Background: Co-infection with hepatitis B (HBV) and hepatitis D (HDV) is common among human immunodeficiency virus (HIV) infected individuals in developing countries and it aggressively accelerates progression of liver disease to cirrhosis and other complications. There is scarcity of data on HDV in sub-Saharan Africa .We investigated the sero-prevalence and factors associated with HDV antibody among HIV/HBV co-infected patients attending a large urban HIV clinic in Uganda. Methods: We screened 189 HIV/HBV co-infected individuals for anti-HDV immunoglobulin G (IgG) and performed logistic regression to determine the associated factors. Socio-demographic, clinical data, immunological status, and liver fibrosis (as determined by the Aspartate transaminase to platelet ratio index and transient elastography) were included. Results: Participants were predominately young and of sound immunologic status (median age 40 years, median CD4 440 cells/µl). 98% were on ART regimens containing anti-HBV active medications (95.2% were on TDF/3TC while 4.8% on 3TC containing regimen). Median duration on ART was 36 months . Anti-HDV was detected in 6/198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis. Conclusions:The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban cohort.
BackgroundEpidemics and pandemics are causing high morbidity and mortality on a still-evolving scale exemplified by the COVID-19 pandemic. Infection prevention and control (IPC) training for frontline health workers is thus essential. However, classroom or hospital ward based training portends an infection risk due to the in-person interaction of participants. We explored the use of Virtual Reality (VR) simulations for frontline health worker training since it trains participants without exposing them to infections that would arise from in-person training. It does away with the requirement for expensive Personal Protective Equipment (PPE) that has been in acute shortage and improves learning, retention and recall. This represents the first attempt in deploying VR-based pedagogy in a Ugandan medical education context.MethodsWe used animated VR-based simulations of bedside and ward-based training scenarios for frontline health workers. The training covered the wearing and stripping of PPE, case management of COVID-19 infected individuals and hand hygiene. It used VR headsets and Graphics Processing Units (GPUs) to actualize an immersive experience, via a hybrid of VR renditions and 360degrees videos. We then compared the level of knowledge acquisition between individuals trained using this method to comparable cohorts previously trained in a classroom setting. That evaluation was supplemented by a qualitative assessment based on feedback from participants about their experience.ResultsThe effort resulted into a well-designed COVID-19 IPC VR curriculum, equivalent VR content and a pioneer cohort of trained frontline health workers. The formalized comparison with classroom-trained cohorts showed relatively better outcomes by way of skills acquired, speed of learning and rates of information retention (P-value =4.0e-09) - suggesting the effectiveness and feasibility of VR as a medium of medical training. Additionally, in the qualitative assessment 90% of the participants rated the method as very good, 58.1% strongly agreed that the activities met the course objectives, and 97.7 % strongly indicated willingness to refer the course to colleagues. ConclusionVR-based COVID-19 IPC training is feasible, effective and achieves enhanced learning while protecting participants from infections within a pandemic context in Uganda. It is a delivery medium transferable to the contexts of other highly infectious diseases.
Background Epidemics and pandemics are causing high morbidity and mortality on a still-evolving scale exemplified by the COVID-19 pandemic. Infection prevention and control (IPC) training for frontline health workers is thus essential. However, classroom or hospital ward-based training portends an infection risk due to the in-person interaction of participants. We explored the use of Virtual Reality (VR) simulations for frontline health worker training since it trains participants without exposing them to infections that would arise from in-person training. It does away with the requirement for expensive personal protective equipment (PPE) that has been in acute shortage and improves learning, retention, and recall. This represents the first attempt in deploying VR-based pedagogy in a Ugandan medical education context. Methods We used animated VR-based simulations of bedside and ward-based training scenarios for frontline health workers. The training covered the donning and doffing of PPE, case management of COVID-19 infected individuals, and hand hygiene. It used VR headsets to actualize an immersive experience, via a hybrid of fully-interactive VR and 360° videos. The level of knowledge acquisition between individuals trained using this method was compared to similar cohorts previously trained in a classroom setting. That evaluation was supplemented by a qualitative assessment based on feedback from participants about their experience. Results The effort resulted in a COVID-19 IPC curriculum adapted into VR, corresponding VR content, and a pioneer cohort of VR trained frontline health workers. The formalized comparison with classroom-trained cohorts showed relatively better outcomes by way of skills acquired, speed of learning, and rates of information retention (P-value = 4.0e-09). In the qualitative assessment, 90% of the participants rated the method as very good, 58.1% strongly agreed that the activities met the course objectives, and 97.7% strongly indicated willingness to refer the course to colleagues. Conclusion VR-based COVID-19 IPC training is feasible, effective and achieves enhanced learning while protecting participants from infections within a pandemic setting in Uganda. It is a delivery medium transferable to the contexts of other highly infectious diseases.
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