Open research Africa最新文献

{"title":"Barriers and facilitators to maternal death surveillance and response at a busy urban National Referral Hospital in Uganda.","authors":"Imelda Namagembe,&nbsp;Jolly Beyeza-Kashesya,&nbsp;Joseph Rujumba,&nbsp;Dan K Kaye,&nbsp;Moses Mukuru,&nbsp;Noah Kiwanuka,&nbsp;Ashley Moffett,&nbsp;Annettee Nakimuli,&nbsp;Josaphat Byamugisha","doi":"10.12688/openresafrica.13438.2","DOIUrl":"https://doi.org/10.12688/openresafrica.13438.2","url":null,"abstract":"<p><p><b>Background:</b> Preventable maternal and newborn deaths remain a global concern, particularly in low- and- middle-income countries (LMICs) Timely maternal death surveillance and response (MDSR) is a recommended strategy to account for such deaths through identifying contextual factors that contributed to the deaths to inform recommendations to implement in order to reduce future deaths. Implementation of MDSR is still suboptimal due to barriers such as inadequate skills and leadership to support MDSR. With the leadership of WHO and UNFPA, there is momentum to roll out MDSR, however, the barriers and enablers for implementation have received limited attention. These have  implications for successful implementation. The aim of this study was: To assess barriers and facilitators to implementation of MDSR at a busy urban National Referral Hospital as perceived by health workers, administrators, and other partners in Reproductive Health. <b>Methods:</b> Qualitative study using in-depth interviews (24), 4 focus-group discussions with health workers, 15 key-informant interviews with health sector managers and implementing partners in Reproductive-Health. We conducted thematic analysis drawing on the Theory of Planned Behaviour (TPB).   <b>Results:</b> The major barriers to implementation of MDSR were: inadequate knowledge and skills; fear of blame / litigation; failure to implement recommendations; burn out because of workload   and inadequate leadership- to support health workers. Major facilitators were involving all health workers in the MDSR process, eliminate blame, strengthen leadership, implement recommendations from MDSR and functionalize lower health facilities (especially Health Centre -IVs). <b>Conclusions:</b> The barriers of MDSR include knowledge and skills gaps, fear of blame and litigation, and other health system factors such as erratic emergency supplies, and leadership/governance challenges. <b>Recommendation</b>: Efforts to strengthen MDSR for impact should use health system responsiveness approach to address the barriers identified, constructive participation of health workers to harness the facilitators and addressing the required legal framework.</p>","PeriodicalId":74358,"journal":{"name":"Open research Africa","volume":"5 ","pages":"31"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10280031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9712084","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":"No association between fertility desire and HIV infections among men and women: Findings from community-based studies before and after implementation of an early antiretroviral therapy (ART) initiation program in the rural district of North-western Tanzania.","authors":"Denna Mkwashapi,&nbsp;Jim Todd,&nbsp;Michael Mahande,&nbsp;John Changalucha,&nbsp;Mark Urassa,&nbsp;Milly Marston,&nbsp;Jenny Renju","doi":"10.12688/openresafrica.13432.1","DOIUrl":"https://doi.org/10.12688/openresafrica.13432.1","url":null,"abstract":"<p><p><b>Background:</b> Fertility is associated with the desire to have children. The impacts of HIV and antiretroviral therapy (ART) on fertility are well known, but their impacts on the desire for children are less well known in Tanzania. We used data from two studies carried out at different periods of ART coverage in rural Tanzania to explore the relationship between HIV infection and fertility desires in men and women. <b>Methods:</b> We conducted secondary data analysis of the two community-based studies conducted in 2012 and 2017 in the Magu Health and Demographic system site, in Tanzania. Information on fertility desires, HIV status, and social-economic and demographic variables were analyzed. Fertility desire was defined as whether or not the participant wanted to bear a child in the next two years. The main analysis used log-binomial regression to assess the association between fertility desire and HIV infection. <b>Results:</b> In the 2012 study, 43% (95% CI 40.7-45.3) of men and 33.3% (95% CI 31.8 - 35.0) women wanted another child in the next two years. In 2017 the percentage rose to 55.7% (95% CI 53.6 - 57.8) in men and 41.5% (95% CI 39.8 - 43.1) in women. Although fertility desire in men and women were higher in HIV uninfected compared to HIV infected, age-adjusted analysis did not show a statistical significance difference in both studies (2012: PR=1.02, 95%CI 0.835 - 1.174, p<0.915 and 2017: PR = 0.90 95%CI 0.743 - 1.084 p= 0.262). <b>Discussion:</b> One-third of women and forty percent of men desired for fertility in 2012, while forty percent of women and nearly half of men desired for fertility in 2017. The data showed fertility desire, in 2012 and 2017 were not related to HIV infection in both periods of ART coverage.</p>","PeriodicalId":74358,"journal":{"name":"Open research Africa","volume":"5 ","pages":"30"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039809","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":"Molecular detection of novel <i>Anaplasma</i> sp <i>.</i> and zoonotic hemopathogens in livestock and their hematophagous biting keds (genus <i>Hippobosca</i>) from Laisamis, northern Kenya.","authors":"Daniel M Mwaki,&nbsp;Kevin O Kidambasi,&nbsp;Johnson Kinyua,&nbsp;Kenneth Ogila,&nbsp;Collins Kigen,&nbsp;Dennis Getange,&nbsp;Jandouwe Villinger,&nbsp;Daniel K Masiga,&nbsp;Mark Carrington,&nbsp;Joel L Bargul","doi":"10.12688/openresafrica.13404.1","DOIUrl":"https://doi.org/10.12688/openresafrica.13404.1","url":null,"abstract":"<p><p><b>Background:</b> Livestock are key sources of livelihood among pastoral communities. Livestock productivity is chiefly constrained by pests and diseases. Due to inadequate disease surveillance in northern Kenya, little is known about pathogens circulating within livestock and the role of livestock-associated biting keds (genus <i>Hippobosca</i>) in disease transmission. We aimed to identify the prevalence of selected hemopathogens in livestock and their associated blood-feeding keds. <b>Methods:</b> We randomly collected 389 blood samples from goats (245), sheep (108), and donkeys (36), as well as 235 keds from both goats and sheep (116), donkeys (11), and dogs (108) in Laisamis, Marsabit County, northern Kenya. We screened all samples for selected hemopathogens by high-resolution melting (HRM) analysis and sequencing of PCR products amplified using primers specific to the genera: <i>Anaplasma, Trypanosoma, Clostridium, Ehrlichia, Brucella, Theileria,</i> and <i>Babesia.</i> <b>Results:</b> In goats, we detected <i>Anaplasma ovis</i> (84.5%), a novel <i>Anaplasma</i> sp. (11.8%), <i>Trypanosoma vivax</i> (7.3%), <i>Ehrlichia canis</i> (66.1%), and <i>Theileria ovis</i> (0.8%). We also detected <i>A. ovis</i> (93.5%), <i>E. canis</i> (22.2%), and <i>T. ovis</i> (38.9%) in sheep. In donkeys, we detected ' <i>Candidatus</i> Anaplasma camelii' (11.1%), <i>T. vivax</i> (22.2%), <i>E. canis</i> (25%), and <i>Theileria equi</i> (13.9%). In addition, keds carried the following pathogens; goat/sheep keds - <i>T. vivax</i> (29.3%) <i>, Trypanosoma evansi</i> (0.86%), <i>Trypanosoma godfreyi</i> (0.86%), and <i>E. canis</i> (51.7%); donkey keds - <i>T. vivax</i> (18.2%) and <i>E. canis</i> (63.6%); and dog keds - <i>T. vivax</i> (15.7%), <i>T. evansi</i> (0.9%), <i>Trypanosoma simiae</i> (0.9%) <i>,</i> <i>E. canis</i> (76%), <i>Clostridium perfringens</i> (46.3%), <i>Bartonella</i> <i>schoenbuchensis</i> (76%), and <i>Brucella abortus</i> (5.6%). <b>Conclusions:</b> We found that livestock and their associated ectoparasitic biting keds carry a number of infectious hemopathogens, including the zoonotic <i>B. abortus</i>. Dog keds harbored the most pathogens, suggesting dogs, which closely interact with livestock and humans, as key reservoirs of diseases in Laisamis. These findings can guide policy makers in disease control.</p>","PeriodicalId":74358,"journal":{"name":"Open research Africa","volume":"5 ","pages":"23"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9791675","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":"Preferences and Expectations of Feedback of Individual Genetic Research Results in African Genomics: Views of South African Parents of Children With Neurodevelopmental Conditions","authors":"O. Matshabane, Cleo A Albertus, Marlyn C. Faure, D. Ralefala, K. Donald, A. Wonkam, J. D. Vries","doi":"10.21203/rs.3.rs-107280/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-107280/v1","url":null,"abstract":"\u0000 BackgroundGenomic medicine is expanding at an exponential pace across the globe and increased access to genome analysis has led to greater generations of genetic results with specific relevance to individuals. AimThis study aims to explore preferences and expectations of feedback of individual genetic research results among parents of children with neurodevelopmental conditions. MethodsFollowing a qualitative approach, we conducted four deliberative focus group discussions with (n=27) South African parents of children involved in genomics research on neurodevelopmental conditions. ResultsMost participants expressed a strong interest in receiving individual genetic results regardless of severity, actionability and preventability. These results were viewed as valuable because they could empower or emancipate individuals, families and communities. Receiving risk information was also believed to motivate healthier lifestyle choices. However, some participants were uncertain or articulated a desire not to receive results due to fears of anxiety or psychological harm. In addition, participants expected to receive results as a demonstration of respect from researchers and articulated it as an act to build trust between researchers and participants. ConclusionsInternationally, a debate continues around whether individual genetic results should or should not be fed back to participants of research studies. In Africa, there is scant literature which has investigated this question and no policies to guide researchers. This study provides a basis of empirical data on perspectives of African participants which could inform work on the development of a consolidated approach to the feedback of incidental findings in the continent.","PeriodicalId":74358,"journal":{"name":"Open research Africa","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41565545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}