mHealth has improved HIV interventions worldwide. Electronic data collection has made it possible to monitor HIV in near real-time. However, the pandemic in low and middle-income countries seem to be evolving in a man...
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ISBN:
(纸本)9781665449267
mHealth has improved HIV interventions worldwide. Electronic data collection has made it possible to monitor HIV in near real-time. However, the pandemic in low and middle-income countries seem to be evolving in a manner leading many to believe the Sustainable Development Goal 3.3 goal of eliminating HIV by 2030 may not be achieved. The use of paper-based health records and lack of universal client unique identification may be contributing to this trend. We aimed to evaluate how data collection integrating barcode identifiers could improve HIV care. A user-centred design (UCD) approach guided the customization of open data kit integrating barcodes. By February 2021, 42,569 females tested for HIV, 2,776 (6.5%) testing positive. Using barcode identifiers, 7,483 of their male partners and 4,652 female partners of their male partners were traced and tested. Over 90% of HIV clients had achieved viral suppression during their 12-month visit. Barcode identifiers in HIV care show great potential for improving testing and treatment adherence. A UCD approach is needed in development of effective interventions.
Highlights•High-sensitivity C-reactive protein (HS-CRP) levels predict long-term mortality in people living with HIV. •Higher HS-CRP is linked to increased mortality in a Kenyan cohort. •HS-CRP combined with CD4 count...
Highlights•High-sensitivity C-reactive protein (HS-CRP) levels predict long-term mortality in people living with HIV. •Higher HS-CRP is linked to increased mortality in a Kenyan cohort. •HS-CRP combined with CD4 count and viral load improves mortality prediction. •HS-CRP > 3.68 mg/L indicates lower survival probability.
Background: The Xpert MTB/RIF (Xpert) assay is used globally to rapidly diagnose tuberculosis and resistance to rifampicin. We investigated the frequency and predictors of false-positive findings of rifampicin resista...
Background: The Xpert MTB/RIF (Xpert) assay is used globally to rapidly diagnose tuberculosis and resistance to rifampicin. We investigated the frequency and predictors of false-positive findings of rifampicin resistance with Xpert. Methods: We did a prospective, observational study of individuals who were enrolled in a Rwandan nationwide diagnostic cohort study (DIAMA trial;NCT03303963). We included patients identified to have rifampicin resistance on initial Xpert testing. We did a repeat Xpert assay and used rpoB Sanger and deep sequencing alongside phenotypic drug susceptibility testing (pDST) to ascertain final rifampicin susceptibility status, with any (hetero)resistant result overriding. We used multivariable logistic regression to assess predictors of false rifampicin resistance on initial Xpert testing, adjusted for HIV status, tuberculosis treatment history, initial Xpert semi-quantitative bacillary load, and initial Xpert probe. Findings: Between May 4, 2017, and April 30, 2019, 175 people were identified with rifampicin resistance at initial Xpert testing, of whom 154 (88%) underwent repeat Xpert assay. 54 (35%) patients were confirmed as rifampicin resistant on repeat testing and 100 (65%) were not confirmed with resistance. After further testing and sequencing, 121 (79%) of 154 patients had a final confirmed status for rifampicin susceptibility. 57 (47%) of 121 patients were confirmed to have a false rifampicin resistance result and 64 (53%) had true rifampicin resistance. A high pretest probability of rifampicin resistance did not decrease the odds of false rifampicin resistance (adjusted odds ratio [aOR] 6·0, 95% CI 1·0–35·0, for new tuberculosis patients vs patients who needed retreatment). Ten (16%) of the 64 patients with true rifampicin resistance did not have confirmed rifampicin resistance on repeat Xpert testing, of whom four had heteroresistance. Of 63 patients with a very low bacillary load on Xpert testing, 54 (86%) were falsely diagnosed w
mHealth as an emerging technology in healthcare is making it easier to streamline processes, reduce cost, accelerate completion of research or health outcomes. However, privacy and security concerns are hampering inte...
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ISBN:
(纸本)9781467393553
mHealth as an emerging technology in healthcare is making it easier to streamline processes, reduce cost, accelerate completion of research or health outcomes. However, privacy and security concerns are hampering integration of mobile technologies in healthcare due to insufficient or lack of guidelines in securing data during transfer and storage. Securing data includes ensuring the confidentiality, integrity, and availability of the electronic data. Security solutions should attempt to be a balance between individual's privacy and making the information accessible when necessary. This study describes an operations research piloting the enrollment processes of patients into a case-based registry. We assess the feasibility and time constraints associated with administration of this secure mHealth system.
A Reliable and accurate public health information system is essential for monitoring health and for evaluating and improving the delivery of health-care services and programmes. In Public health, decision-making is cr...
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A Reliable and accurate public health information system is essential for monitoring health and for evaluating and improving the delivery of health-care services and programmes. In Public health, decision-making is critically dependent on the timely availability of accurate and sound data. Open Data Kit (ODK) a free and open-source set of tools can be used by health organizations to author, field, and manage mobile data collection as a sustainable m-Health solution. m-Health encompasses health-related uses of telecommunication and multimedia technologies within health service delivery and public health systems in data collection and management to enhance data quality, reduce turn-around time and facilitate immediate feedback to health systems. This paper evaluates the implementation of ODK as an m-Health solution to enhance data management in public health.
The Nigeria national Response Management Information System (NNRIMS), developed in 2004 as a framework for monitoring and evaluating the country’s response to HIV, does not function at an optimum level due to several...
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The Nigeria national Response Management Information System (NNRIMS), developed in 2004 as a framework for monitoring and evaluating the country’s response to HIV, does not function at an optimum level due to several challenges, including a confusing proliferation of vertical reporting systems, competition among sectors, and the nascent nature of the monitoring and evaluation (M&E) sub-systems within many institutions. An assessment of the existing M&E system was conducted to verify whether the system has the capacities to provide essential data for monitoring the epidemic and identifying critical programming gaps. Nigeria’s national Agency for the control of aids (NACA) used an organizing framework for a national HIV M&E system developed by UNaids, to assess the strengths and weaknesses of the NNRIMS to generate data for evidence-based decisionmaking. The participatory approach used during an assessment workshop ensured that the process was country-led and -owned to build consensus and local capacity, and that it encouraged adoption of a single national-level multisectoral HIV M&E system. The assessment found an operable M&E system at the national level but a much weaker system at the state and local levels and across seven other sectors. There are multiple data collection and reporting tools at the facility level that lead to vertical reporting systems, which increases the burden of reporting at lower levels, especially by service providers. Human resources are being developed, but problems remain with the quantity and quality of staff. Data use, though evident at the national level, is still very weak among five of the seven sectors assessed. The assessment results have been used to develop a national costed M&E workplan to which all stakeholders contributed in a coordinated response to strengthen the system.
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