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Prevalence and Factors Associated with Hypertension among Anti-Retroviral Therapy Patients Aged 15 Years and above in Makonde District, zimbabwe, 2012: An Analytic Cross Sectional Study

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World Journal of Cardiovascular Diseases 2015年第9期5卷 266-277页

作者： Blessing Ruwimbo Mutede Tapiwa Magure Notion Tafara Gombe Donewell Bangure Mufuta Tshimanga More Mungati Department of Community Medicine University of Zimbabwe Harare Zimbabwe national aids council Zimbabwe Harare Zimbabwe

Background: Anti-retroviral therapy (ART) has reduced morbidity and mortality among HIV-infected individuals over the last years. The increase in survival of HIV patients has contributed to the emergence of other chronic conditions in these individuals, such as hypertension, renal, and cardiovascular disease. Hypertension and HIV infection are both mostly asymptomatic but can lead to fatal and disabling illness. Hypertension among HIV-infected individuals, although not completely elucidated, may be explained by the aging of population, the effect of HIV on vascular tone anti-retroviral therapy and traditional risk factors such as weight gain, smoking, dyslipidemia, and drug abuse. The factors associated with hypertension among ART patients in a predominantly rural setting were studied in this paper. Methods: We conducted an analytical cross sectional study at 13 health facilities in Makonde District a rural district in Mashonaland West Province of zimbabwe where we systematically selected 393 of 400 ART patients aged 15 years and above. Structured interviewer administered questionnaires were used to collect data on demographic characteristics. Written and informed consent was sought and obtained from all study participants. We obtained parental consent followed by assent from participants younger than 16 years. All enrolled patients had physical measurements done. Chi square test and stratified & logistic regression analysis were done using Epi info version 3.5.1. All calculations were done at 95% confidence interval. Results: Results from 393 participants were analysed. The prevalence and awareness of hypertension were 34.9% and 30% respectively. Only 9.6% were taking medication. Independent risk factors were duration of ART > 2 years (POR 2.23;95%CI: 1.08;4.61), waist to hip ratio (women) > 0.85 (POR 3.45;95%CI: 1.60;5.88), B.M.I > 25 (POR 2.18;95%CI: 1.40;3.8). Protective factors were: Symptomatic HIV disease (POR 0.36;95%CI: 0.14;0.97) and being informally emplo

关键词： ART Patients Prevalence Hypertension Makonde zimbabwe

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Trend Analysis of HIV Testing Services in zimbabwe, 2007-2016: A Secondary Dataset Analysis

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Open Journal of Epidemiology 2017年第3期7卷 285-297页

作者： Sithabiso Dube Tsitsi Juru T. Magure Gerald Shambira Notion Tafara Gombe Mufuta Tshimanga Department of Community Medicine University of Zimbabwe Harare Zimbabwe national aids council Harare Zimbabwe

Background: HIV Testing Services (HTS) is a full range of services (e.g. counselling and post-test referrals) that are offered together with HIV testing. It is an important prevention strategy and the gateway to treatment. The national targets in 2016 were to test 1.1 million people of which 54% was achieved. We determined trends of HTS in zimbabwe from 2007 to 2016. Methods: A secondary dataset analysis was conducted using national aids council Core-Output Indicators dataset. Variables captured include total and repeat tests, counselling and referrals. Microsoft excel and Epi Info was used to generate frequencies, percentages and conduct chi square test for trends. Panda-Class Libraries was to attain estimates of HTS uptake till 2020. We used χ2 and p-values for statistical significance. Results: All (10,847.223) records were analysed. HIV tests per year increased from 340,705 in 2007, to 1,974,795 in 2015 (χ2 0.10492, p-value 0.74615). In 2007, 31% (n = 106,884) clients tested positive whilst in 2016 only 7% (n = 121,196) were positive (χ2 0.01166, p-value 0.91402). The 25 - 49 year age-group tested consistently highest throughout the 10year period (χ2 0.0558 p-value 0.813). The 15 - 24 year age-group had the highest yield (11% in 2015). Females (χ2 0.1074, p-value 0.743) consistently tested higher than males (χ2 0.0614, p-value 0.804). From 2007 to 2013 women had higher yields but by September 2016 males had a higher positivity of 8% (p-value χ2 0.658 p-value = 0.417). We estimate that 179,935 people living with HIV will know their status by 2020. Conclusion: HIV tests in zimbabwe have increased but yield has decreased. Increase in repeat tests may be an indication of exhaustion of particular HTS strategies. Following this analysis it was recommended that HTS utilize various models such as HIV self-test to cater for populations with high yields.

关键词： HIV Testing Services Secondary Dataset

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An Evaluation of Prevention of the Mother-to-Child Transmission Program in Murewa District, 2021

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Open Journal of Epidemiology 2022年第3期12卷 300-316页

作者： Hellen Kabaya Bernard Madzima Addmore Chadambuka Mujinga Karakadzai Tsitsi Juru Notion Gombe Mufuta Tshimanga Department of Primary Health Care Sciences: Family Medicine University of Zimbabwe Global and Public Health Unit Zimbabwe Field Epidemiology Training Program Harare Zimbabwe national aids council of zimbabwe Harare Zimbabwe Africa Field Epidemiology Network Harare Zimbabwe

Background: Prevention of mother-to-child transmission (PMTCT) program includes a cascade of services given to prevent mother-to-child transmission (MTCT) of HIV in-utero, during delivery and during breastfeeding. zimbabwe has made tremendous progress in increasing coverage of PMTCT services and reducing MTCT rate. COVID-19 has negatively impacted HIV programs. Murewa was among the districts with the most COVID-19 cases. We evaluated the PMTCT program in Murewa District in the face of COVID-19 challenges. Methods: We assessed inputs, processes, outputs and outcomes of the PMTCT program using the logic model approach. We collected data using interviewer-administered questionnaire, records review, and a checklist to assess availability of inputs, processes carried out and outputs realized from the program. We randomly selected health workers and program recipients. We used Epi info 7 to compute frequencies, means and proportions. Results: Murewa District had 58 health workers in post against an establishment of 92. Seven out of 16 facilities reported having HIV test-kit stockout. Only 4/16 were conducting postnatal clinics. No PMTCT training were conducted. Only 1872/5693 (33%) of HIV consumables including HIV test kits and CD4 count reagents were procured. The reasons reported for low PMTCT coverage in Murewa were fear of contracting COVID-19 at health facilities 33/43 (77%), lack of bus fare 28/43 (65%) and unavailability of medical consumables 26/43 (60%). Conclusion: The PMTCT program in Murewa District failed to meet targets for inputs, processes, and outputs worsened by the impact of the COVID-19 pandemic. The reasons for low PMTCT coverage in Murewa District were reported to be due to fear of contracting COVID-19, unavailability of medical consumables and COVID-19 travelling restrictions. We recommended development of guidelines on provision of PMTCT services amid the COVID-19 pandemic. We gave health education to program recipients on the importance to access

关键词： COVID-19 PMTCT Program Murewa District

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Molecular mechanisms implicated in SARS-CoV-2 liver tropism

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World Journal of Gastroenterology 2022年第48期28卷 6875-6887页

作者： Jorge Quarleri M.Victoria Delpino Institute for Biomedical Research on Retroviruses and aids Faculty of Medical SciencesNational Scientific and Technical Research Council-University of Buenos AiresBuenos Aires 1121Argentina

The coronavirus disease 2019(COVID-19)pandemic is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Hepatic involvement is common in SARS-CoV-2-infected *** is currently accepted that the direct and indirect hepatic effects of SARS-CoV-2 infection play a significant role in *** individuals with pre-existing infectious and non-infectious liver disease,who are at a remarkably higher risk of developing severe COVID-19 and death,this pathology is most medically *** review emphasizes the current pathways regarded as contributing to the gastrointestinal and hepatic ailments linked to COVID-19-infected patients due to an imbalanced interaction among the liver,systemic inflammation,disrupted coagulation,and the lung.

关键词： SARS-CoV-2 Viral hepatitis Non-infectious liver disease Hyperinflammation Coronavirus disease 2019

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A novel motion tracking system for evaluation of functional rehabilitation of the upper limbs

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Neural Regeneration Research 2013年第19期8卷 1773-1782页

作者： ngel Gil-Agudo Ana de los Reyes-Guzmán Iris Dimbwadyo-Terrer Benito Peasco-Martín Alberto Bernal-Sahún Patricia López-Monteagudo Antonio del Ama-Espinosa José Luis Pons Department of Biomechanics and Technical aids National Hospital for Spinal Cord Injury Health Department Indra SystemsAlcobendas Madrid Spain Bioengineering Group Spanish National Research Council (CSIC) Arganda del ReyMadrid Spain

Upper limb function impairment is one of the most common sequelae of central nervous system in jury, especially in stroke patients and when spinal cord injury produces tetraplegia. Conventional assessment methods cannot provide objective evaluation of patient performance and the effec tiveness of therapies. The most common assessment tools are based on rating scales, which are inefficient when measuring small changes and can yield subjective bias. In this study, we designed an inertial sensorbased monitoring system composed of five sensors to measure and analyze the complex movements of the upper limbs, which are common in activities of daily living. We devel oped a kinematic model with nine degrees of freedom to analyze upper limb and head movements in three dimensions. This system was then validated using a commercial optoelectronic system. These findings suggest that an inertial sensorbased motion tracking system can be used in patients who have upper limb impairment through data integration with a virtual realitybased neurorehabili tation system.

关键词： neural regenerationtion tracking upperroregenerationbrain injury spinal cordmb: neurorehabilitationnjury kinematic analysis inertial measurement mo-virtual reality sensors grants-supported paper neu-

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Severe Visual Impairment in Schools (A PEEK Study)

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Open Journal of Ophthalmology 2022年第3期12卷 307-321页

作者： Busisiwe Mzyece Orapeleng Malemane Andrew Chimatira Boniface Macheka council for the Blind Bulawayo Zimbabwe Ministry of Health and Child Care Harare Zimbabwe Community Medicine Department University of Zimbabwe Harare Zimbabwe

Childhood visual impairment is a major public health concern. The global financial burden of childhood-onset blindness is greater than that of adult-onset blindness due to the longer span of living. The importance of good vision for education and socialisation from an early age has prompted the adoption of vision screening in schools by many national eye care programmes in zimbabwe. Therefore, the aim and purpose of this study were to determine the prevalence of visual impairment and the pattern of eye conditions affecting school children screened during the course of the “Portable Eye Examination Kit (PEEK) project.” The study was a retrospective review that utilized data that was collated and analysed from the PEEK project dashboard from June 2019 to December 2020 by well-trained eye health care providers. The sample size was 4591 school-going children aged between 5 to 20 years of age recruited from the Harare and Bulawayo schools. Results showed that 58% did not have any eye problems while 24% had a red watery and itchy eye, 10% had a red eye, 2% had lid and globe issues and 2% had strabismus. The visual acuity results showed that the majority of participants, 2/3, had a good vision as they recorded a Snellen acuity test score of 6/9 or better. In addition, 1/5 had mild visual impairment, and about 2% of the participants were legally blind. 15% of the participants recruited in this study had moderate to severe visual impairment.

关键词： Visual Acuity Visual Impairment PEEK Childhood Blindness

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Changing HIV Epidemic in North-Eastern India and Its Relationship with Development and Programmatic Indicators

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World Journal of aids 2015年第3期5卷 265-274页

作者： Chiranjeev Bhattacharjya Sangram Kishor Patel Samiran Panda Alok Kr. Deb Assam State aids Control Society National AIDS Control Organization Guwahati India HIV and aids Program Population Council New Delhi India national Institute of Cholera and Enteric Diseases ICMR Kolkata India

Background: Although there has been significant reduction in HIV prevalence and new HIV infections in India, some of the low/moderate prevalence states have been showing long term increase in HIV prevalence and new HIV infections. Assam, a state in northeast India is one such low HIV prevalence state where HIV prevalence and new HIV infections have almost doubled in the last few years. This study examined the trend of HIV prevalence across districts/regions of Assam and its association with developmental and program indicators. Materials and Methods: A retrospective descriptive analysis of secondary data from the national aids Control Program, Census of India-2011, and District Level Household and Facility Survey-3 was conducted. The time period covered under the secondary data analysis was 2007 to 2012. Correlation and Chi-square for trend tests were also used in this paper. Results: During 2007 and 2012, HIV positivity (%) increased relatively in North Assam (46.9%) followed by South Assam (11.5%) while there has been a relative decline in West Assam (﹣51.5%). Correlation analysis showed statistically significant association between HIV prevalence and female literacy, population using mobile phone, population using internet, women (15 - 49 years) seeking treatment for any STI/RTI, proportion of brothel based FSWs, FSWs having <5 clients per week and proportion of condom utilized annually. Conclusion: Program efforts in the state should be focus on the districts with increasing HIV prevalence. Emphasis should be given in planning strategies to address the program gaps among the high risk and vulnerable populations in the state.

关键词： HIV Epidemic Program and Development Indicator North-Eastern India

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Causes of Death among HIV-Infected Adults Registered in Selected Anti-Retroviral Therapy Centers in North-Eastern India

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World Journal of aids 2015年第2期5卷 90-99页

作者： Chiranjeev Bhattacharjya Damodar Sahu Sangram Kishor Patel Niranjan Saggurti Arvind Pandey Assam State aids Control Society National AIDS Control Organization Guwahati India national Institute of Medical Statistics ICMR New Delhi India HIV and aids Program Population Council New Delhi India

Background: Causes of death related studies in HIV infected population are necessary to devise disease specific preventive interventions at both state and national level HIV programs. This study examines the causes of death among HIV-infected individuals registered at selected Anti-Retroviral Therapy (ART) centers in the era of treatment in north-eastern India. Data and Methods: A retrospective chart review of causes of death was undertaken among HIV-infected patients who were treated between January 2006 and November 2012 at three selected ART centers in Assam, a north-eastern state of India. Reported causes of death were coded as per the guidelines of the International Classification of Diseases (ICD-10) to determine the deaths to standard definitions. Results: Among 5612 HIV-infected patients registered over a period of 71 months, 370 deaths have occurred. Tuberculosis (28%) was the leading cause of death followed by death due to aids related complex (11%), wasting syndrome and multiple infections (9% each). Deaths due to selected causes were significantly associated with patient’s use of alcohol, WHO clinical stage, CD4 count at the time of diagnosis, presence of opportunistic infections during treatment and ART adherence. Median survival duration was shortest among patients who had CD4 count aids-related causes. Tuberculosis has remained the leading cause of death among the HIV patients on ART. Strengthening the linkages and referral between the HIV and TB program will be crucial to reduce the aids-related deaths attributed to tuberculosis.

关键词： Causes of Death HIV aids Tuberculosis ART Assam Northeastern India

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Using UNaids’s organizing framework to assess Nigeria’s national HIV monitoring and evaluation system

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Open Journal of Preventive Medicine 2012年第3期2卷 372-378页

作者： Kayode Ogungbemi Kola A. Oyediran Stephanie Mullen Anne LaFond Aderemi Azeez David Boone Tendayi Ndori Mharadze Natasha Kanagat Akinyemi Atobatele Measure Evaluation Project John Snow Inc. Washington D.C. USA Monitoring and Evaluation Zimbabwe AIDS Network Harare Nigeria national aids and STIs Control Programme Federal Ministry of Health Abuja Nigeria Strategic Knowledge Management National Agency for the Control of AIDS (NACA) Abuja Nigeria USAID/Nigeria Abuja Nigeria

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.

关键词： HIV/aids Nigeria 12 Components M&E System

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Safety of Blood Maintained in zimbabwe: Low Transfusion Transmissible Infections among Blood Donors

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Journal of Biosciences and Medicines 2020年第7期8卷 35-43页

作者： David Zezai Palanivel Chinnakali Riitta A. Dlodlo Hamufare D. Mugauri Philip Owiti Menard Mutenherwa George Mavunganidze Lucy M. Marowa Tonderai Mapako national Blood Service zimbabwe (NBSZ) Harare Zimbabwe Department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) Puducherry India International Union against Tuberculosis and Lung Disease Paris France Ministry of Health and Child Care AIDS and TB Unit Harare Zimbabwe national Tuberculosis Leprosy and Lung Disease Programme Ministry of Health Nairobi Kenya

Background: Low level of transfusion transmissible infections (TTIs) is an indicator of a well-performing blood donor program. Aim: The study was designed to estimate the prevalence of TTIs and to evaluate the demographic characteristics of reactive and non-reactive blood donors in zimbabwe in 2018. Methods: A cross-sectional study was conducted using routinely available data from January to December 2018 in five branches of national Blood Service zimbabwe (NBSZ). After initial screening for high-risk behavior with a questionnaire, weight, blood pressure and hemoglobin level, eligible donors were invited for blood donation. The following laboratory tests for TTIs were done: antibodies and antigen tests for human immunodeficiency virus 1 and 2 (HIV 1/2), tests for the surface antigen of hepatitis B virus (HBV), testing for hepatitis C virus (HCV) antibody and antibodies for treponema pallidum. Information on age, gender, NBSZ branch, marital status, occupation, donor type (first time/repeat) and TTIs test results were extracted from the NBSZ electronic database (e-Delphyn blood bank software). Results: Out of a sample of 1586 blood donors, thirteen (0.81%) were reactive to at least one TTI marker;five (0.32%) were reactive for human immunodeficiency virus, seven (0.44%) for hepatitis B and one (0.06%) for syphilis. There were no samples with co-infection and hepatitis C virus markers. The prevalence of TTIs was highest in the 31 - 45 years age group (2.3%) and among first-time blood donors (4.7%). The prevalence of all TTI was low with the highest prevalence of 0.44% for the hepatitis B virus. Conclusion: Continued concerted efforts will help to maintain satisfactory blood safety in zimbabwe.

关键词： Transfusion Transmissible Infections Blood Donors Hepatitis Human Immunodeficiency Virus SORT IT

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