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Title: Development of Assays to Estimate HIV Incidence. Meeting proceedings, Chapel Hill, North Carolina, May 13-14, 2009.
Author: Meeting on the Development of Assays to Estimate HIV Incidence (2009: Chapel Hill)
Source: [Research Triangle Park], North Carolina, Family Health International [FHI], 2009. [70] p.
Abstract: Family Health International (FHI) convened a meeting on the Development of Assays to Estimate HIV Incidence on May 13-14, 2009 at the Carolina Inn in Chapel Hill, North Carolina. The purpose of this meeting was to assess how new and existing technologies and research could be applied to advance the development of assays to estimate HIV incidence. Nearly fifty leading experts including immunologists, epidemiologists, HIV transmission experts, assay developers, virologists, industry representatives, and potential users of assays participated in the meeting. The meeting was primarily supported by the Bill & Melinda Gates Foundation and in conjunction with and the support of the World Health Organization (WHO), the HIV Prevention Trials Network (HPTN), and the Center for HIV / AIDS Vaccine Immunology (CHAVI). (Excerpt)
Language: English
Keywords:
DEVELOPING COUNTRIES | SUMMARY REPORT | RESEARCH METHODOLOGY | VALIDITY | ESTIMATION TECHNIQUES | INCIDENCE | EPIDEMIOLOGY | STUDY DESIGN | HIV INFECTIONS | AWARENESS | TREATMENT | PROGRAM ACTIVITIES | PROGRAM EVALUATION | Measurement | Public Health | Health | Viral Diseases | Diseases | Knowledge | Sociocultural Factors | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Programs | Organization and Administration
Document Number: 331753

Title: A case study of reproductive health supplies in Ghana.
Author: Akitobi E; Leahy E; Nerquaye-Tetteh J
Source: Washington, D.C., Population Action International, 2009 Jun. 30 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Ghana. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
GHANA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors
Document Number: 331428

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Peer Reviewed

Title: Right conclusion, wrong method [letter]
Author: Berger VW
Source: European Journal of Contraception and Reproductive Health Care. 2009 Aug;14(4):317-8; author reply 319-20.
Abstract: This letter to the editor takes issue with an article written by Ferreira et al regarding contraceptive counseling after an abortion. It agrees that there is no evidence indicating contraceptive counseling is effective in increasing acceptance and use of contraceptive methods after an abortion, but disagrees with the method used to arrive at that conclusion. It specifically finds the combination of the Jadad score to evaluate trial quality and the cutoff of three as indicating a high quality trial as flawed.
Language: English
Keywords:
UNITED STATES OF AMERICA | CRITIQUE | RESEARCH METHODOLOGY | CLINICAL TRIALS | POSTABORTION CARE | COUNSELING | CONTRACEPTIVE USAGE | CONTRACEPTIVE METHOD ACCEPTABILITY | VALIDITY | Developed Countries | North America | Americas | Clinical Research | Health Services | Delivery of Health Care | Health | Clinic Activities | Program Activities | Programs | Organization and Administration | Contraception | Family Planning | Measurement
Document Number: 342949

Title: Maternal mortality in low-income countries: what interventions have been evaluated and how should the evidence base be developed further?
Author: Burchett HE; Mayhew SH
Source: International Journal of Gynaecology and Obstetrics. 2009 Apr;105(1):78-81.
Abstract: OBJECTIVE: This article reviews the evidence for the effectiveness of non-clinical interventions to reduce maternal mortality in low-income settings and identifies the gaps in the evidence base. METHODS: A systematic search was conducted to identify reviews and evaluations of non-clinical interventions to reduce maternal mortality in lower-income countries with high maternal mortality published between 1997 and 2008. Studies were reviewed to identify the topic focus, study design, and outcomes measured. RESULTS: There were 109 intervention evaluations and 30 reviews identified. Studies had been conducted in less than half of the countries and were generally poor quality. More studies focused on tertiary prevention (i.e., preventing death) rather than secondary prevention (i.e., preventing complications). More interventions sought to address quality of care than delays in seeking or accessing care. CONCLUSIONS: While evidence partly reflects difficulties in evaluating complex public health interventions, more robust study designs are possible to evaluate interventions to reduce maternal mortality. In addition, better standardized outcome measures are needed. This overview identifies topic areas neglected by intervention research.
Language: English
Keywords:
UNITED KINGDOM | RESEARCH REPORT | INTERVENTIONS | LOW INCOME POPULATION | MATERNAL MORTALITY | EVALUATION | RESEARCH METHODOLOGY | Developed Countries | Europe, Western | Europe | Programs | Organization and Administration | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Mortality | Population Dynamics | Demographic Factors | Population
Document Number: 341377

Title: Zambia: National long term forecasting and quantification for family planning commodities, 2009-2015.
Author: Bwembya M; Mbewe RK
Source: Arlington, Virginia, John Snow [JSI], DELIVER, 2009. 23 p. (USAID Contract No. GPO-I-01-06-00007-00)
Abstract: In December 2008, the Ministry of Health (MOH) and the Society for Family Health (SFH), with technical assistance from the USAID | DELIVER PROJECT, conducted a national long term quantification of contraceptive needs from 2009 -2015. The quantification's overall objective was to calculate the contraceptive requirements for each year of the forecast period and to use those requirements to mobilize resources for the country to support contraceptive commodity security. This report presents the findings of the quantification as well as the methodology used and assumptions made to arrive at these findings.
Language: English
Keywords:
ZAMBIA | SUMMARY REPORT | RESEARCH METHODOLOGY | TECHNICAL ASSISTANCE | USAID | NEEDS ASSESSMENT | CONTRACEPTIVE PREVALENCE | CONTRACEPTIVE SECURITY | COLD CHAIN | LOGISTICS | FUNDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Programs | Organization and Administration | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Evaluation | Contraceptive Usage | Contraception | Family Planning | Contraceptive Availability | Management | Financial Activities | Economic Factors
Document Number: 331474

Peer Reviewed

Title: Comparison of laboratory methods for analysis of non-nucleoside reverse transcriptase inhibitor resistance in Ugandan infants.
Author: Church JD; Huang W; Parkin N; Marlowe N; Guay LA; Omer SB; Musoke P; Jackson JB; Eshleman SH
Source: AIDS Research and Human Retroviruses. 2009 Jul;25(7):657-63.
Abstract: Detailed comparisons of HIV drug resistance assays are needed to identify the most useful assays for research studies, and to facilitate comparison of results from studies that use different methods. We analyzed nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance in 40 HIV-infected Ugandan infants who had received nevirapine (NVP)-based prophylaxis using the following assays: an FDA-cleared HIV genotyping assay (the ViroSeq HIV-1 Genotyping System v2.0), a commercially available HIV genotyping assay (GeneSeq HIV), a commercially available HIV phenotyping assay (PhenoSense HIV), and a sensitive point mutation assay (LigAmp). ViroSeq and GeneSeq HIV results (NVP resistance yes/no) were similar for 38 (95%) of 40 samples. In 6 (15%) of 40 samples, GeneSeq HIV detected mutations in minor subpopulations that were not detected by ViroSeq, which identified two additional infants with NVP resistance. LigAmp detected low-level mutations in 12 samples that were not detected by ViroSeq; however, LigAmp testing identified only one additional infant with NVP resistance. GeneSeq HIV and PhenoSense HIV determinations of susceptibility differed for specific NNRTIs in 12 (31%) of the 39 samples containing mixtures at relevant mutation positions. PhenoSense HIV did not detect any infants with NVP resistance who were not identified with GeneSeq HIV testing. In this setting, population sequencing-based methods (ViroSeq and GeneSeq HIV) were the most informative and had concordant results for 95% of the samples. LigAmp was useful for the detection and quantification of minority variants. PhenoSense HIV provided a direct and quantitative measure of NNRTI susceptibility.
Language: English
Keywords:
UGANDA | RESEARCH REPORT | DATA ANALYSIS | COMPARATIVE STUDIES | RESEARCH METHODOLOGY | INFANT | PERSONS LIVING WITH HIV/AIDS | HIV | POPULATION GENETICS | LABORATORY PROCEDURES | HIV TESTING | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Genetics | Biology | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342880

Peer Reviewed

Title: [Abortion: 20 years of Brazilian research] Aborto: 20 anos de pesquisas no Brasil.
Author: Diniz D; Correa M; Squinca F; Braga KS
Source: Cadernos�de Saude Publica. 2009 Apr;25(4):939-942.
Abstract: The aim of this paper is to discuss the main characteristics of the scientific literature on abortion in Brazil. Data were collected from 88 literature bases, and 2,109 documents from 1987 to 2008 were retrieved. Based on the findings, the field of abortion in Brazil is dominated by female researchers affiliated with public universities and nongovernmental organizations from the Southeast, with training in health sciences. There is no research on abortion in the North, while 14% of the studies were conducted in the Northeast and 4% in the Central-West. Abortion has been a constant theme in the scientific literature in Brazil, increasing in the mid-20th century.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | DATA COLLECTION | LITERATURE REVIEW | SCIENCE | ABORTION | GEOGRAPHIC FACTORS | RESEARCH METHODOLOGY | South America, Eastern | South America | Latin America | Americas | Developing Countries | Sociocultural Factors | Fertility Control, Postconception | Family Planning | Population
Document Number: 341865 Notification

Peer Reviewed

Title: Role of breastfeeding cessation in mediating the relationship between maternal HIV disease stage and increased child mortality among HIV-exposed uninfected children.
Author: Fox MP; Brooks DR; Kuhn L; Aldrovandi G; Sinkala M; Kankasa C; Horsburgh R; Thea DM
Source: International Journal of Epidemiology. 2009 Apr;38(2):569-76.
Abstract: BACKGROUND: Maternal CD4 count predicts child mortality in HIV-uninfected children born to HIV-infected women. METHODS: To explore the mediating role of breastfeeding cessation in this relationship, we compared marginal structural models of maternal CD4 count on child death with and without adjustment for breastfeeding. RESULTS: In crude analyses, children of mothers with CD4<200 during pregnancy were 3.2 times more likely to die by 18 months (CI 1.3-8.1) as children whose mothers had CD4>500. Earlier breastfeeding cessation was also associated with low CD4 (HR 1.8; CI 1.2-2.7). After adjusting for breastfeeding and low birth weight using a marginal structural model, the low CD4 count-child mortality association through 18 months was reduced 17%. The change was overestimated using a traditional Cox proportional hazards model (35% reduction in HR from 3.4 to 2.5). CONCLUSIONS: Our analysis suggests that only a small part of the effect of low vs high CD4 count on child mortality through 18 months is mediated through breastfeeding cessation. Our results must be taken into account when deciding whether or not to recommend breastfeeding for infants of HIV-infected mothers.
Language: English
Keywords:
AFRICA | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | CHILD MORTALITY | BREASTFEEDING | INFANT MORTALITY | HIV | RESEARCH METHODOLOGY | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Mortality | Population Dynamics | Infant Nutrition | Nutrition | Health | HIV Infections | Viral Diseases | Diseases
Document Number: 341015

Title: Youth as research fieldworkers in a context of HIV/AIDS
Author: Francis D; Hemson C
Source: African Journal of AIDS Research. 2009;8(2):223-230.
Abstract: While youth-to-youth research approaches have increased in both popularity and practice, our understanding of the processes and mechanisms underlying the successes or failures of 'peer researchers' is still developing. This study addresses the question through qualitative research, drawing on observations of the process of training out-of-school youths as research fieldworkers, reflections on the interviews with respondents, and focus group discussions with the young fieldworkers. The authors found several advantages to using fieldworkers who are close in their characteristics to that of respondents. These benefits included ready access to respondents, the immediate use of language appropriate to the respondents, and an ability to swiftly establish rapport. They authors also observed several limitations: the peer researchers struggled with the wish of some respondents to establish supportive friendships with them, they lacked the authority of an academic researcher, and they sometimes resorted to false promises in attempts to get cooperation. The authors conclude that using youths as peer researchers is neither better nor worse than using professional researchers, but each approach can produce its own challenges and possibilities.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RESEARCH METHODOLOGY | QUALITATIVE RESEARCH | OUT-OF-SCHOOL YOUTHS | INTERVIEWERS | PEER GROUPS | HIV INFECTIONS | TRAINING PROGRAMS | POWER | INTERPERSONAL RELATIONS | LANGUAGE | ETHICS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Educational Status | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Survey Personnel | Surveys | Sampling Studies | Studies | Knowledge Sources | Communication | Viral Diseases | Diseases | Education | Political Factors | Sociocultural Factors | Behavior
Document Number: 339895

10.

Peer Reviewed

Title: Health discourse, sexual slang and ideological contradictions among Mozambican youth: implications for method.
Author: Groes-Green C
Source: Culture, Health and Sexuality. 2009 Aug;11(6):655-668.
Abstract: Findings from fieldwork on condom use among young people in Mozambique confirm the need to remain alert to the ideological and linguistic bias of applied research methods. Using conventional health discourse to interview young people about their sexuality resulted in incorrect or socially acceptable answers rather than accurate information about their sexual behavior. In order to gain a deeper understanding of sexual cultures and to make HIV prevention efforts relevant to young people, the author suggests that researchers and policy-makers approach respondents with a language that is sensitive to the local ideological and linguistic context.
Language: English
Keywords:
MOZAMBIQUE | CRITIQUE | RESEARCH METHODOLOGY | FOCUS GROUPS | STUDENTS | CONDOM USE | SEX BEHAVIOR | SEXUALITY | LANGUAGE | INTERVIEWS | INTERPERSONAL COMMUNICATION | VALIDITY | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Data Collection | Education | Risk Reduction Behavior | Behavior | Personality | Psychological Factors | Communication | Measurement
Document Number: 339891

11.

Title: [Weight gain due to hormonal contraception: myth or truth?] Gewichtsveranderung unter hormonalen Kontrazeptiva: Mythos oder Wahrheit?
Author: Hani D; Imthurn B; Merki-Feld GS
Source: Gynakologisch - Geburtshilfliche Rundschau. 2009;49(2):87-93.
Abstract: Weight gain is one of the side effects often attributed to the use of hormonal contraception. Concern about weight gain can hinder particularly young women to use a safe contraceptive method or may be a reason for early discontinuation. In the following review, we present studies examining the influence of different contraceptive methods on weight change and discuss the results and methodological problems. During use of hormonal contraceptives, weight fluctuates by about 3 kg over an observation interval from 6 to 24 months. Only in a subgroup of Depo Provera users is the increase in weight higher: the proportion of women gaining >3 kg/year is higher compared with the other hormonal contraceptives. Interestingly users of intrauterine devices experience a weight gain too, which is approximately double that of the average female population. The age-associated weight gain has been described to be 0.1 kg/m(2) annually, corresponding to about 300 g/year.
Language: German
Keywords:
RESEARCH REPORT | RESEARCH METHODOLOGY | WOMEN | BODY WEIGHT | ORAL CONTRACEPTIVES, SIDE EFFECTS | Demographic Factors | Population | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health
Document Number: 330951

12.

Title: A case study of reproductive health supplies in Mexico.
Author: Indacochea CM
Source: Washington, D.C., Population Action International, 2009 Jun. 36 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders.This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Mexico. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
MEXICO | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | FUNDS | North America | Americas | Developing Countries | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors
Document Number: 331429

13.

Title: A case study of reproductive health supplies in Nicaragua.
Author: Indacochea CM; Leahy E
Source: Washington, D.C., Population Action International, 2009 Jun. 36 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Nicaragua. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
NICARAGUA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | ADVOCACY | PROMOTION | KNOWLEDGE | Developing Countries | Central America | Latin America | Americas | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Communication | Marketing
Document Number: 331430

14.

15.

Title: A case study of reproductive health supplies in Tanzania.
Author: Leahy E; Druce N; Akitobi E; Hardee K; Vogel CG
Source: Washington, D.C., Population Action International, 2009 Jun. 32 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders.This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Tanzania. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
TANZANIA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | PROMOTION | KNOWLEDGE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Marketing
Document Number: 331431

16.

Title: A case study of reproductive health supplies in Uganda.
Author: Leahy E; Akitobi E
Source: Washington, D.C., Population Action International, 2009 Jun. 34 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Uganda. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
UGANDA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | PROMOTION | INFORMATION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Marketing
Document Number: 331432

17.

Title: A case study of reproductive health supplies in Bangladesh.
Author: Patykewich L; Leahy E
Source: Washington, D.C., Population Action International, 2009 Jun. 42 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders. This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Bangladesh. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
BANGLADESH | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | Developing Countries | Asia, Southern | Asia | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors
Document Number: 331427

18.

Title: Maternal and early onset neonatal bacterial sepsis: burden and strategies for prevention in sub-Saharan Africa.
Author: Seale AC; Mwaniki M; Newton CR; Berkley JA
Source: Lancet Infectious Diseases. 2009 Jul;9(7):428-38.
Abstract: Maternal and child health are high priorities for international development. Through a Review of published work, we show substantial gaps in current knowledge on incidence (cases per live births), aetiology, and risk factors for both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa. Although existing published data suggest that sepsis causes about 10% of all maternal deaths and 26% of neonatal deaths, these are likely to be considerable underestimates because of methodological limitations. Successful intervention strategies in resource-rich settings and early studies in sub-Saharan Africa suggest that the burden of maternal and early onset neonatal bacterial sepsis could be reduced through simple interventions, including antiseptic and antibiotic treatment. An effective way to expedite evidence to guide interventions and determine the incidence, aetiology, and risk factors for sepsis in sub-Saharan Africa would be through a multiarmed factorial intervention trial aimed at reducing both maternal and early onset neonatal bacterial sepsis in sub-Saharan Africa.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | RESEARCH METHODOLOGY | INCIDENCE | MATERNAL HEALTH | MATERNAL MORTALITY | BACTERIAL AND FUNGAL DISEASES | PREVENTIVE HEALTH CARE | ANTENATAL CARE | PREVENTION AND CONTROL | Africa | Developing Countries | Measurement | Health | Mortality | Population Dynamics | Demographic Factors | Population | Infections | Diseases | Health Services | Delivery of Health Care | Maternal Health Services | Maternal-Child Health Services | Primary Health Care
Document Number: 342056

19.

Title: South African national HIV prevalence, incidence, behaviour and communication survey 2008: a turning tide among teenagers?
Author: Shisana O; Rehle T; Simbayi LC; Zuma K; Jooste S
Source: Cape Town, South Africa, HSRC Press, 2009. [116] p.
Abstract: This report is the third in a series of population-based HIV seroprevalence surveys that started in 2002 and were repeated in 2005 and again in 2008. The survey found that South Africa's HIV epidemic has leveled off at a prevalence of 10.9 percent for people aged two years and older, with 5.2 million people estimated to be living with HIV in 2008. HIV prevalence has also declined among children aged 2-14, from 5.6 percent in 2002 to 2.5 percent in 2008, and a decline in new infections has also been noted among teenagers aged 15-19. But the survey warns that the overall situation remains "dire" since South Africa has the world's largest HIV-positive population.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | RESEARCH METHODOLOGY | INCIDENCE | ADOLESCENTS | SEX BEHAVIOR | RISK BEHAVIOR | HIV TESTING | ANTIRETROVIRAL DRUGS | TREATMENT | ETHICS | INFORMED CONSENT | LABORATORY PROCEDURES | PROGRAM ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Measurement | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Sociocultural Factors | Programs | Organization and Administration
Document Number: 342037

20.

Peer Reviewed

Title: Estimating incidence of HIV infection in Uganda [letter]
Author: Todd J; Lutalo T; Kaleebu P
Source: JAMA. Journal of the American Medical Association. 2009 Jan 14;301(2):159-60; author reply 160-1.
Abstract: To the Editor: Dr Mermin and colleagues reported results from the nationally representative survey conducted in Uganda in 2004, showing an overall HIV prevalence of 6.35%. The BED assay was then applied to this cross-sectional study to identify recent HIV infections to give an estimated incidence of 1.8 per 100 person-years and a prevalence-toincidence ratio of 3.3:1. In another study of a rural population of 18 000 from Masaka in 2004, the HIV prevalence was 7.7%, similar to the national estimate, but incidence was 0.5 per 100 person-years, giving a prevalence-to-incidence ratio of 15.4:1. An HIV incidence of 1.8 per 100 person-years in a population with an HIV prevalence of 6.35% suggests that average survival following HIV infection is much shorter than that currently observed in Uganda and elsewhere in Africa. The alternative explanation of a dramatic increase in HIV incidence in Uganda would not be consistent with observations from the longitudinal studies. We are concerned that the reported incidence estimates may be overestimates, possibly due to the inability of the BED assay to discriminate reliably between recent infection and advanced disease. The BED assay in Africa, where subtypes A, C, and D predominate, was shown to overestimate HIV incidence by a factor of 4. In 2006, the Centers for Disease Control and Prevention repeated the recommendations from UNAIDS (the Joint United Nations Programme on HIV/AIDS) that the BED assay should not be used for incidence estimates or monitoring of trends in HIV incidence and reiterated the need for improvements in both the laboratory and statistical methods before the BED assay could be widely used. It is not clear whether the laboratory tests or the statistical analyses have been improved and validated for the BED assay used in this study. Concerns about the validity of the BED assay necessitate caution in interpreting this estimate of HIV incidence in Uganda and emphasize the need for further development and validation of the BED assay before its wider use. Increasing HIV-1 diversity and greater access to antiretroviral therapy are likely to limit the role of the BED assay in estimating HIV incidence in developing countries, so longitudinal population-based cohorts will continue to be needed to generate reliable estimates of HIV incidence. (full-text)
Language: English
Keywords:
UGANDA | CRITIQUE | HIV TESTING | INCIDENCE | RESEARCH METHODOLOGY | VALIDITY | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement
Document Number: 329783

21.

Peer Reviewed

Title: Diagnosis of antiretroviral therapy failure in Malawi: poor performance of clinical and immunological WHO criteria.
Author: van Oosterhout JJ; Brown L; Weigel R; Kumwenda JJ; Mzinganjira D; Saukila N; Mhango B; Hartung T; Phiri S; Hosseinipour MC
Source: Tropical Medicine and International Health. 2009 Aug;14(8):856-61.
Abstract: OBJECTIVES: In antiretroviral therapy (ART) scale-up programmes in sub-Saharan Africa viral load monitoring is not recommended. We wanted to study the impact of only using clinical and immunological monitoring on the diagnosis of virological ART failure under routine circumstances. METHODS: Clinicians in two urban ART clinics in Malawi used clinical and immunological monitoring to identify adult patients for switching to second-line ART. If patients met clinical and/or immunological failure criteria of WHO guidelines and had a viral load <400 copies/ml there was misclassification of virological ART failure. RESULTS: Between January 2006 and July 2007, we identified 155 patients with WHO criteria for immunological and/or clinical failure. Virological ART failure had been misclassified in 66 (43%) patients. Misclassification was significantly higher in patients meeting clinical failure criteria (57%) than in those with immunological criteria (30%). On multivariate analysis, misclassification was associated with being on ART <2 years [OR = 7.42 (2.63, 20.95)] and CD4 > 200 cells/microl [OR = 5.03 (2.05, 12.34)]. Active tuberculosis and Kaposi's sarcoma were the most common conditions causing misclassification of virological ART failure. CONCLUSION: Misclassification of virological ART failure occurs frequently using WHO clinical and immunological criteria of ART failure for poor settings. A viral load test confirming virological ART failure is therefore advised to avoid unnecessary switching to second-line regimens.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | RESEARCH METHODOLOGY | MONITORING | EXAMINATIONS AND DIAGNOSES | ANTIRETROVIRAL THERAPY | HIV | LABORATORY PROCEDURES | HIV TESTING | IMMUNOLOGIC FACTORS | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Evaluation | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV Infections | Viral Diseases | Diseases | Laboratory Examinations and Diagnoses | Immunity | Immune System | Physiology | Biology
Document Number: 342975

22.

23.

24.

Title: Assessing integration methodology (AIM): a handbook for measuring and assessing the integration of family planning and other reproductive health services.
Author: Population Council. Frontiers in Reproductive Health
Source: Washington, DC, Population Council, 2008. viii, 156 p. (USAID Contract No. HRN-A-00-98-00012-00)
Abstract: The Assessing Integration Methodology (AIM) was developed to guide decisions regarding the feasibility, quality, and effectiveness of specific service combinations. The AIM handbook covers integration of family planning with the following services: HIV counseling and testing; Postabortion care; Antenatal care; Detection and management of sexually transmitted infections; Postpartum care. Decisionmakers can use the AIM handbook to assess the feasibility of linking services, identify programmatic or structural barriers to integration, pilot-test approaches to integrating services, evaluate the effect of linked or integrated services, and assess and evaluate the costs of models to integrate services. The handbook includes data-collecting forms to support and evaluate integration efforts, including forms for client and provider interviews, service and equipment inventory, and other documentation forms.
Language: English
Keywords:
AFRICA | MANUAL | RESEARCH METHODOLOGY | DATA COLLECTION | FAMILY PLANNING | REPRODUCTIVE HEALTH | MATERNAL HEALTH | CHILD HEALTH | HEALTH SERVICES | ANTENATAL CARE | POSTABORTION CARE | HIV PREVENTION | AIDS PREVENTION | SEXUALLY TRANSMITTED DISEASE PREVENTION | INTEGRATED PROGRAMS | Developing Countries | Health | Delivery of Health Care | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | HIV Infections | Viral Diseases | Diseases | AIDS | Sexually Transmitted Diseases | Reproductive Tract Infections | Infections | Programs | Organization and Administration
Document Number: 315210

25.

Peer Reviewed

Title: Qualitative to quantitative: linked trajectory of method triangulation in a study on HIV/AIDS in Goa, India.
Author: Bailey A; Hutter I
Source: AIDS Care. 2008 Oct;20(9):1119-24.
Abstract: With 3.1 million people estimated to be living with HIV/AIDS in India and 39.5 million people globally, the epidemic has posed academics the challenge of identifying behaviours and their underlying beliefs in the effort to reduce the risk of HIV transmission. The Health Belief Model (HBM) is frequently used to identify risk behaviours and adherence behaviour in the field of HIV/AIDS. Risk behaviour studies that apply HBM have been largely quantitative and use of qualitative methodology is rare. The marriage of qualitative and quantitative methods has never been easy. The challenge is in triangulating the methods. Method triangulation has been largely used to combine insights from the qualitative and quantitative methods but not to link both the methods. In this paper we suggest a linked trajectory of method triangulation (LTMT). The linked trajectory aims to first gather individual level information through in-depth interviews and then to present the information as vignettes in focus group discussions. We thus validate information obtained from in-depth interviews and gather emic concepts that arise from the interaction. We thus capture both the interpretation and the interaction angles of the qualitative method. Further, using the qualitative information gained, a survey is designed. In doing so, the survey questions are grounded and contextualized. We employed this linked trajectory of method triangulation in a study on the risk assessment of HIV/AIDS among migrant and mobile men. Fieldwork was carried out in Goa, India. Data come from two waves of studies, first an explorative qualitative study (2003), second a larger study (2004-2005), including in-depth interviews (25), focus group discussions (21) and a survey (n=1259). By employing the qualitative to quantitative LTMT we can not only contextualize the existing concepts of the HBM, but also validate new concepts and identify new risk groups.
Language: English
Keywords:
INDIA | RESEARCH REPORT | RESEARCH METHODOLOGY | QUALITATIVE RESEARCH | QUANTITATIVE RESEARCH | MIGRANT WORKERS | HIV PREVENTION | AIDS PREVENTION | SEX BEHAVIOR | RISK BEHAVIOR | BELIEFS | Developing Countries | Asia, Southern | Asia | Labor Force | Human Resources | Economic Factors | HIV Infections | Viral Diseases | Diseases | AIDS | Behavior | Culture | Sociocultural Factors
Document Number: 329416

26.
Peer Reviewed

Title: Methods used in the 1982, 1993, and 2004 birth cohort studies from Pelotas, Rio Grande do Sul State, Brazil, and a description of the socioeconomic conditions of participants' families.
Author: Barros AJ; Santos IS; Matijasevich A; Araujo CL; Gigante DP; Menezes AM; Horta BL; Tomasi E; Victora CG; Barros FC
Source: Cadernos de Saude Publica. 2008;24 Suppl 3:S371-80.
Abstract: Three birth cohorts are currently being followed in Pelotas, Southern Brazil, in order to assess changes in birth conditions, growth, development, morbidity, and infant mortality, as well as the influence of pre- and perinatal factors on the subsequent morbidity of participants in their adult lives. We provide a description of the methodology used for the cohort studies that began in 1982, 1993, and 2004 in Pelotas, and a description of the economic conditions of the families involved. For the three cohorts, similar strategies were used to recruit babies born to mothers living in the municipality's urban area. These included daily visits to maternity hospitals where births were identified, mothers interviewed, and newborns examined. Over this time frame, there has been a significant reduction in the number of births due to declining fertility rates amongst the target population. Salaries (measured as a multiple of the minimum wage) were stable across cohorts, but quality of life indicators--such as the availability of piped water, flushing toilets and refrigerators--showed clear improvements. Mothers' levels of education improved markedly. Important changes in the demographic profile of risk factors and health outcomes are being recorded by the Pelotas cohorts.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | COHORT ANALYSIS | PARTICIPATION | SOCIOECONOMIC FACTORS | FERTILITY RATE | BIRTH RATE | EDUCATIONAL STATUS | MORBIDITY | INFANT MORTALITY | RESEARCH METHODOLOGY | Developing Countries | South America, Eastern | South America | Latin America | Americas | Social Behavior | Behavior | Economic Factors | Fertility Measurements | Fertility | Population Dynamics | Demographic Factors | Population | Socioeconomic Status | Diseases | Mortality
Document Number: 330457

27.

Peer Reviewed

Title: Methodological issues in the study of the socioeconomic consequences of HIV/AIDS.
Author: Beegle K; De Weerdt J
Source: AIDS. 2008 Jul;22 Suppl 1:S89-94.
Abstract: Rigorous empirical research on the socioeconomic effects of AIDS is important for developing appropriate strategies to mitigate impacts and ultimately improve living standards. This paper provides a broad overview of the challenges in studying the impact of the epidemic on individuals, households and economies, drawing examples from existing studies. We start with a discussion of macro-economic studies and argue that they reach vastly different conclusions about the impact of AIDS, depending on what parameter assumptions they make. Whereas microstudies could provide insights into some of these parameters and effects, there are many technical hurdles to overcome. We discuss the use of comparator groups, spillover effects, longitudinal datasets and the time horizons of studies. Under scrutiny of these technical requirements, the existing empirical evidence of the impoverishing effects of AIDS deaths on African households seems unexpectedly limited. After many years of study, large gaps remain in theempirical literature with regard to our understanding of the magnitude and heterogeneity of these impacts. We conclude that the literature thus far has not convincingly shown that AIDS is the main contributor to low levels and high inequities of socioeconomic outcomes in Africa. Demand for research on the causal impact of HIV/AIDS on poverty is only increasing with the scaling up of antiretroviral treatment.
Language: English
Keywords:
AFRICA | DEVELOPING COUNTRIES | RESEARCH REPORT | LITERATURE REVIEW | HIV INFECTIONS | AIDS | EPIDEMIOLOGIC METHODS | POVERTY | RESEARCH METHODOLOGY | SOCIOECONOMIC FACTORS | Viral Diseases | Diseases | Economic Factors
Document Number: 328236

28.
Title: Estimation of mortality due to AIDS--a review.
Author: Bhattacharya M; Neogi SB
Source: Indian Journal of Public Health. 2008 Jan-Mar;52(1):21-7.
Abstract: HIV/AIDS has emerged as a major public health problem since its recognition as an emerging disease a couple of decades ago. While detection of HIV/AIDS cases remains a problem, ascertainment of AIDS deaths has emerged as a bigger challenge and concern. Despite a plethora of literature focusing on the methods to estimate AIDS deaths, none seems to be fulfilling the requirements for universal acceptance. In this paper, we give a systematic review of various methods used by experts to have a reliable estimate of the number of deaths due to AIDS. Initial assessments were derived from morgue based estimates in Africa which showed that AIDS was a leading cause of death. Its impact on demography was noticed in some of the studies conducted wherein age and sex specific mortality rates, standardized mortality ratios, potential years of life lost and decrease in life expectancy were calculated. "Excess mortality factor" as observed in 1980s and 1990s also indicated the approximate number of AIDS deaths. Besides, orphan hood method and verbal autopsy technique too, emerged as reliable means to identify mortality due to AIDS. Some indirect methods like estimation of deaths due to opportunistic infections like tuberculosis could also be a good indicator. The paper reviews the merits and possible biases encountered with each of the methods.
Language: English
Keywords:
DEVELOPING COUNTRIES | RESEARCH REPORT | RESEARCH METHODOLOGY | ESTIMATION TECHNIQUES | DEATH RATE | AIDS | MORTALITY | RELIABILITY | Population Dynamics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Measurement
Document Number: 328950

29.

Title: The gendered impact of AIDS on orphans and education in KwaZulu-Natal, South Africa.
Author: Boler T
Source: In: Gender equality, HIV, and AIDS. A challenge for the education sector edited by Sheila Aikman, Elaine Unterhalter, and Tania Boler. Oxford, United Kingdom, Oxfam GB, 2008. :84-101.
Abstract: This chapter examines the gendered dimensions of the impact of AIDS on orphans' education, drawing on data from KwaZulu-Natal, one of the provinces in South Africa with extremely high levels of HIV infection. In sub-Saharan Africa, there are currently an estimated 11.4 million children orphaned by AIDS,2 and 1.2 million in South Africa alone. If a child is orphaned, what difference does it make if the child is a boy or a girl? How is education affected differently if the mother dies or if the father dies? (excerpt)
Language: English
Keywords:
SOUTH AFRICA | LITERATURE REVIEW | RESEARCH METHODOLOGY | ORPHANS AND VULNERABLE CHILDREN | AIDS | EDUCATION | SOCIOECONOMIC FACTORS | IMPACT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Economic Factors | Communication
Document Number: 330174

30.

Peer Reviewed

Title: Circumcision and HIV infection: assessment of causality.
Author: Byakika-Tusiime J
Source: AIDS and Behavior. 2008 Nov;12(6):835-841.
Abstract: Whether the observed association between male circumcision and HIV infection is causal or not has not been verified. We did a meta-analysis of published data and applied Hill�s criteria for causality on all available evidence to assess presence of a causal association. Analysis was by the random effects method. Summary estimates were calculated for all studies combined and for sub groups stratified by type of study population, study design, and method of ascertaining circumcision status. Thirteen studies were included. Circumcised men had a reduced risk for HIV infection (adjusted RRoverall = 0.42, 95% CI 0.33-0.53; RRRCT = 0.43 95% CI 0.32-0.59, RRobservational = 0.39, 95% CI 0.27-0.56). Available evidence satisfies six of Hill�s criteria: strength of association, consistency, temporality, coherence, biological plausibility, and experiment. These results provide unequivocal evidence that circumcision plays a causal role in reducing the risk of HIV infection among men.
Language: English
Keywords:
GLOBAL | RESEARCH REPORT | HIV INFECTIONS | HIV PREVENTION | MALE CIRCUMCISION | LITERATURE REVIEW | DATA ANALYSIS | RESEARCH METHODOLOGY | Viral Diseases | Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 322654


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