• 【马丁-格鲁伯在南非的联系。解剖学研究。】 复制标题 收藏 收藏
    DOI:10.1016/s0266-7681(97)80396-8 复制DOI
    作者列表:Taams KO
    BACKGROUND & AIMS: One hundred and twelve forearms in 56 preserved cadavers were dissected to assess the incidence of Martin-Gruber connections in a population in South Africa. The connections were found in 13 cadavers (23%) and one was bilateral. There were no significant racial or sexual differences in the incidence. The course of Martin-Gruber connections and their anatomical relationship with the ulnar artery are illustrated.

    背景与目标: 解剖了56具保存尸体中的112只前臂,以评估南非人口中Martin-Gruber连接的发生率。在13具尸体 (23%) 中发现了连接,其中1具是双侧的。发病率没有明显的种族或性别差异。说明了Martin-Gruber连接的过程及其与尺动脉的解剖关系。
  • 【冈比亚按蚊2La染色体倒置与非洲恶性疟原虫的易感性有关。】 复制标题 收藏 收藏
    DOI:10.7554/eLife.25813 复制DOI
    作者列表:Riehle MM,Bukhari T,Gneme A,Guelbeogo WM,Coulibaly B,Fofana A,Pain A,Bischoff E,Renaud F,Beavogui AH,Traore SF,Sagnon N,Vernick KD
    BACKGROUND & AIMS: :Chromosome inversions suppress genetic recombination and establish co-adapted gene complexes, or supergenes. The 2La inversion is a widespread polymorphism in the Anopheles gambiae species complex, the major African mosquito vectors of human malaria. Here we show that alleles of the 2La inversion are associated with natural malaria infection levels in wild-captured vectors from West and East Africa. Mosquitoes carrying the more-susceptible allele (2L+a) are also behaviorally less likely to be found inside houses. Vector control tools that target indoor-resting mosquitoes, such as bednets and insecticides, are currently the cornerstone of malaria control in Africa. Populations with high levels of the 2L+a allele may form reservoirs of persistent outdoor malaria transmission requiring novel measures for surveillance and control. The 2La inversion is a major and previously unappreciated component of the natural malaria transmission system in Africa, influencing both malaria susceptibility and vector behavior.
    背景与目标: : 染色体倒位抑制遗传重组并建立共同适应的基因复合物或超基因。2La反转是冈比亚按蚊物种复合体 (人类疟疾的主要非洲蚊子媒介) 中广泛存在的多态性。在这里,我们显示2La反转的等位基因与来自西非和东非的野生捕获载体中的自然疟疾感染水平有关。携带更敏感的等位基因 (2L a) 的蚊子在行为上也不太可能在房屋内被发现。针对室内静止蚊子的病媒控制工具,如蚊帐和杀虫剂,目前是非洲疟疾控制的基石。2L a等位基因水平高的人群可能会形成持续的室外疟疾传播库,需要采取新的监测和控制措施。2La倒置是非洲自然疟疾传播系统的主要且以前未被重视的组成部分,影响疟疾的易感性和媒介行为。
  • 【撒哈拉以南非洲艾滋病毒诊断和开始抗逆转录病毒治疗之间的方案损失: 系统评价和荟萃分析。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-3156.2012.03089.x 复制DOI
    作者列表:Mugglin C,Estill J,Wandeler G,Bender N,Egger M,Gsponer T,Keiser O,IeDEA Southern Africa.
    BACKGROUND & AIMS: OBJECTIVES:To assess the proportion of patients lost to programme (died, lost to follow-up, transferred out) between HIV diagnosis and start of antiretroviral therapy (ART) in sub-Saharan Africa, and determine factors associated with loss to programme. METHODS:Systematic review and meta-analysis. We searched PubMed and EMBASE databases for studies in adults. Outcomes were the percentage of patients dying before starting ART, the percentage lost to follow-up, the percentage with a CD4 cell count, the distribution of first CD4 counts and the percentage of eligible patients starting ART. Data were combined using random-effects meta-analysis. RESULTS:Twenty-nine studies from sub-Saharan Africa including 148,912 patients were analysed. Six studies covered the whole period from HIV diagnosis to ART start. Meta-analysis of these studies showed that of the 100 patients with a positive HIV test, 72 (95% CI 60-84) had a CD4 cell count measured, 40 (95% CI 26-55) were eligible for ART and 25 (95% CI 13-37) started ART. There was substantial heterogeneity between studies (P < 0.0001). Median CD4 cell count at presentation ranged from 154 to 274 cells/μl. Patients eligible for ART were less likely to become lost to programme (25%vs. 54%, P < 0.0001), but eligible patients were more likely to die (11%vs. 5%, P < 0.0001) than ineligible patients. Loss to programme was higher in men, in patients with low CD4 cell counts and low socio-economic status and in recent time periods. CONCLUSIONS:Monitoring and care in the pre-ART time period need improvement, with greater emphasis on patients not yet eligible for ART.
    背景与目标:
  • 【南非健康方面的公私互动: 扩大规模的机会。】 复制标题 收藏 收藏
    DOI:10.1093/heapol/czt042 复制DOI
    作者列表:Kula N,Fryatt RJ
    BACKGROUND & AIMS: :South Africa has long recognized partnerships between the public and private sectors as a policy objective in health, but experience is still limited and poorly documented. The objectives of this article are to understand the factors that increase the likelihood of success of public-private interactions in South Africa, and identify and discuss opportunities for them to be scaled up. There is a strong legislative framework and a number of guidelines and tools that have been developed by the Treasury for managing partnerships. The review of literature confirmed the need for the state to have effective regulations in order to oversee quality and standards and to provide stewardship and oversight. The public sector requires sufficient capacity not only to manage relationships with the private sector but also to enable innovation and experimentation. Evaluation is an integral part of all interactions not only to learn from successes but also to identify any perverse incentives that may lead to unintended consequences. Four case studies show that the private for-profit sector is already engaged in a number of projects that are closely aligned to current health system reform priorities. Factors that increase the likelihood of interactions being successful include: increasing the government's capacity to manage public-private relationships; choosing public-private interactions that are strategically important to national goals; building a knowledge base on what works, where and why; moving from pilots to large scale initiatives; harnessing the contracting expertise in private providers; and encouraging innovation and learning.
    背景与目标: : 南非长期以来一直承认公共部门和私营部门之间的伙伴关系是卫生方面的政策目标,但经验仍然有限,而且文献记载很少。本文的目的是了解增加南非公私互动成功可能性的因素,并确定和讨论扩大它们的机会。财政部为管理伙伴关系制定了强有力的立法框架和许多准则和工具。对文献的审查证实,国家需要制定有效的法规,以监督质量和标准,并提供管理和监督。公共部门不仅需要足够的能力来管理与私营部门的关系,而且还需要创新和实验。评估是所有互动的组成部分,不仅要从成功中学习,而且要确定可能导致意外后果的任何不正当激励措施。四个案例研究表明,私营营利部门已经参与了许多与当前卫生系统改革优先事项密切相关的项目。增加互动成功可能性的因素包括: 提高政府管理公私关系的能力; 选择对国家目标具有战略重要性的公私互动; 建立有效的知识基础,在何处以及为什么; 从试点转向大规模计划; 利用私人供应商的合同专业知识; 鼓励创新和学习。
  • 【亚洲和非洲农产品太阳能干燥器回顾: 一种创新景观方法。】 复制标题 收藏 收藏
    DOI:10.1016/j.jenvman.2020.110730 复制DOI
    作者列表:Udomkun P,Romuli S,Schock S,Mahayothee B,Sartas M,Wossen T,Njukwe E,Vanlauwe B,Müller J
    BACKGROUND & AIMS: :Solar drying is one of the most efficient and cost-effective, renewable, and sustainable technologies to conserve agricultural products in Asian and sub-Saharan African (SSA) countries. This review paper presents the different types of solar dryers that are widely used in Africa and Asia. In addition, the pre-eminent effects of their use on product quality, as well as their economic, environmental, and social impacts, are highlighted. Since financial, external, and structural factors play a key role in the adoption and scaling of solar dryers, this paper also discusses the impact of these factors on the effectiveness of solar drying technologies in selected Asian and SSA countries.
    背景与目标: : 太阳能干燥是亚洲和撒哈拉以南非洲 (SSA) 国家保护农产品的最有效,最具成本效益,可再生和可持续的技术之一。本文介绍了在非洲和亚洲广泛使用的不同类型的太阳能干燥器。此外,还强调了它们的使用对产品质量的突出影响,以及它们的经济、环境和社会影响。由于金融,外部和结构因素在太阳能干燥机的采用和扩展中起着关键作用,因此本文还讨论了这些因素对选定的亚洲和SSA国家太阳能干燥技术有效性的影响。
  • 【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:

+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