This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.
Background Tuberculosis (TB) is amongst the top five causes of death in women of childbearing age (15-�44 years). Little is known about treatment of pregnant women with drug-resistant TB (DR-TB). Treatment for pregnant women remains challenging and more complex in DR-TB/HIV co-infection, where an evidence-based guide to clinical practice is limited. The study reviewed treatment and pregnancy outcomes and birth outcomes of their newborn in a cohort of pregnant women with DR-TB from three MDR-TB hospitals during 2010 and 2018. Design/Methods Data were extracted from: TB register and patient clinic notes using a standardized case record form. Information on DR-TB treatment, pregnancy and Adverse Drug Events (ADEs) of twenty-six pregnant women treated with individualized second-line TB medications were captured. The frequency of favourable and adverse outcomes regarding disease and pregnancy were evaluated. Results The mean age was 29 years (SD ±5.1), with the minimum and maximum age of 21 and 40 years, respectively. Eleven (42.3%) were previously treated with first-line TB drugs, 11 (42.3%) never treated before and 4 (15.4%) were previously treated for DR-TB. Of the 26 women, 15 (57.7%) had at least one ADE, but most had more than one ADE. Seventeen women were successfully treated, and 22 live births recorded. Live birth outcome was significantly associated with trimester of initiation of DR-TB treatment (p = 0.036). The proportion of live births for the pregnancy trimester when DR-TB treatment was initiated, were 60.0%, 90.9% and 100.0%, for first, second and third trimester, respectively.
The ongoing highly contagious coronavirus disease 2019 (COVID-19) pandemic, which started in Wuhan, China, in December 2019, has now become a global public health problem. Using publicly available data from the COVID-19 data repository of Our World in Data, we aimed to investigate the influences of spatial socio-economic vulnerabilities and neighbourliness on the COVID-19 burden in African countries. We analyzed the first wave (January–September 2020) and second wave (October 2020 to May 2021) of the COVID-19 pandemic using spatial statistics regression models. As of 31 May 2021, there was a total of 4,748,948 confirmed COVID-19 cases, with an average, median, and range per country of 101,041, 26,963, and 2191 to 1,665,617, respectively. We found that COVID-19 prevalence in an Africa country was highly dependent on those of neighbouring Africa countries as well as its economic wealth, transparency, and proportion of the population aged 65 or older (p-value < 0.05). Our finding regarding the high COVID-19 burden in countries with better transparency and higher economic wealth is surprising and counterintuitive. We believe this is a reflection on the differences in COVID-19 testing capacity, which is mostly higher in more developed countries, or data modification by less transparent governments. Country-wide integrated COVID suppression strategies such as limiting human mobility from more urbanized to less urbanized countries, as well as an understanding of a county’s social-economic characteristics, could prepare a country to promptly and effectively respond to future outbreaks of highly contagious viral infections such as COVID-19.
BackgroundPeople with spinal cord injury (PWSCI) who use wheelchairs for mobility tend to be physically inactive because of their limited mobility. Poor endurance and exercise tolerance, associated with poor physical fitness, can make it challenging to meet the physical demands of activities such as manoeuvring a wheelchair over gravel roads. This may lead to poor community participation in activities PWSCI were involved in pre-morbidly. To date, no studies have been conducted in South Africa on what the relationship is between physical fitness and community participation in PWSCI.AimThe purpose of this study was to establish the relationship between physical fitness and community participation in PWSCI.MethodologyAn exploratory cross-sectional survey was conducted on PWSCI living in the Greater Tshwane Metropolitan City. Physical fitness was measured using the 6 minute push test (6MPT) and the Borg scale. Community participation was measured using the Reintegration to Normal Living Index (RNLI). The data were analysed using the Spearman’s Rank correlation at a 5% level of significance.ResultsModerate to poor associations were found between the 6MPT and the Borg scale with the RNLI (r = 0.637; p < 0.001 and r = −0.325; p = 0.013, respectively). These results indicate that the participants who were able to push further in 6 min and had better endurance were more satisfied with their perceived community participation.ConclusionThis study shows that there is a relationship between physical fitness and community participation in PWSCI. Information gained from this study lays the foundation for more studies in this area, and for possible improvement in rehabilitation practice.
ObjectivesWe report the effectiveness of a mentoring approach to improve health workers’ (HWs’) knowledge, attitudes and confidence with counselling on HIV and infant feeding.DesignQuasi-experimental controlled before–after study.SettingRandomly selected primary healthcare clinics (n=24 intervention, n=12 comparison); two districts, South Africa.ParticipantsAll HWs providing infant feeding counselling in selected facilities were invited.InterventionsThree 1–2 hours, on-site workshops over 3–6 weeks.Primary outcome measuresKnowledge (22 binary questions), attitude (21 questions—5-point Likert Scale) and confidence (19 questions—3-point Likert Scale). Individual item responses were added within each of the attitude and confidence domains. The respective sums were taken to be the domain composite index and used as a dependent variable to evaluate intervention effect. Linear regression models were used to estimate the mean score difference between intervention and comparison groups postintervention, adjusting for the mean score difference between them at baseline. Analyses were adjusted for participant baseline characteristics and clustering at health facility level.ResultsIn intervention and comparison sites, respectively: 289 and 131 baseline and 253 and 114 follow-up interviews were conducted (August–December 2017). At baseline there was no difference in mean number of correctly answered knowledge questions; this differed significantly at follow-up (15.2 in comparison; 17.2 in intervention sites (p<0.001)). At follow-up, the mean attitude and confidence scores towards breast feeding were better in intervention versus comparison sites (p<0.001 and p=0.05, respectively). Controlling for confounders, interactions between time and intervention group and preintervention values, the attitude score was 5.1 points significantly higher in intervention versus comparison groups.ConclusionA participatory, low-intensity on-site mentoring approach to disseminating updated infant feeding guidelines improved HWs’ knowledge, attitudes and confidence more than standard dissemination via a circular. Further research is required to evaluate the effectiveness, feasibility and sustainability of this approach at scale.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.