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Search Results: 1 - 10 of 2374 matches for " Anita Asiimwe "
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Success with antiretroviral treatment for children in Kigali, Rwanda: Experience with health center/nurse-based care
Johan van Griensven, Ludwig De Naeyer, Jeanine Uwera, Anita Asiimwe, Claire Gazille, Tony Reid
BMC Pediatrics , 2008, DOI: 10.1186/1471-2431-8-39
Abstract: Program treatment and outcome data were reported from two government-run health centers that were supported by Médecins Sans Frontières (MSF) in Kigali, Rwanda between October 2003 and June 2007. Interviews were held with health center staff and MSF program records were reviewed to describe the organization of the program. Important aspects included adequate training and supervision of nurses to manage ARV treatment. The program also emphasized family-centered care addressing the psychosocial needs of both caregivers and children to encourage early diagnosis, good adherence and follow-up.A total of 315 children (< 15 years) were started on ARVs, at a median age of 7.2 years (range: 0.7–14.9). Sixty percent were in WHO clinical stage I/II, with a median CD4% of 14%. Eighty-nine percent (n = 281) started a stavudine-containing regimen, mainly using the adult fixed-dose combination. The median follow-up time after ARV initiation was 2 years (interquartile range 1.2–2.6). Eighty-four percent (n = 265) of children were still on treatment in the program. Thirty (9.5%) were transferred out, eight (2.6%) died and 12 (3.8%) were lost to follow-up. An important feature of the study was that viral loads were done at a median time period of 18 months after starting ARVs and were available for 87% of the children. Of the 174 samples, VL was < 400 copies/ml in 82.8% (n = 144). Two children were started on second-line ARVs. Treatment was changed due to toxicity for 26 children (8.3%), mainly related to nevirapine.This report suggests that providing ARVs to children in a health center/nurse-based program is both feasible and very effective. Adequate numbers and training of nursing staff and an emphasis on the psychosocial needs of caregivers and children have been key elements for the successful scaling-up of ARVs at this level of the health system.Treatment of children with the acquired immunodeficiency syndrome (AIDS) using antiretroviral drugs (ARVs) has been a major challenge i
Patient Enrolment into HIV Care and Treatment within 90 Days of HIV Diagnosis in Eight Rwandan Health Facilities: A Review of Facility-Based Registers
Felix R. Kayigamba, Mirjam I. Bakker, Hadassa Fikse, Veronicah Mugisha, Anita Asiimwe, Maarten F. Schim van der Loeff
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0036792
Abstract: Introduction Access to antiretroviral therapy (ART) has increased greatly in sub-Saharan Africa. However many patients do not enrol timely into HIV care and treatment after HIV diagnosis. We studied enrolment into care and treatment and determinants of non-enrolment in Rwanda. Methods Data were obtained from routine clinic registers from eight health facilities in Rwanda on patients who were diagnosed with HIV at the antenatal care, voluntary counselling-and-testing, outpatient or tuberculosis departments between March and May 2009. The proportion of patients enrolled into HIV care and treatment was calculated as the number of HIV infected patients registered in ART clinics for follow-up care and treatment within 90 days of HIV diagnosis divided by the total number of persons diagnosed with HIV in the study period. Results Out of 482 patients diagnosed with HIV in the study period, 339 (70%) were females, and the median age was 29 years (interquartile range [IQR] 24–37). 201 (42%) enrolled into care and treatment within 90 days of HIV diagnosis. The median time between testing and enrolment was six days (IQR 2–14). Enrolment in care and treatment was not significantly associated with age, sex, or department of testing, but was associated with study site. None of those enrolled were in WHO stage 4. The median CD4 cell count among adult patients was 387 cells/mm3 (IQR: 242–533 cells/mm3); 81 of 170 adult patients (48%) were eligible to start ART (CD4 count<350 cells/mm3 or WHO stage 4). Among those eligible, 45 (56%) started treatment within 90 days of HIV diagnosis. Conclusion Less than 50% of diagnosed HIV patients from eight Rwandan health facilities had enrolled into care and treatment within 90 days of diagnosis. Improving linkage to care and treatment after HIV diagnosis is needed to harness the full potential of ART.
Is increasing complexity of algorithms the price for higher accuracy? virtual comparison of three algorithms for tertiary level management of chronic cough in people living with HIV in a low-income country
Constance Mukabatsinda, Jasmine Nguyen, Bettina Bisig, Lutgarde Lynen, Yerma D Coppens, Anita Asiimwe, Jef Van den Ende
BMC Medical Informatics and Decision Making , 2012, DOI: 10.1186/1472-6947-12-2
Abstract: Data were collected at the University Hospital of Kigali (CHUK) in a total of 201 HIV-positive hospitalised patients with chronic cough. We simulated management of each patient following the three algorithms. The first was locally tailored by clinicians from CHUK, the second and third were drawn from publications by Médecins sans Frontières (MSF) and the World Health Organisation (WHO). Semantic analysis techniques known as Clinical Algorithm Nosology were used to compare them in terms of complexity and similarity. For each of them, we assessed the sensitivity, delay to diagnosis and hypothetical harm of false positives and false negatives.The principal diagnoses were tuberculosis (21%) and pneumocystosis (19%). Sensitivity, representing the proportion of correct diagnoses made by each algorithm, was 95.7%, 88% and 70% for CHUK, MSF and WHO, respectively. Mean time to appropriate management was 1.86 days for CHUK and 3.46 for the MSF algorithm. The CHUK algorithm was the most complex, followed by MSF and WHO. Total harm was by far the highest for the WHO algorithm, followed by MSF and CHUK.This study confirms our hypothesis that sensitivity and patient safety (i.e. less expected harm) are proportional to the complexity of algorithms, though increased complexity may make them difficult to use in practice.The algorithmic approach to guidelines has been introduced and promoted on a large scale since the 1970s. This flowchart representation of step-by-step clinical logic guides the management of a patient with symptoms, clinical signs, or results of technical examinations. The transition from one step to the next is mostly dichotomous, which means that only one out of two choices can be made at each step. Moreover, the logic is serial: only one pathway can be followed by a single patient.The original purpose of algorithmic guideline implementation was twofold. First, with continuing concern over the rising costs of health care, health policy makers have been impressed b
Provider-Initiated HIV Testing and Counselling in Rwanda: Acceptability among Clinic Attendees and Workers, Reasons for Testing and Predictors of Testing
Felix R. Kayigamba, Mirjam I. Bakker, Judith Lammers, Veronicah Mugisha, Emmanuel Bagiruwigize, Anita Asiimwe, Maarten F. Schim. van der Loeff
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0095459
Abstract: Introduction Routine provider-initiated HIV testing and counselling (PITC) may increase HIV testing rates, but whether PITC is acceptable to health facility (HF) attendees is unclear. In the course of a PITC intervention study in Rwanda, we assessed the acceptability of PITC, reasons for being or not being tested and factors associated with HIV testing. Methods Attendees were systematically interviewed in March 2009 as they left the HF, regarding knowledge and acceptability of PITC, history of testing and reasons for being tested or not. Subsequently, PITC was introduced in 6 of the 8 HFs and a second round of interviews was conducted. Independent factors associated with testing were analysed using logistic regression. Randomly selected health care workers (HCWs) were also interviewed. Results 1772 attendees were interviewed. Over 95% agreed with the PITC policy, both prior to and after implementation of PITC policy. The most common reasons for testing were the desire to know one’s HIV status and having been offered an HIV test by an HCW. The most frequent reasons for not being tested were known HIV status and test not being offered. In multivariable analysis, PITC, age ≥15 years, and not having been previously tested were factors significantly associated with testing. Although workload was increased by PITC, HIV testing rates increased and HCWs overwhelmingly supported the policy. Conclusion Among attendees and HCWs in Rwandan clinics, the acceptability of PITC was very high. PITC appeared to increase testing rates and may be helpful in prevention and early access to treatment.
Statutory Law, Patriarchy and Inheritance: Home ownership among Widows in Uganda
F Asiimwe
African Sociological Review / Revue Africaine de Sociologie , 2009,
Abstract: This paper discusses the ways in which urban widows in Uganda are deprived of home ownership upon the death of their husbands. It is based on a qualitative research conducted in the middle-income areas of Kampala between 2004 and 2007. The results show that the institutional legal framework and the patriarchal customary practices and beliefs deprive widows of home ownership notwithstanding the gender sensitive Constitution. The study also shows that the special ways in which widows are able to inherit the matrimonial home upon the death of their husbands demonstrate the difficulty widows face to become home owners.
Lay Perceptions about Tuberculosis among Non-UK-Born Black Africans in the United Kingdom  [PDF]
Caroline Asiimwe, Ruth Cross, Jessica Haberer
Journal of Tuberculosis Research (JTR) , 2015, DOI: 10.4236/jtr.2015.34023
Abstract: Background: Tuberculosis among non-UK-born Black Africans has been gradually recognized as a public health problem in the UK despite the various interventions implemented. Objectives: To explore the perceptions of non-UK-born Black Africans about TB health risk; to explore the health seeking behavior of the non-UK-born Black Africans in relation to TB and to explore lay views on TB health education and screening as opportunities for health promotion. Methodology and Study Design: A qualitative methodology was used on a purposively selected sample of 12 non-UK-born Black Africans living in Leeds. Face-to-face interviews were conducted to explore the lay perceptions about TB. Thematic analysis was used to derive important themes in accordance to the study objectives. Ethical approval was provided by Leeds Metropolitan University. Setting: Community setting of non-UK-born Black Africans in Leeds, UK. Results: This population holds mixed views and perceptions about tuberculosis, few facilitators and many barriers existed to current TB prevention efforts. The barriers included: language barriers, barriers related to services and systems, immigration status and stigma despite the benefits involved. The potential for black African communities to readily increase the likelihood of behavior change was found as an important finding for this study. Conclusions: Tuberculosis is a preventable public health problem. Involvement of the non-UK-born black Africans communities in the TB prevention may be beneficial for reducing and tackling TB rates in this population. Such an approach is potentially inexpensive and more readily implementable than other suggested strategies such as changes to immigration policies.
Gender Dynamics and Homeownership in Kampala Trapped by Laws: A Sociogical Perspective
Florence Akiiki Asiimwe
The Social Sciences , 2013,
Abstract: In this study present the existing laws of Uganda and how these enable or inhibit married women, widows in or from owning a matrimonial home has been presented. The supreme law of Uganda (The Constitution) seems to be gender sensitive in regard to a number of aspects but is not specifically clear on matrimonial property like a home. The Intestate Succession Law, seems not to favour widows in as far as inheritance rights of the matrimonial home is concerned. The widow is only allowed to have user rights and keep the home for the male heir. What would save the widow is for a husband to bequeath the home to his wife. Unfortunately, very few men make wills and a few that make them really bequeath the matrimonial home to their wives apart from allowing them to occupy the home until she dies. This is regardless of whether the widow contributed to the home or not. Similarly, the divorce law is very silent on division of the matrimonial home upon divorce or separation. The decision is left with the Courts of law to decide. The Registration Act is supportive in as far as giving individuals a right to own property is concerned. However, there is no legal framework for couples to co-own the matrimonial home. The decision is left to individual couples.
Abstract: This study aims to look at the differences of Islamic stocks on the Indonesia Stock Exchange (BEI) before and after the announcement of the price increase of fuel oil (BBM) on 15 May 2015. The method used is quantitative research with paired sample t-test. Research shows that there are significant differences abnormal return before and after the announcement of fuel price increases as well as demonstrate the dif-ference by delaying the trading activity in the stock transaction that makes the average transaction decreased from prior events (event).
Antimicrobial Drug Resistance and Plasmid Profiles of Salmonella Isolates from Humans and Foods of Animal Origin in Uganda  [PDF]
Kalule J. Bosco, Deogratius H. Kaddu-Mulindwa, Benon B. Asiimwe
Advances in Infectious Diseases (AID) , 2012, DOI: 10.4236/aid.2012.24025
Abstract: Salmonella organisms are among the most common causes of human bacterial gastroenteritis worldwide, and food animals are important reservoirs of these bacteria. A further danger lies in the development of drug resistance in these organisms, primarily driven by non-prudent overuse of antiinfectives. The current study compared the plasmid profiles and drug susceptibility patterns of Salmonella isolates from man and foods of animal origin in Uganda. A total of 92 Salmonella isolates (58 from man and 34 from foods of animal origin) were analyzed. Identification was done by using biochemical tests; plasmid profiling by agarose gel electrophoresis while susceptibility testing to tetracycline, ampicillin, chloramphenicol, nalidixic acid, trimethoprim-sulphamethoxazole, ciprofloxacin, ceftriaxone and tetracycline were done by the Kirby Bauer Disc Diffusion method. Among the human isolates, 57/58 (98.3%, 95% CI, 91.8% - 99.9%) were susceptible to Ciprofloxacin compared to 32/34 (94.1%, 95% CI, 81.9% - 91%) of animal-derived isolates. On the other hand, 48/58 (82.7%, 95% CI, 71.4% - 91%) human-derived isolates were resistant to Trimethoprim sulfamethoxazole compared to 29/34(85.3%) of the animal-derived isolates. Fifty four percent (n = 50) of the all the isolates were resistant to at least three antibiotics whereas only 2.2% (n = 2) were susceptible to all the seven drugs tested. Most worrying, however, was the fact that only 45% percent of the isolates were sensitive to all the three drugs (chloramphenicol, nalidixic acid and ciprofloxacin) commonly used in the treatment of salmonellosis in this setting. The risk of ampicillin resistance was three times more likely to occur in animal-derived as compared to human-derived isolates (Odds Ratio = 2.705, 95% CI, 1.3 - 5.8) as was that to nalidixic acid (Odds Ratio = 2.895, 95% CI, 1.17 - 7.2). Plasmid profile analysis showed eight clusters comprising of 68.7% (46/67) of the isolates. In five of the eight clusters, there were both animal and human-derived isolates. Resistant strains of Salmonella are common in this setting and meat/meat products are the commonest source of infection. A majority of the isolates are multi-drug resistant, and there is evidence of cross-species transmission of plasmids, and possibly drug resistance, between animals and humans.
History and Advancement of the Family of Log Periodic Toothed Planer Microstrip Antenna  [PDF]
Arti Vaish, Anita Dalal
Journal of Electromagnetic Analysis and Applications (JEMAA) , 2011, DOI: 10.4236/jemaa.2011.36039
Abstract: This paper presents the family of logarithmically periodic toothed planer antennas. In this the dimensions of the succes-sive sections were increased in geometric progression for a wide bandwidth usage. A band width of 7% for trapezoid toothed, 26% for zigzag toothed and 50% for cross-toothed VSWR < 2 has been obtained from the proposed antennas. Investigations on the gain and radiation characteristics have been carried out. The investigations show that the pro-posed designs not only offers the enhanced bandwidth but also possesses the same characteristics over the desired fre-quency band at same probe feed position.
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