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Title: Male circumcision: a cancer prevention strategy?
Source: Lancet Oncology. 2009 May;10(5):431.
Abstract: Given that less than 20% of males are circumcised in many developing countries, and that male circumcision is relatively simple and reduces viral infection, might this practice be more widely used as a preventive measure against cancer? In developing countries, male circumcision could have a vital role in specific segments of the population depending on the answers to specific scientific and infrasturcture related questions. Discussions around male circumcision strategies should be encouraged within the context of cancer prevention, and these should include local communities alongside assessments of current capacities, measurable targets, cost analyses and modelling, and the development of practicable guidelines, so as to place male circumcision within the possible options available for disease prevention.
Language: English
Keywords:
UGANDA | SUMMARY REPORT | PREVALENCE | MEN | MALE CIRCUMCISION | CANCER | PREVENTION AND CONTROL | HIV PREVENTION | STANDARDS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Measurement | Research Methodology | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Neoplasms | Diseases | HIV Infections | Viral Diseases
Document Number: 341199

Peer Reviewed

Title: A new agenda for children affected by HIV/AIDS [editorial]
Source: Lancet. 2009 Feb 14;373(9663):517.
Abstract: As is so often the case in the provision of health care and deciding research agendas, children have been sidelined in the fight against HIV/AIDS. According to the latest UNAIDS figures, nearly 2 million children live with HIV worldwide, two-thirds in sub-Saharan Africa. In addition, 12 million children in sub-Saharan Africa have lost one or two parents due to HIV/AIDS. Many more live with a parent or carer with HIV. A very small proportion of infected children receive antiretroviral treatment, and prevention of mother-to-child transmission is only given to a third of women. Diagnosis in infancy is difficult and therefore often delayed. Child-friendly medication is lacking. 60% of children in southern Africa live in poverty. Now that HIV/AIDS is evolving from an acute emergency into a chronic epidemic, the way to deliver treatment and achieve prevention needs to change radically from an individualistic approach to a broader strategic one. Children and families need to take centre stage. In an excellent report, based on 2 years of research and analyses, the Joint Learning Initiative on Children and HIV/AIDS-an independent alliance of researchers, implementers, activists, policy makers, and people living with HIV-has presented recommendations for such a change in direction. Home Truths: Facing the Facts on Children, AIDS, and Poverty, released on Feb 10, points out three broad policies that will make an immediate and long lasting difference to children: support children through immediate or extended families and deliver integrated family-centred services; strengthen community action to support families; and address family poverty through national social protection. Such policies are AIDS-sensitive but not AIDS-directed. The family is the most important support structure for children. The report argues that the way orphans have been defined (as having lost one or both parents) and have become the centre of attention for many HIV/AIDS policies has been unhelpful, if not damaging. 88% of children labelled as orphans have a surviving parent and overall 95% continue to live with extended families. Additionally, children who live with HIV-positive parents have needs long before their parents die. Children need to stay within a family or kinship structure. Infected children usually live with others who are infected with the virus. The whole family, not the individual, needs to become the unit for support and treatment. The report advocates home health visiting and early childhood development interventions together with strategies to encourage children's education. The use of schools as intervention platforms misses the opportunity to reach children early and to reach those who are not in education-the majority in some countries. Economic strengthening of families has to be the basis to allow many of these programmes to fully succeed. The best immediate support for families is given by com munity groups. International donors need to work with these groups in partnership to avoid duplication, confusion, and waste of time and money. The authors suggest that coordination could be strengthened with a district committee that maintains an active register of community activities and devises a system of accountability that is understood by all and serves the com munity. All activities should be delivered within a framework that is based on best practice. Communities also have a crucial role to act as a backstop when families break down or when children live in an abusive environment. Family poverty and undernutrition can be addressed through income-transfer programmes, such as Mexico's Oportunidades programme or South Africa's child support grants. These projects are efficient and simple, empower women, and can act as a springboard for other more complex schemes, such as microfinance loans. Such economic support increases school attendance, reduces illnesses, improves growth, and encourages uptake of health services. The largest portion of money is usually used to purchase food. Extreme poverty, rather than HIV infection, should be used as a criterion to avoid stigma and resentment. The report argues that "any developing country, no matter how poor, can afford social protection packages for children". The positive effect of this policy is now established beyond doubt and no further pilot studies are needed. To integrate all these strategies, governments need to take the lead with national plans and frameworks to scale-up programmes for children and families. With this approach, society as a whole will be strengthened with intergenerational effects that will go a long way towards, but also go well beyond, tackling the effects of HIV/AIDS. Putting children and families at the centre will show long-term vision with guaranteed future benefits. (fulll-text)
Language: English
Keywords:
AFRICA, SUB SAHARAN | SUMMARY REPORT | CHILDREN | HIV INFECTIONS | AIDS | POVERTY | MALNUTRITION | CHILD HEALTH | HEALTH SERVICES | DELIVERY OF HEALTH CARE | TREATMENT | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Socioeconomic Factors | Economic Factors | Nutrition Disorders | Health | Medical Procedures | Medicine
Document Number: 341049

7.
Title: Impact of new WHO growth standards on the prevalence of acute malnutrition and operations of feeding programs - Darfur, Sudan, 2005-2007.
Author: Centers for Disease Control and Prevention (CDC)
Source: MMWR. Morbidity and Mortality Weekly Report. 2009 Jun 5;58(21):591-4.
Abstract: Acute malnutrition among children aged 6-59 months is a key indicator routinely used for describing the presence and magnitude of humanitarian emergencies. In the past, the prevalence of acute malnutrition and admissions to feeding programs has been determined using the growth reference developed by the World Health Organization (WHO), CDC, and the National Center for Health Statistics (NCHS). In 2006, WHO released new international growth standards and recommended their use in all nutrition programs. To evaluate the impact of transitioning to the new standards, CDC analyzed anthropometric data for children aged 6-59 months from Darfur, Sudan, collected during 2005-2007. This report describes the results of that analysis, which indicated that use of the new standards would have increased the prevalence of global acute malnutrition on average by 14% and would have increased the prevalence of severe acute malnutrition on average by 100%. Admissions to feeding programs would have increased by 56% for moderately malnourished children and by 260% for severely malnourished children. For programs in Darfur, this would have resulted in approximately 23,200 more children eligible for therapeutic feeding programs. For the immediate future, the prevalence of acute malnutrition in children should be reported using both the old WHO/CDC/NCHS reference and the new WHO standards. More research is needed to better ascertain the validity of the admission criteria based on the new WHO standards in predicting malnutrition-related morbidity and mortality.
Language: English
Keywords:
SUDAN | SUMMARY REPORT | WHO | STANDARDS | PREVALENCE | CHILD DEVELOPMENT | GROWTH | MALNUTRITION | NUTRITION PROGRAMS | EVALUATION | Developing Countries | Africa, North | Africa | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Research Methodology | Measurement | Biology | Nutrition Disorders | Diseases | Primary Health Care | Health Services | Delivery of Health Care | Health
Document Number: 341622

10.

Title: Constructive men's engagement in reproductive health: a training-of-trainers' manual. Couple communication and shared decisionmaking related to reproductive health.
Author: Futures Group International. Health Policy Initiative; Care International. Keneya Ciwara; Mali. Ministere de la Sante. Division de la Sante Reproductive
Source: Washington, D.C., Futures Group International, Health Policy Initiative, 2009 May. 26 p. (USAID Contract No. GPO-I-01-05-00040-00)
Abstract: This curriculum was developed as part of a USAID | Health Policy Initiative, Task Order 1 project focused on building an enabling policy and institutional environment for constructive men's engagement (CME) in reproductive health in Mali. The project worked with the Ministry of Health and other partners in facilitating the process of creating national guidelines to integrate CME in family planning and reproductive health (FP / RH) and to improve women's and men's uptake of FP / RH services. The project brought together the assembly of a large, multisectoral group of stakeholders to develop, refine, and validate Mali's national guidelines in support of the national Reproductive Health Strategic Plan. The Minister of Health quickly approved the guidelines and signed them into effect on May 20, 2008. This document contains the manual used in the pilot workshops with relais communautaires. It is designed to enable community health educators to incorporate activities related to constructive men's engagement in reproductive health (CME-RH) in their daily work. This includes promoting dialogue among men and women to increase couple communication and shared decisionmaking related to FP / RH. As such, it can be adapted in other settings, based on local needs.
Language: English
Keywords:
KENYA | MANUAL | TRAINING ACTIVITIES | COUPLES | DECISION MAKING | TRAINING OF TRAINERS | REPRODUCTIVE HEALTH | MEN'S INVOLVEMENT | INTERPERSONAL COMMUNICATION | WORKSHOPS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Training Programs | Education | Family Characteristics | Family and Household | Sociocultural Factors | Behavior | Health | Programs | Organization and Administration | Communication
Document Number: 331535

11.

Title: RAPID Mali: Population, development, and quality of life.
Author: Futures Group International. Health Policy Initiative; Mali. Minist�re de la Sant�
Source: [Bamako], Mali, Futures Group International, Health Policy Initiative, 2009 May. [56] p.
Abstract: Mali's population has tripled since it achieved independence in 1960. The country's fertility rate has remained stagnant for the past two decades and contraceptive prevalence rates remain much lower than in many other African countries. At the current rate of growth, the population would double in size in about 24 years. The purpose of this presentation is to examine some of the implications of this rapid growth for Mali's social and economic development. It is divided into six sections: Mali's Vision; Population Situation; Relationship Between Population and Economic Development; Population and Socioeconomic Development; Contraceptive Use, Unmet FP Need, and Effects of High Fertility on Maternal and Child Health; and Policy Response. This powerpoint presentation draws on analysis conducted using the RAPID model.
Language: English
Keywords:
MALI | SUMMARY REPORT | YOUTH | CONTRACEPTIVE USAGE | FERTILITY | FAMILY PLANNING | MATERNAL HEALTH | CHILD HEALTH | POLICY | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Population Dynamics | Health | Political Factors | Sociocultural Factors
Document Number: 331558

12.

Title: Starting with the classroom: updating family planning knowledge in East Africa.
Author: IntraHealth International. Capacity Project
Source: Chapel Hill, North Carolina, IntraHealth International, Capacity Project, 2009 Feb. [2] p. (Voices No. 28)
Abstract: In Kenya, a dedicated midwifery tutor is working hard to train students at Aga Khan University but worries that he isn't teaching them the latest information and techniques. Many of his fellow instructors are in the same situation. "We had our last refresher training ten years ago," he laments. In Tanzania, a midwifery tutor from Tumaini University Faculty of Nursing observes, "Many nurses who are providing service have never been updated on new issues [in family planning]. It will be our responsibility to see how we can help as a training institution because we will send our students to some of these clinics." To build instructors' capacity and address the knowledge gaps, the Capacity Project partnered with East, Central and Southern Africa (ECSA) Health Community and Africa's Health in 2010 to deliver a week-long workshop on Contemporary Issues in Family Planning for midwifery tutors in Kenya, Tanzania and Uganda. Held in Dar es Salaam in April 2008, the workshop updated the knowledge of 22 tutors and enabled them to teach their students more effectively. A quantitative and qualitative evaluation showed the workshop to be highly successful. Average scores climbed from 58% on the pre-test to 81% on the post-test. Additionally, 94% reported that they have used the workshop information and resources to update their colleagues. (excerpt)
Language: English
Keywords:
AFRICA, SUB SAHARAN | PROGRESS REPORT | EVALUATION | MIDWIVES AND MIDWIFERY | NURSE-MIDWIVES | FAMILY PLANNING EDUCATION | SEX EDUCATION | USAID | CAPACITY BUILDING | WORKSHOPS | CONTRACEPTION | MATERNAL-CHILD HEALTH SERVICES | PERFORMANCE IMPROVEMENT | AUDIOVISUAL AIDS | Africa | Developing Countries | Health Personnel | Delivery of Health Care | Health | Education | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Program Sustainability | Programs | Organization and Administration | Family Planning | Primary Health Care | Health Services | Management | Educational Methods | Educational Activities
Document Number: 325236

13.

Title: Spatial analysis of logistics indicator data for health commodities.
Author: John Snow [JSI]. DELIVER
Source: Arlington, Virginia, JSI, DELIVER, 2009 Jul. 6 p.
Abstract: The USAID | DELIVER PROJECT has developed robust monitoring and evaluation tools to quantitatively and qualitatively assess the performance of logistics systems for essential health commodities. The purpose of this paper is to explore how analysis of stock indicators by location provides added value to these data sets, through a relatively minor investment in GPS devices and GIS software. Beginning with visual examination of logistics indicator data within a geographic context and progressing to network analysis, each of the spatial analysis methods presented in this paper presents its own set of strengths and weaknesses, yet they all excel in providing insights into the logistics system that might not otherwise be understood or even observed by simply looking at tabular data of stock levels for different facilities in the health system. Since a logistics system is inherently a geographically heterogeneous entity, using cartographic and spatial analysis tools may prove to be a crucial asset in assisting managers to identify key questions related to the performance of the logistics system and focus on potential causes and solutions. Moving forward, it will be useful to build off of the descriptive strengths of the spatial analysis methods described herein and begin building more robust statistical models that measure correlation between different components of the logistics system and commodity availability, while still accounting for the geographical variability of the data. (Excerpts)
Language: English
Keywords:
ZAMBIA | PARAGUAY | SUMMARY REPORT | PILOT PROJECTS | DATA COLLECTION | DATA ANALYSIS | USAID | LOGISTICS | GEOGRAPHY | INFORMATION RETRIEVAL SYSTEMS | DISTANCE | STREETS AND ROADS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | South America, Central | South America | Latin America | Americas | Studies | Research Methodology | Government Agencies | Organizations | Political Factors | Sociocultural Factors | Management | Organization and Administration | Social Sciences | Science | Data Storage and Retrieval | Information Processing | Information | Geographic Factors | Population | Transportation | Economic Factors
Document Number: 331660

14.

15.

16.

17.

Title: Building support for orphans and vulnerable children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: We provide solid scientific evidence about programs targeting orphans and vulnerable children to help governments and communities provide better care for these children in need. The Council�s studies apply innovative research techniques to address complex issues about providing care and services to children affected by HIV. The Council�s evaluation of the RAPIDS intervention has highlighted the effectiveness of program activities and valuable lessons for program managers and providers. A mid-term evaluation in 2007 showed important progress, such as more help with school books, uniform fees, and transportation and improvements in school attendance among vulnerable children. Results from the 2009 data collection promise to provide further guidance to program managers on how to ensure the greatest impact with available resources. (Excerpts)
Language: English
Keywords:
ZAMBIA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | PROGRAM ACTIVITIES | MANAGEMENT | INFORMATION | FINANCIAL ACTIVITIES | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Programs | Organization and Administration | Economic Factors
Document Number: 331493

18.

Title: Helping mothers keep their babies safe from HIV.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: The Population Council's evaluation of m2m provided solid evidence that the program was helping women use services to prevent transmission of HIV to their children. An innovative program, mothers2mothers (m2m), was created in South Africa to support HIV-positive pregnant women. The program trains and employs HIV-positive mothers who have used services to prevent mother-to-child transmission of HIV. These "mentor mothers" organize health talks and conduct regular support groups for their peers. They also reach out to the community to help women follow feeding practices that are best for their baby. They promote safer sex and family planning, and encourage mothers to return for HIV treatment and to bring their baby to the clinic for HIV testing. Women who participated in m2m were more likely to talk about their HIV status with friends and family members, to receive drugs to reduce the chance that their baby would be infected with HIV, and to follow recommended infant feeding practices. Following the evaluation, the program has expanded to hundreds of other locations in South Africa and beyond to Lesotho, Zambia, Kenya, Rwanda, Malawi, and Swaziland -- providing hope and care to HIV-positive mothers across Africa.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | WOMEN | PERSONS LIVING WITH HIV/AIDS | INFANT NUTRITION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | PARTICIPATION | STIGMA | SOCIAL DISCRIMINATION | UTILIZATION OF HEALTH CARE | COUNSELING | TREATMENT | NEEDS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | Nutrition | Health | Disease Transmission Control | Prevention and Control | Social Behavior | Behavior | Social Problems | Sociocultural Factors | Health Services | Delivery of Health Care | Clinic Activities | Program Activities | Programs | Organization and Administration | Medical Procedures | Medicine | Economic Factors
Document Number: 331490

19.

20.

Title: Increasing HIV testing for at-risk children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: The Caregiver Project is helping HIV-positive children access life-saving medical treatment and providing an outreach model that can be replicated across Africa. The project trains grandmothers (called �grannies") to serve as peer supporters for elderly caregivers. The grannies provide information about pediatric HIV testing and treatment to elderly caregivers who come to Social Security Agency sites to get grants for social services for children and the elderly. Grannies offer caregivers referral cards that list the locations of pediatric testing services and encourage them to take the children to be tested. The Caregiver Project is targeting an important gateway to accessing these children, the elderly caregivers, and motivating caregivers to seek care through age-appropriate resources. (Excerpts)
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | CARE AND SUPPORT | PROMOTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Marketing | Economic Factors | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine
Document Number: 331491

21.

Title: Overcoming barriers to treatment for children.
Author: Population Council
Source: Momentum. 2009 Jun;:[1] p.
Abstract: Only 11 percent of HIV-positive children eligible for treatment in Kenya receive life-saving therapy. Through surveys, group discussions, and interviews with families and health workers, Council researchers identified barriers that prevent parents and caregivers from seeking treatment for HIV-infected children. Applying its research findings, the Council and the government of Kenya are supporting community-awareness activities to educate and assist caregivers, inform them of available services, and reduce stigma. The Council is also working with health facilities to improve counseling, support, and outreach services, and to provide Kenya's government with recommendations for improving pediatric HIV services so HIV-positive children across the country receive life-saving treatment. (Excerpts)
Language: English
Keywords:
KENYA | SUMMARY REPORT | ORPHANS AND VULNERABLE CHILDREN | PERSONS LIVING WITH HIV/AIDS | OBSTACLES | TREATMENT | UTILIZATION OF HEALTH CARE | HEALTH SERVICES | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Family and Household | Sociocultural Factors | HIV Infections | Viral Diseases | Diseases | Organization and Administration | Medical Procedures | Medicine | Delivery of Health Care | Health
Document Number: 331492

22.

Title: Advice columns in South African print publications.
Author: Soul City Institute for Health and Development Communication
Source: [Houghton, South Africa], Soul City Institute for Health and Development Communication, [2009]. 17 p.
Abstract: This paper reports on a study about letters to and responses from advice columnists in 13 South African publications over a three-month period. Approximately 40 percent of letters to the columnists asked for advice about multiple concurrent partnerships, but less than half of the answers included information related to HIV and the increased risk of infection that accompanies such relationships. Instead, the columnists chose to focus on emotional or moral issues of concurrent partnerships. The paper highlights this missed opportunity to address HIV-prevention issues.
Language: English
Keywords:
SOUTH AFRICA | SUMMARY REPORT | RESPONDENTS | PRINTED MEDIA | HIV INFECTIONS | AIDS | KNOWLEDGE | COUNSELING | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Mass Media | Communication | Viral Diseases | Diseases | Sociocultural Factors | Clinic Activities | Program Activities | Programs | Organization and Administration
Document Number: 331820

23.

Peer Reviewed

Title: HIV infection and tuberculosis in South Africa: an urgent need to escalate the public health response.
Author: Abdool Karim SS; Churchyard GJ; Abdool Karim Q; Lawn SD
Source: Lancet. 2009 Sep 12;374(9693):921-33.
Abstract: One of the greatest challenges facing post-apartheid South Africa is the control of the concomitant HIV and tuberculosis epidemics. HIV continues to spread relentlessly, and tuberculosis has been declared a national emergency. In 2007, South Africa, with 0.7% of the world's population, had 17% of the global burden of HIV infection, and one of the world's worst tuberculosis epidemics, compounded by rising drug resistance and HIV co-infection. Until recently, the South African Government's response to these diseases has been marked by denial, lack of political will, and poor implementation of policies and programmes. Nonetheless, there have been notable achievements in disease management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts, and scale-up of free antiretroviral therapy (ART). Care for acutely ill AIDS patients and long-term provision of ART are two issues that dominate medical practice and the health-care system. Decisive action is needed to implement evidence-based priorities for the control of the HIV and tuberculosis epidemics. By use of the framework of the Strategic Plans for South Africa for tuberculosis and HIV/AIDS, we provide prioritised four-step approaches for tuberculosis control, HIV prevention, and HIV treatment. Strong leadership, political will, social mobilisation, adequate human and financial resources, and sustainable development of health-care services are needed for successful implementation of these approaches.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | HIV INFECTIONS | TUBERCULOSIS | ANTIRETROVIRAL THERAPY | DRUG RESISTANCE | HEALTH SERVICES | DELIVERY OF HEALTH CARE | MANAGEMENT | TREATMENT | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | Viral Diseases | Diseases | Infections | HIV | Medical Procedures | Medicine | Health
Document Number: 342870

24.

Title: Risk factors associated with low CD4+ lymphocyte count among HIV-positive pregnant women in Nigeria.
Author: Abimiku A; Villalba-Diebold P; Dadik J; Okolo F; Mang E; Charurat M
Source: International Journal of Gynaecology and Obstetrics. 2009 May 20;
Abstract: OBJECTIVE: To determine the risk factors for CD4+ lymphocyte counts of 200 cells/mm(3) or lower in HIV-positive pregnant women in Nigeria. METHOD: A cross-sectional data analysis from a prospective cohort of 515 HIV-positive women attending a prenatal clinic. Risk of a low CD4+ count was estimated using logistic regression analysis. RESULTS: CD4+ lymphocyte counts of 200 cells/mm(3) or lower (280+/-182 cells/mm(3)) were recorded in 187 (36.3%) out of 515 HIV-positive pregnant women included in the study. Low CD4+ count was associated with older age (adjusted odds ratio [aOR] 10.71; 95% confidence interval [CI], 1.20-95.53), lack of condom use (aOR, 5.16; 95% CI, 1.12-23.8), history of genital ulcers (aOR, 1.78; 95% CI, 1.12-2.82), and history of vaginal discharge (aOR; 1.62; 1.06-2.48). CONCLUSIONS: Over 35% of the HIV-positive pregnant women had low CD4+ counts, indicating the need for treatment. The findings underscore the need to integrate prevention of mother-to-child transmission with HIV treatment and care, particularly services for sexually transmitted infections.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | HEMATOLOGICAL EFFECTS | RISK FACTORS | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | CONDOM USE | SEXUALLY TRANSMITTED DISEASES | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Health | Disease Transmission Control | Prevention and Control | Risk Reduction Behavior | Behavior | Reproductive Tract Infections | Infections
Document Number: 341452

25.

Title: Building laboratory infrastructure to support scale-up of HIV/AIDS treatment, care, and prevention: in-country experience.
Author: Abimiku AG
Author: Institute of Human Virology, University of Maryland School of Medicine PEPFAR
Source: American Journal of Clinical Pathology. 2009 Jun;131(6):875-86.
Abstract: An unprecedented influx of funds and support through large programs such as the Global Fund for AIDS, Malaria and Tuberculosis and the World Health Organization's and President's Emergency Plan for AIDS Relief (PEPFAR) has made it possible for more than 1 million persons in resource-limited settings to access AIDS treatment and several million more to be in care and prevention programs. Nevertheless, there remain major challenges that prevent AIDS drugs and care from reaching many more in need, especially in rural settings. The roll-out of a high-quality treatment, care, and prevention program depends on an effective and reliable laboratory infrastructure. This article presents a strategy used by the Institute of Human Virology (IHV)-University of Maryland and its affiliate IHV-Nigeria to establish a multifaceted, integrated tier laboratory program to support a PEPFAR-funded scale-up of its AIDS Care Treatment in Nigeria program, in collaboration with the Centers for Disease Control and Prevention and the Nigerian government, as a possible model for overcoming a key challenge that faces several resource-limited countries trying to roll out and scale-up their HIV/AIDS treatment, care, and prevention program.
Language: English
Keywords:
NIGERIA | CRITIQUE | HIV INFECTIONS | CARE AND SUPPORT | TREATMENT | HIV PREVENTION | LABORATORY | EQUIPMENT AND SUPPLIES | LABORATORY EXAMINATIONS AND DIAGNOSES | TESTING | TUBERCULOSIS | INTEGRATED PROGRAMS | TRAINING ACTIVITIES | STANDARDS | QUALITY CONTROL | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Viral Diseases | Diseases | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine | Examinations and Diagnoses | Measurement | Research Methodology | Infections | Programs | Organization and Administration | Training Programs | Education
Document Number: 341766

26.

Peer Reviewed

Title: Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria.
Author: Abiodun OM; Balogun OR
Source: Contraception. 2009 Feb;79(2):146-9.
Abstract: BACKGROUND: A survey was conducted to evaluate the pattern of sexual behavior and contraceptive use among female students aged 15 to 24 years attending tertiary institutions in Ilorin, Nigeria. STUDY DESIGN: A valid and reliable semistructured questionnaire was self-administered to a sampled population of 600 students aged 15 to 24 years. RESULTS: Of the 600 students, 562 (93.7%) completed the questionnaire. Most (98.6%) of the respondents were unmarried, 77.6% have had sexual intercourse, 67.8% have had an unwanted pregnancy while 63.5% have had induced abortion. All the respondents were aware of contraceptives, but only 25.4% have ever used any contraceptive method. The most common sources of information about contraception among the respondents were friends/relatives (73.7%), while the fear of side effects of modern contraceptives was the most common reason (77.5%) for nonuse. CONCLUSION: The fear of side effects is the main reason for low contraceptive prevalence among young female students of tertiary institutions in Ilorin. Reproductive health services should focus more on delivery of adequate and accurate information about contraceptives to improve use among young women.
Language: English
Keywords:
NIGERIA | RESEARCH REPORT | QUESTIONNAIRES | ADOLESCENTS, FEMALE | YOUTH | CONTRACEPTIVE USAGE | SEXUALITY | SEX BEHAVIOR | CONTRACEPTIVE PREVALENCE | Africa, Western | Africa, Sub Saharan | Africa | Developing Countries | Adolescents | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Personality | Psychological Factors | Behavior
Document Number: 329609

27.

Title: Prevention of invasive pneumococcal disease in HIV-infected children: expanding the toolbox [editorial]
Author: Abzug MJ; Pelton SI
Source: Journal of Infectious Diseases. 2009 Apr 15;199(8):1109-11.
Abstract: Invasive pneumococcal disease (IPD) remains a threat to HIV-infected children, adolescents, and adults in both developed and emerging nations. In the pre-highly active antiretroviral therapy (HAART) era, Mao et al. identified a cumulative incidence of 6.1 cases per 100 patient-years through age 7 years among HIV-infected children in Massachusetts, a rate 100-300-fold that seen in HIV-uninfected immunocompetent children in the United States. Similarly, Westwood et al. reported an IPD rate of 13 cases per 100 patient-years in Capetown, South Africa, a large proportion of which were lower respiratory tract infections. With widespread use of HAART in the United States, the rate of pneumococcal bacteremia declined by 80%, to 1.9 cases per 100 patient-years; this residual rate still remained at least 10-fold greater than that among HIV-uninfected children, and children who suffered an episode of pneumococcal bacteremia were more likely to die during follow-up than were HIV-infected children without an episode. These data identify the need to protect HIV-infected children from infection with Streptococcus pneumoniae, even in populations treated with HAART. (excerpt)
Language: English
Keywords:
UNITED STATES OF AMERICA | MASSACHUSETTS | SOUTH AFRICA | SUMMARY REPORT | CLINICAL TRIALS | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ADULTS | ADOLESCENTS | ANTIRETROVIRAL THERAPY | DISEASE PREVENTION | VACCINES | Developed Countries | North America | Americas | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Prevention and Control | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341354

28.

Peer Reviewed

Title: Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission.
Author: Adair T
Source: Journal of Biosocial Science. 2009 Mar;41(2):269-78.
Abstract: In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | KAP SURVEYS | DEMOGRAPHIC AND HEALTH SURVEYS | MULTIVARIATE ANALYSIS | URBAN POPULATION | WOMEN IN DEVELOPMENT | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | KNOWLEDGE | CONTRACEPTION | NEEDS ASSESSMENT | BIRTH SPACING | POVERTY | ATTITUDES | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Surveys | Sampling Studies | Studies | Research Methodology | Demographic Surveys | Population Dynamics | Demographic Factors | Population | Data Analysis | Population Characteristics | Economic Development | Economic Factors | Disease Transmission Control | Prevention and Control | Diseases | Sociocultural Factors | Family Planning | Evaluation | Socioeconomic Factors | Psychological Factors | Behavior | Program Evaluation | Programs | Organization and Administration
Document Number: 331114

29.

Title: Maternal and perinatal outcome in teenage pregnancies in Sudan.
Author: Adam GK; Elhassan EM; Ahmed AM; Adam I
Source: International Journal of Gynaecology and Obstetrics. 2009 May;105(2):170-1.
Abstract: Pregnancy and childbirth in teenage women pose special risks for both mother and baby. As well as significant medical, nutritional, social, and economic risks, teenage pregnancy is associated with increased risks for adverse pregnancy outcomes, such as preterm birth, low birth weight, and death in the neonatal or postnatal periods. There is a paucity of literature regarding the maternal and perinatal outcome of teenage pregnancies in Sudan, Africa. The aim of the present study was to assess the risk of anemia, operative delivery, and perinatal complications (mainly low birth weight) among primiparous teenagers with a singleton delivery compared with a similar group of women aged 20-24 years. (excerpt)
Language: English
Keywords:
SUDAN | RESEARCH REPORT | COMPARATIVE STUDIES | PREGNANT WOMEN | ADOLESCENT PREGNANCY | PREGNANCY OUTCOMES | ANEMIA | LOW BIRTH WEIGHT | MATERNAL AGE | EDUCATIONAL STATUS | Developing Countries | Africa, North | Africa | Studies | Research Methodology | Population Characteristics | Demographic Factors | Population | Reproductive Behavior | Fertility | Population Dynamics | Pregnancy | Reproduction | Diseases | Birth Weight | Body Weight | Physiology | Biology | Parental Age | Age Factors | Socioeconomic Status | Socioeconomic Factors | Economic Factors
Document Number: 341382

30.


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