1358 research outputs found
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The relationship between malaria and HIV
No full textObjective: To determine if there is an association between HIV and malaria infection Design: A cross sectional survey. Setting: Sanyati Rural District, a malarious endemic area of Zimbabwe. Subjects: 338 volunteers aged 15 months to 76 years. Main Outcome Measures: Prevalence of Malaria and HIV. Results: The prevalence of malaria and HIV was 26.6% and 26.3% respectively. There was no association between prevalence of HIV and malaria. Conclusion: There is no association between malaria and HIV.Research Board of the University of Zimbabw
Factors Associated with Untimely Antiretroviral Drug Pick-up by Patients in Bindura District.
No full textIntroduction
Timely antiretroviral drug pick up is one of the early warning indicators for monitoring HIV drug resistance. Timely antiretroviral drug pick up is essential in the prevention of emergence of HIV drug resistance. The scale up of ART programme is not directly proportional to clients picking their drugs on time. This study sought to establish ART drug pick up patterns of ART clients, prevalence of untimely drug pick up and the associated factors.
Methods: The study was an analytic cross-sectional study. Two hundred and seventy-seven (277) respondents were randomly selected from attendees of ART clinics at ART sites. Interviewer-administered pretested questionnaires were used to collect data. Epi info version 3.5.1 was used to create frequencies and proportions were calculated as well as Odds ratios to determine associations. Logistic regression analysis was done to identify independent risk factors and to control for confounding variables.
Results: Two hundred and seventy-seven (277) ART clients were included in the study. The prevalence of untimely drug pick up was 40.4%. The median number of times participants missed drug pick on time in the past 12 months was 1 (Q1=1; Q3=2) and the main reason for not picking up drugs on time was social problems like attending funerals and not having bus fares. Those who had short time (0-6 months) on treatment [POR = 0.45 (95% CI; 0.27 - 0.77)] and having one month or less supply [POR = 0.50 (95% CI: 0.30 - 0.81)] were significantly associated with a lower likeliness of missing drug pick up time. Barriers such as adverse effects [AOR = 1.84 (95% CI: 1.13 - 3.01)], user fees [AOR = 1.96 (95% CI: 1.06 - 3.60)], and long distances to ART sites [AOR 1.96 (95% CI: 1.11 – 3.47)] were significantly associated with high likeliness of missing drug pick up time. These factors remained statistically significant on logistic regression analysis and stratified analysis showed that age was modifying the relationship between distance and drug pick up time.
Conclusion and Recommendations
ART clients were mainly missing drug pick up time due to long distance to ART sites, user fees and adverse effects to drugs. The District Health Executive need to scale up ART outreach in order to provide services for those who stay far away from ART sites
Faculty Development Workshop Summary Notes 26-28 July 2011
No full textUniversity of Zimbabwe, College of Health Sciences under the NECTAR programme conducted a
three day Faculty Development training workshop. The workshop which was facilitated by Associate
Professor Eva Aagaard, Professor Nancy Madinger, and Dr. Jake Gray from the University of
Colorado Denver, USA recorded an average of 50 participants on a daily basis. The objective of the
workshop was to introduce and acquaint participants to basic knowledge on: Curriculum Development;
Team Based Learning; Bedside Clinical Teaching and Lecture methods. The workshop was officially
opened by Professor Midion Chidzonga, the current Dean of the College of Health Sciences. The
workshop was conducted in sessions with each of the 3 instructors facilitating specific sessions. This
report is a summary of how the workshop unfolded.
Workshop Objectives:
To introduce faculty to the theory and practice of:
• Curriculum Development
• Medical Education Pedagogies
• Student Assessment
SesNational Institute of Health (NIH
eLearning for a Developing Economy
No full texteLearning, although not entirely new, has taken on a renewed form and focus with the advent
of new technologies like Web 2.0 which allow for easier collaboration and the growth of social
media. As with any new technology being introduced into a very traditional formal sector like
Education, there are a number of barriers to ICT in education and the progress is cautiously
slow. In addition outcomes of eLearning are very different from traditional outcomes and are
difficult to measure with the current techniques, which further complicates or distracts from
implementation and the evaluation.
Advocates of eLearning need to embrace that this is complimentary to current educational
techniques and should be intended to enhance a learners experience and not completely
replace it. Opponents need to appreciate that the new technology is able to assist in producing
better equipped students with new 21st Century skills, at the same time opening a learner to a
more global perspective.
Developing Economies stand to gain significant benefits in advancing their education sector
with the correct and careful implementation of eLearning structures. Although much of the
focus for eLearning implementation is on access to technology, there are a number of other
factors that have to be considered to effectively implement an eLearning program;
1. Shared Vision and Policies aligned to social and economic desired impacts
2. 21st Century Pedagogy requirements
3. Foundational ICT Skills
4. Curriculum Framework
5. Contingency Planning
6. Skilled Personnel and continued professional development
7. Suitable equipment
8. Technical Support
9. Assessment and Evaluation
eLearning is essential for a developing country. The process requires a long term plan and
commitment but the end result could allow us to not only leap-frog but surpass other countries
in having adequately prepared graduates for the 21st Century
Effect of Community Infant and Young Child Feeding Counseling on Infant Feeding Knowledge, Attitudes and Practices in Harare City 2013
No full textBackground
A preliminary review of nutrition reports for Harare City revealed that set targets for exclusive breastfeeding rate, timely initiation of breastfeeding, median duration of breastfeeding and stunting were not met. All these are a consequence of poor infant feeding knowledge, attitudes and practices on the child. This study aims to find out the effect of community infant and young child feeding counseling on maternal knowledge attitudes and practices on optimal infant feeding in Harare City.
Methodology
A prospective cohort study was conducted in Harare City on pregnant and lactating women. The exposure was receiving counseling in community infant and young child feeding. Interviewer administered questionnaires, key informant interviews, focus group discussions and record reviews were used to collect data.
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Results
Mothers who received counseling in community infant and young child feeding had better knowledge on optimal infant and young child feeding at endpoint (mean knowledge score = 7.8, SD = 1.36 ) compared to the unexposed group (mean knowledge score = 5.4, SD = 1.53) and this was statistically significant (p = 0.005 ). Community infant and young child feeding counseling had an effect on timely initiation of breastfeeding, giving water, exclusive breastfeeding and giving solids. Most of the respondents, 92% in the exposed group had a positive attitude towards optimal infant and young child feeding practices as compared to the non-exposed group.
Conclusio
Identifying motivational factors in job performance and how they relate to attrition among village health workers in Shurugwi and Chirumanzu districts, Zimbabwe.
No full textBackground: Motivation is one of the key determinants of village health worker performance. Motivation is difficult to assess and can be measured by a series of questions which can be grouped into smaller sets that accurately define motivation, through factor analysis. Motivation predicts job related behaviours like attrition. Such behaviours are also difficult to measure; however, proxies can be used, like intent to quit. Logistic regression can then be used to determine how the motivation groups are related to attrition.
Method: The village health worker survey enrolled 338 village health workers working in Chirumanzu and Shurugwi. All the respondents were asked a series of questions that assess motivation when they came for their routine meetings. Factor analysis was used to reduce the number of items assessing motivation from 16. Logistic regression analysis was used to determine the association between motivation factors and attrition.
Results: The 16 items measuring motivation were reduced to 2, namely peer support and dissatisfaction, through factor analysis. Logistic regression analysis showed that peer support was 36% protective to attrition while the odds of attrition were 3.20 times when there is dissatisfaction.
Conclusion: Peer pressure and dissatisfaction are two major variables that define motivation and both are associated with attrition. Peer pressure is a protective variable while dissatisfaction is a risk factor
Etiology and risk factors of meningitis in patients admitted at a Central Hospital in Harare
No full textObjective: To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare.
Design: Cross-sectional study.
Setting: Tertiary, urban-based referral hospital.
Subjects: Patients suspected of having meningitis admitted at Parirenyatwa hospital were consecutively recruited into the study until sample size accrual.
Main Outcome Measures: (a) Prevalence of pathogens associated with meningitis, (b) Risk factors of meningitis.
Results: Two hundred and ninety six (296) patients with clinically suspected meningitis were recruited into the study, 51.7 %( n=115) were male. Meningitis was confirmed in 20.6% (n=61) cases with the following pathogens, C. neoformans 45.9 % ( n=28); S. pneumoniae 27.9 % (n=17); tuberculosis 4.9 % ( n=3); probable viral meningitis 6.6% (n=4 and other bacteria 14.8% (n=9). Patients from crowded households were also more likely to suffer from meningitis than those from sparsely populated households (p<0.001). Conclusion: C. neoformans was the single commonest cause of microbiology positive meningitis. The use of latex agglutination increases the proportion of detected pathogens both fungal and bacterial when used in conjunction with cerebrospinal fluid (CSF) gram stain and culture. Cryptococcus neoformans and S. pneumoniae are the leading causes of meningitis in patients admitted at Parirenyatwa Hospital
Proceedings Of The Nectar/Chris/Imherz Workshop Held At Harare Holiday Inn 3rd - 5th Of February 2011
No full textProf Hakim started the workshop by welcoming the guests
and thanked them for being punctual and then handed over
to the Chair of the morning session Prof Chidzonga who
formally welcomed the guests to the workshop making special
mention of the guests from UK, USA and South Africa
before handing over to the Vice Chancellor, Prof Nyagura
to give the Official Opening Speech
Ethical considerations in the care of the patient with HIV/AIDS
No full textThese are the proceedings of a hypothetical case presented at the Wednesday Clinical Meeting, by the Department of Medicine, Parirenyatwa Hospital. The case was based on actual life experiences that were obtained in the care of HIV/AIDS patients. The discussion was guided in such a way as to place emphasis 01 ethical issues and less on clinical considerations. The aim was to draw on participants’ experience and practici of medicine in today’s Zimbabwe. For the purpose of discussions, it was accepted that absolutely correct opinions in ethical issues of medical practice in relation to AIDS/HIV may not exist, and that the discussion was as important as any conclusions that may be reached
Baseline Serological Markers of Hepatitis B Virus Co-Infection in the Development of Antiretroviral Therapy for Africa (DART) Population of Human Immuno Deficiency Virus Infected Patients
No full textHepatitis B virus (HBV) seroprevalence and serology profiles were retrospectively determined for 957 individuals in the Development of Antiretroviral Therapy for Africa (DART), human immunodeficiency virus (HIV) infected population. Baseline HBV serology markers were tested for and samples identified for viral load test in the HBV sub study investigating development of HBV Tenofovir (TDF)/lamivudine (3TC) resistance in HIV-1 positive treatment naïve individuals initiating TDF/3TC combination therapy as part of HAART. The patients received TDF/3TC combination therapy as part of HAART and samples were taken at baseline and at 4, 12, 24 and 48 weeks and every 48 weeks thereafter until last visit, up to 6 years. All samples were tested for anti-HBc and HBsAg with further testing for anti-HBs and HBe markers in anti-HBc+/HBsAg- and anti-HBc+/HBsAg+samples respectively using enzyme immune assays. In this population 164 patients were HBsAg positive giving a 17.1 % HBsAg seroprevalence (males 18.3 %, females 15.8 %). Five hundred and thirty (530) samples or 55.4 % were positive for the anti-HBc marker. One hundred and thirty five patients had isolated anti-HBc and will be tested for occult HBV, 103 were anti-HBc+/HBsAg+/HBe marker + and were identified for viral load tests on baseline and follow up samples to investigate HBV TDF/3TC resistance evidenced by viral rebound. The results infer a high prevalence of HBV co-infection in HIV infected individuals in Zimbabwe. HIV positive individuals are at risk of co-infection with HBV because of the shared routes of infection of HIV and HBV. This is supported by the high level of exposure to HBV evidenced by 55.4 % anti-HBc seroprevalence in the DART cohort. There was evidence of active hepatitis, 103 individuals with positive HBe markers, and HBV DNA tests can be done on these baseline and follow up samples to monitor the efficacy of TDF/3TC combination therapy in suppressing viral rebound. Viral load tests can also be done on 135 samples with isolated anti-HBc to determine the prevalence of occult HBV in this cohort.
KEY WORDS: HBV seroprevalence, HIV co-infection, HBV tenofovir/lamivudine resistance
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ACKNOWLEDGEMENTS
This thesis was made possible through the support of the Development of Antiretroviral therapy for Africa (DART) study group who provided the samples. I am grateful to Dr Chirara, Prof Robertson and other members of the DART study for allowing me to contribute to the DART HBV sub study through this project. Dr Chirara and Prof Robertson provided me with invaluable support, guidance and mentorship throughout the project.
The University of Zimbabwe department of medical microbiology virology laboratory members provided me with the necessary training to do this work and opened the doors of their laboratory for me to work in, for that I am most grateful. Thank you Ms Berejena and Mr T. Mamvura.
I also thank my classmates in the MSc medical microbiology program for the shared experiences throughout this program