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Evaluation of a mobile application to support HIV self-testing in Johannesburg, South Africa
No full textBackground: Human immunodeficiency virus self-testing (HIVST) reduces barriers associated with facility-based testing; however, no formal mechanism exists for users to self-report results or link to care. The AspectTM HIVST mobile application (app) was developed for use in South Africa.Objectives: This study evaluated the acceptability and feasibility of the AspectTM HIVST app for individuals from the inner city of Johannesburg.Method: This cross-sectional pilot, with a convenience sample of 300 adults, was conducted in July 2018. Participants were provided an OraQuick HIVST kit and a smartphone preloaded with the app, then asked to follow the in-app instructions for use (IFU) to complete the HIVST and upload results. Trained healthcare workers (HCWs) observed and recorded any deviations from the IFU, and conducted a post-test survey to assess acceptability. Feasibility was evaluated by the number of participants who agreed to participate, completed the self-test, and uploaded all information onto the app correctly.Results: Most participants (98.7%) found the app easy to use. To reduce difficulties related to the IFU (26; 8.7%), participants suggested multimedia supplements (4; 1.3%), additional languages (4; 1.3%) and simplified instructions (5; 1.7%). All individuals approached, agreed to participate, 267 (89.0%) correctly completed all steps and 210 (78.7%) successfully captured all information on the app. Most errors (26; 8.7%) were testing errors and 1 (0.3%) was from the app sequence. Twelve (4.5%) errors were with test strip imaging and 72 (27.0%) discordances were with demographic information.Conclusion: Despite some challenges with IFU interpretation and data capture via the app, this pilot showed that the AspectTM HIVST app is an acceptable way to upload mobile HIVST results and demographic information to a central database
Characteristics and outcomes of older people on antiretroviral therapy in Tlokwe Clinics, South Africa
No full textBackground: South Africa (SA) has a large human immunodeficiency virus (HIV) epidemic but little is known of its effect on those ≥ 60 years of age viz. ‘older-persons’ living with HIV (OPLWH). Numbers in this age group are increasing and are expected to place a greater strain on existing resources.Objectives: To describe the demographic features and the co-morbidities of OPLWH in Tlokwe. This included an assessment of viral load (VL) suppression and the identification of associations between patient characteristics and clinical outcomes.Methods: A retrospective file review was undertaken to cover the period 01 May 2017 to 30 April 2018. Descriptive statistics were applied to demographic and clinical data and to treatment outcomes. Statistically significant associations were subjected to logistic regression analysis.Results: Of the 191 participants, 111/191 (58.1%) were female and 167/191 (87.4%) were 60 ̶70 years of age. Of the participants, 154/191 (81.9%) were virally suppressed (< 400 copies/mL). Hypertension (n = 106/191, 55.5%) was the most frequently identified co-morbidity. A CD4 cell count of ≥ 350 cells/mm3 at last assessment correlated positively with VL suppression (odds ratio 2.3, confidence interval 1.05–5.02, p = 0.037).Conclusion: Although the level of VL suppression in this cohort was high, greater effort is required to bring this in line with the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommendations viz. 90% viral suppression in PLWH by 2030. Further research is needed to define the evolving long-term needs of OPLWH and to facilitate entry into care of those currently not in care
Neural tube defects in the Free State province from 2012 to 2016. Is there an increase?
No full textBackground: Neural tube defects (NTDs) are anomalies of the central nervous system caused by the defective closure of the neural tube during early embryogenesis. A significant decline in the incidence of NTDs after folic acid fortification of food in South Africa was previously shown. Recently, clinical geneticists have voiced concerns that there is a possible resurgence in the number of NTDs.Objectives: The aim of this study was to determine the incidence of NTDs at a South African Hospital from 2012 to 2016.Methods: This is a retrospective cross-sectional study where all babies with NTDs born in, or referred to Universitas Hospital were included as study participants. Information was collected for both the mother and the baby from hospital records and data forms.Results: Seventy-seven cases of NTDs were captured from 2012 to 2016. The incidence of NTDs was 0.34/1000 births in the Free State province, and 1.21/1000 births if only the data for babies born in Universitas Hospital and Pelonomi Hospital were used. Further analysis showed a male: female ratio of 1:1. Open spina bifida was the most common defect at 71.4%.Conclusion: The incidence of NTDs in the Free State province was low compared to other South African and international studies. The incidence for the metropolitan hospitals is comparable to that of previous studies. This discrepancy is a marker of poor data recording and will impact healthcare planning. A statistically significant increase in NTDs could notbe proven
Urine lipoarabinomannan for rapid tuberculosis diagnosis in HIV-infected adult outpatients in Khayelitsha
No full textBackground: Decreasing tuberculosis (TB) mortality is constrained by diagnostic and treatment delays. The World Health Organization (WHO) recently actively recommended the point-of-care Alere Determine Lipoarabinomannan Ag assay (AlereLAM) to assist in the diagnosis of tuberculosis in specific HIV-infected outpatients.
Objectives: The primary objective of this study was to compare time to ambulatory TB treatment in HIV-infected adults with CD4 ≤ 100 cells/μL before and after (‘primary comparison groups’) availability of AlereLAM. In pre-specified subgroups, we prospectively assessed AlereLAM-positive prevalence.
Method: Clinicians prospectively performed AlereLAM in HIV-infected adults with TB symptoms and either CD4 ≤ 100 cells/μL or ‘seriously ill’ criteria. In a retrospective arm of equal duration, clinicians retrospectively collected data on HIV-infected adults with CD4 ≤ 100 cells/μL who initiated TB treatment.
Results: A total of 115 prospectively eligible adults (of whom 55 had CD4 ≤ 100 cells/μL) and 77 retrospectively eligible patients were included. In the primary comparison groups, the retrospective and prospective arms had similar age and sex distribution. With availability of AlereLAM, the time to TB treatment decreased from a median of 4 to 3 days (p = 0.0557). With availability of AlereLAM, same-day TB treatment initiation rose from 9.1% to 32.7% (p = 0.0006). In those with CD4 ≤ 100 only, those with ‘seriously ill’ criteria only, and in those meeting either, or both, of these criteria, AlereLAM was positive in 10.5%, 21.9%, 34.8% and 48.4% respectively.
Conclusion: Availability of AlereLAM led to more patients initiating same-day TB treatment. Using both CD4 ≤ 100 and ‘seriously ill’ criteria gave the greatest yield. Results of this study have informed local policy design
Quality assessment of commercially available metronidazole tablets marketed in Enugu state, Nigeria
No full textIn this study, six different brands of commercially available samples of metronidazole tablets from various manufacturers were subjected to quality assessment. The study-s aim was to check the quality parameters of the marketed metronidazole tablets through in vitro testing to ensure that all tablets possess the Pharmacopoeal qualities. Dissolution profile in 0.1 N hydrochloric acid, hardness, weight uniformity, friability, thickness, disintegration time and absolute drug content were among the in vitro metrics utilized. From the results there were significant differences between the studied brands in the various tablet parameters. All the six brands passed the weight uniformity test,hardness test, disintegration test, thickness and dissolution tests, hence could be adjudged of good quality
Quality control studies on some commercially available brands of ciprofloxacin tablets in Anambra State
No full textCiprofloxacin is a synthetic flouroquinolone derivative with broad spectrum antibacterial activity. It is widely used in the treatment of urinary tract infection, lower respiratory tract infection, bacterial diarrhoea, skin and soft tissue, bone and joint infections, gonorrhea and also in surgical prophylaxis. This study is aimed at assessing the quality of eight brands of Ciprofloxaxin (Ciproxamed, Ciprogud, Cisepro, Ciprofaith, Acipro, Nemel, Cipronol and Biocipro) tablets marketed in Anambra State, South Eastern Nigeria. The following official and non official tests were carried out on all the selected brands: disintegration time, dissolution rate, weight uniformity, content of active ingredient, friability, hardness (also known as crushing strength) and thickness. The result showed that the mean disintegration time for all the selected tablets was foundto be within specified limits of USP. In the weight uniformity test, twenty tablets of each selected brand were collected at random. The brands A2 (Ciprogud) and A7(Cipronol) with standard deviation 13.6470 and 11.1916 respectively, failedthetest, while others A1 (Cipromaxed), A3 (Cisepro), A4 (Ciprofaith), A5 (Acipro), A6 (Nemel Cipro), A8 (Biocipro) withstandard deviation 2.7961, 3.7191, 4.9468, 4.6597, 2.5644 respectively, passed. In the dissolution test,all the brands met the Pharmacopoeial specification, except A1 (Cipromaxed), A5 (Acipro) and A8 (Biocipro). In the content of API test, all thebrands tested met the specification. All the brands tested passed the friability specification. In the hardness test, all brands of ciprofloxacin tablets tested were within the limit range of between 5 kgF (minimum) and 8 kgF (maximum)
Women’s Awareness and Beliefs of Breast Cancer at Al-Baha, Saudi Arabia
No full textBackground: Women’s awareness and beliefs about breast cancer in Saudi Arabia were not fully investigated. The aim of this descriptive study was to assess women’s awareness and beliefs toward breast cancer in Al-Baha, Saudi Arabia.
Methods: This is a descriptive cross-sectional study; it was conducted among women attending the Women and Child Care Center at Alawi Royal Mall in Alaqiq for mammogram screening of breast cancer. A convenient sampling technique was used; it included women who attended the center in the period from September 2021 to December 2021, and who agreed to participate. The data were collected using a questionnaire consisting of questions on awareness and beliefs toward breast cancer. The data were analyzed using SPSS software.
Results: The current study showed that the level of awareness in women was high toward breast cancer general information (42.9%), the meaning of malignancy (54.3%), and ways for detecting breast cancer (42.9%), it was also shown that they had fair awareness on myths related to breast cancer (45.7%), and signs and symptoms of breast cancer (51.4%). The study also showed that the women have a high level of beliefs toward breast cancer health services (48.6%), the ability of breast cancer to be prevalent in some families (45.7%), the ways of breast cancer self-detection (34.3%), and mammogram role in early detection of breast cancer (34.3%). It was found that the occupation of women and women’s level of education significantly improved the awareness in women. It was shown that the occupation of women and their level of education were significantly related to the level of beliefs toward breast cancer (21.4%) compared to 16.7% for women working in the private sectors.
Conclusion: Women in Al-Baha have a high level of awareness and beliefs about breast cancer. The occupation of women and women’s level of education are associated with a high level of awareness and beliefs toward breast cancer 
Nursing Students’ Satisfaction with Online Learning Experiences During Covid-19 Pandemic at Albaha University, Saudi Arabia
Get PDFBackground: The teaching process in universities had faced several challenges during the COVID-19 pandemic. As most universities have shifted to online learning, this study aimed to assess nursing students’ satisfaction with online learning during the pandemic.
Methods: This is a descriptive cross-sectional study; it was conducted among nursing students during the COVID-19 pandemic. The authors used an adopted online questionnaire to assess students’ satisfaction. The data were analyzed by SPSS software.
Results: The study found that nursing students age was mainly between 22-24 years (78.9%), both male (46.1%) and female (53.9%) students. The nursing students’ satisfaction with online learning during COVID-19 was moderate (23.68%) to high (64.47%). A significant relationship was observed between students age and sex with satisfaction levels in online learning with a p-value less than 0.05.
Conclusions: The study showed that the nursing students were satisfied with an online learning experience. Female students and those who are between 22-24 years have significantly higher levels of satisfaction
Prevalence and Correlates of Youth Contraceptives Utilization among Students of Selected Higher Education Institutions in Addis Ababa
No full textCompared to adults, youth are characterized by significant physiological, psychological and social changes and aspirations that place their life at risky sexual and reproductive behaviors. Despite the global initiatives and enabling national policy environments, in practice most regions of the world still fall short of meeting these commitments. In the developing world, including Ethiopia, adolescents’ sex and sexuality are socio-culturally sensitive issues to discuss openly. Because of that many young people in general and students in particular are less informed, less experienced in, and less comfortable about accessing contraceptive services than are adults. That results in very low uptake of contraceptive services among youth. The objective of this paper is, therefore, to analyze the prevalence of and factors associated with contraceptive services uptake among 354 randomly selected young students from two higher education institutions in Addis Ababa, Ethiopia. Data were collected using a cross-sectional survey questionnaire. The key predictors of contraception use were examined using binary logistic regression model. Results show that nearly half of the respondents were users of contraception, which is comparable to results from other studies. Being female; not having contraceptive methods knowledge; being from a woman-headed household; and not being sure about the adequacy/number of service centers are positively associated with the odds of contraceptives uptake, which does not necessarily equate with current use. Whereas, not obtaining information from service providing workers; having no concern about service providing workers' friendliness and/or confidentiality; and privacy in getting the service were negatively associated with contraceptives uptake. Female students can be used to better influence their male counterparts to use contraceptives. The findings suggest that service providing workers may be used as promising sources of information to boost contraceptives uptake. Uptake can be increased by minimizing barriers that hinder privacy, provider unfriendliness and service non-confidentiality. Family planning programs including counseling should employ Behaviour Change Communication (BCC) focusing on minimizing myths, misconceptions, shame, rumors, societal stigma, and traditional beliefs
Diversité et qualité microbiologique des poissons de mer vendus dans le District de Bamako (Mali)
Get PDFLes poissons de mer sont de plus en plus abondants au Mali, pays continental à faune ichtyologique dulcicole. Pour une question de revenus et aussi de disponibilité, plusieurs ménages citadins consomment le poisson de mer qui, en dépit de sa provenance lointaine, coûte moins cher que le poisson d’eau douce. Ces poissons de mer présentent une diversité et une flore bactérienne responsable de leur altération. La diversité et la qualité microbiologique des poissons de mer vendus à Bamako ont été caractérisées. Pour ce faire, l’inventaire ichtyologique des espèces commercialisées sur les différents marchés a été réalisé. Des prélèvements ont été effectués sur les espèces les plus fréquentes (Plectorhinchus mediterraneus, Arius latiscutatus, Carlarius heudelotii, Mugil cephalus, Bembrops heterurus, Halobatrachus didactylus), pour rechercher la flore totale sur milieu PCA. Les isolats obtenus ont été caractérisés et identifiés sur des galeries miniaturisées API20E. Au total, 74 espèces de poissons réparties entre 65 genres et 39 familles ont été inventoriées. Les espèces les plus abondantes et rencontrées toute l’année sont Carlarius heudelotii, Caranx crysos, Chloroscombrus chrysurus, Selene dorsalis, Trachinotus ovatus, Sardinella aurita, Sardinella maderensis, Drepane africana, Eucinostomus melanopterus, Brachydeuterus auritus, Plectorhinchus mediterraneus, Parapristipoma octolineatum, Pomadasys jubelini, Pomadasys peroteti, Pomadasys rogeri, Liza falcipinnis, Mugil cephalus, Galeoides decadactylus, Pseudololitus senegalensis, Umbrina canariensis, Scomber japonicus, Dentex dentex, Diplodus sargus et Pagrus pagrus. La flore bactérienne était constituée essentiellement d’Enterobacteriaceae et de Pseudomonadaceae, avec des espèces pouvant altérer la qualité marchande et d’autres la qualité sanitaire des poissons. Les Pseudomonas (49,25%), Enterobacter (10,45%), Serratia (10,45%), Aeromonas (8,96%), Photobacterium (7,46%) étaient les plus fréquents. Ces résultats enrichiront le répertoire des ressources halieutiques importées au Mali.
English title: Diversity and microbiological quality of sea fish sold in the District of Bamako (Mali)
Marine fish are increasingly abundant in Mali, a continental country with freshwater fish fauna. Many city households consume sea fish which, despite its distant origin, costs less than freshwater fish. These sea fish have a diversity and a bacterial flora responsible for their deterioration. The diversity and microbiological quality of sea fish sold in Bamako have been characterized. To do this, the ichthyological inventory of the species sold on the various markets was carried out. Samples were taken from the most frequent species (Plectorhinchus mediterraneus, Arius latiscutatus, Carlarius heudelotii, Mugil cephalus, Bemblops heterurus, Halobatrachus didactylus), to find the total flora on PCA medium. The isolates obtained were characterized and identified on API20E miniaturized strips. In total, 74 species of fish distributed between 65 genera and 39 families were inventoried. The most abundant species encountered all year round are Carlarius heudelotii, Caranx crysos, Chloroscombrus chrysurus, Selene dorsalis, Trachinotus ovatus, Sardinella aurita, Sardinella maderensis, Drepane africana, Eucinostomus melanopterus, Brachydeuterus auritus, Plectorhinchus mediterraneus, Parapristipoma octolineatum, Pomadasys jubelini , Pomadasys peroteti, Pomadasys rogeri, Liza falcipinnis, Mugil cephalus, Galeoides decadactylus, Pseudololitus senegalensis, Umbrina canariensis, Scomber japonicus, Dentex dentex, Diplodus sargus and Pagrus pagrus. The bacterial flora consisted mainly of Enterobacteriaceae and Pseudomonadaceae, with species that could affect the marketability and others the sanitary quality of the fish. Pseudomonas (49.25%), Enterobacter (10.45%), Serratia (10.45%), Aeromonas (8.96%), Photobacterium (7.46%) were the most common. These results will enrich the repertoire of fishery resources imported into Mali.