽  
Baraka Munyanderu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cesarean Section ◽  
Controlled Trial ◽  
Surgical Site Infections ◽  
Sub Saharan Africa ◽  
P Value ◽  
Prevention Measures ◽  
Randomized Controlled ◽  
Emergency Cesarean ◽  
Sub Saharan

Abstract Introduction: Surgical Site Infections (SSIs) are infections that occur at or near the surgical incision within 30 days of the surgery. SSIs are the commonest form of hospital acquired infections in sub Saharan Africa with estimates between 15%-45%. Cesarean delivery is the single most important risk factor for postpartum infections, carrying a 5 to 20-fold increase in the risk of developing sepsis, with an even higher risk when the operation is an emergency. In sub Saharan Africa, the leading cause of maternal mortality is puerperal sepsis. There is a need for simple interventions that can reduce this burden of SSI in the limited resource settings. Therefore, the purpose of this study was to measure the effectiveness of chloroxylenol in reducing the incidence of post Cesarean section surgical site infections at Mbarara Regional Referral Hospital.Methods: We conducted a single blinded randomized controlled trial at MRRH maternity ward in which women due for CS were randomized into either control or intervention arms. The intervention was a complete body bath with chloroxylenol antiseptic soap before the operation, while the control arm study participants received a standard pre-operative preparation procedures according to the existing ward protocol. All participants were followed up for 30 days and assessed using a standard SSI screening tool.Results: Ninety-six women were randomized, and 48 were assigned to either arm. The overall incidence of SSI was 30.21%. The incidence of SSI was significantly lower in the intervention compared to the control arm, at 6.25% in the intervention arm versus 54.17% in the control arm (p value<0.001). Chloroxylenol bath was protective of SSI with a 90% risk reduction for SSI (95% confidence interval of 67% – 97%).Conclusion: A preoperative bath with chloroxylenol for pregnant mothers is associated with a significantly lower risk of post Cesarean section surgical site infections. Health facilities with a high burden of post SSI should consider adding this simple and effective intervention to the existing infection prevention measures. Clinical Trials.gov registration (NCT03544710)

scholarly journals An education session on sickle cell disease with teachers in Lagos, Nigeria: evaluation of a randomized controlled trial

2018 ◽  
Vol 5 (3) ◽  
pp. 115-124
Author(s):  
Bolanle Ola ◽  
Ayoola Olajide ◽  
Segun Olajide ◽  
Iain R. Williamson ◽  
Simon M. Dyson
Keyword(s):  
Randomized Controlled Trial ◽  
Sickle Cell Disease ◽  
Young People ◽  
Sickle Cell ◽  
Controlled Trial ◽  
Intervention Group ◽  
Sub Saharan Africa ◽  
Cell Disease ◽  
Education Session ◽  
Randomized Controlled

Sickle cell disease is a major public health issue in sub-Saharan Africa, with Nigeria having the largest absolute numbers of young people living with sickle cell disease. Research in the Global North suggests that young people with sickle cell disease are not well supported at school, whilst research in the Global South focuses on attitudes to the identification of genetic carriers to prevent births of children with sickle cell disease, rather than support of those with the sickle cell disease condition itself. Between 2015 and 2017 a randomized controlled trial based on one hour education session for school teachers, based on information contained in a guide to school policy on sickle cell disease, was conducted with 402 young people with sickle cell disease across 314 schools in Lagos State, Nigeria. Young people with sickle cell disease in both intervention group and control groups showed significant decreases in the number of days of school absence and in self-reported indicators of lack of support, and significant increases in self-reported indicators of school support. The results suggest a breakdown of the randomization, probably because the young people with sickle cell disease all reacted positively to researchers taking an interest in their welfare in a context where they would usually be heavily stigmatized and would be inclined to hide their sickle cell disease status from others at school. In conclusion, conditions conducive to conducting successful research on sickle cell disease in this context - increased self-esteem in young people with sickle cell disease, reduction in within-school stigmatizing attitudes, and commitment by policy makers to improve the situation of young people in schools – are the very factors that would improve the experiences of young people living with sickle cell disease at school in Lagos, Nigeria. The fact that positive changes did occur warrants further research on this topic.

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