Gates Open Research最新文献

{"title":"Development of a core outcome set for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats.","authors":"Veronica Pingray, Karen Klein, Juan Pedro Alonso, María Belizan, Gabriella Radice, Magdalena Babinska, Mabel Berrueta, Mercedes Bonet","doi":"10.12688/gatesopenres.15136.2","DOIUrl":"10.12688/gatesopenres.15136.2","url":null,"abstract":"<p><strong>Background: </strong>Maternal and perinatal health is often directly and indirectly affected during infectious disease epidemics. Yet, a lack of evidence on epidemics' impact on women and their offspring delays informed decision-making for healthcare providers, pregnant women, women in the post-pregnancy period and policy-makers. To rapidly generate evidence in these circumstances, we aim to develop a Core Outcome Set (COS) for maternal and perinatal health research and surveillance in light of emerging and ongoing epidemic threats.</p><p><strong>Methods: </strong>We will conduct a Systematic Review and a four-stage modified Delphi expert consensus. The systematic literature will aim to inform experts on outcomes reported in maternal and perinatal research and surveillance during previous epidemics. The expert consensus will involve two individual, anonymous online surveys to rate outcomes' importance and suggest new ones, one virtual meeting to discuss disagreements, and one in-person meeting to agree on the final COS, outcomes definitions and measurement methods. Four panels will be established to participate in the modified Delphi with expertise in (a) maternal and perinatal health, (b) neonatal health, (c) public health and emergency response, and (d) representation of civil society. We will recruit at least 20 international experts for each stakeholder group, with diverse backgrounds and gender, professional, and geographic balance. Only highly-rated outcomes (with at least 80% of ratings being 7-9 on a 9-point Likert scale) and no more than 10% of low ratings (1-3) will be included in the final COS.</p><p><strong>Conclusions: </strong>Implementing this COS in future maternal and perinatal research and surveillance, especially in the context of emerging and ongoing epidemic threats, will facilitate the rapid and systematic generation of evidence. It will also enhance the ability of policy-makers, healthcare providers, pregnant women and women in the post-pregnancy period and their families to make well-informed choices in challenging circumstances.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"8 ","pages":"24"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of women's bargaining power within couples on contraceptive use in Cameroon.","authors":"Dimitri Tchakounté Tchuimi, Benjamin Fomba Kamga","doi":"10.12688/gatesopenres.13100.3","DOIUrl":"10.12688/gatesopenres.13100.3","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) and the Health Sector Strategy (2016-2027) focuses on increasing modern contraceptive prevalence as a means to reduce maternal death. This paper identifies women's bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to analyze the association between women's bargaining power within couples and modern contraceptive use.</p><p><strong>Methods: </strong>The data used come from the fifth Demographic and Health Survey (DHS) conducted in 2018. Women's bargaining power within couple is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. The logistic regression model was used to analyze the relationship between WBPCI and modern contraceptive use.</p><p><strong>Results: </strong>The results of the descriptive statistics show that women's bargaining power is higher among women who use contraception than for those who do not. The results of the logistic regression model show that an increase of WBPCI was significantly associated with higher chances of using a modern contraceptive method (OR = 1.352; 95% CI: 1.257, 1.454; p <0.01). The education of women is also a key determinant since educated women were at least two times more likely to use a modern contraceptive method than uneducated women.</p><p><strong>Conclusions: </strong>To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself, but should also focus on social policies to empower women in the household.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"4 ","pages":"20"},"PeriodicalIF":0.0,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraceptive access and use before and during the COVID-19 pandemic: a mixed-methods study in South Africa and Zambia.","authors":"Rebecca L Callahan, Alice F Cartwright, Mags Beksinska, Margaret Kasaro, Jennifer H Tang, Cecilia Milford, Christina Wong, Marissa Velarde, Virginia Maphumulo, Maria Fawzy, Manze Chinyama, Esther Chabu, Mayaba Mudenda, Jennifer Smit","doi":"10.12688/gatesopenres.14590.1","DOIUrl":"10.12688/gatesopenres.14590.1","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected global access to health services, including contraception We sought to explore effects of the pandemic on family planning (FP) service provision and use in South Africa and Zambia, including on implant and intrauterine device (IUD) users' desire and ability to obtain removal.</p><p><strong>Methods: </strong>Between August 2020 and April 2021, we conducted surveys with 537 women participating in an ongoing longitudinal contraceptive continuation study. We also carried out in-depth interviews with 39 of the survey participants and 36 key informants involved in FP provision. We conducted descriptive analysis of survey responses and thematic analysis of interviews.</p><p><strong>Results: </strong>Contraceptive use changed minimally in this sample with the emergence of COVID-19. Fewer than half of women (n=220) reported that they tried to access FP since the start of the pandemic. The vast majority of those seeking services were using short-acting methods and 95% were able to obtain their preferred method. The proportion of women not using a method before and after the start of the pandemic did not change in Zambia (31%), and increased from 8% to 10% in South Africa. Less than 7% of implant or IUD users in either country reported wanting removal. Among the 22 who sought removal, 10 in Zambia and 6 in South Africa successfully obtained removal. In qualitative interviews, those reporting challenges to service access specifically mentioned long queues, deprioritization of contraceptive services, lack of transportation, stock-outs, and fear of contracting COVID-19 at a facility. Key informants reported stock-outs, especially of injectables, and staff shortages as barriers.</p><p><strong>Conclusions: </strong>We did not find a substantial impact of COVID-19 on contraceptive access and use among this sample; however, providers and others involved in service provision identified risks to continuity of care. As the COVID-19 pandemic wanes, it continues to be important to monitor people's ability to access their preferred contraceptive methods.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":" ","pages":"61"},"PeriodicalIF":0.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45501849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>TitrationAnalysis</i>: a tool for high throughput binding kinetics data analysis for multiple label-free platforms.","authors":"Kan Li, Richard H C Huntwork, Gillian Q Horn, S Munir Alam, Georgia D Tomaras, S Moses Dennison","doi":"10.12688/gatesopenres.14743.2","DOIUrl":"10.12688/gatesopenres.14743.2","url":null,"abstract":"<p><p>Label-free techniques including Surface Plasmon Resonance (SPR) and Biolayer Interferometry (BLI) are biophysical tools widely used to collect binding kinetics data of bimolecular interactions. To efficiently analyze SPR and BLI binding kinetics data, we have built a new high throughput analysis tool named the <i>TitrationAnalysis</i>. It can be used as a package in the Mathematica scripting environment and ultilize the non-linear curve-fitting module of Mathematica for its core function. This tool can fit the binding time course data and estimate association and dissociation rate constants ( <i>k _a</i> and <i>k _d</i> respectively) for determining apparent dissociation constant ( <i>K _D</i> ) values. The high throughput fitting process is automatic, requires minimal knowledge on Mathematica scripting and can be applied to data from multiple label-free platforms. We demonstrate that the <i>TitrationAnalysis</i> is optimal to analyze antibody-antigen binding data acquired on Biacore T200 (SPR), Carterra LSA (SPR imaging) and ForteBio Octet Red384 (BLI) platforms. The <i>k _a</i> , <i>k _d</i> and <i>K _D</i> values derived using <i>TitrationAnalysis</i> very closely matched the results from the commercial analysis software provided specifically for these instruments. Additionally, the <i>TitrationAnalysis</i> tool generates user-directed customizable results output that can be readily used in downstream Data Quality Control associated with Good Clinical Laboratory Practice operations. With the versatility in source of data input source and options of analysis result output, the <i>TitrationAnalysis</i> high throughput analysis tool offers investigators a powerful alternative in biomolecular interaction characterization.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":" ","pages":"107"},"PeriodicalIF":0.0,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10667272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47965964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden, causes, and risk factors of perinatal mortality in Eastern Africa: a protocol for systematic review and meta-analysis.","authors":"Yohanis Alemeshet Asefa, Lars Åke Persson, Anna C Seale, Nega Assefa","doi":"10.12688/gatesopenres.13915.2","DOIUrl":"10.12688/gatesopenres.13915.2","url":null,"abstract":"<p><strong>Background: </strong>Although global mortality rates in children under 5 years have decreased substantially in the last 30 years, there remain around 2.6 million stillbirths and 2.9 million neonatal deaths each year. The majority of these deaths occur in Africa and South Asia. To reduce perinatal deaths in East Africa, knowledge of the burden, but also the risk factors and causes of perinatal deaths are crucial. To the best of our knowledge, reviews have previously focused on the burden of perinatal deaths; here we aim to synthesize evidence on the burden, causes, and risk factors for perinatal mortality in East Africa.</p><p><strong>Methods: </strong>We will conduct a systematic literature search in Medline, Web of Science, EMBASE, Global Health, SCOPUS, Cochrane Library, CINAHL, HINARI, African Index Medicus, African Journals Online (AJOL), and WHO African Regional Office (AFRO) Library. The study population includes all fetuses and newborns from ≥22 weeks of gestation (birth weight ≥500gm) to 7 days after birth, with reported causes or/and determinants as exposure, and perinatal mortality (stillbirths and/or early neonatal deaths) as an outcome. We will include studies from 2010 to 2022, and to facilitate the inclusion of up-to-date data, we will request recent data from ongoing surveillance in the region. To assess the quality of included studies, we will use the Joanna Briggs Institute quality assessment tool for observational and trial studies. We will analyze the data using STATA version 17 statistical software and assess heterogeneity and publication bias by Higgins' I ² and funnel plot, respectively.</p><p><strong>Conclusions: </strong>This systematic review will search for published studies, and seek unpublished data, on the burden, causes, and risk factors of perinatal mortality in East Africa. Findings will be reported, and gaps in the evidence base identified, with recommendations, with the ultimate aim of reducing perinatal deaths.</p><p><strong>Protocol registration: </strong>PROSPERO-CRD42021291719.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"123"},"PeriodicalIF":0.0,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strengths and weaknesses of the South-South Learning Exchange: a qualitative analysis of experts' perspectives.","authors":"Isotta Triulzi, Rita Kabra, Komal Preet Allagh, James Kiarie","doi":"10.12688/gatesopenres.14699.2","DOIUrl":"10.12688/gatesopenres.14699.2","url":null,"abstract":"<p><strong>Background: </strong>South-South learning exchange (SSLE) refers to an interactive learning process where peers exchange knowledge and experience to work towards a beneficial change. Despite organizations having recently increased the opportunity to run SSLEs, the SSLE support mechanisms and processes are not well documented in the scientific literature. This study explored experts' perspectives on SSLEs, strengths, weaknesses and mechanisms leading to sustainable outcomes.</p><p><strong>Methods: </strong>We conducted a qualitative study using semi-structured interviews on experiences of participants and organizers of SSLEs. Data were collected between 1st September 2021 to 26th November 2021. All data were digitally recorded, transcribed verbatim, and analysed. In the analysis, we adopted an inductive approach derived from thematic analysis.</p><p><strong>Results: </strong>Sixteen experts, who have participated in or facilitated one or more SSLE, were interviewed. The experts' accounts demonstrated an appreciation of participants' empowerment, positive peer-to-peer \"mind change\" and convincing and powerful hands-on learning of this approach as strengths in the implementation of the SSLE. Being resource heavy, participant and donor reluctance and absence of a validated methodology emerged as main weaknesses of the South-South learning approach, which could impair the effectiveness of this scheme.</p><p><strong>Conclusions: </strong>The strengths of SSLEs are anchored in the theories of experiential and social learning, highlighting SSLE's potential to create an environment that enhances knowledge exchange. the study highlights the challenges SSLE initiatives face. In particular, these include limited commitment and funds, limited evidence of impact, disparate approaches, and the absence of standardized guidelines and evaluation practices.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"116"},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How resilient were family planning programs during the COVID-19 pandemic?  Evidence from 70 countries.","authors":"Karen Hardee, Rebecca Rosenberg, John Ross, Imelda Zosa-Feranil","doi":"10.12688/gatesopenres.14856.2","DOIUrl":"10.12688/gatesopenres.14856.2","url":null,"abstract":"<p><strong>Background: </strong>At the beginning of the COVID-19 pandemic fears of severe disruptions to family planning (FP) and access to services abounded. This paper uses a unique data source, a special Supplement added to the 2021 round of the National Composite Index for Family Planning (NCIFP), to assess in depth the resilience of FP programs in the face of the COVID-19 pandemic across 70 countries spanning six regions.</p><p><strong>Methods: </strong>The 2021 NCIFP included 961 key informants who were asked questions to assess interference in the countries' ability to achieve objectives, ability to maintain commitment to FP, and availability of information and services. Open ended responses added context.</p><p><strong>Results: </strong>All programs were affected; the magnitude of effects varies by region and country. While the average resilience score, at 47 out of 100, implies middling levels of resilience, further analysis showed that despite interference in many components of programming, with some exceptions, the COVID-19 pandemic generally did not diminish government commitment to FP and programs remained resilient in providing access to services. Common themes mentioned by 178 respondents (18.5% of respondents) included: fear of infection; disruption of services / difficulty with lockdown and travel restrictions; staff / facilities diverted to COVID-19; access to reproductive health services and contraceptive methods affected; shifts in services / outreach; interference with logistics & supplies, training & supervision, and M&E; lack of attention to FP/sexual reproductive health; financing reduced or diverted; and effects on existing partnerships. A strong enabling environment for FP, which the NCIFP is designed to measure, was positively correlated with continued government commitment and access to contraceptive methods during COVID-19.</p><p><strong>Conclusion: </strong>These findings are instructive for programming: it will face challenges and 'interference' when unanticipated shocks like COVID-19 occur, with strong FP programs best prepared to exhibit resilience.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"121"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding options for HIV testing: A process evaluation of a community-led HIV self-testing intervention among men who have sex with men in Kenya.","authors":"Memory Melon, Bernadette Kombo, Mary Mugambi, Margaret Njiraini, Kennedy Olango, Manas Migot, Samuel Kuria, Martin Kyana, Peter Mwakazi, Japheth Kioko, Shem Kaosa, Maria Mensah, Matthew Thomann, Janet Musimbi, Helgar Musyoki, Parinita Bhattacharjee, Robert Lorway, Lisa Lazarus","doi":"10.12688/gatesopenres.14819.2","DOIUrl":"10.12688/gatesopenres.14819.2","url":null,"abstract":"<p><strong>Background: </strong>Men who have sex with men (MSM) in Kenya continue to face barriers to HIV testing, which leads to delays in HIV prevention and care. An HIV self-testing (HIVST) intervention was implemented in three Kenyan counties to increase coverage and frequency of HIV testing among MSM communities with high HIV prevalence. The evaluation study examined how HIVST can increase testing among MSM who are unaware of their status by increasing coverage, frequency, and early uptake of testing and support linkages to prevention and treatment. We share results from the process evaluation of the intervention implemented in partnership with MSM-led organizations.</p><p><strong>Methods: </strong>For a 12-month period between August 2019 and July 2020, the project team conducted in-depth interviews with HIVST users, monthly meetings with programme implementation teams, and monthly monitoring data reviews. Polling booth surveys were also conducted with participants. The process evaluation explored the fidelity, feasibility, coverage, acceptability, quality, and effectiveness of the HIVST intervention.</p><p><strong>Results: </strong>An average of 793 MSM received 1,041 HIVST kits on a monthly basis through different distribution channels. Of those who received HIVST kits, 67% were distributed to infrequent testers and non-testers. Testing frequency among users increased to 82% for those who had a recent test during the previous three months, compared to 58% of HIVST non-users. There was a high linkage to care and treatment services (84%) among those who tested reactive for HIV at endline. MSM shared preferring HIVST kits because of its convenience and privacy. During the COVID-19 pandemic, adaptations to the intervention were made to support ongoing HIV testing and linkages to services.</p><p><strong>Conclusion: </strong>The introduction of HIVST in MSM-led HIV prevention programmes was feasible with high acceptability. The involvement of the MSM community in the design, implementation and evaluation of the intervention was a key factor to intervention success.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"7 ","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2024-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11259586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasopharyngeal Dysbiosis Precedes the Development of Lower Respiratory Tract Infections in Young Infants, a Longitudinal Infant Cohort Study.","authors":"Rotem Lapidot, Tyler Faits, Arshad Ismail, Mushal Allam, Zamantungwak Khumalo, William MacLeod, Geoffrey Kwenda, Zachariah Mupila, Ruth Nakazwe, Daniel Segrè, William Evan Johnson, Donald M Thea, Lawrence Mwananyanda, Christopher J Gill","doi":"10.12688/gatesopenres.13561.2","DOIUrl":"10.12688/gatesopenres.13561.2","url":null,"abstract":"<p><strong>Background: </strong>Infants suffering from lower respiratory tract infections (LRTIs) have distinct nasopharyngeal (NP) microbiome profiles that correlate with severity of disease. Whether these profiles precede the infection or are a consequence of it, is unknown. In order to answer this question, longitudinal studies are needed.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of NP samples collected in a longitudinal birth cohort study of Zambian mother-infant pairs. Samples were collected every two weeks from 1-week through 14-weeks of age. Ten of the infants in the cohort who developed LRTI were matched 1:3 with healthy comparators. We completed 16S rRNA gene sequencing on the samples each of these infants contributed and compared the NP microbiome of the healthy infants to infants who developed LRTI.</p><p><strong>Results: </strong>The infant NP microbiome maturation was characterized by transitioning from <i>Staphylococcus</i> dominant to respiratory-genera dominant profiles during the first three months of life, similar to what is described in the literature. Interestingly, infants who developed LRTI had distinct NP microbiome characteristics before infection, in most cases as early as the first week of life. Their NP microbiome was characterized by the presence of <i>Novosphingobium, Delftia</i>, high relative abundance of <i>Anaerobacillus, Bacillus</i>, and low relative abundance of <i>Dolosigranulum,</i> compared to the healthy controls. Mothers of infants with LRTI also had low relative abundance of <i>Dolosigranulum</i> in their baseline samples compared to mothers of infants that did not develop an LRTI.</p><p><strong>Conclusions: </strong>Our results suggest that specific characteristics of the NP microbiome precede LRTI in young infants and may be present in their mothers as well. Early dysbiosis may play a role in the causal pathway leading to LRTI or could be a marker of underlying immunological, environmental, or genetic characteristics that predispose to LRTI.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"48"},"PeriodicalIF":0.0,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11266592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and experiences of intravenous iron treatment for anaemia in pregnancy in Malawi: a formative qualitative study.","authors":"Lucinda Manda-Taylor, Macdonald Kufankomwe, Gertrude Chatha, Effie Chipeta, Elisabeth Mamani-Mategula, Martin N Mwangi, Magaret Kelaher, Khic-Houy Prang, Ricardo Ataíde, Sant-Rayn Pasricha, Kamija Samuel Phiri","doi":"10.12688/gatesopenres.13631.4","DOIUrl":"10.12688/gatesopenres.13631.4","url":null,"abstract":"<p><strong>Background: </strong>The study objective was to explore opinions, identify experiences, and describe perspectives on the acceptability of intravenous (IV) iron to treat anaemia in pregnancy and identify potential barriers and facilitators of introducing IV iron in the Malawian healthcare system.</p><p><strong>Methods: </strong>We conducted 15 in-depth interviews and two focus group discussions with pregnant women, and seven in-depth interviews with health workers at a community-based health centre in Blantyre and a tertiary hospital in Zomba.</p><p><strong>Results: </strong>Most women who used IV iron treatment during the second trimester of pregnancy reported feeling better and stronger after receiving the intervention. Women perceived that IV iron treatment worked faster than oral iron tablets and increased their haemoglobin count. However, cultural beliefs that IV iron treatment will cause miscarriage and the perception that study procedures involved Satanism and vampirism practices were barriers to acceptability. Health workers found IV iron treatment easy to administer because it is a single-dose treatment, simultaneously reducing the burden for pregnant women taking daily oral iron tablets. However, health workers expressed concerns about the costs and the need to train health workers before the large-scale implementation and integration of IV iron treatment into Malawi's routine care.</p><p><strong>Conclusions: </strong>Despite the perceived concerns and challenges experienced in participating in the first IV iron infusion trial in Malawi, participants' reflections suggest that IV iron infusion is acceptable for treating iron-deficiency anaemia in pregnancy. Participant advocate groups can offer a peer-to-peer education approach to sensitize and engage community members on the benefits of treatment and dispel concerns when the country contemplates integrating IV iron infusion for treating anaemia in pregnancy in Malawi.</p>","PeriodicalId":12593,"journal":{"name":"Gates Open Research","volume":"6 ","pages":"66"},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10917769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}