Faculty Opinions recommendation of Evaluation of near point-of-care viral load implementation in public health facilities across seven countries in sub-Saharan Africa.

BackgroundHIV, diabetes and hypertension have a high disease burden in sub-Saharan Africa. Healthcare is organised in separate clinics, which may be inefficient. In a cohort study, we evaluated integrated management of these conditions from a single chronic care clinic.ObjectivesTo determined the feasibility and acceptability of integrated management of chronic conditions in terms of retention in care and clinical indicators.Design and settingProspective cohort study comprising patients attending 10 health facilities offering primary care in Dar es Salaam and Kampala.InterventionClinics within health facilities were set up to provide integrated care. Patients with either HIV, diabetes or hypertension had the same waiting areas, the same pharmacy, were seen by the same clinical staff, had similar provision of adherence counselling and tracking if they failed to attend appointments.Primary outcome measuresRetention in care, plasma viral load.FindingsBetween 5 August 2018 and 21 May 2019, 2640 patients were screened of whom 2273 (86%) were enrolled into integrated care (832 with HIV infection, 313 with diabetes, 546 with hypertension and 582 with multiple conditions). They were followed up to 30 January 2020. Overall, 1615 (71.1%)/2273 were female and 1689 (74.5%)/2266 had been in care for 6 months or more. The proportions of people retained in care were 686/832 (82.5%, 95% CI: 79.9% to 85.1%) among those with HIV infection, 266/313 (85.0%, 95% CI: 81.1% to 89.0%) among those with diabetes, 430/546 (78.8%, 95% CI: 75.4% to 82.3%) among those with hypertension and 529/582 (90.9%, 95% CI: 88.6 to 93.3) among those with multimorbidity. Among those with HIV infection, the proportion with plasma viral load <100 copies/mL was 423(88.5%)/478.ConclusionIntegrated management of chronic diseases is a feasible strategy for the control of HIV, diabetes and hypertension in Africa and needs evaluation in a comparative study.

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A spatial database of health facilities managed by the public health sector in sub Saharan Africa

Scientific Data ◽

10.1038/s41597-019-0142-2 ◽

2019 ◽

Vol 6 (1) ◽

Cited By ~ 29

Author(s):

Joseph Maina ◽

Paul O. Ouma ◽

Peter M. Macharia ◽

Victor A. Alegana ◽

Benard Mitto ◽

...

Keyword(s):

Public Health ◽

Spatial Database ◽

Health Sector ◽

Health Facilities ◽

Sub Saharan Africa ◽

The Public ◽

Public Health Sector ◽

Sub Saharan

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Point-of-Care Viral Load Testing for Sub-Saharan Africa: Informing a Target Product Profile

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw161 ◽

2016 ◽

Vol 3 (3) ◽

Cited By ~ 12

Author(s):

Andrew N. Phillips ◽

Valentina Cambiano ◽

Fumiyo Nakagawa ◽

Deborah Ford ◽

Tsitsi Apollo ◽

...

Keyword(s):

Viral Load ◽

Point Of Care ◽

Sub Saharan Africa ◽

Load Testing ◽

Viral Load Testing ◽

Trade Offs ◽

Art Program ◽

Product Profile ◽

Load Tests ◽

Sub Saharan

Abstract Point-of-care viral load tests are being developed to monitor patients on antiretroviral therapy (ART) in sub-Saharan Africa. Test design involves trade-offs between test attributes, including accuracy, complexity, robustness, and cost. We used a model of the human immunodeficiency virus epidemic and ART program in Zimbabwe and found that the attributes of a viral load testing approach that are most influential for cost effectiveness are avoidance of a high proportion of failed tests or results not received, use of an approach that best facilitates retention on ART, and the ability to facilitate greater use of differentiated care, including through expanding coverage of testing availability.

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Determining virological suppression and resuppression by point-of-care viral load testing in a HIV care setting in sub-Saharan Africa

EClinicalMedicine ◽

10.1016/j.eclinm.2019.12.001 ◽

2020 ◽

Vol 18 ◽

pp. 100231

Author(s):

Giovanni Villa ◽

Adam Abdullahi ◽

Dorcas Owusu ◽

Colette Smith ◽

Marilyn Azumah ◽

...

Keyword(s):

Viral Load ◽

Care Setting ◽

Point Of Care ◽

Virological Suppression ◽

Sub Saharan Africa ◽

Hiv Care ◽

Load Testing ◽

Viral Load Testing ◽

Sub Saharan

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Application of a public health strategy to large-scale point-of-care screening for sickle cell disease in rural sub-Saharan Africa

Blood Advances ◽

10.1182/bloodadvances.2018gs112321 ◽

2018 ◽

Vol 2 (Supplement_1) ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

C. Chunda-Liyoka ◽

A. A. Kumar ◽

P. Sambo ◽

F. Lubinda ◽

L. Nchimba ◽

...

Keyword(s):

Public Health ◽

Sickle Cell Disease ◽

Large Scale ◽

Point Of Care ◽

Sub Saharan Africa ◽

Public Health Strategy ◽

Cell Disease ◽

Health Strategy ◽

Scale Point ◽

Sub Saharan

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Health Systems’ Preparedness to Provide Post-abortion Care: Assessment of Health Facilities in Burkina Faso, Kenya and Nigeria

10.21203/rs.3.rs-769638/v1 ◽

2021 ◽

Author(s):

Kenneth Okoth Juma ◽

Ramatou Ouedraogo ◽

Joshua-Amo Adjei ◽

Ali Sie ◽

Mamadou Ouattara ◽

...

Keyword(s):

Public Health ◽

Burkina Faso ◽

Health Facilities ◽

Sub Saharan Africa ◽

Unsafe Abortion ◽

Public Health Facilities ◽

Abortion Care ◽

Post Abortion Care ◽

Care Assessment ◽

Post Abortion

Abstract Background: In many parts of sub-Saharan Africa (SSA), access to abortion is legally restricted, which partly contributes to high incidence of unsafe abortion. This may result in unsafe abortion-related complications that demand long hospital stays, treatment and attendance by skilled health providers. There is however, limited evidence on the capacity of public health facilities to deliver post-abortion care (PAC) in these settings. We describe and discuss the preparedness and capacity of public health facilities to deliver complete and quality PAC services in Burkina Faso, Kenya and Nigeria. Methods: A cross-sectional survey of primary, secondary and tertiary-level public health facilities was conducted between November 2018 and February 2019 in the three countries. Data on signal functions for measuring the ability of health facilities to provide post-abortion services were collected and analyzed. These data included information on essential PAC equipment and supplies, PAC staffing and training among others. Results: Across the three countries, fewer primary health facilities (ranging from 4.3%–12.2% in Kenya and Burkina Faso) had the capacity to deliver on all components of basic PAC services. Only one in three (30–33%) of referral facilities across Burkina Faso, Kenya and Nigeria could provide comprehensive PAC services. Lack of trained staff, absence of necessary equipment and lack of PAC commodities and supplies were a main reason for inability to deliver specific PAC services (such as surgical procedures for abortion complications, blood transfusion and post-PAC contraceptive counselling). Further, the lack of capacity to refer acute PAC cases to higher-level facilities was identified as a key weakness in provision of post-abortion care services. Conclusions: Our findings reveal considerable gaps and weaknesses in the delivery of basic and comprehensive PAC within the three countries. There is need for increased investments by governments to strengthen capacity of primary, secondary and tertiary public health facilities to deliver quality PAC services.

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Evaluation of the Malaria Surveillance System in Kaduna State, Nigeria 2016

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7775 ◽

2017 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Baffa S. Ibrahim ◽

Aisha A. Abubakar ◽

Ummulkhulthum A. Bajoga ◽

Patrick M. Nguku

Keyword(s):

Public Health ◽

Surveillance System ◽

Health Facilities ◽

Sub Saharan Africa ◽

Malaria Surveillance ◽

Case Definitions ◽

Malaria Burden ◽

Mortality Case ◽

Sub Saharan ◽

Public Health Surveillance System

ObjectiveTo describe the process of operation of the system and assessits key attributes, to determine the effectiveness and efficiency ofthe surveillance system and make appropriate recommendations tostakeholders for its improvement.IntroductionMalaria is a parasitic disease caused by Plasmodium falciparum.About 3.2 billion people worldwide are at risk of malaria.1Childrenand pregnant women are particularly vulnerable to the disease. Sub-Saharan Africa carries a high share of the global malaria burden.2Effective malaria surveillance system is essential in the control andelimination of malaria. Worldwide, there were an estimated 198million cases of malaria in 2013 and 584,000 deaths.1,3,4MethodsThis study was conducted using the “CDC’s Updated Guidelinesfor Evaluating Public Health Surveillance System, 2001”. Keystakeholders and Malaria Focal Persons were interviewed. IntegratedDisease Surveillance and Response case summary data from Januaryto December 2014 was reviewed. Data analysis was done usingMicrosoft Excel 2016 and Epi-info 7.ResultsThe system provides information on malaria trends, morbidityand mortality. Case definitions are well understood by participants.All Malaria focal persons (MFPs) were willing to continue usingthe system. Standardized data collection tools are available in 91%of Health Facilities (HF). The system was rated flexible by 91%of MFPs. The system was however not representative because datawere essentially from public health facilities only. The system hasan average timeliness of 37.7% and completeness of 59.4%, bothparameters were below the State’s 80% target. About 91% MFPs hadrefresher training, while 78% MFPs received supportive supervision.Main challenges identified were lack of commodities in all HFs, andinadequate mobile facilities in 70% of HFs.ConclusionsThe Kaduna state Malaria surveillance system is meeting itsobjectives. However, challenges are observed in its timeliness,representativeness, and data quality. Efforts should be made tointegrate tertiary and private health facilities into the system. MFPsneed more training on malaria reporting to improve timeliness anddata quality. There is the need to improve on the supply of malariatreatment commodities to all health facilities within Kaduna state.

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