• 【受艾滋病毒影响的青春期母亲及其子女: 撒哈拉以南非洲证据和经验的范围审查。】 复制标题 收藏 收藏
    DOI:10.1080/17441692.2020.1775867 复制DOI
    作者列表:Toska E,Laurenzi CA,Roberts KJ,Cluver L,Sherr L
    BACKGROUND & AIMS: :While adolescents have received increasing attention in the global HIV response and international strategies and commitments, adolescent mothers and their children remain largely overlooked in research, funding and, programming for health-related outcomes. We conducted an extensive scoping review of current evidence on the experiences of adolescent mothers affected by HIV and their children in this region. We included published literature and conference abstracts, complemented by consultations with key stakeholders, and a review of documents through grey literature searching. First, we summarise the experiences of adolescent mothers and their children related to HIV and key health and development indicators. The syndemic of early motherhood and HIV in sub-Saharan Africa increases the vulnerability of adolescent mothers and their children. We then highlight lessons from a series of promising programmes focused on supporting adolescent mothers through novel approaches. In sub-Saharan Africa, supporting adolescent mothers living in high HIV-risk communities is critical not only to eliminate HIV/AIDS, but also to attain the Sustainable Development Goals. While research on and programming for adolescent mothers and their children is growing, the complex needs for this vulnerable group remain unmet. We conclude with evidence gaps and programming priorities for adolescent mothers affected by HIV and their children.
    背景与目标: : 尽管青少年在全球艾滋病毒应对措施以及国际战略和承诺中受到越来越多的关注,但青少年母亲及其子女在与健康有关的成果的研究,资金和方案编制方面仍然被忽视。我们对该地区受艾滋病毒影响的青春期母亲及其子女的经历的当前证据进行了广泛的范围界定审查。我们包括了已发表的文献和会议摘要,并与主要利益相关者进行了磋商,并通过灰色文献搜索对文件进行了审查。首先,我们总结了青春期母亲及其子女与艾滋病毒有关的经验以及关键的健康与发展指标。撒哈拉以南非洲地区早期孕产和艾滋病毒的共同感染增加了青春期母亲及其子女的脆弱性。然后,我们重点介绍了一系列有前途的计划的教训,这些计划侧重于通过新颖的方法支持青春期母亲。在撒哈拉以南非洲,支持生活在艾滋病毒高风险社区的青春期母亲不仅对消除艾滋病毒/艾滋病至关重要,而且对实现可持续发展目标也至关重要。尽管对青少年母亲及其子女的研究和规划正在增长,但对这一弱势群体的复杂需求仍未得到满足。最后,我们为受艾滋病毒影响的青春期母亲及其子女提供了证据空白和计划优先事项。
  • 【EPIVAC撒哈拉以南非洲预防接种方案财政可持续性国际会议,2012年2月16至18日,贝宁瓦达。】 复制标题 收藏 收藏
    DOI:10.1016/j.vaccine.2013.07.027 复制DOI
    作者列表:Drach M,Le Gargasson JB,Mathonnat J,Da Silva A,Kaddar M,Colombini A
    BACKGROUND & AIMS: :The introduction of new vaccines with much higher prices than traditional vaccines results in increasing budgetary pressure on immunization programs in GAVI-eligible countries, increasing the need to ensure their financial sustainability. In this context, the third EPIVAC (Epidemiology and Vaccinology) technical conference was held from February 16 to 18, 2012 at the Regional Institute of Public Health in Ouidah, Benin. Managers of ministries of health and finance from 11 West African countries (GAVI eligible countries), as well as former EPIVAC students and European experts, shared their knowledge and best practices on immunization financing at district and country level. The conference concluded by stressing five major priorities for the financial sustainability of national immunization programs (NIPs) in GAVI-eligible countries. - Strengthen public financing by increasing resources and fiscal space, improving budget processes, increasing contribution of local governments and strengthen efficiency of budget spending. - Promote equitable community financing which was recognized as a significant and essential contribution to the continuity of EPI operations. - Widen private funding by exploring prospects offered by sponsorship through foundations dedicated to immunization and by corporate social responsibility programs. - Contain the potential crowding-out effect of GAVI co-financing and ensure that decisions on new vaccine introductions are evidence-based. - Seek out innovative financing mechanisms such as taxes on food products or a national solidarity fund.
    背景与目标: : 采用价格比传统疫苗高得多的新疫苗,导致符合免疫联盟资格的国家预防接种计划的预算压力增加,增加了确保其财务可持续性的需求。在这方面,第三次EPIVAC (流行病学和疫苗学) 技术会议于2012年2月16日月18日至18日在贝宁Ouidah的区域公共卫生研究所举行。来自11个西非国家 (符合GAVI资格的国家) 的卫生和财政部经理以及前EPIVAC学生和欧洲专家分享了他们在地区和国家一级预防接种筹资知识和最佳做法。会议结束时强调了符合免疫联盟资格的国家国家预防接种方案财政可持续性的五个主要优先事项。-通过增加资源和财政空间,改善预算程序,增加地方政府的贡献并提高预算支出效率来加强公共融资。-促进公平的社区筹资,这被认为是对扩大免疫方案业务连续性的重大贡献。-通过致力于预防接种基金会和企业社会责任计划探索赞助提供的前景,扩大私人资金。-包含GAVI共同资助的潜在挤出效应,并确保有关新疫苗引进的决定是基于证据的。-寻找创新的融资机制,例如对食品征税或国家团结基金。
  • 【种族、人口和基因组学: 作为实验室的非洲。】 复制标题 收藏 收藏
    DOI:10.1016/j.socscimed.2008.07.018 复制DOI
    作者列表:Braun L,Hammonds E
    BACKGROUND & AIMS: :Much of the recent debate over race, genetics, and health has focused on the extent to which typological notions of race have biological meaning. Less attention, however, has been paid to the assumptions about the nature of "populations" that both inform contemporary biological and medical research and that underlie the concept of race. Focusing specifically on Africa in the 1930s and 1940s, this paper explores the history of how fluid societies were transformed into bounded units amenable to scientific analysis. In the so-called "Golden Age of Ethnography," university-trained social anthropologists, primarily from Britain and South Africa, took to the field to systematically study, organize, and order the world's diverse peoples. Intent on creating a scientific methodology of neutral observation, they replaced amateur travelers, traders, colonial administrators, and missionaries as authoritative knowledge producers about the customs, beliefs, and languages of indigenous peoples. At the same time, linguists were engaged in unifying African languages and mapping language onto primordial "tribal" territories. We argue that the notion of populations or "tribes" as discrete units suitable for scientific sampling and classification emerged in the 1930s and 1940s with the ethnographic turn in social anthropology and the professionalization and institutionalization of linguistics in Western and South African universities. Once named and entered into international atlases and databases by anthropologists in the U.S., the existence of populations as bounded entities became self-evident, thus setting the stage for their use in large-scale population genetic studies and the contemporary reinvigoration of broad claims of difference based on population identification.
    背景与目标: : 最近关于种族,遗传学和健康的许多辩论都集中在种族类型学概念在多大程度上具有生物学意义。然而,人们对 “人口” 性质的假设的关注较少,这些假设既为当代生物学和医学研究提供了信息,又为种族概念奠定了基础。本文特别关注20世纪30年代和20世纪40年代的非洲,探讨了流动社会如何转变为适合科学分析的有限单位的历史。在所谓的 “民族志的黄金时代” 中,主要来自英国和南非的受过大学训练的社会人类学家进入该领域,系统地研究,组织和秩序世界上的各个民族。为了建立一种科学的中立观察方法,他们取代了业余旅行者,商人,殖民地管理者和传教士,成为有关土著人民习俗,信仰和语言的权威知识生产者。同时,语言学家致力于统一非洲语言并将语言映射到原始的 “部落” 领土上。我们认为,人口或 “部落” 作为适合科学采样和分类的离散单位的概念出现在20世纪30年代中,并与社会人类学的人种学转向以及西方和南非大学语言学的专业化和制度化20世纪40年代。一旦被美国人类学家命名并进入国际地图集和数据库,种群作为有界实体的存在就变得不言而喻了,从而为它们在大规模种群遗传研究中的使用奠定了基础,并在当代重振了广泛的主张基于种群识别的差异。
  • 【南非艾滋病毒感染者妇女产后参与艾滋病毒护理的前瞻性评估协议。】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2019-035465 复制DOI
    作者列表:Psaros C,Stanton AM,Bedoya CA,Mosery N,Evans S,Matthews LT,Haberer J,Vangel M,Safren S,Smit JA
    BACKGROUND & AIMS: INTRODUCTION:KwaZulu-Natal (KZN), South Africa (SA) has the highest prevalence of pregnant women living with HIV in the world. Pregnancy and the postpartum period offer opportunities to engage women in HIV care, to prevent perinatal transmission and to optimise maternal and infant well-being. However, research suggests that remaining engaged in HIV care during this time can be challenging. METHODS AND ANALYSIS:We are conducting a 5-year prospective cohort study among pregnant women living with HIV in KZN to estimate the rates and factors associated with attrition from HIV care during this critical period. To determine who is most likely to fall out of care, we are examining a range of relevant variables informed by a socioecological model of HIV care, including individual, relational, community and healthcare system variables. We are enrolling 18-45-year-old women, at 28 weeks or more of pregnancy, who are living with HIV and currently taking antiretroviral therapies. Participants complete quantitative assessments at baseline (pregnancy) and at 6, 12, 18 and 24 months postpartum. A subset of women and their partners are invited to complete qualitative interviews to further explore their experiences in HIV care. The main study outcomes are suppressed HIV RNA and retention in care at each study assessment. Our understanding of the factors that drive postpartum attrition from HIV care will ultimately inform the development of interventions to facilitate continued engagement in postpartum HIV care. ETHICS AND DISSEMINATION:This protocol has been approved by the Human Research Ethics Committee (Medical) at The University of the Witwatersrand (Johannesburg, SA) and the Partners Human Research Committee at Partners HealthCare (Boston, Massachusetts, USA). Site support and approval were obtained from the District Hospital and the KZN Provincial Department of Health. Results will be disseminated through peer-reviewed manuscripts, reports and both local and international presentations (Ethics Registration #170 212).
    背景与目标:
  • 【南非索韦托青少年男女创伤暴露的流行率、类型和相关性: 对艾滋病毒预防的影响。】 复制标题 收藏 收藏
    DOI:10.1186/s12889-016-3832-0 复制DOI
    作者列表:Closson K,Dietrich JJ,Nkala B,Musuku A,Cui Z,Chia J,Gray G,Lachowsky NJ,Hogg RS,Miller CL,Kaida A
    BACKGROUND & AIMS: BACKGROUND:Youth trauma exposure is associated with syndemic HIV risk. We measured lifetime prevalence, type, and correlates of trauma experience by gender among adolescents living in the HIV hyper-endemic setting of Soweto, South Africa. METHODS:Using data from the Botsha Bophelo Adolescent Health Survey (BBAHS), prevalence of "ever" experiencing a traumatic event among adolescents (aged 14-19) was assessed using a modified Traumatic Event Screening Inventory-Child (TESI-C) scale (19 items, study alpha = 0.63). We assessed self-reported number of potentially traumatic events (PTEs) experienced overall and by gender. Gender-stratified multivariable logistic regression models assessed independent correlates of 'high PTE score' (≥7 PTEs). RESULTS:Overall, 767/830 (92%) participants were included (58% adolescent women). Nearly all (99.7%) reported experiencing at least one PTE. Median PTE was 7 [Q1,Q3: 5-9], with no gender differences (p = 0.19). Adolescent men reported more violent PTEs (e.g., "seen an act of violence in the community") whereas women reported more non-violent HIV/AIDS-related PTEs (e.g., "family member or someone close died of HIV/AIDS"). High PTE score was independently associated with high food insecurity among adolescent men and women (aOR = 2.63, 95%CI = 1.36-5.09; aOR = 2.57, 95%CI = 1.55-4.26, respectively). For men, high PTE score was also associated with older age (aOR = 1.40/year, 95%CI = 1.21-1.63); and recently moving to Soweto (aOR = 2.78, 95%CI = 1.14-6.76). Among women, high PTE score was associated with depression using the CES-D scale (aOR = 2.00, 95%CI = 1.31-3.03,) and inconsistent condom use vs. no sexual experience (aOR = 2.69, 95%CI = 1.66-4.37). CONCLUSION:Nearly all adolescents in this study experienced trauma, with gendered differences in PTE types and correlates, but not prevalence. Exposure to PTEs were distributed along social and gendered axes. Among adolescent women, associations with depression and inconsistent condom use suggest pathways for HIV risk. HIV prevention interventions targeting adolescents must address the syndemics of trauma and HIV through the scale-up of gender-transformative, youth-centred, trauma-informed integrated HIV and mental health services.
    背景与目标:
  • 【2014年东非女性市场商人的高流动性和艾滋病毒流行率。】 复制标题 收藏 收藏
    DOI:10.1097/QAI.0000000000001252 复制DOI
    作者列表:Camlin CS,El Ayadi AM,Kwena ZA,McFarland W,Johnson MO,Neilands TB,Bukusi EA,Cohen CR
    BACKGROUND & AIMS: BACKGROUND:The contribution of women's mobility to the HIV/AIDS epidemic in Africa is poorly understood, despite women's high mobility and evidence that it is associated with higher-risk sexual behavior. We sought to measure levels of mobility, HIV prevalence, and related risk behaviors among female traders in Kisumu, Kenya. METHODS:We used global positioning system mapping to develop a probability-based sample and recruited 305 female market traders for participation in a survey and voluntary HIV counseling and testing in 2014. We estimated HIV prevalence and fitted logistic regression models to measure associations between mobility, risk behaviors, and HIV infection. RESULTS:HIV prevalence was 25.6% (95% confidence interval: 21.0 to 30.8); 11.5% had migrated (changed residence, over county, or national boundary) in the past year and 39.3% in the past 5 years. More than one-third (38.3%) spent nights away from main residence in the past month, with 11.4% spending more than a week away. Multiple partners were reported by 13.1% of women in the last year; 16% of married women reported a concurrent partnership. Mobility was not significantly associated with HIV prevalence, although recent short-term mobility was significantly correlated with higher numbers of sexual partners in the past year. CONCLUSIONS:Female market traders were highly mobile, and HIV prevalence among traders was higher than in the general population of women of reproductive age in Kisumu (15.3% in 2013), and Nyanza Province, Kenya (16.1% in 2012). High HIV prevalence and risk behavior among women in this study warrant accelerated attention to HIV prevention and care needs of mobile women, including market traders.
    背景与目标:
  • 【艾滋病毒感染不会不成比例地影响撒哈拉以南非洲的穷人。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2007-11-01
    来源期刊:AIDS
    DOI:10.1097/01.aids.0000300532.51860.2a 复制DOI
    作者列表:Mishra V,Assche SB,Greener R,Vaessen M,Hong R,Ghys PD,Boerma JT,Van Assche A,Khan S,Rutstein S
    BACKGROUND & AIMS: BACKGROUND:Wealthier populations do better than poorer ones on most measures of health status, including nutrition, morbidity and mortality, and healthcare utilization. OBJECTIVES:This study examines the association between household wealth status and HIV serostatus to identify what characteristics and behaviours are associated with HIV infection, and the role of confounding factors such as place of residence and other risk factors. METHODS:Data are from eight national surveys in sub-Saharan Africa (Kenya, Ghana, Burkina Faso, Cameroon, Tanzania, Lesotho, Malawi, and Uganda) conducted during 2003-2005. Dried blood spot samples were collected and tested for HIV, following internationally accepted ethical standards and laboratory procedures. The association between household wealth (measured by an index based on household ownership of durable assets and other amenities) and HIV serostatus is examined using both descriptive and multivariate statistical methods. RESULTS:In all eight countries, adults in the wealthiest quintiles have a higher prevalence of HIV than those in the poorer quintiles. Prevalence increases monotonically with wealth in most cases. Similarly for cohabiting couples, the likelihood that one or both partners is HIV infected increases with wealth. The positive association between wealth and HIV prevalence is only partly explained by an association of wealth with other underlying factors, such as place of residence and education, and by differences in sexual behaviour, such as multiple sex partners, condom use, and male circumcision. CONCLUSION:In sub-Saharan Africa, HIV prevalence does not exhibit the same pattern of association with poverty as most other diseases. HIV programmes should also focus on the wealthier segments of the population.
    背景与目标:
  • 【对艾滋病和性别平等小额信贷的干预 (图片): 妇女参与扩大形象方案和南非农村亲密伴侣暴力的经验。】 复制标题 收藏 收藏
    DOI:10.1007/s11121-019-01070-w 复制DOI
    作者列表:Knight L,Ranganathan M,Abramsky T,Polzer-Ngwato T,Muvhango L,Molebatsi M,Stöckl H,Lees S,Watts C
    BACKGROUND & AIMS: :The Intervention with Microfinance for AIDS and Gender Equity (IMAGE) programme has been scaled up to three provinces in South Africa. This paper explores associations between women's engagement in the intervention, intimate partner violence (IPV) and factors associated with IPV and partner abuse. We enrolled women receiving group-based microfinance loans plus gender training into the scaled-up IMAGE cohort study (n = 860). We present cross-sectional analysis on participants' characteristics and intervention engagement and use multivariate logistic regression to explore associations. 17% of women reported lifetime (95% CI 15 to 20%) and 7% past year (95% CI 5 to 9%) IPV, 9% past-year economic (95% CI 7 to 11%) and 11% past-year emotional (95% CI 9 to 14%) abuse. Women under 35 years had higher levels of IPV and emotional abuse. 53% of women attended all the trainings, 83% continuously borrowed and 98% agreed the training had a major impact on their life. Attendance was associated with improved partner relationships (χ2p < 0.001), but not lower IPV risk. Odds of past-year IPV decreased the more types of support (e.g. advice) women received from group members (aOR 0.27, p < 0.001 among those reporting all support versus none or some). A similar pattern was seen for economic, but not emotional, abuse. The scaled-up IMAGE intervention is widely acceptable and may support improvements in partner relationships, but younger women need to be targeted. Group support appears to be a potentially important component of the intervention.
    背景与目标: : 针对艾滋病和性别平等的小额信贷干预 (IMAGE) 计划已扩大到南非的三个省。本文探讨了妇女参与干预,亲密伴侣暴力 (IPV) 以及与IPV和伴侣虐待相关的因素之间的关联。我们将接受基于小组的小额信贷贷款加上性别培训的女性纳入了放大图像队列研究 (n = 860)。我们对参与者的特征和干预参与度进行了横断面分析,并使用多元逻辑回归来探索关联。17% 的女性报告了一生 (95% CI 15至20%) 和7% 过去一年 (95% CI 5至9%) IPV,9% 过去一年的经济 (95% CI 7至11%) 和11% 过去一年的情感 (95% CI 9至14%) 滥用。35岁以下的妇女的IPV和情感虐待水平较高。53% 的妇女参加了所有培训,83% 不断借阅,98% 同意培训对她们的生活产生了重大影响。出勤与改善的伴侣关系相关 (χ2p <0.001),但不降低IPV风险。过去一年IPV的几率降低了从小组成员获得的更多类型的支持 (例如,建议) (aOR 0.27,在报告所有支持的人中,p <0.001,而没有或一些)。在经济上,但没有情感上的虐待,也看到了类似的模式。扩大形象干预是广泛接受的,可能支持改善伴侣关系,但年轻女性需要成为目标。团体支持似乎是干预的潜在重要组成部分。
  • 【南部非洲感染艾滋病毒/艾滋病的男女乏力症状负担。】 复制标题 收藏 收藏
    DOI:10.1016/j.jana.2007.05.001 复制DOI
    作者列表:Voss JG,Sukati NA,Seboni NM,Makoae LN,Moleko M,Human S,Molosiwa K,Holzemer WL
    BACKGROUND & AIMS: :HIV-related fatigue is a debilitating and disabling symptom that persists for months and years. In 743 HIV/AIDS patients from Southern Africa, the authors found ratings of HIV-related fatigue to be highly prevalent. The authors conducted a secondary data analysis within the theoretical context of the University of California, San Francisco Symptom Management Model. The analysis focused on 538 patients who reported fatigue to investigate correlates and predictors of fatigue severity in relationship to demographic and HIV/AIDS illness indicators, as well as HIV-specific physical and psychological symptoms. A hierarchical regression model explored the contributions of those five blocks on fatigue severity. Of the 47% of the total variance in fatigue severity, a combination of variables within the health and illness block (6%), the physical symptoms block (7%) and the psychological symptom block (2%) contributed significantly to the increase in fatigue severity scores. Fatigue severity in Southern Africa was moderate, and the factors contributing to the perceived fatigue were most likely related to symptoms of acute HIV disease (such as fever and gastrointestinal problems). In conclusion, fatigue severity is less impacted by demographic or environmental variables but much more by co-occurring symptoms and HIV disease severity. The results of this study imply the need for more research to understand if improvements in water quality and access to food would prevent infection and diarrhea and whether sufficient access to antiretroviral treatments to manage the HIV infection would improve fatigue and co-occurring symptom profiles.
    背景与目标: : 与艾滋病毒相关乏力是一种使人衰弱和致残的症状,持续数月甚至数年。在来自南部非洲的743名HIV/AIDS患者中,作者发现与HIV相关乏力等级非常普遍。作者在加州大学旧金山分校症状管理模型的理论背景下进行了二次数据分析。该分析的重点是538报告乏力的患者,以调查乏力严重程度与人口统计学和HIV/AIDS疾病指标以及HIV特异性身体和心理症状的相关性和预测因素。分层回归模型探讨了这五个区块对乏力严重程度的贡献。乏力严重程度的总方差的47% 中,健康和疾病块 (6%) 、身体症状块 (7%) 和心理症状块 (2%) 内的变量的组合显著地促进乏力严重程度评分的增加。南部非洲乏力严重程度中等,导致疲劳的因素很可能与急性HIV疾病的症状 (发热和胃肠道问题) 有关。总之乏力严重程度受人口统计学或环境变量的影响较小,而受共同出现的症状和HIV疾病严重程度的影响更大。这项研究的结果意味着需要进行更多的研究,以了解水质的改善和食物的获取是否可以预防感染和腹泻,以及是否有足够的抗逆转录病毒治疗来管理HIV感染可以改善乏力和共同发生的症状特征。
  • 【卫生信息系统的可持续性: 南部非洲三国定性研究。】 复制标题 收藏 收藏
    DOI:10.1186/s12913-016-1971-8 复制DOI
    作者列表:Moucheraud C,Schwitters A,Boudreaux C,Giles D,Kilmarx PH,Ntolo N,Bangani Z,St Louis ME,Bossert TJ
    BACKGROUND & AIMS: BACKGROUND:Health information systems are central to strong health systems. They assist with patient and program management, quality improvement, disease surveillance, and strategic use of information. Many donors have worked to improve health information systems, particularly by supporting the introduction of electronic health information systems (EHIS), which are considered more responsive and more efficient than older, paper-based systems. As many donor-driven programs are increasing their focus on country ownership, sustainability of these investments is a key concern. This analysis explores the potential sustainability of EHIS investments in Malawi, Zambia and Zimbabwe, originally supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR). METHODS:Using a framework based on sustainability theories from the health systems literature, this analysis employs a qualitative case study methodology to highlight factors that may increase the likelihood that donor-supported initiatives will continue after the original support is modified or ends. RESULTS:Findings highlight commonalities around possible determinants of sustainability. The study found that there is great optimism about the potential for EHIS, but the perceived risks may result in hesitancy to transition completely and parallel use of paper-based systems. Full stakeholder engagement is likely to be crucial for sustainability, as well as integration with other activities within the health system and those funded by development partners. The literature suggests that a sustainable system has clearly-defined goals around which stakeholders can rally, but this has not been achieved in the systems studied. The study also found that technical resource constraints - affecting system usage, maintenance, upgrades and repairs - may limit EHIS sustainability even if these other pillars were addressed. CONCLUSIONS:The sustainability of EHIS faces many challenges, which could be addressed through systems' technical design, stakeholder coordination, and the building of organizational capacity to maintain and enhance such systems. All of this requires time and attention, but is likely to enhance long-term outcomes.
    背景与目标:
  • 【广泛的发热性疾病评估 (FIEBRE): 非洲和亚洲发热原因的多站点前瞻性观察研究方案。】 复制标题 收藏 收藏
    DOI:10.1136/bmjopen-2019-035632 复制DOI
    作者列表:Hopkins H,Bassat Q,Chandler CI,Crump JA,Feasey NA,Ferrand RA,Kranzer K,Lalloo DG,Mayxay M,Newton PN,Mabey D,FIEBRE Consortium.
    BACKGROUND & AIMS: INTRODUCTION:Fever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps. METHODS AND ANALYSIS:FIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use. ETHICS AND DISSEMINATION:Ethics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739).
    背景与目标:
  • 【告知非洲鳞状细胞食管癌的病因研究重点: 对已知和假定危险因素的特定环境暴露的综述。】 复制标题 收藏 收藏
    DOI:10.1002/ijc.30292 复制DOI
    作者列表:McCormack VA,Menya D,Munishi MO,Dzamalala C,Gasmelseed N,Leon Roux M,Assefa M,Osano O,Watts M,Mwasamwaja AO,Mmbaga BT,Murphy G,Abnet CC,Dawsey SM,Schüz J
    BACKGROUND & AIMS: :Esophageal squamous cell carcinoma (ESCC) is one of the most common cancers in most Eastern and Southern African countries, but its etiology has been understudied to date. To inform its research agenda, we undertook a review to identify, of the ESCC risk factors which have been established or strongly suggested worldwide, those with a high prevalence or high exposure levels in any ESCC-affected African setting and the sources thereof. We found that for almost all ESCC risk factors known to date, including tobacco, alcohol, hot beverage consumption, nitrosamines and both inhaled and ingested PAHs, there is evidence of population groups with raised exposures, the sources of which vary greatly between cultures across the ESCC corridor. Research encompassing these risk factors is warranted and is likely to identify primary prevention strategies.
    背景与目标: 食管鳞状细胞癌 (ESCC) 是大多数东部和南部非洲国家最常见的癌症之一,但其病因迄今尚未得到充分研究。为了告知其研究议程,我们进行了审查,以确定在世界范围内已经建立或强烈建议的ESCC风险因素,在任何受ESCC影响的非洲环境中具有高流行率或高暴露水平的因素及其来源。我们发现,对于迄今为止已知的几乎所有ESCC危险因素,包括烟草,酒精,热饮料消费,亚硝胺以及吸入和摄入的PAHs,都有证据表明人群暴露量增加,其来源在不同文化之间差异很大ESCC走廊。包含这些风险因素的研究是必要的,并且有可能确定一级预防策略。
  • 【HPV-16/18 AS04-adjuvanted疫苗在南非HIV阳性妇女中的安全性和免疫原性: 一项部分盲的随机安慰剂对照研究。】 复制标题 收藏 收藏
    DOI:10.1016/j.vaccine.2013.09.032 复制DOI
    作者列表:Denny L,Hendricks B,Gordon C,Thomas F,Hezareh M,Dobbelaere K,Durand C,Hervé C,Descamps D
    BACKGROUND & AIMS: :In developing countries, risk of human papillomavirus (HPV) infection may be increased by the high prevalence of human immunodeficiency virus (HIV) infection. We evaluated the safety and immunogenicity of the HPV-16/18 AS04-adjuvanted vaccine in HIV-infected women in South Africa. Asymptomatic HIV-positive women aged 18-25 years (N=120) were stratified by CD4⁺ T-cell count and randomised (1:1) to receive HPV-16/18 vaccine (Cervarix®; GlaxoSmithKline Vaccines) or placebo (Al[OH]3) at 0, 1 and 6 months (double-blind). HIV-negative women (N=30) received HPV-16/18 vaccine (open label). Anti-HPV-16/18 antibody and CD4⁺ T-cell responses, CD4⁺ T-cell count, HIV viral load, HIV clinical stage and safety were evaluated for 12 months. The safety and reactogenicity profile of the HPV-16/18 vaccine was comparable in HIV-positive and HIV-negative women. Irrespective of baseline HPV status, all HIV-positive and HIV-negative women who received the HPV-16/18 vaccine were seropositive for both HPV-16 and HPV-18 after the second vaccine dose (month 2) and remained seropositive for both antigens at month 12. Anti-HPV-16/18 antibody titres at month 12 remained substantially above levels associated with natural infection. The HPV-16/18 vaccine induced sustained anti-HPV-16/18 CD4⁺ T-cell responses in both HIV-positive and HIV-negative women. No impact of baseline CD4⁺ T-cell count or HIV viral load was observed on the magnitude of the immune response in HIV-positive women. In HIV-positive women, CD4⁺ T-cell count, HIV viral load and HIV clinical stage were unaffected by HPV-16/18 vaccine administration. In conclusion, the HPV-16/18 AS04-adjuvanted vaccine appears immunogenic and well-tolerated in women with HIV infection. Study ID: 107863/NCT00586339.
    背景与目标: : 在发展中国家,人类免疫缺陷病毒 (HIV) 感染的高患病率可能会增加人类乳头瘤病毒 (HPV) 感染的风险。我们评估了HPV-16/18 AS04-adjuvanted疫苗在南非HIV感染妇女中的安全性和免疫原性。18-25岁无症状HIV阳性妇女 (N = 120) 通过CD4 + T细胞计数进行分层,并随机 (1:1) 接受HPV-16/18疫苗 (Cervarix)®; 葛兰素史克疫苗) 或安慰剂 (Al[OH]3) 在0、1和6个月 (双盲)。HIV阴性妇女 (N = 30) 接受HPV-16/18疫苗 (开放标签)。Anti-HPV-16/18抗体和CD4 + T细胞应答,CD4 + T细胞计数,HIV病毒载量,HIV临床分期和安全性进行12个月的评估。HPV-16/18疫苗的安全性和反应原性在HIV阳性和HIV阴性妇女中相当。无论基线HPV状况如何,所有接受HPV-16/18疫苗的HIV阳性和HIV阴性妇女在第二次疫苗剂量 (第2个月) 后HPV-16和HPV-18均呈血清阳性,并且在第12个月时两种抗原均呈血清阳性。第12个月时的Anti-HPV-16/18抗体滴度基本上高于与自然感染相关的水平。HPV-16/18疫苗在HIV阳性和HIV阴性妇女中均诱导了持续的anti-HPV-16/18 CD4 T细胞应答。未观察到基线CD4 + T细胞计数或HIV病毒载量对HIV阳性女性免疫反应的影响。在HIV阳性妇女中,CD4 + T细胞计数,HIV病毒载量和HIV临床阶段不受HPV-16/18疫苗给药的影响。总之,HPV-16/18 AS04-adjuvanted疫苗在HIV感染妇女中表现出免疫原性和耐受性良好。研究编号: 107863/nct00586339。
  • 【EIF4G1 R1205H和VPS35 D620N突变在南非帕金森氏病中很少见。】 复制标题 收藏 收藏
    DOI:10.1016/j.neurobiolaging.2013.08.023 复制DOI
    作者列表:Blanckenberg J,Ntsapi C,Carr JA,Bardien S
    BACKGROUND & AIMS: :The R1205H mutation in the eukaryotic translation initiation factor 4G1 (EIF4G1) gene and the D620N mutation in the vacuolar protein sorting 35 (VPS35) gene were recently found in patients with autosomal dominant or sporadic forms of Parkinson's disease (PD). In the present study, 418 South African PD patients and 528 control subjects of diverse ethnicities were screened using the KASP (Kompetitive Allele Specific PCR) genotyping assay. The mutations were not found in our study, suggesting that they are not a common cause of PD in South African patients. Further studies are needed on the frequency of these 2 mutations in other sub-Saharan African populations.
    背景与目标: : 最近在常染色体显性或散发性帕金森氏病 (PD) 患者中发现了真核翻译起始因子4G1 (EIF4G1) 基因中的R1205H突变和液泡蛋白分选35 (VPS35) 基因中的D620N突变。在本研究中,使用KASP (Kompetitive等位基因特异性PCR) 基因分型试验筛选了418名南非PD患者和528不同种族的对照受试者。在我们的研究中未发现这些突变,这表明它们不是南非患者PD的常见原因。需要进一步研究这两种突变在其他撒哈拉以南非洲人群中的频率。
  • 【南非的营养转变: 南非夸祖鲁-纳塔尔省农村的女小学生超重,肥胖,体重不足和发育迟缓。】 复制标题 收藏 收藏
    DOI:10.7196/samj.6922 复制DOI
    作者列表:Tathiah N,Moodley I,Mubaiwa V,Denny L,Taylor M
    BACKGROUND & AIMS: BACKGROUND:Malnutrition substantially impacts the health outcomes of children. Globally, the childhood prevalence of overweight and obesity has increased, while underweight and stunting (though decreasing) continues to pose a major public health challenge. In low- to middle-income countries, a mixed pattern of over- and undernutrition (nutritional transition) can exist in communities. OBJECTIVE:To describe the prevalence of malnutrition among female learners in the Nongoma and Ceza districts in Zululand, KwaZulu-Natal (KZN). METHODS:We performed a secondary analysis of anthropometric data collected during the 2011 HPV Vaccination Demonstration Project. School health teams, comprising trained nurses, measured the height (in cm) and weight (in kg) of 963 female learners in 31 primary schools. Internationally accepted standardised measures were used as cut-offs for defining overweight, obesity, underweight and stunting. RESULTS:We found evidence of both under- and overnutrition. Overall, 9% of female learners were overweight, 3.8% obese, 4% underweight and 9.2% stunted (using WHO/NCHS criteria). The highest levels of stunting were in the 11 - 12-year age groups, of underweight in the 10-year age group, of overweight and obesity in the 9 - 10-year age groups. Moreover, a proportion of underweight (17.4%), overweight (11.1%) and obese (22.9%) learners were also stunted. CONCLUSION:Our study describes the prevalence of overweight and obesity, wasting and stunting of female learners in KZN and suggests the presence of a nutritional transition in these rural communities; however, further studies are needed. Our findings emphasise the need for health promotion and education programs in schools.
    背景与目标:

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录