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Using intersectional gender analysis to identify challenges in tuberculosis care at four health care facilities in Uganda

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Infectious Diseases of Poverty 2024年第1期13卷 91-91页

作者： Winters Muttamba Samson Omongot Irene Najingo Roseline Nuwarinda Esther Buregyeya Mariam Otmani del Barrio Rosemary Morgan Bruce Kirenga Sarah Ssali Makerere University Lung Institute Makerere University Kampala Uganda Division of Infection and global health School of Medicine University of St Andrews St. Andrews UK Infectious Disease Institute Makerere University Kampala Uganda School of Public health Makerere University Kampala Uganda UNICEF UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) World Health Organization Geneva Switzerland Johns Hopkins Bloomberg School of Public health Baltimore MD USA School of Women and Gender Studies Makerere University Kampala Uganda

Background tuberculosis(TB)care could be considered as a continuum from symptom recognition,decision to seek care,diagnosis,treatment initiation and treatment completion,with care along the continuum influenced by several *** dimensions could influence TB care,and indeed,more men than women are diagnosed with TB each *** study was done to identify social stratifiers that intersect with gender to influence TB *** A cross-sectional qualitative study was done at four health facilities in 3 districts in central Uganda between October 2020 and December *** was collected from patients seeking a diagnosis or on TB treat-ment through focus group discussions and key informant *** themes around gender guided by a gender and intersectionality lens were developed and thereafter thematic content analysis was *** Women have increased vulnerability to TB due to bio mass exposure through roles like *** have increased access to health care services as they interface with the health care system frequently given their role as child bearers and child care *** have a duty to provide for their families and this most often is prioritised over healthcare seeking,and together with belief that they are powerful beings leads to poor healthcare seeking hab-its and delays in healthcare *** on when and where to seek care were not straightforward for women,who most often rely on their husbands/partners to make *** Men and women experience challenges to TB care,and that these challenges are deeply rooted in roles assigned to them and further compounded by *** challenges need to be addressed through intersec-tional gender responsive interventions if TB control is to be improved.

关键词： tuberculosis Gender Intersectionality Masculinity

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发展中国家的与HIV联合的结核病:流行病学与预防策略

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国际结核病与肺部疾病杂志 1996年第2期 81-92页

作者： J.P.Narain M.C.Raviglione A.Kochi 李荣德 tuberculosis programme global programme on aids.world health organization.geneva Switzerland tuberculosis programme

结核病与HIV的联合给公共卫生和社会经济带来直接的严重威胁,在第三世界尤其如此。1992年初,WHO估计自HIV大流行开始以来,约有400万人已受结核杆菌和HIV双重感染,其中95％在发展中国家。结核病和HIV之间的联合是显而易见的,因为在HIV受... 详细信息

结核病与HIV的联合给公共卫生和社会经济带来直接的严重威胁,在第三世界尤其如此。1992年初,WHO估计自HIV大流行开始以来,约有400万人已受结核杆菌和HIV双重感染,其中95％在发展中国家。结核病和HIV之间的联合是显而易见的,因为在HIV受染者中,结核病的发病率估计可高达每年5—8％,结核病病人中HIV的血清阳性率很高,爱滋病病人中结核病大量出现,以及在几个非洲国家中结核病病例报告人数的增加与HIV流行的扩展相一致。这两种流行病对于一些资源贫乏国家的冲击造成社会的和医疗的可怕后果,当前业已过度紧张的卫生机构必须面对日益严重的结核病问题。HIV感染使结核病的形势更加恶化,因为它能使受双重感染者的潜伏性结核病再度活跃的机会增加,又能使原HIV受染者新感染的结核病加速进展。这又会引起一般人口中结核病感染危险率的增加和随之而来的病例增多。为了对这一迫切问题作出反应,必须在那些结核病控制规程建立不完善而且HIV和结核病感染盛行的国家中,将加强结核病控制规程置于最优先的地位。除了通过结核病病人的早期诊断和及时治疗来提高治愈率以外,还有两项需加以考虑的主要策略,即在HIV感染的人群中施行卡介苗接种,以及预防性的化学治疗。

关键词：结核病 HIV血清阳性 HIV感染流行病学化学治疗淋巴结炎卡介苗接种血清阴性结核菌素皮肤试验结核病控制

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Are monitoring and evaluation systems adequate to report the programmatic coverage of HIV services among key populations in countries?

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Infectious Diseases of Poverty 2019年第4期8卷 75-81页

作者： Jinkou Zhao Sonia Arias Garcia Ed Ngoksin Jesus Maria Garcia Calleja Chinelo Ogbuanu Sandra Kuzmanovska Nicholas Oliphant David Lowrance Nathalie Zorzi Peter M.Hansen Keith Sabin The global Fund to fight aids Tuberculosis and MalariaChemin du Pommier 40Grand-Saconnex 1218GenevaSwitzerland Center for global health School of Public HealthNanjing Medical UniversityNanjingChina Jiangsu Provincial Center for Disease Control and Prevention NanjingChina Strateg ic Information and Evaluation Department the Joint United Nations Programme on HIV/AIDSGenevaSwitzerland Department of HIV/aids World Health OrganizationGenevaSwitzerland

There was no global guidance or agreement regarding when a country has an adequate system to report on the service packages among human immunodeficiency virus(HIV)key *** article describes an approach to categorizing the system in a country for reporting the service package among HIV key *** approach consists of four dimensions,namely the epidemiological significance,comprehensiveness of the service packages,geographic coverage of services,and adequacy of the monitoring *** proposed categorization approach utilizes available information and can inform the improvement of the service delivery and monitoring systems among HIV key populations.

关键词： services among service

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Patients direct costs to undergo TB diagnosis

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Infectious Diseases of Poverty 2016年第1期5卷 221-229页

作者： Rachel M.Anderson de Cuevas Lovett Lawson Najla Al-Sonboli Nasher Al-Aghbari Isabel Arbide Jeevan B.Sherchand Emenyonu E.Nnamdi Abraham Aseffa Mohammed A.Yassin Saddiq T.Abdurrahman Joshua Obasanya Oladimeji Olanrewaju Daniel Datiko Sally J.Theobald Andrew Ramsay S.Bertel Squire Luis E.Cuevas Liverpool School of Tropical Medicine Pembroke PlaceLiverpool L35QAUK Zankli Medical Center AbujaNigeria Bingham University Nassarawa StateAbujaNigeria Medical Faculty Sana’a UniversitySana’aYemen National tuberculosis Institute Sana’aYemen Bushullo Major health Centre AwassaEthiopia Tribhuvan University Institute of Medicine KathmanduNepal Armauer Hansen Research Institute Addis AbabaEthiopia The global Fund to Fight aids Tuberculosis and MalariaGenevaSwitzerland Federal Capital Territory tuberculosis and Leprosy Control programme AbujaNigeria Nigeria tuberculosis and Leprosy Control programme AbujaNigeria REACH Ethiopia HawassaEthiopia UNICEF/UNDP/world Bank/WHO Special programme for Research and Training in Tropical Diseases World Health OrganizationGenevaSwitzerland

Background:A major impediment to the treatment of TB is a diagnostic process that requires multiple *** of patient costs associated with diagnosis use different protocols and are not ***:We aimed to describe the direct costs incurred by adults attending TB diagnostic centres in four countries and factors associated with expenditure for *** of 2225 adults attending smear-microscopy centres in Nigeria,Nepal,Ethiopia and ***>18 years with cough>2 weeks were enrolled *** costs were quantified using structured *** with costs>75^(th) quartile were considered to have high expenditure(cases)and compared with patients with costs<75^(th) quartile to identify factors associated with high ***:The most significant expenses were due to clinic fees and *** participants attended the centres with *** expenditure was associated with attending with company,residing in rural areas/other towns and ***:The costs incurred by patients are substantial and share common patterns across *** user fees,transparent charging policies and reimbursing clinic expenses would reduce the poverty-inducing effects of direct diagnostic *** locations with limited resources,support could be prioritised for those most at risk of high expenditure;those who are illiterate,attend the service with company and rural residents.

关键词： tuberculosis Costs Access to healthcare Ethiopia Nepal Nigeria Yemen

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Antibody seropositivity and endemicity of chikungunya and Zika viruses in Nigeria

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Animal Diseases 2023年第2期3卷 104-114页

作者： Peter Asaga Mac Philomena E.Airiohuodion Raman Velayudhan Shaistha Zubair Markos Tadele Jude,O.Aighobahi Chukwuma Anyaike Axel Kroeger Marcus Panning Institute of Virology University Medical FreiburgHermann Herder Str1179104 FreiburgGermany world health organization Special Programme for Research and Training in Tropical Diseases(TDR)Avenue Appia 201211 Geneva 27Switzerland world health organization WHO/NTD UnitAvenue Appia 201211 Geneva 27Switzerland Maldives National University BuruzuMaguMaleMaldives Ethiopian Institute Of Agricultural Research/EIAR Addis AbabaEthiopia Icon Clinical Research Heinrich‑Hertz Starsse 2663225 Langen HessenBerlinGermany Federal Ministry of health National Tuberculosis and Leprosy ControlProgrammeAbujaNigeria Centre for Medicine and Society Faculty of MedicineUniversity of FreiburgFreiburgGermany

Mosquito-borne infections are of global health concern because of their rapid spread and upsurge,which creates a risk for *** virus(CHIKV),an arbovirus disease transmitted by Aedes aegypti or ***,and malaria,a parasitic disease transmitted by Anopheles gambiae,are prevalent in Nigeria and neighbouring countries,but their burden and possible coinfections are poorly *** this study,we investigated the antibody seropositivity and endemicity of chikungunya and Zika viruses(ZIKV)in three regions of Nigeria.A cross-sectional serosurvey was conducted on 871 *** were collected from outpatients by simple random *** of the samples were performed using recomLine Tropical Fever for the presence of antibody serological marker IgG immunoblot with CHIKV VLP(virus like particle),ZIKV NS1 and ZIKV Equad according to manufacturers’instructions and malaria RDT for malaria *** was a significantly higher antibody seropositivity against CHIKV in the central region than in the northern and southern regions(69.5%,291/419),while ZIKV-seropositivity(22.4%,34/152)and CHIKV-ZIKV co-circulating antibody seropositivity(17.8%,27/152)were notably higher in the southern region than in the central and northern *** investigation revealed an unexpectedly high antibody seropositivity and concealed endemicity of CHIKV and ZIKV in three Nigerian *** seropositivity of detectable antibodies differed among the three geographical locations.

关键词： Chikungunya Zika Cocirculation Seroprevalence Nigeria Endemicity Malaria

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China’s 1-3-7 surveillance and response strategy for malaria elimination: Is case reporting, investigation and foci response happening according to plan?

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Infectious Diseases of Poverty 2015年第1期4卷 465-473页

作者： Shui-Sen Zhou Shao-Sen Zhang Li Zhang Aafje ECRietveld Andrew RRamsay Rony Zachariah Karen Bissell Rafael Van den Bergh Zhi-Gui Xia Xiao-Nong Zhou Richard ECibulskis National Institute of Parasitic Diseases Chinese Center for Disease Control and PreventionKey Laboratory of Parasite and Vector BiologyMOHWHO Collaborating Centre for Tropic DiseasesNational Center for International Research on Tropical Diseases207 Rui Jin Er RoadShanghai200025People’s Republic of China global Malaria programme World Health Organization20 Avenue AppiaCH-1211Geneva 27Switzerland Special programme for Research and Training in Tropical Diseases(TDR) 20 Avenue AppiaCH-1211Geneva 27Switzerland Médecins Sans Frontieres Brussels Operational CentreLuxembourgLuxembourg International Union Against tuberculosis and Lung Disease ParisFrance

Background:The China’s 1-3-7 strategy was initiated and extensively adopted in different types of counties(geographic regions)for reporting of malaria cases within 1 day,their confirmation and investigation within 3 days,and the appropriate public health response to prevent further transmission within 7 *** the level of compliance to the 1-3-7 strategy at the county level is a first step towards determining whether the surveillance and response strategy is happening according to *** study assessed if the time-bound targets of the 1-3-7 strategy were being sustained over *** information would be useful to improve implementation of the 1-3-7 strategy in ***:This cross-sectional study involved country-wide programmatic data for the period January 1st 2013 to June 30th *** variables were extracted from the national malaria information system and included socio-demographic information,type of county,date of diagnosis,date of reporting,date of case investigation,case classification(indigenous,or imported,or unknown),focus investigation,date of reactive case detection(RACD),and date of indoor residual spraying(IRS).Summary statistics and proportions were used and comparisons between groups were assessed using the chi-square *** of significance was set at a P-value≤***:Of a total of 5,688 malaria cases from 731 counties,there were 55(1%)indigenous cases(only in Type 1 and Type 2 counties)and 5,633(99%)imported cases from all types of *** was no delay in reporting malaria cases by type of *** terms of case investigation,97.5%cases were investigated within 3 days with the proportion of delays(1.5%)in type 2 counties,being significantly lower than type 1 counties(4.1%).Regarding active foci,96.4%were treated by RACD and/or ***:The performance of 1-3-7 strategy was encouraging but identified some challenges that if addressed can further improve implementation.

关键词： 1-3-7 strategy Malaria elimination Surveillance and response

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global burden, distribution, and interventions for infectious diseases of poverty

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Infectious Diseases of Poverty 2014年第1期3卷 192-198页

作者： Zulfiqar A Bhutta Johannes Sommerfeld Zohra S Lassi Rehana A Salam Jai K Das Center of Excellence in Women&Child health The Aga Khan UniversityKarachiPakistan Center for global Child health Hospital for Sick Children TorontoCanada UNDP/world Bank/WHO Special programme for Research and Training in Tropical Diseases(TDR) GenevaSwitzerland Division of Women and Child health The Aga Khan UniversityKarachiPakistan

Infectious diseases of poverty(IDoP)disproportionately affect the poorest population in the world and contribute to a cycle of poverty as a result of decreased productivity ensuing from long-term illness,disability,and social *** 2010,the global deaths from HIV/aids have increased to 1.5 million and malaria mortality rose to 1.17 *** from neglected tropical diseases rose to 152,000,while tuberculosis killed 1.2 million people that same *** regional variations exist in the distribution of these diseases as they are primarily concentrated in rural areas of Sub-Saharan Africa,Asia,and Latin America,with geographic overlap and high levels of ***-based interventions exist to prevent and control these diseases,however,the coverage still remains low with an emerging challenge of antimicrobial ***,community-based delivery platforms are increasingly being advocated to ensure sustainability and combat *** of the high morbidity and mortality burden of these diseases,especially in resource-poor settings,it is imperative to conduct a systematic review to identify strategies to prevent and control these ***,we attempted to evaluate the effectiveness of one of these strategies,that is community-based delivery for the prevention and treatment of *** this paper,we describe the burden,epidemiology,and potential interventions for *** subsequent papers of this series,we describe the analytical framework and the methodology used to guide the systematic reviews,and report the findings and interpretations of our analyses of the impact of community-based strategies on individual IDoPs.

关键词： Infectious diseases of poverty Neglected tropical diseases malaria HIV/aids tuberculosis Community-based interventions Community platforms Community-health workers

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评价国家结核病规划:孟加拉国的经验

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国际结核病与肺部疾病杂志 2000年第1期3卷 1-3页

作者： J.A.Kumaresan P.de Colombani Smith 刘青 global tuberculosis programme WHO Geneva Switzerland world health organization Dhaka Bangladesh. world health organization Kathmandu Nepal

定期评价结核病控制的效果以便估价国家规划取得的进展和制订未来计划。这种评价需要简单可靠的方法。本文概述了孟加拉国1997年实施的国家结核病规划的评价方法与结果。作者结论认为,类似的评价不仅有助于验证常规登记制度的报告,而且... 详细信息

定期评价结核病控制的效果以便估价国家规划取得的进展和制订未来计划。这种评价需要简单可靠的方法。本文概述了孟加拉国1997年实施的国家结核病规划的评价方法与结果。作者结论认为,类似的评价不仅有助于验证常规登记制度的报告,而且有助于制订发展方针和未来计划。关键词:结核病控制;规划评价;

关键词：结核病控制孟加拉国病例发现 tuberculosis 世界卫生组织治疗结果涂阳病人 Program 非政府组织登记报告制度

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限定性片段长度多态性分析用于发展中国家结核病流行病学研究

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国际结核病与肺部疾病杂志 1998年第2期 63-73页

作者： D.L.Cohn R.J.O’Brien 丁北川 Research and Surveillance Unit Global Tuberculosis ProgrammeWorld Health Organzation.GenevaSwitzerlandDenver Disease Control ServiceDenver Public Health and Department of MedicineDivision of Infectious DiseasesUniversity Colorado Health Sciences CenterDenverCO Research and Surveillance Unit Global Tuberculosis Programme.World Health Organization.GenevaSwitzerlandDivision of Tuberculosis Elimination.National Center for HIVSTDand TB PreventionCenters for Dontrol and PreventionAtlantaGAUSA

限定性片段长度多态性(RFLP)分型的DNA指纹是最常使用的方法,该方法使结核病流行病学和病因学调查得以进行革新的研究。在结核分支杆菌中存在的插入序列IS6110的使用,通常被考虑为标准的RFLP方法,但另一些辅助方法的分子分型技术可以在... 详细信息

限定性片段长度多态性(RFLP)分型的DNA指纹是最常使用的方法,该方法使结核病流行病学和病因学调查得以进行革新的研究。在结核分支杆菌中存在的插入序列IS6110的使用,通常被考虑为标准的RFLP方法,但另一些辅助方法的分子分型技术可以在选择的环境中使用。在发达国家和发展中国家中,都有一些流行病学研究使用RFLP分型。其主要发现包括传播链的证实和鉴定(敏感和耐药的结核菌菌种都有)、人群中菌种簇的分布、外源性再感染与复发的区分、更好的理解结核病病因学、实验室交叉污染的鉴定和洞察菌种的分子学进化。对于那些结核病负担极重的发展中国家来说,已明确在结核病流行病学研究中,使用RFLP分析主要为下列三方面:1)人群传播,2)医院内传播,和3)人类免疫缺陷病毒相关的结核病。作为规程的要点,建议研究者在经过完好设计的、涉及发展中国家控制措施有影响的流行病学研究中可被采用。

关键词： RFLP DNA指纹结核病分子流行病学传播

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Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study

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Infectious Diseases of Poverty 2013年第1期2卷 195-212页

作者： Ikeoluwapo O Ajayi Ayodele S Jegede Catherine O Falade Johannes Sommerfeld Epidemiology and Biostatistics Research Unit Institute of Medical Research and TrainingCollege of MedicineUniversity of IbadanIbadanNigeria Department of Epidemiology and Medical Statistics College of MedicineUniversity of IbadanIbadanNigeria Department of Sociology The Faculty of Social SciencesUniversity of IbadanIbadanNigeria Department of Pharmacology and Therapeutics College of MedicineUniversity of MedicineUniversity of IbadanIbadanNigeria Special programme for Research and Training in Tropical Diseases(TDR) World Health OrganizationGenevaSwitzerland

Background:Many simple,affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations(urban and rural)and inadequate community participation.A proven strategy to address the problem of access to health interventions is the Community Directed Interventions(CDI)approach,which has been used successfully in rural *** study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan,***:A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo *** methods comprising 12 focus group discussions(FGDs)with community members and 73 key informant interviews(KIIs)with community leaders,programme managers,community-based organisations(CBOs),non-government organisations(NGOs)and other stakeholders at federal,state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services,as well as to explore the potential resources for a CDI *** interviews were audio *** analysis was used to analyse the ***:Malaria,upper respiratory tract infection,diarrhoea and measles were found to be prevalent in children,while hypertension and diabetes topped the list of diseases among *** was financed mainly by out-of-pocket *** and location were identified as hindrances to utilisation of health facilities;informal cooperatives(esusu)were available to support those who could not pay for ***,nutrition,reproductive health,tuberculosis(TB)and leprosy,environmental health,malaria and HIV/aids control programmes were the ongoing *** strategies included house-to-house,home-based treatment,health education and *** participation in the planning,implementation and monitoring of development projects was reported as common practic

关键词： Community directed intervention Urban poor health interventions Community participation

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