1.  Title: Efficacy and acceptability of rapid, point-of-care HIV testing in two clinical settings in Ghana. Author: Appiah LT; Havers F; Gibson J; Kay M; Sarfo F; Chadwick D Source: AIDS Patient Care and STDs. 2009 May;23(5):365-9. Abstract: This study assessed the efficacy and acceptability of two rapid point-of-care HIV assays used in a voluntary counseling and testing (VCT) and a tuberculosis (TB) clinic in Kumasi, Ghana. Over a 4-week period in 2007, 95 individuals attending the VCT clinic and 35 patients with newly diagnosed TB were offered a rapid HIV test. Rates of return for positive results and attendance at the HIV clinic were compared with 471 individuals (395 attending the VCT clinic and 76 patients with TB), tested during an 8-week period 6 months earlier using standard testing procedures. All patients offered a rapid test in each clinic underwent testing, compared to 93% of VCT clients and 40% of TB patients offered a test 6 months earlier. In the rapid testing period, 37%, 60%, and 3% of the VCT clients and 26%, 74% and 0% of the TB patients had positive, negative, or indeterminate serology, respectively. There were no discordant results following retesting of patients with a positive test. All patients attending either the VCT or TB clinics who tested positive for HIV with the point-of-care test returned to the HIV clinic for care, while only 64% and 95%, respectively, of the patients previously testing positive had returned for follow-up. Both clients and staff showed high levels of satisfaction with the rapid testing procedure. In conclusion, rapid point-of-care testing in both of these settings was successful in improving diagnosis of HIV infection and engaging those testing positive in a clinical care program. Language: English Keywords: GHANA | RESEARCH REPORT | COMPARATIVE STUDIES | CLIENTS | HIV TESTING | PROGRAM ACCEPTABILITY | CLINIC ACTIVITIES | VOLUNTARY COUNSELING AND TESTING | TUBERCULOSIS | SATISFACTION | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Program Evaluation | Infections | Diseases | Psychological Factors | Behavior Document Number: 342184 |
| 2. Title: [Characterization of tuberculosis among HIV/AIDS patients at a referral center in Mato Grosso do Sul] Caracterizacao da tuberculose em portadores de HIV/AIDS em um servico de Author: Cheade Mde F; Ivo ML; Siqueira PH; Sa RG; Honer MR Source: Revista Da Sociedade Brasileira De Medicina Tropical. 2009 Mar-Apr;42(2):119-25. Abstract: Tuberculosis was investigated regarding its clinical presentation, treatment outcome and sociodemographic profile among HIV patients attended at a referral center in Mato Grosso do Sul, in 2003-2005. Sixty-six medical files on patients over 14 years of age and data from the Brazilian National Information System for Notifiable Diseases relating to tuberculosis and from the Mortality Information System were analyzed. Most of the patients were male, white, of low schooling level and from urban areas. Increased extrapulmonary clinical presentation was found and it correlated with the degree of immunological competence. The main reasons for ceasing treatment were cure (reached after longer-than-expected follow-up) and death (of six patients at the beginning of the tuberculosis treatment). Information gaps were found in the tuberculosis notification records and medical files. The study revealed the need for early diagnosis of tuberculosis among HIV-positive patients, improvements in medical records and follow-up beyond the recommended duration, because of changes to the clinical evolution of tuberculosis in cases of comorbidity with HIV. Language: Portuguese Keywords: BRAZIL | RESEARCH REPORT | CLINIC ACTIVITIES | PERSONS LIVING WITH HIV/AIDS | TUBERCULOSIS | SOCIOECONOMIC STATUS | TREATMENT | DATA COLLECTION | RECORDS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Infections | Socioeconomic Factors | Economic Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Research Methodology | Information Processing | Information Document Number: 342168 |
| 3. Title: Urinary screening abnormalities in antiretroviral-naive HIV-infected outpatients and implications for management--a single-center study in South Africa. Author: Fabian J; Naicker S; Venter WD; Baker L; Naidoo S; Paget G; Wadee S Source: Ethnicity and Disease. 2009 Spring;19(1 Suppl 1):S1-80-5. Abstract: Few urinary screening studies have been performed to determine the incidence of urinary abnormalities in antiretroviral therapy-naive, HIV-infected outpatients. From published data, the incidence appears to be high, particularly when compared with populations outside sub-Saharan Africa. In South Africa, urinary screening in antiretroviral therapy clinics is not routinely practiced. The aim of this descriptive study was to screen antiretroviral therapy-naive, HIV-infected outpatients attending the HIV clinic for urinary abnormalities, namely leukocyturia, microscopic hematuria, and microalbuminuria/proteinuria. This study showed that 84% of the screened population had AIDS (CD4 count < 200 cells/ mm3), and the incidence of abnormalities on urinary dipstick testing was high: 30% had leukocyturia, 33% had microscopic hematuria, and 44% had microalbuminuria/proteinuria. In patients with leukocyturia, an infective organism was cultured in only 29.1% of cases, predominantly Escherichia coli (70%) with sterile leukocyturia comprising the remainder. There may be an association with tuberculosis (TB) or sexually transmitted infections (STI) in the sterile leucocyturia group, but this remains to be confirmed. In those with a culture positive result the most common organism was E. coli (70%), which exhibited 90% resistance to cotrimoxazole, demonstrating that cotrimoxazole prophylaxis is not effective to prevent urinary tract infection in this group. On the basis of these findings, it has been proposed that urinary screening be considered standard of care in HIV clinics in South Africa. An algorithm has been proposed for use in antiretroviral therapy clinics in South Africa to guide clinicians regarding the cost-effective management of urinary dipstick abnormalities. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | SAMPLING STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | RENAL EFFECTS | UROGENITAL EFFECTS | SCREENING | AIDS | PREVALENCE | CLINIC ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Urogenital System | Physiology | Biology | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement Document Number: 341942 |
| 4. Peer Reviewed Title: Sexual behaviour, condom use and rates of sexually transmitted infections in HIV clinic attendees in South East London. Author: Hamlyn E; Welz T; Rebaudengo S; Simms H; Poulton M Source: International Journal of STD and AIDS. 2009 Sep 16; Abstract: The aim of this study was to examine sexual behaviour, condom use and rates of sexually transmitted infections (STIs) among attendees at a dedicated on-site STI clinic at a South London HIV centre. Data were prospectively collected by using a nurse-completed questionnaire. Ninety-eight percent of women reported one or no sexual partners in the preceding three months, whereas 57% of men who have sex with men (MSM) reported two or more partners. Only 28% of women, 53% of heterosexual men and 29% of MSM always used a condom for vaginal or anal intercourse. Positive STI diagnoses were found in 17.5% of women, 20% of heterosexual men and 49% of MSM. Twenty percent of patients who reported always using a condom and 38% of MSM reporting no sexual activity in the preceding three months had an STI. These results highlight the need for safe sex promotion and STI screening in HIV-infected patients regardless of self-reported sexual activity. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | PROSPECTIVE STUDIES | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HETEROSEXUALS | MEN HAVING SEX WITH MEN | CONDOM USE | SEX BEHAVIOR | SEXUALLY TRANSMITTED DISEASES | PREVALENCE | QUESTIONNAIRES | CLINIC ACTIVITIES | SCREENING | Developed Countries | Europe, Western | Europe | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Behavior | Risk Reduction Behavior | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 342841 |
| 5. Title: Use of the internet by patients attending specialist clinics in Sri Lanka: a cross sectional study. Author: Kommalage M Source: BMC Medical Informatics and Decision Making. 2009;9:12. Abstract: BACKGROUND: The internet is a relatively new medium of disseminating health information. Studies on Internet usage for health information are mainly done in developed countries and very few studies have been carried out in developing countries. METHODS: The Internet usage of patients who were attending specialist clinics in Teaching Hospital Karapitiya and Southern Hospital in Galle, Sri Lanka was investigated. The study was carried out on the following specialities; General Medicine, Pediatrics, General Surgery and Cardiothoracic surgery. Information was collected using an investigator-administered questionnaire while patients were waiting for a consultation. RESULTS: Three hundred and fifty five patients (or guardians in the Pediatric clinic) participated in the study. One hundred seventy two (48.3%) participants have heard about the Internet. There was a relationship between awareness of the Internet and age, educational level and the clinic attended. There was no difference of awareness depending on the gender or the hospital. Only three participants (0.97%) have used the Internet to find information about their disease conditions. Close relatives searched the Internet about the conditions of two participants. Altogether, the Internet was used to search information on the disease condition of five participants (1.4%). CONCLUSION: Very low usage of the Internet for health information retrieval in this study is probably due to low awareness of the Internet and low educational level. This low usage of Internet and the associated reasons shown in this study can be generalized to Sri Lanka and probably to other low-income countries that have lower educational level than Sri Lanka. Language: English Keywords: SRI LANKA | RESEARCH REPORT | KAP SURVEYS | CROSS SECTIONAL ANALYSIS | TARGET POPULATION | INTERNET | INFORMATION SOURCES | AGE FACTORS | EDUCATIONAL STATUS | CLINIC ACTIVITIES | EXAMINATIONS AND DIAGNOSES | HEALTH EDUCATION | Developing Countries | Asia, Southern | Asia | Surveys | Sampling Studies | Studies | Research Methodology | Program Design | Programs | Organization and Administration | Information Networks | Communication | Information | Population Characteristics | Demographic Factors | Population | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Program Activities | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Education Document Number: 331071 |
| 6. Peer Reviewed Title: Use of task-shifting to rapidly scale-up HIV treatment services: experiences from Lusaka, Zambia. Author: Morris MB; Chapula BT; Chi BH; Mwango A; Chi HF; Mwanza J; Manda H; Bolton C; Pankratz DS; Stringer JS; Reid SE Source: BMC Health Services Research. 2009;9:5. Abstract: The World Health Organization advocates task-shifting, the process of delegating clinical care functions from more specialized to less specialized health workers, as a strategy to achieve the United Nations Millennium Development Goals. However, there is a dearth of literature describing task shifting in sub-Saharan Africa, where services for antiretroviral therapy (ART) have scaled up rapidly in the face of generalized human resource crises. As part of ART services expansion in Lusaka, Zambia, we implemented a comprehensive task-shifting program among existing health providers and community-based workers. Training begins with didactic sessions targeting specialized skill sets. This is followed by an intensive period of practical mentorship, where providers are paired with trainers before working independently. We provide on-going quality assessment using key indicators of clinical care quality at each site. Program performance is reviewed with clinic-based staff quarterly. When problems are identified, clinic staff members design and implement specific interventions to address targeted areas. From 2005 to 2007, we trained 516 health providers in adult HIV treatment; 270 in pediatric HIV treatment; 341 in adherence counseling; 91 in a specialty nurse "triage" course, and 93 in an intensive clinical mentorship program. On-going quality assessment demonstrated improvement across clinical care quality indicators, despite rapidly growing patient volumes. Our task-shifting strategy was designed to address current health care worker needs and to sustain ART scale-up activities. While this approach has been successful, long-term solutions to the human resource crisis are also urgently needed to expand the number of providers and to slow staff migration out of the region. Language: English Keywords: ZAMBIA | RESEARCH REPORT | CLINICAL RESEARCH | HEALTH PERSONNEL | ADMINISTRATIVE PERSONNEL | URBAN POPULATION | CAPACITY BUILDING | ANTIRETROVIRAL THERAPY | AIDS PREVENTION | ORGANIZATION AND ADMINISTRATION | MANAGEMENT | COUNSELING | USER COMPLIANCE | CLINIC ACTIVITIES | ON-THE-JOB TRAINING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Research Methodology | Delivery of Health Care | Health | Population Characteristics | Demographic Factors | Population | Program Sustainability | Programs | HIV | HIV Infections | Viral Diseases | Diseases | AIDS | Program Activities | Behavior | Training Programs | Education Document Number: 331094 |
| 7. Title: Need for syphilis screening and counselling in HIV counselling and testing centres: a curtain raiser study from north India. Author: Nag VL; Dash NR; Pathak A; Agarwal SK Source: Australian Journal of Rural Health. 2009 Apr;17(2):102-6. Abstract: BACKGROUND: Voluntary counselling and testing centres (VCTC) are important HIV screening points for the population with suspicion or apprehension for HIV, because of high-risk exposures. Theoretically, these are also at the risk of having co-infections, commonest being syphilis. The present short-term study was aimed at knowing the sero-reactivity of syphilis among a study cohort attending the VCTC in King George's Medical University, Lucknow, India. METHOD: During a 2.5-month period, 49 HIV-positive and 171 HIV-negative sera were tested for venereal disease research laboratory (VDRL). The positive sera were further tested for treponema pallidum haemagglutination (TPHA). RESULT: Eleven (22.4%) HIV-positive sera and 104 (60.8%) HIV-negative sera were VDRL-reactive (>or=1:8 dilutions). Of these, TPHA was reactive in three (27.3%) and four (3.9%), respectively. CONCLUSION: The result might suggest the need for routine screening and counselling for syphilis at VCTC. Studies from other centres on larger population are required. Language: English Keywords: INDIA | RESEARCH REPORT | STATISTICAL STUDIES | SYPHILIS | SCREENING | INCIDENCE | HIV INFECTIONS | VOLUNTARY COUNSELING AND TESTING | CLINIC ACTIVITIES | LABORATORY PROCEDURES | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Viral Diseases | HIV Testing | Laboratory Examinations and Diagnoses | Program Activities | Programs | Organization and Administration Document Number: 341687 |
| 8. Peer Reviewed Title: Hormonal contraception and risk of bacterial vaginosis diagnosis in an observational study of women attending STD clinics in Baltimore, MD. Author: Rifkin SB; Smith MR; Brotman RM; Gindi RM; Erbelding EJ Source: Contraception. 2009 Jul;80(1):63-7. Abstract: BACKGROUND: The protective effect of hormonal contraception may offer a potential intervention against bacterial vaginosis (BV). STUDY DESIGN: Three hundred thirty reproductive-age women enrolled in a contraceptive program from April 2005 to October 2006 at two sexually transmitted diseases clinics in Baltimore, MD. Participants were supplied with hormonal contraceptives of their choice and followed prospectively. BV was diagnosed by Amsel's criteria. Results from population-level analysis were compared to a case-crossover analysis. RESULTS: BV was diagnosed in 189 (13.0%) of the visits among 133 (40.3%) women. In the population-level analysis, the use of progestin-only and combined contraception was associated with a decreased risk of BV compared to intervals of no hormonal contraceptive use [adjusted odds ratio (AOR): 0.42 (95% CI: 0.20-0.88) and AOR: 0.66 (95% CI: 0.39-1.10), respectively]. The case-crossover analysis demonstrated a similar trend in findings. CONCLUSION: Hormonal contraception was associated with a decreased risk of BV in an STD clinic cohort. Language: English Keywords: UNITED STATES OF AMERICA | MARYLAND | RESEARCH REPORT | DATA ANALYSIS | CLINIC ACTIVITIES | WOMEN | VAGINOSIS | DEPO-PROVERA | ORAL CONTRACEPTIVES, COMBINED | CONTRACEPTIVE AGENTS, PROGESTIN | Developed Countries | North America | Americas | Research Methodology | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Vaginal Abnormalities | Diseases | Medroxyprogesterone Acetate | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Oral Contraceptives | Contraceptive Methods Document Number: 341582 |
| 9. Peer Reviewed Title: Timeliness and completion rate of immunization among Nigerian children attending a clinic-based immunization service. Author: Sadoh AE; Eregie CO Source: Journal of Health, Population, and Nutrition. 2009 Jun;27(3):391-5. Abstract: To achieve maximal protection against vaccine-preventable diseases, a child should receive all immunizations within recommended intervals. Clinic records of 512 Nigerian children were evaluated for timeliness in receiving vaccines and the completion rates of the schedule. About 30% of the children presented after four weeks of age for their first immunization; 18.9-65% of the children were delayed in receiving various vaccines compared to the recommended ages for receiving the vaccines. Only 227 (44.3%) children were fully immunized. Health education and mass mobilization of the community and health workers are recommended to improve the uptake of vaccines and to encourage timely receipt of vaccines. Language: English Keywords: NIGERIA | RESEARCH REPORT | CHILDREN | IMMUNIZATION | IMMUNIZATION SCHEDULE | TIME FACTORS | CLINIC ACTIVITIES | HEALTH EDUCATION | SOCIAL MOBILIZATION | VACCINES | ADMINISTRATION AND DOSAGE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Primary Health Care | Health Services | Delivery of Health Care | Health | Population Dynamics | Program Activities | Programs | Organization and Administration | Education | Social Change | Sociocultural Factors | Medical Procedures | Medicine | Drugs | Treatment Document Number: 341923 |
| 10. Peer Reviewed Title: Planning for Posttrial Access to Antiretroviral Treatment for Research Participants in Developing Countries. Author: Shah S; Elmer S; Grady C Source: American Journal of Public Health. 2009 Jul 16; Abstract: Despite recognition of the importance of posttrial access to antiretroviral therapy (ART), the implementation process has not been studied. We examined whether National Institutes of Health (NIH) guidance was being implemented in NIH-funded ART trials conducted in developing countries between July 2005 and June 2007. All of the 18 studies we identified had posttrial access plans for trial participants. More than 70% had specific mechanisms for posttrial access, but none guaranteed long-term sponsor funding after the trials. The plans reflected variation in local contexts and the uncertainty of predicting local conditions in the long term. The strength of the NIH guidance may be that it encourages investigators to formulate plans in advance and to work with other stakeholders to provide access to ART. Language: English Keywords: DEVELOPING COUNTRIES | RESEARCH REPORT | STUDIES | CLINIC ACTIVITIES | ANTIRETROVIRAL THERAPY | PARTICIPATION | ETHICS | INFORMED CONSENT | TREATMENT | FUNDS | INTERNATIONAL COOPERATION | PROGRAM ACCESSIBILITY | Research Methodology | Program Activities | Programs | Organization and Administration | HIV | HIV Infections | Viral Diseases | Diseases | Social Behavior | Behavior | Sociocultural Factors | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Financial Activities | Economic Factors | Political Factors | Program Evaluation Document Number: 342040 |
| 11. Peer Reviewed Title: Contraceptive use among women attending an open access genitourinary medicine department. Author: Trewinnard K; Foley E Source: International Journal of STD and AIDS. 2009 Aug;20(8):573-4. Abstract: Termination of pregnancy rates among young women are rising in the UK and are associated with poor use of reliable contraceptive methods. Many women attending the genitourinary (GU) department for sexually transmitted infection screening do so because of poor or no condom use and are at ongoing risk of unwanted pregnancy. Few of these women attend a contraception clinic, where a full range of contraceptive methods, including long-acting reversible contraception, are available. In this study of 152 women of reproductive age, half stated that they needed further contraceptive advice. In total four-fifths of the women without a reliable method of contraception wanted contraceptive advice and/or future contraceptive provision in the GU medicine clinic. Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | CLIENTS | WOMEN | CONTRACEPTIVE USAGE | QUESTIONNAIRES | CLINIC ACTIVITIES | NEEDS | FAMILY PLANNING CLINIC ATTENDANCE | CONTRACEPTIVE DISTRIBUTION | PREGNANCY, UNWANTED | CONDOM USE | Developed Countries | Europe, Western | Europe | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Contraception | Family Planning | Economic Factors | Family Planning Program Evaluation | Family Planning Programs | Distributional Activities | Reproductive Behavior | Fertility | Population Dynamics | Risk Reduction Behavior | Behavior Document Number: 342132 |
12.  Title: Transporting, storing, and handling malaria rapid diagnostic tests in health clinics. Author: World Health Organization [WHO]. Regional Office for the Western Pacific; John Snow [JSI]. DELIVER; Foundation for Innovative New Diagnostics [FIND]; Roll Back Malaria Partnership; United States. President's Malaria Initiative Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009 Jul. [35] p. (USAID Contract No. GPO-I-03-06-00007-00) Abstract: The publication is intended for staff at health clinics that use malaria rapid diagnostic tests (RDTs). It describes the basic principles for management and storage of RDT stock, and it outlines practical solutions for protecting RDTs against high temperatures during storage and transport. It also describes how to manage waste generated from RDT use. Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | TECHNICAL ASSISTANCE | HEALTH PERSONNEL | HEALTH FACILITIES | CLINIC ACTIVITIES | MALARIA PREVENTION | TESTING | STORAGE AND WAREHOUSES | LOGISTICS | WASTE MANAGEMENT | PHARMACY DISTRIBUTION | TRANSPORTATION | Programs | Organization and Administration | Delivery of Health Care | Health | Program Activities | Malaria | Parasitic Diseases | Diseases | Measurement | Research Methodology | Management | Environment | Nonclinical Distribution | Distributional Activities | Economic Factors Document Number: 331477 |
| 13. Peer Reviewed Title: Performance of serological tests for syphilis in sexually transmitted diseases clinics in Guangxi Autonomous Region, China: implications for syphilis surveillance and control. Author: Yin YP; Wei WH; Wang HC; Zhu BY; Yu YH; Chen XS; Peeling RW; Cohen MS Source: Sexual Health. 2009 Mar;6(1):5-9. Abstract: BACKGROUND: China is experiencing a growing syphilis epidemic. Individuals are currently screened and cases are confirmed using traditional serological testing methods. METHODS: A total of 11 558 serum specimens from patients at 14 sexually transmitted diseases (STD) clinics at provincial, prefecture and county levels in Guangxi Autonomous Region were tested at local clinics using the toluidine red unheated serum test (TRUST) and the SD Bioline Syphilis 3.0 Treponema Pallidum (SD-TP) test and then transported to the National STD Reference Laboratory for TRUST and confirmatory Treponema pallidum particle assay (TPPA) testing. RESULTS: In local clinics, 13.2% of specimens were TRUST positive and 12.8% were TRUST and SD-TP positive. At the Reference Laboratory, 15.4% of specimens were TRUST positive and 11.8% were TRUST and TPPA positive. Local clinics showed a significantly higher prevalence of active syphilis compared with results from the Reference Laboratory (12.8 v. 11.8%, chi(2) = 4.59, P = 0.03). The local TRUST tests had consistent results with Reference Laboratory tests qualitatively among 96.2% of the specimens and quantitatively among 95.5% of the specimens. The algorithm of TRUST screening and then SD-TP confirmation among positive TRUST specimens at local STD clinics had 96.6% sensitivity and 99.3% specificity in diagnosing active syphilis compared with the 'gold standard' based on TRUST and TPPA positivity at the Reference Laboratory (positive predictive value 95.1% and negative predictive value 99.5%). CONCLUSION: The TRUST screening and SD-TP confirmation in combination can be used at local STD clinics for the efficient diagnosis of serologically active syphilis. However, continuing capacity building and quality assurance remain critical in ensuring the quality of syphilis diagnosis at local clinics. Language: English Keywords: CHINA | RESEARCH REPORT | CLIENTS | SYPHILIS | SCREENING | DISEASE TRANSMISSION CONTROL | CLINIC ACTIVITIES | LABORATORY EXAMINATIONS AND DIAGNOSES | PREVALENCE | Asia, Eastern | Asia | Developing Countries | Program Activities | Programs | Organization and Administration | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Prevention and Control | Measurement | Research Methodology Document Number: 341692 |
| 14. Title: Introducing the community-based distribution of injectable contraceptive in Uganda. Author: Family Health International [FHI] Source: Research Triangle Park, North Carolina, Family Health International [FHI], 2008. 2 p. (USAID Contract No. GPO-A-00-05-00022-0Research Utilization Case Studies) Abstract: Research has shown that properly trained paramedical personnel can safely provide injectable contraceptives, yet the community-based distribution (CBD) of injectables remains controversial in many parts of Africa. Save the Children USA, Family Health International (FHI), and the Uganda Ministry of Health collaborated to introduce the CBD of the injectable depot-medroxyprogesterone acetate (DPMA) in Uganda. The intervention included a safety and feasibility study in the district of Nakasongola, scale-up in additional districts, and advocacy efforts. The intervention confirmed that CBD workers in Uganda can safely and effectively provide DMPA. Contraceptive prevalence increased by an estimated two to three percentage points in Nakasongola, and a follow-on evaluation of the project in three districts showed high continuation rates for women who received DMPA from CBD workers. Scale-up continues in additional districts and with new service-delivery organizations. Language: English Keywords: UGANDA | SUMMARY REPORT | PILOT PROJECTS | HEALTH PERSONNEL | COMMUNITY WORKERS | COMMUNITY-BASED DISTRIBUTION | CONTRACEPTIVE USAGE | INJECTABLES | CLINIC ACTIVITIES | TRAINING ACTIVITIES | IMPACT | INTERVENTIONS | PROGRAM EFFECTIVENESS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Delivery of Health Care | Health | Nonclinical Distribution | Distributional Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Contraceptive Methods | Training Programs | Education | Communication | Program Evaluation Document Number: 325366 |
| 15. Peer Reviewed Title: HIV prevalence in voluntary counseling and testing centers compared with national HIV serosurvey data in Uganda. Author: Baryarama F; Bunnell RE; Montana L; Hladik W; Opio A; Musinguzi J; Kirungi W; Waswa-Bright L; Mermin JH Source: JAIDS. Journal of Acquired Immune Deficiency Syndromes. 2008 Oct 1;49(2):183-9. Abstract: OBJECTIVES: To compare HIV prevalence from routine voluntary counseling and testing (VCT) data with a population-based serosurvey in Uganda and to assess the utility of VCT data as a supplemental data source for HIV surveillance. METHODS: We analyzed HIV testing data from 75,640 unique VCT clients aged 15-59 years collected from August 2004 to January 2005 at 160 VCT sites. We excluded clients who reported illness as the reason for testing. During the same time period, 18,525 adults aged 15-59 years were tested for HIV in the Uganda HIV/AIDS Sero-Behavioral Survey (UHSBS). We compared UHSBS HIV prevalence with age-standardized VCT prevalence, overall and among stand-alone and facility-based VCT sites. RESULTS: HIV prevalence in urban areas was similar overall [UHSBS: 9.7%, 95% confidence interval (CI) 8.6 to 10.7; VCT: 10.1%, CI 9.8 to 10.5] and for both men (UHSBS: 6.3%, CI 4.9 to 7.6; VCT: 7.1, CI 6.6 to 7.5) and women (UHSBS: 12.2%, CI 10.6 to 13.7; VCT: 12.9%, CI 12.3 to 13.4). Urban prevalence from UHSBS (9.7%, CI 8.6 to 10.7), VCT stand-alone sites (10.3% CI 9.8 to 10.8), and VCT sites in health facility settings (10.0%, CI 9.5 to 10.4) was similar. However, in rural areas where VCT coverage is much lower than in urban areas (10% versus 31%), HIV prevalence was much higher among rural VCT clients (8.2%, CI 7.9% to 8.4%) than among rural UHSBS participants (5.2%, CI 4.8% to 5.5%). This resulted in overall higher HIV prevalence among all VCT clients (8.8%, CI 8.7 to 9.1) compared with all survey participants (5.9%, CI 5.6 to 6.2). CONCLUSIONS: After excluding clients who give illness as a reason for testing, VCT data may be used without further adjustment to monitor the HIV epidemic among urban Ugandans using either VCT data from stand-alone or health facility-based sites. However, monitoring rural and overall HIV prevalence using VCT data may not be appropriate until the uptake of VCT in rural areas is significantly improved or an adjustment factor is applied. Language: English Keywords: UGANDA | RESEARCH REPORT | PREVALENCE | DATA ANALYSIS | URBAN AREAS | CLIENTS | VOLUNTARY COUNSELING AND TESTING | CLINIC ACTIVITIES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Geographic Factors | Population | Program Activities | Programs | Organization and Administration | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 329041 |
| 16. Peer Reviewed Title: Uptake of an HIV voluntary counseling and testing program for pregnant women in Georgia. Author: Butsashvili M; Preble E; Kamkamidze G; Robinson J; Chubinishvili O; Sukhiashvili R Source: AIDS Care. 2008 Oct;20(9):1125-7. Abstract: From 2002 to 2005 the Elizabeth Glaser Pediatric AIDS Foundation prevention of mother-to-child transmission of HIV project operated in Georgia and was managed by the Maternal and Child Care Union. The project covered Tbilisi, the capital, and included 34 clinics that provide women's healthcare. Out of 35,385 pregnant women starting prenatal care in clinics involved in the project, 91% (32,262) had received HIV counseling and, among those counseled, 94% (30,330) were tested for HIV antibodies; 14 pregnant women (<0.001%) were found to be HIV-infected. Language: English Keywords: GEORGIA | RESEARCH REPORT | CLINIC ACTIVITIES | WOMEN | PREGNANT WOMEN | VOLUNTARY COUNSELING AND TESTING | HIV TESTING | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | HIV INFECTIONS | ANTENATAL CARE | Developing Countries | Asia, Southwestern | Asia | Program Activities | Programs | Organization and Administration | Demographic Factors | Population | Population Characteristics | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Disease Transmission Control | Prevention and Control | Diseases | Viral Diseases | Maternal Health Services | Maternal-Child Health Services | Primary Health Care Document Number: 329415 |
| 17. Title: The unique features of pediatric HIV-1 in sub-Saharan Africa. Author: De Baets AJ; Ramet J; Msellati P; Lepage P Source: Current HIV Research. 2008 Jun;6(4):351-62. Abstract: In order to adapt African programs for antiretroviral treatment (ART) to children's needs, a good understanding of the unique features of pediatric HIV in Africa and realistic expectations of the results of such programs are crucial. We compared pediatric HIV in African settings to pediatric HIV in Western settings and to adult HIV in African settings. As an illustration, we also compared baseline characteristics and ART-outcomes from 15 African pediatric studies, 11 Western pediatric studies and 15 studies of African adults. Several differences in diagnostic, clinical, immunological and virological characteristics were identified, as well as variations in the most influential factors for disease progression and response to ART. Environmental factors may influence disease progression, mortality, loss to follow-up, adherence and the need to adapt the regimen. Many of the responses to ART are two-phased, the first phase taking longer in children than in adults. The selected African pediatric programs recorded a higher increase in median CD4-percent than the selected Western pediatric programs and a higher increase in CD4-count than the selected African adult programs. Compared to the adult programs, the African pediatric programs had lower drop-out rates, higher reported adherence levels and comparable mortality rates. The Western pediatric programs, however, had the lowest mortality rates. While several challenges complicate comparisons between ART-programs, increased knowledge of the unique features of pediatric HIV in Africa may greatly assist in improving pediatric HIV care on a global level. Language: English Keywords: AFRICA, SUB SAHARAN | DEVELOPED COUNTRIES | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | COMPARATIVE STUDIES | CHILDREN | ADULTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | ANTIRETROVIRAL THERAPY | CLINIC ACTIVITIES | TIME FACTORS | USER COMPLIANCE | DELIVERY OF HEALTH CARE | AGE SPECIFIC DEATH RATE | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | HIV | Program Activities | Programs | Organization and Administration | Population Dynamics | Behavior | Health | Death Rate | Mortality Document Number: 329834 |
| 18. Peer Reviewed Title: Assessing the quality of data aggregated by antiretroviral treatment clinics in Malawi. Author: Makombe SD; Hochgesang M; Jahn A; Tweya H; Hedt B Source: Bulletin of the World Health Organization. 2008 Apr;86(4):310-314. Abstract: As national antiretroviral treatment (ART) programmes scale-up, it is essential that information is complete, timely and accurate for site monitoring and national planning. The accuracy and completeness of reports independently compiled by ART facilities, however, is often not known. This study assessed the quality of quarterly aggregate summary data for April to June 2006 compiled and reported by ART facilities ("site report") as compared to the "gold standard" facility summary data compiled independently by the Ministry of Health supervision team ("supervision report"). Completeness and accuracy of key case registration and outcome variables were compared. Data were considered inaccurate if variables from the site reports were missing or differed by more than 5% from the supervision reports. Additionally, we compared the national summaries obtained from the two data sources. Monitoring and evaluation of Malawi's national ART programme is based on WHO's recommended tools for ART monitoring. It includes one master card for each ART patient and one patient register at each ART facility. Each quarter, sites complete cumulative cohort analyses and teams from the Ministry of Health conduct supervisory visits to all public sector ART sites to ensure the quality of reported data. Most sites had complete case registration and outcome data; however many sites did not report accurate data for several critical data fields, including reason for starting, outcome and regimen. The national summary using the site reports resulted in a 12% undercount in the national total number of persons on first-line treatment. Several facility-level characteristics were associated with data quality. While many sites are able to generate complete data summaries, the accuracy of facility reports is not yet adequate for national monitoring. The Ministry of Health and its partners should continue to identify and support interventions such as supportive supervision to build sites' capacity to maintain and compile quality data to ensure that accurate information is available for site monitoring and national planning. (author's) Language: English Keywords: MALAWI | RESEARCH REPORT | MONITORING | EVALUATION | INFORMATION | QUALITY CONTROL | ANTIRETROVIRAL THERAPY | RELIABILITY | CLINIC ACTIVITIES | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Organization and Administration | HIV | HIV Infections | Viral Diseases | Diseases | Measurement | Research Methodology | Program Activities | Programs | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health Document Number: 325938 |
| 19. Peer Reviewed Title: Clients' perspectives on HIV/AIDS care and treatment and reproductive health services in South Africa. Author: Orner P; Cooper D; Myer L; Zweigenthal V; Bekker LG; Moodley J Source: AIDS Care. 2008 Nov;20(10):1217-23. Abstract: Qualitative research was conducted with HIV-positive women and men of reproductive age attending HIV/AIDS care and treatment services at a public health clinic in Cape Town, South Africa. Focus group discussions were held with women (n = 4) and men (n = 4), and in-depth interviews were held with four men to explore perceptions and experiences of HIV/AIDS care and treatment and sexual and reproductive health (SRH) care. Respondents praised their HIV/AIDS care and treatment, reflected on how it improved their quality of life and contrasted this with suboptimal care at other public health facilities, including SRH services. Women wanted integrated services, especially for contraception and to reduce stigma. HIV-positive men's lack of experience with SRH services and antipathy towards attending "women's" health services were highlighted. Challenges to involving men in HIV/AIDS care and treatment and SRH services and measures to address this were identified. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | QUALITATIVE RESEARCH | WOMEN | MEN | PERSONS LIVING WITH HIV/AIDS | CLIENTS | REPRODUCTIVE AGE | REPRODUCTIVE HEALTH | HEALTH SERVICES | HIV INFECTIONS | AIDS | CLINIC ACTIVITIES | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Demographic Factors | Population | Persons Living With HIV/AIDS | Viral Diseases | Diseases | Program Activities | Programs | Organization and Administration | Reproduction | Health | Delivery of Health Care | Medical Procedures | Medicine Document Number: 329588 |
| 20. Title: Community-based approaches to combating malnutrition and poor education among girls in resource-poor settings: report of a large scale intervention in Pakistan. Author: Pappas G; Agha A; Rafique G; Khan KS; Badruddin SH; Peermohamed H Source: Rural and Remote Health. 2008 Jul-Sep;8(3):820. Abstract: INTRODUCTION: Malnutrition and low levels of education continue to be major problems in many developing countries, especially for female children. METHODS: In Pakistan, a large-scale school lunch program was implemented in 29 of the poorest rural districts through a public-private partnership. The project provided freshly prepared meals in 4035 government primary girls' schools over a 2 year period. The primary strategy was empowerment of women in the community who volunteered to plan the meals, purchase the food, and cook and serve the meals. The project collected data from growth monitoring, attendance records, pre- and post-intervention community based surveys, focus group discussions, and the use of other ethnographic methods. A study on changes in the levels of malnutrition was based on an analytical sample of 203,116 girls who received at least two sets of body measurements at least 6 months apart. RESULTS: Over the intervention period, wasting declined by almost half and school enrolment increased by 40%. Girls who entered the program early were found to have similar levels of malnutrition to girls who entered late, suggesting that factors external to the program were not associated with the decrease in malnutrition. CONCLUSION: This study demonstrates the potential success and scalability of school feeding programs in Pakistan. Lessons learned include that synergies are found when working across sectors (health, education, and empowerment) and that there are challenges to intersectoral projects. Globalization may undermine this successful model as Pakistan considers expanded school feeding programs. Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | MEDICAL STUDENTS | RURAL POPULATION | PERCEPTION | SATISFACTION | RURAL HEALTH SERVICES | CLINICS | TRAINING PROGRAMS | FEEDBACK | CLINIC ACTIVITIES | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Students | Education | Population Characteristics | Demographic Factors | Population | Psychological Factors | Behavior | Health Services | Delivery of Health Care | Health | Health Facilities | Evaluation Methodology | Evaluation | Program Activities | Programs | Organization and Administration Document Number: 328881 |
| 21. Peer Reviewed Title: Contraception and medical gynaecology for HIV-positive women in a one-stop clinic. Author: Samuel MI; Welch J; Tenant-Flowers M; Brady M; Poulton M Source: International Journal of STD and AIDS. 19(8):559-560. Abstract: HIV-positive women may be reluctant to attend gynaecology or family planning clinics for fear of divulging their condition. Therefore, a referral clinic was opened within the HIV clinic. Retrospective case-note reviews of 197 new patients revealed 109 with a variety of medical gynaecology conditions (menorrhagia being the commonest) and 88 sought contraception. The full range of contraceptives was used, including Mirena for the treatment of menorrhagia as well as contraception and the combined pill adjusted for interaction with liver enzyme-inducing antiretroviral drugs. The acceptance of contraceptive advice and gynaecological evaluation by the patients has resulted in improved reproductive health services for these HIV-positive women. In centres with large cohorts of HIV-positive women, this type of one-stop specialist clinic will be very effective in providing high-quality reproductive health care and hence, this type of clinic is recommended for such centres. (author's) Language: English Keywords: UNITED KINGDOM | RESEARCH REPORT | HIV INFECTIONS | TREATMENT | WOMEN | INTEGRATED PROGRAMS | CLINIC ACTIVITIES | FAMILY PLANNING CLINIC ATTENDANCE | HEALTH SERVICES | Developed Countries | Europe, Western | Europe | Viral Diseases | Diseases | Medical Procedures | Medicine | Delivery of Health Care | Health | Demographic Factors | Population | Programs | Organization and Administration | Program Activities | Family Planning Program Evaluation | Family Planning Programs | Family Planning Document Number: 327830 |
| 22. Title: Intrauterine devices (IUDs). Second edition. Participant's guide. Author: Solter C Source: Watertown, Massachusetts, Pathfinder International, 2008 Feb. [120] p. Abstract: This training curriculum is designed to train physicians, nurses, and midwives in contraceptive counseling, the advantages and disadvantages of the IUD, eligibility criteria for its use, and insertion and removal of the IUD. It actively involves participants in the learning process through simulation skills practice, discussions, and clinical practice, using objective knowledge, attitude, and skills checklists. Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | EVALUATION | PHYSICIANS | FAMILY PLANNING PERSONNEL | IUD | CLINIC ACTIVITIES | ON-THE-JOB TRAINING | ATTITUDES | HEALTH EDUCATION MATERIALS | FAMILY PLANNING EDUCATION | CONTRAINDICATIONS | CURRICULUM | PROCEDURES | Health Personnel | Delivery of Health Care | Health | Family Planning Programs | Family Planning | Contraceptive Methods | Contraception | Program Activities | Programs | Organization and Administration | Training Programs | Education | Psychological Factors | Behavior | Health Education | Treatment | Medical Procedures | Medicine | Health Services Document Number: 325493 |
| 23. Title: Impact of youth peer education programs: Final results from an FHI / YouthNet study in Zambia. Author: Svenson G; Burke H; Johnson L Source: Research Triangle Park, North Carolina, Family Health International [FHI], YouthNet, 2008. 55 p. (Youth Research Working Paper No. 9FHI Working Paper Series No. WP08-02USAID Cooperative Agreement No. GPH-A-00-01-00013-00USAID Cooperative Agreement No. GPO-A-00-05-00022-00) Abstract: Youth peer education (YPE) is a widely used approach for promoting sexual and reproductive health (SRH) and preventing HIV. This study sought to determine the effect of YPE programs on SRH behaviors among youth. Phase 1 of this study focused on identifying core components of YPE programs. In Phase 1, conducted March 2003 - December 2004, four successful YPE programs in Zambia and the Dominican Republic were followed, using a descriptive, process evaluation approach. Phase 1 identified core elements believed to be important for sustainability and peer educator retention. Phase 2 focused on programs in Zambia and was designed to assess the interrelationships among program inputs, outputs, exposure and outcomes. Phase 2 was conducted February 2005 - August 2006 and sought to link the quality of YPE programming to SRH behaviors. In conclusion, this study found a chain of associations indicating that YPE in Zambia promotes HIV prevention behaviors. Overall, a significant number of young people in Zambia were exposed to YPE. Exposure to YPE programs was associated with some SRH risk-reduction behaviors, appropriate referrals, and use of SRH services by highly vulnerable youth. The core components of YPE programming, as measured by eight checklists, appear to be equally important in terms of program quality – useful information when designing and implementing effective YPE programs. The higher quality YPE programs were clearly making a difference for Zambian youth. The remaining challenge is to raise the standards of all YPE programs so that they all make a difference in the lives of vulnerable youth. (Excerpts) Language: English Keywords: ZAMBIA | EVALUATION REPORT | SURVEYS | PEER EDUCATORS | YOUTH PROGRAMS | REPRODUCTIVE HEALTH | PROGRAM EFFECTIVENESS | COUNSELING | REFERRAL AND CONSULTATION | CLINIC ACTIVITIES | SEX BEHAVIOR | HIV PREVENTION | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Sampling Studies | Studies | Research Methodology | Education | Programs | Organization and Administration | Health | Program Evaluation | Program Activities | Behavior | HIV Infections | Viral Diseases | Diseases | Risk Reduction Behavior | Reproductive Tract Infections | Infections Document Number: 331613 |
| 24. Peer Reviewed Title: Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries. Author: Valentine N; Darby C; Bonsel GJ Source: Social Science and Medicine. 2008 May;66(9):1939-1950. Abstract: Quality of care research has reached some agreement on concepts like structure, process and outcome, and non-clinical versus clinical processes of care. These concepts are commonly explored through surveys measuring patient experiences, yet few surveys have focused on patient, or "user", priorities across different quality dimensions. Population surveys on priorities can contribute to, although not replace participation in, policy decision making. Using 105,806 survey interview records from the World Health Organization's (WHO's) general population surveys in 41 countries, this paper describes the relative importance of eight domains in the non-clinical quality of care concept WHO calls "health systems responsiveness". Responsiveness domains are divided into interpersonal domains (dignity, autonomy, communication and confidentiality) and structural domains (quality of basic amenities, choice, access to social support networks and prompt attention). This paper explores variations in domain importance by country-level variables (country of residence, human development, health system expenditure, and "geographic zones") and by subpopulations defined by sex, age, education, health status, and utilization. Most respondents selected prompt attention as the most important domain. Dignity was selected second, followed by communication. Access to social support networks was identified as the least important domain. In general, convergence in rankings was stronger across subpopulations within countries than across countries. Yet even across diverse countries, there was more convergence than divergence in views. These results provide a ranking of quality of care criteria for consideration during health reform processes further to the usual emphasis on clinical quality and supply-side efficiency. (author's) Language: English Keywords: GLOBAL | RESEARCH REPORT | CROSS-CULTURAL COMPARISONS | CLIENTS | HEALTH PERSONNEL | WHO | QUALITY OF HEALTH CARE | SURVEYS | CLIENT-STAFF RELATIONS | SOCIAL NETWORKS | CLINIC ACTIVITIES | TIME FACTORS | Comparative Studies | Studies | Research Methodology | Program Activities | Programs | Organization and Administration | Delivery of Health Care | Health | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Health Services Evaluation | Program Evaluation | Sampling Studies | Interpersonal Relations | Behavior | Friends and Relatives | Family and Household | Population Dynamics | Demographic Factors | Population Document Number: 325889 |
| 25. Title: Ethiopia's Health Extension Program: Pathfinder International's support 2003-2007. Author: Wilder J Source: Addis Ababa, Ethiopia, Pathfinder International, 2008 Feb. 7 p. Abstract: In 2003, the Ethiopian Federal Ministry of Health (FMOH) launched a new health care plan, the "Accelerated Expansion of Primary Health Care Coverage," through a comprehensive Health Extension Program (HEP). Recognizing the huge gap between need and health care services available, the FMOH has focused on "providing quality promotive, preventive, and selected curative health care services in an accessible and equitable manner to reach all segments of the population, with special attention to mothers and children. The policy places particular emphasis on establishing an effective and responsive health delivery system for those who live in rural areas." More than 84 percent of Ethiopians live in rural areas, many remote and difficult to access. The government recognized the need to develop health care delivery capacity, "designed to improve the health status of families, with their full participation, using local technologies and the community's skill and wisdom." The HEP draws on the same principles as Primary Health Care, but focuses on the improvement of prevention skills and behaviors within the household, and involves fewer facility-based services. Most of the activities listed in the National Health Sector Program (HSDP) Strategies are to be implemented through the HEP. (excerpt) Language: English Keywords: ETHIOPIA | PROGRESS REPORT | EVALUATION | GOVERNMENT AGENCIES | HEALTH PERSONNEL | COMMUNITY WORKERS | GOVERNMENT PROGRAMS | PRIMARY HEALTH CARE | CAPACITY BUILDING | DELIVERY OF HEALTH CARE | COMMUNITY HEALTH SERVICES | USAID | TRAINING PROGRAMS | HOME VISITS | CLINIC ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Organizations | Political Factors | Sociocultural Factors | Health | Programs | Organization and Administration | Health Services | Program Sustainability | Education | Communication | Program Activities Document Number: 325471 |
| 26. Title: Clinical facility and services assessment field guide: quality assurance (QA) and quality improvement (QI). Author: Family Health International [FHI]. Asia Pacific Regional Office Source: Bangkok, Thailand, FHI, Asia Pacific Regional Office, [2007]. 22 p. Abstract: This guide is part of FHI's global efforts to create standards in quality care and to develop tools to support the achievement of quality services. In addition to the clinical QA/QI checklists, this guide also accompanies a QA/QI training package currently under development. The development of this guide has drawn heavily on the significant experience of FHI's Asia Pacific regional and country offices in delivering such clinical services, and on the tools they developed in support of QA/QI initiatives. However, it remains a work in progress, to be updated as and when appropriate. As such, feedback on its content and use is appreciated, and should be directed to Director, Technical Support, Public Health Programs, Asia Pacific Regional Office. In the following chapters, this guide provides an introduction to FHI's QA/QI initiative and operational framework (Chapter 1), a summary of the facility assessment process (Chapter 2), and then individual chapters on preparation for the service visit (Chapter 3), the clinical facility assessment visit itself (Chapter 4) and post-assessment visit actions (Chapter 5). (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | MANUAL | KAP SURVEYS | HEALTH PERSONNEL | QUALITY CONTROL | PERFORMANCE IMPROVEMENT | AIDS PREVENTION | HIV PREVENTION | CLINICS | CLINIC ACTIVITIES | HEALTH SERVICES EVALUATION | QUESTIONNAIRES | TUBERCULOSIS | SEXUALLY TRANSMITTED DISEASE PREVENTION | CONFIDENTIAL INFORMATION | Surveys | Sampling Studies | Studies | Research Methodology | Delivery of Health Care | Health | Organization and Administration | Management | AIDS | HIV Infections | Viral Diseases | Diseases | Health Facilities | Program Activities | Programs | Program Evaluation | Infections | Sexually Transmitted Diseases | Reproductive Tract Infections | Ethics | Sociocultural Factors Document Number: 322037 |
| 27. Title: Introducing WHO's sexual and reproductive health guidelines and tools into national programmes. Principles and processes of adaptation and implementation. Author: Church K; Kabra R; Mbizvo M Source: Geneva, Switzerland, World Health Organization [WHO], Department of Reproductive Health and Research, 2007. 25 p. (WHO/RHR/07.4) Abstract: The Departments of Reproductive Health and Research (RHR) and Making Pregnancy Safer (MPS) at the World Health Organization (WHO) have developed a series of guidelines and tools to promote evidence-based practices in sexual and reproductive health within programs. The guidance developed by WHO/RHR and WHO/MPS includes: norms, standards and protocols designed to inform the development and revision of national policies and standards; programmatic guides to inform the development of sexual and reproductive health programs; tools and clinical guides designed to be used by health-care providers in clinical setting, according to evidence-based norms. The guidance covers a range of themes, including maternal and neonatal health, family planning, prevention and control of reproductive tract infections and sexually transmitted infections (RTIs/STIs) and the prevention of unsafe abortion. The various documents are based on scientific evidence and have been developed by WHO/RHR and WHO/MPS as generic global materials that are not specific to any one national context. (excerpt) Language: English Keywords: DEVELOPING COUNTRIES | RECOMMENDATIONS | EVALUATION | HEALTH PERSONNEL | POLICYMAKERS | WOMEN IN DEVELOPMENT | REPRODUCTIVE HEALTH | WHO | SEXUALLY TRANSMITTED DISEASE PREVENTION | GOVERNMENT PROGRAMS | STANDARDS | HEALTH POLICY | MATERNAL HEALTH | CLINIC ACTIVITIES | BEST PRACTICES | Delivery of Health Care | Health | Administrative Personnel | Organization and Administration | Economic Development | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Diseases | Programs | Research Methodology | Policy | Program Activities Document Number: 326314 |
| 28. Title: Playing in the waiting room of an infant outpatient clinic from the perspective of children and their companions. Author: da Silva Pedro IC; Nascimento LC; Poleti LC; Garcia de Lima RA; Falleiros de Mello D; Rosa Luiz FM Source: Revista Latino-Americana de Enfermagem. 2007 Mar-Apr;15(2):290-297. Abstract: Playing is one way children use to communicate with the world that surrounds them. This descriptive-exploratory study aimed to understand the experience of playing for children and their companions in an outpatient waiting room. We performed semi-structured interviews with 12 children and those responsible for them. In the data analysis, three themes were identified: waiting time: "there is no other way, you have to wait"; using the time to play: turning the clinic into a more pleasant space; and the toy as a relations mediator. Playing is revealed to be an effective pediatric nursing intervention strategy in helping the child to overcome barriers imposed by the assistance. This resource favors the communication process among children, companions and professionals and, thus, greatly contributes to improve the care delivery. (author's) Language: English Keywords: BRAZIL | RESEARCH REPORT | KAP SURVEYS | PARENTS | INFANT | FRIENDS AND RELATIVES | NURSES AND NURSING | PLAY | CLINIC ACTIVITIES | WAITING AREAS AND QUEUES | TIME FACTORS | INTERPERSONAL RELATIONS | South America, Eastern | South America | Latin America | Americas | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Health Personnel | Delivery of Health Care | Health | Behavior | Program Activities | Programs | Organization and Administration | Workplace | Employment | Macroeconomic Factors | Economic Factors | Population Dynamics Document Number: 319680 |
| 29. Title: Are opportunities for vitamin A supplementation being utilised at primary health-care clinics in the Western Cape Province of South Africa? Author: Hendricks M; Beardsley J; Bourne L; Mzamo B; Golden B Source: Public Health Nutrition. 2007 Oct;10(10):1082-1088. Abstract: The objectives were to determine missed opportunities and problems relating to implementation of the Vitamin A Supplementation Programme in urban and rural regions of the Western Cape Province of South Africa. A cross-sectional survey was conducted at primary health-care (PHC) clinics in Cape Metropole, an urban region, and West Coast Winelands, a rural region, of the Western Cape. A purposive sample of clinics where more than 30 children were seen per day was drawn from 10 of the 11 districts in the Cape Metropole region and the two districts of the West Coast Winelands region. The number of children selected from each district was weighted in terms of population size for the two regions. At each clinic visited, the first five to 10 children seen on a day, and meeting the inclusion criteria for vitamin A supplementation (VAS) based on the vitamin A provincial policy guidelines, were selected. These included children with low birth weight (LBW), growth faltering, underweight and severe undernutrition, recurrent diarrhoea and lower respiratory tract infection (LRTI), tuberculosis, measles, HIV/AIDS and eye signs of vitamin A deficiency. Clinic records were reviewed following consultation with the PHC nurse to identify if the child required vitamin A, exit interviews were conducted with mothers/caregivers, and Road to Health Charts (RTHCs) were reviewed. At the end of the study, PHC managers were interviewed to determine if problems could be identified with the Programme. Forty-three of 123 (35%) and 13 of 40 (33%) of the fixed PHC clinics in the Cape Metropole and West Coast Winelands regions were visited, and a total of 300 children (234 from Cape Metropole, 66 from West Coast Winelands) with a mean (standard deviation) age of 24.3 (16.3) months and who met the inclusion criteria for VAS were selected. Of the total sample of children, 198 (66%) had multiple (i.e. more than one) indication and 102 (34%) had a single indication for VAS. There were a total of 617 indications for VAS in the two regions; 238 (39%) for growth faltering, 119 (19%) for underweight, 98 (16%) for LBW, 70 (11%) for LRTI, 51 (8%) for diarrhoea, 21 (3%) for HIV/AIDS and 20 (3%) for tuberculosis. A total of 102 (34%) of the children in the two regions received vitamin A supplements (Cape Metropole 29%; West Coast Winelands 52%). A record was made on the RTHC of 79 (77%) of the children who received VAS (Cape Metropole 76%; West Coast Winelands 79%). Twenty-four per cent of the mothers knew why their child had been given vitamin A (Cape Metropole 29%; West Coast Winelands 12%). Eleven per cent of the mothers had previously heard about the Vitamin A Supplementation Programme (Cape Metropole 12%; West Coast Winelands 6%). More than 81% of PHC managers indicated that health staff had been trained to implement the Vitamin A Supplementation Programme. The main problems identified by health staff in the two regions were lack of vitamin A capsules, inadequate training and difficulties in implementing the Programme. Opportunities to administer vitamin A were underutilised in both regions. Recommendations such as improving mothers' awareness of the benefits of vitamin A and training of PHC nurses were made to the provincial Department of Health and are being implemented to improve the effectiveness of the Programme. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | NURSES AND NURSING | CHILDREN | RURAL POPULATION | VITAMIN A | FOOD SUPPLEMENTATION | PRIMARY HEALTH CARE | CLINIC ACTIVITIES | MALNUTRITION | CHILD NUTRITION | DIARRHEA | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Health Personnel | Delivery of Health Care | Health | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Vitamins and Minerals | Physiology | Biology | Nutrition Programs | Health Services | Program Activities | Programs | Organization and Administration | Nutrition Disorders | Diseases | Nutrition Document Number: 321058 |
| 30. Peer Reviewed Title: Home-based versus clinic-based self-sampling and testing for sexually transmitted infections in Gugulethu, South Africa: Randomised controlled trial. Author: Jones HE; Altini L; de Kock A; Young T; van de Wijgert JH Source: Sexually Transmitted Infections. 2007 Dec 1;83(7):552-557. Abstract: The objectives were to test whether more women are screened for sexually transmitted infections when offered home-based versus clinic-based testing and to evaluate the feasibility and acceptability of self-sampling and self-testing in home and clinic settings in a resource-poor community. Women aged 14-25 were randomised to receive a home kit with a pre-paid addressed envelope for mailing specimens or a clinic appointment, in Gugulethu, South Africa. Self-collected vaginal swabs were tested for gonorrhoea, chlamydia and trichomoniasis using PCR and self-tested for trichomoniasis using a rapid dipstick test. All women were interviewed at enrolment on sociodemographic and sexual history, and at the 6-week follow-up on feasibility and acceptability. 626 women were enrolled in the study, with 313 in each group; 569 (91%) completed their 6-week follow-up visit. Forty-seven per cent of the women in the home group successfully mailed their packages, and 13% reported performing the rapid test and/or mailing the kit (partial responders), versus 42% of women in the clinic group who kept their appointment. Excluding partial responders, women in the home group were 1.3 (95% CI 1.1 to 1.5) times as likely to respond to the initiative as women in the clinic group. Among the 44% who were tested, 22% tested positive for chlamydia, 10% for trichomoniasis, and 8% for gonorrhoea. Self-sampling and self-testing are feasible and acceptable options in low-income communities such as Gugulethu. As rapid diagnostic tests become available and laboratory infrastructure improves, these methodologies should be integrated into services, especially services aimed at young women. (author's) Language: English Keywords: SOUTH AFRICA | RESEARCH REPORT | CLINICAL TRIALS | WOMEN | SEXUALLY TRANSMITTED DISEASES | TESTING | SELF CARE | CLINIC ACTIVITIES | SCREENING | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Clinical Research | Research Methodology | |