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Understanding adherence in virally suppressed and unsuppressed human immunodeficiency virus-positive urban patients on second-line antiretroviral treatment
No full textBackground: Understanding antiretroviral therapy (ART) adherence may assist in designing effective support interventions.Objectives: This study elicited perspectives on how to promote treatment adherence from virologically suppressed and unsuppressed patients receiving second-line ART.Methods: This was a cross-sectional study conducted with randomly selected patients active on second-line ART, from five public health facilities in the Johannesburg inner city. Data were collected on demographics, clinical information, participant’s experiences and ART knowledge. Virological failure was defined as exceeding 1000 copies/mL.Results: The study sample comprised 149 participants; of which 47.7% (n = 71) were virally unsuppressed and 69.1% (n = 103) were women; the median age of the participants was 42 years (interquartile range [IQR] 36–47 years). Experiencing medication-related difficulties in taking second-line ART (p = 0.003), finding second-line regimen more difficult to take than a first-line regimen (p = 0.001) and experiencing side effects (p < 0.001) were all subjective predictors of virological failure. Participants’ recommendations for improving adherence included the introduction of a single tablet regimen (31.6%, n = 55), reducing the dosage to once daily (26.4%, n = 46) and reducing the pill size for second-line regimen (4.0%, n = 7).Conclusion: The results of this study highlight the importance of improving patients’ knowledge about adherence and motivation to continue ART use despite the persistence of side effects and difficulties with taking medication
Healthcare worker compliance with cervical cancer screening guidelines. An audit at district and regional level of care in the Pietermaritzburg Metropolitan area of KwaZulu-Natal
No full textBackground: In South Africa (SA) there are screening guidelines for cervical cancer in women living with HIV (WLWH). To our knowledge there is lack of data concerning the knowledge of health care workers (HCWs) about cervical cancer screening guidelines before the initiation of antiretroviral therapy (ART) in WLWH.Objectives: To investigate the knowledge and familiarity of HCWs regarding cervical cancer screening guidelines in WLWH.Methods: A cross-sectional questionnaire-based study exploring compliance with cervical cancer screening guidelines before initiating ART was conducted with 85 HCWs in the antiretroviral (ARV) clinics of a district and regional hospitals in KwaZulu-Natal, SA. Data were analysed using Stata V13 and a p-value of ≤ 0.05 was considered statistically significant.Results: Eighty-five HCWs were included in the study. Health care workers’ responses to knowledge about cervical cancer screening in WLWH were suboptimal and revealed significant gaps. Most HCWs did not know the screening intervals of WLWH. Statistically significant associations were found between an HCW’s occupation and responses to the Likert scale questions.Conclusion: Although the majority of HCWs were familiar with cervical cancer screening guidelines in WLWH, the study highlights that there are deficiencies in both knowledge and practice. Creating awareness among HCWs regarding the current methods of cervical cancer screening is a necessary to reduce morbidity and mortality from cervical cancer in WLWH
Antiretroviral therapy under the wing of the COVID-19 epidemic: One look, and different solutions
No full textNo Abstract
Arterial stiffness is associated with oxidative stress and endothelial activation among persons with treated HIV in Zambia
No full textObjectives: To assess the relationships of oxidative stress and endothelial activation with vascular stiffness among PLWH.
Method: Fifty-four PLWH on antiretroviral therapy > 5 years and 57 HIV-negative controls, all aged 18–45 years, were enrolled from the University Teaching Hospital, Lusaka, Zambia. Oxidative stress was measured by nitrotyrosine, a peroxynitrite biomarker, and endothelial activation by soluble intercellular adhesion molecule-1 (sICAM-1) plasma levels. Vascular compliance was measured using carotid-radial pulse wave velocity (crPWV) and arterial stiffness index (crASI).
Results: PLWH had higher sICAM-1 levels (median 345 ng/mL) compared to controls (275 ng/mL, p < 0.01), as well as higher nitrotyrosine levels (297 versus 182 nM; p = 0.02). Median crPWV was similar between the groups, but PLWH had higher crASI (2.4 versus 2.2 cm/ms; p < 0.05). After adjusting for age, fat mass, and blood pressure, the estimated effect of a one unit increase in nitrotyrosine on crPWV were twofold higher in the PLWH, but neither reached significance. In a model pooling all participants, there were significant differences in the relationship of nitrotyrosine with crPWV and crASI by HIV status.
Conclusion: PLWH in sub-Saharan Africa had significantly greater oxidative stress and endothelial activation compared to HIV-negative individuals. These factors may contribute to increased arterial stiffness and higher CVD prevalence in this population
Efficacy and Safety of Warfarin Therapy: Comparison Between Specialized INR Clinic and General Medical Clinic
No full textBackground: Although warfarin is known as effective oral anticoagulant to prevent thromboembolic events, its’ narrow therapeutic index requires ambient and good follow-up to reduce its therapeutic complications. There is a continuous debate whether the best practice to accomplish this goal is in a specialized international normalized ratio clinic (INR-C) or in a general medical clinic (General-C). Few, if any, studies have been done in Sudan to compare the safety and efficacy of anticoagulant therapy in those clinics. Thus, the objective of this study was to compare the efficacy and safety of anticoagulant therapy in INR-C and in General-C.
Methods: This is a prospective hospital-based study where 200 patients were divided into two groups (group A and B) of 100 patients. Group A were in the INR-C at Ahmed Gasim specialized hospital and group B in the General-Cat AL-Shaab teaching hospital. The study was conducted from September 2019 to April 2020. All patients were on warfarin treatment and regular follow-ups were conducted. Demographic and clinical data were collected and analyzed statistically using SPSS version 20. Ethical approval was obtained from the ethical committee of the Sudanese Medical Specialization Board (SMSB).
Results: Of the 200 patients, 118/59% were females and 82/41% were males. Target international normalized ratio (INR) for group (A) was achieved in 56% of the patients in the first visit, increased to 63% in the second visit, and 75% in the third follow-up, compared with 24% of the patients from group (B) in the initial and second follow-up visit, to 43% in the third visit (P value=0.05). Knowledge about drug and food interaction of coagulation agents was higher (91%) among patients in group (A) compared with group (B) (56%). Drug interaction awareness was found in 89% of the patients in group (A) compared with only 40% in group (B) (P value=0.05). Major bleeding was reported in 2% and 14% of the patients of group (A) and (B) respectively, whereas minor bleeding was seen in 4% of group (A) and 11% of group (B).
Conclusion: The study showed that INR-C is more efficient and safer for patients on regular warfarin therapy compared with the General-C. 
Anxiety and Depression Among Sudanese Nurses During the COVID-19 Pandemic: A Cross-sectional Study
No full textBackground: While treating patients during a pandemic, nurses are at risk of mental health issues caused by the stress they face. This study aimed to examine the degree of anxiety and depression among Sudanese nurses throughout the coronavirus disease 2019 (COVID-19) pandemic and demographic features and their association with depression and anxiety.
Methods: An online-based cross-sectional study was conducted on Sudanese nurses. Data were collected from eligible nurses using a three-part questionnaire: demographic questions, the generalized anxiety disorder-7 (GAD-7), and the major depression index (MDI). We used the Chi-square test and Spearman or point biserial correlation to assess the association between demographics, anxiety, and depression.
Results: Two hundred and forty-six nurses from Sudan participated in this study. Around 69.5% of participants experienced mild to severe anxiety, while 26.4% revealed mild to severe depression. We found a significant association between depression and anxiety (P < 0.001). However, we did not find a significant association between depression or anxiety categories and the baseline characteristics of participants.
Conclusion: Our study demonstrates high rates of anxiety and depression among Sudanese nurses throughout the COVID-19 pandemic. As we found no association between anxiety and depression with personal characteristics, psychological support should be given to all nurses’ categories as all of them nearly have the same risk for anxiety and depression. 
Impact of COVID-19 on Violence Against Women and Girls in Addis Ababa
No full textThere is no doubt that promoting a safer, Gender-Based Violence (GBV) free environment for women and girls gives them greater safety and security, better health and education, and, more control over their life choices. The main objective of the study was to explore the impacts of COVID-19 in relation to violence against women and girls in Addis Ababa. A Cross-sectional study design with concurrent mixed study method was employed. Primary data was collected from 1084 women (15-49 years old) selected using three-stage stratified sampling procedure, 12 key informants and one case study. Data were collected using household survey questionnaire, key informant interview and in-depth interview guides. The odds of gender-based violence was higher by at least 1.6 times among women and girls who had no formal education and primary education compared to those who had secondary and above level of education. Women and girls residing in large household size (6+) had significantly higher odds of gender-based violence compared to those who were living in households with less than six members. Women and girls who were living in rented house were 1.3 times more likely to be exposed to gender-based violence compared to those living in their own house. There should be aggressive and continuous community education through behavioral change communication strategies that will eventually help to significantly promote knowledge and attitude on adverse effects of gender-based violence
Enquête ethnobotanique sur la diversité paysanne et l’utilisation du faux sésame (Ceratotheca sesamoides Endl.) au Burkina Faso
Get PDFLe but de cette étude est de promouvoir le faux sésame qui est en voie d’extinction. A cet effet, des enquêtes ethnobotaniques sur le faux sésame ont été réalisées en novembre 2019 au Burkina Faso. L’objectif de l’étude était de connaitre les variétés paysannes de faux sésame et leurs usages, ainsi que leur mode de gestion au Burkina Faso. Ainsi, 240 exploitants agricoles ont été interviewés dans deux zones agro-climatiques à savoir la zone soudano- sahélienne et la zone soudanienne du Burkina Faso. Les questions portaient sur les noms vernaculaires, la gestion paysanne, le mode d'obtention et de conservation des semences et des feuilles, l'importance socio-économique et culturelle de la plante. Les résultats de l’étude ont montré qu’il existe 15 noms vernaculaires. La dénomination de l’espèce est liée soit à la couleur de la tige, soit à la couleur des feuilles, soit à la présence du mucilage. Les feuilles conservées de l’espèce constituent une source de revenus pour les paysans. Les feuilles sont utilisées dans les mets locaux, dans les astuces médicales traditionnelles et dans les rituels. En somme, l’étude a montré que le faux sésame est bénéfique pour les populations locales tant au plan économique, nutritif, médicinal qu’au plan artisanal.
English title: Ethnobotanical survey on farmer diversity and use of false sesame (<i>Ceratotheca sesamoides</i> Endl.) in Burkina Faso
This study aimed to promote the endangered false sesame. To this end, ethnobotanical surveys on false sesame were conducted in November 2019 in Burkina Faso. The objective of the study was to know the farmers' varieties of false sesame and their uses, as well as their management mode in Burkina Faso. To this end, 240 farmers were interviewed in two agro-climatic zones, namely the Sudano-Sahelian zone and the Sudanian zone of Burkina Faso. Questions were asked about vernacular names, farmer management, the method of obtaining and conserving seeds and leaves, and the socio-economic and cultural importance of the plant. The results of the study showed that there are 15 vernacular names. The name of the species is related either to the color of the stem, the color of the leaves, or the presence of mucilage. The preserved leaves of the species are a source of income for the farmers. The leaves are used in local dishes, in traditional medicinal tricks, and rituals. In sum, the study showed that false sesame is beneficial to the local population in terms of economy, nutrition, and medicine as well as in terms craftsmanship.
 
Analysis of the exploitation and management of the artisanal shrimp fishery (Farfantepenaeus notialis) in the Saloum Delta
Get PDFThe management of the coastal small-scale shrimp fishery in the Saloum delta is based on the opening and closing of the fishery. This approach is highly contested by many fishermen who still pursue fishing activities. To reach this goal, samples of 500 grams of shrimp are purchased once a month from the catches of fishing gear targeting shrimp in the following areas: Foundiougne, Sibassor, Djirnda, Missira and Betenti. On site, the cephalothoracic length and individual weight of shrimp are measured to the nearest tenth of a millimeter, using an electronic caliper and weighed to the nearest tenth of a gram using a precision field scale. The relative importance of the two sexes in the catches of the different fishing gears is analysed every month using a 300 g sample of the biggest shrimp. Sex is determined by naked-eye observation of the shrimp, based on the sex recognition key developed by Schneider (1992) and Vries and Lefèvre (1967). The analysis of the evolution of the sizes of the shrimp caught in the different fishing areas allows us to locate the optimal period of closure of the fishery between the months of June and October, which corresponds to the main reproduction period of the white shrimp in the Saloum delta.