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Outcomes of an individual counselling programme in Grozny, Chechnya: a randomised controlled study
No full textTo evaluate the effectiveness of individual counselling on functioning of clients participating in a mental health intervention in a humanitarian setting
Risk Factors for Vaginal Colonization and Relationship between Bacterial Vaginal Colonization and In-Hospital Outcomes in Women with Obstructed Labor in a Ugandan Regional Referral Hospital
No full textIntroduction\ud
. The proportion of women with severe maternal morbidity from obstructed labor is between 2 and 12% in resource-limited settings. Maternal vaginal colonization with group B streptococcus (GBS),\ud
Escherichia coli\ud
, and\ud
Enterococcus\ud
spp. is associated with maternal and neonatal morbidity. It is unknown if vaginal colonization with these organisms in obstructed labor women is associated with poor outcomes.\ud
Objectives\ud
. To determine whether vaginal colonization with GBS,\ud
E. coli\ud
, or\ud
Enterococcus\ud
is associated with increased morbidity among women with obstructed labor and to determine the risk factors for colonization and antibiotic susceptibility patterns.\ud
Methods\ud
. We screened all women presenting in labor to Uganda’s Mbarara Regional Referral Hospital maternity ward from April to October 2015 for obstructed labor. Those meeting criteria had vaginal swabs collected prior to Cesarean delivery and surgical antibiotic prophylaxis. Swabs were inoculated onto sterile media for routine bacterial culture and antimicrobial susceptibility testing.\ud
Results\ud
. Overall, 2,168 women were screened and 276 (13%) women met criteria for obstructed labor. Vaginal swabs were collected from 272 women (99%), and 170 (64%) were colonized with a potential pathogen: 49% with\ud
E. coli\ud
, 5% with GBS, and 8% with\ud
Enterococcus\ud
. There was no difference in maternal and fetal clinical outcomes between those colonized and not colonized. The number of hours in labor was a significant independent risk factor for vaginal colonization (aOR 1.02, 95% CI 1.00–1.03,\ud
\ud
\ud
P\ud
=\ud
0.04\ud
\ud
\ud
). Overall, 38% of GBS was resistant to penicillin; 61% of\ud
E. coli\ud
was resistant to ampicillin, 4% to gentamicin, and 5% to ceftriaxone and cefepime. All enterococci were ampicillin and vancomycin susceptible.\ud
Conclusion\ud
. There was no difference in maternal or neonatal morbidity between women with vaginal colonization with\ud
E. coli\ud
, GBS, and\ud
Enterococcus\ud
and those who were not colonized. Duration of labor was associated with increased risk of vaginal colonization in women with obstructed labor
Mixed methods evaluation of MSF primary care based NCD service in Irbid, Jordon: February 2017 - February 2018
No full textMixed methods evaluation of MSF primary care based NCD service in Irbid, JordanNon-communicable diseases (NCD) are the leading causes of mortality and morbidity among Syrian refugees in Jordan. Following the onset of the Syrian crisis in 2011, the Jordanian health system was overwhelmed by the chronic disease burden among this group. In response, in late 2014, Médecins sans Frontières Operational Centre Amsterdam (MSF-OCA) opened an NCD service at two primary care centres targeting non-camp based Syrian refugees and vulnerable Jordanians in Irbid, north Jordan, using a multi-disciplinary primary care model. The programme focused on the NCDs causing most deaths in pre-war Syria: cardiovascular disease (CVD), including hypertension, diabetes (DM), and chronic respiratory disease. The model evolved in response to patient needs, programmatic lessons learned and contextual changes. A programme evaluation was done, aiming to refine the model, generate evidence on its feasibility, acceptability and effectiveness and learn lessons to inform translation of a similar model of NCD care to comparable humanitarian settings
The role of pediatric nursing in the provision of quality care in humanitarian settings: a qualitative study in Tonkolili District, Sierra Leone
No full textPrevalence and vaccination coverage of Hepatitis B among healthcare workers in Cameroon: A national seroprevalence survey
No full textHepatitis B virus (HBV) infection is hyperendemic in Cameroon, and health care workers (HCWs) are at high-risk of infection. We aimed to assess prevalence, risk factors and vaccine coverage of HBV infection among HCWs in Cameroon. We conducted a cross-sectional study in 16 hospitals across all regions of Cameroon. HCWs were tested for HBV using rapid diagnostic tests (RDT). We collected data on socio-demographics and HBV vaccination status. We estimated prevalence of HBV and used Poisson regression models with robust standard errors to model the prevalence ratios of HBV positivity between covariates. We enrolled 1,824 of 1,836 eligible HCWs (97.5%). The mean age was 34 (SD: 10) years, 65.3% (n=1787) were women, and 11.4% (n=1747) had three or more doses of the HBV vaccine. Overall, we found a HBV prevalence of 8.7% (95% CI: 5.2 - 14.3%). Patient transporters had the highest crude prevalence (14.3%; 95%CI: 5.4-32.9%), whereas medical doctors had the lowest (3.2%; 95%CI: 0.8%-12.1%). The Far North Region had the highest prevalence of HBV (24.0%; 95%CI: 18.3%-30.8%). HBV prevalence decreased with increasing doses of the HBV vaccine (10.3% for no doses vs 3.5% for three or more doses; P<0.001). In conclusion, approximately 1 in 12 HCWs in Cameroon have evidence of HBV infection, yet fewer than 1 in 6 have been fully vaccinated. Our results illustrate the urgent need to scale up systematic HBV screening and targeted vaccination of HCWs in the region. This article is protected by copyright. All rights reserved
Using ante-natal clinic prevalence data to monitor temporal changes in malaria incidence in a humanitarian setting in the Democratic Republic of Congo.
No full textThe number of clinical cases of malaria is often recorded in resource constrained or conflict settings as a proxy for disease burden. Interpreting case count data in areas of humanitarian need is challenging due to uncertainties in population size caused by security concerns, resource constraints and population movement. Malaria prevalence in women visiting ante-natal care (ANC) clinics has the potential to be an easier and more accurate metric for malaria surveillance that is unbiased by population size if malaria testing is routinely conducted irrespective of symptoms
A Multisectoral Emergency Response Approach to a Cholera Outbreak in Zambia: October 2017-February 2018
No full textHigh Prevalence of Infection and Low Incidence of Disease in Child Contacts of Patients with Drug-resistant Tuberculosis: a Prospective Cohort Study
No full textWe aimed to measure the prevalence and incidence of latent tuberculosis infection (LTBI) and tuberculosis (TB) disease in children in close contact with patients with drug-resistant TB (DR-TB) in a country with high DR-TB prevalence