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  • Epidemiologic and Clinical Features of Lassa Fever Outbreak in Nigeria, January 1-May 6, 2018.

    Posted 2019-05-22 09:39:32 by: The HealthFolk Team

    Related Articles Epidemiologic and Clinical Features of Lassa Fever Outbreak in Nigeria, January 1-May 6, 2018. Emerg Infect Dis. 2019 Jun;25(6):1066-1074 Authors: Ilori EA, Furuse Y, Ipadeola OB, Dan-Nwafor CC, Abubakar A, Womi-Eteng OE, Ogbaini-Emovon E, Okogbenin S, Unigwe U, Ogah E, Ayodeji O, Abejegah C, Liasu AA, Musa EO, Woldetsadik SF, Lasuba CLP, Alemu W, Ihekweazu C, Nigeria Lassa Fever National Response Team Abstract Lassa fever (LF) is endemic to Nigeria, where the disease causes substantial rates of illness and death. In this article, we report an analysis of the epidemiologic and clinical aspects of the LF outbreak that occurred in Nigeria during January 1-May 6, 2018. A total of 1,893 cases were reported; 423 were laboratory-confirmed cases, among which 106 deaths were recorded (case-fatality rate 25.1%). Among all confirmed cases, 37 occurred in healthcare workers. The secondary attack rate among 5,001 contacts was 0.56%. Most (80.6%) confirmed cases were reported from 3 states (Edo, Ondo, and Ebonyi). Fatal outcomes were significantly associated with being elderly; no administration of ribavirin; and the presence of a cough, hemorrhaging, and unconsciousness. The findings in this study should lead to further LF research and provide guidance to those preparing to respond to future outbreaks. PMID: 31107222 [PubMed - in ...

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  • The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria.

    Posted 2019-05-22 09:39:32 by: The HealthFolk Team

    Related Articles The impact of monetary incentives on referrals by traditional birth attendants for postnatal care in Nigeria. BMC Pregnancy Childbirth. 2019 May 20;19(1):150 Authors: Chukwuma A, Mbachu C, McConnell M, Bossert TJ, Cohen J Abstract BACKGROUND: Gaps in postnatal care use represent missed opportunities to prevent maternal and neonatal death in sub-Saharan Africa. As one in every three non-facility deliveries in Nigeria is assisted by a traditional birth attendant (TBA), and the TBA's advice is often adhered to by their clients, engaging TBAs in advocacy among their clients may increase maternal and neonatal postnatal care use. This study estimates the impact of monetary incentives for maternal referrals by TBAs on early maternal and neonatal postnatal care use (within 48 h of delivery) in Nigeria. METHODS: We conducted a non-blinded, individually-randomized, controlled study of 207 TBAs in Ebonyi State, Nigeria between August and December 2016. TBAs were randomly assigned with a 50-50 probability to receive $2.00 for every maternal client that attended postnatal care within 48 h of delivery (treatment group) or to receive no monetary incentive (control group). We compared the probabilities of maternal and neonatal postnatal care use within 48 h of delivery in treatment and control groups in an intention-to-treat analysis. We also ascertained if the care received by mothers and newborns during these visits followed World Health Organization guidelines. RESULTS: Overall, 207 TBAs participated in this study: 103 in the treatment group and 104 in the control group. The intervention increased the proportion of maternal clients of TBAs that reported attending postnatal care within 48 h of delivery by 15.4 percentage points [95% confidence interval (CI): 7.9-22.9]. The proportion of neonatal clients of TBAs that reportedly attended postnatal care within 48 h of delivery also ...

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  • New methodologies for the estimation of population vulnerability to diseases: a case study of Lassa fever and Ebola in Nigeria and Sierra Leone.

    Posted 2019-05-22 09:39:32 by: The HealthFolk Team

    Related Articles New methodologies for the estimation of population vulnerability to diseases: a case study of Lassa fever and Ebola in Nigeria and Sierra Leone. Philos Trans R Soc Lond B Biol Sci. 2019 Jul 08;374(1776):20180265 Authors: Kajero O, Del Rio Vilas V, Wood JLN, Lo Iacono G Abstract Public health practitioners require measures to evaluate how vulnerable populations are to diseases, especially for zoonoses (i.e. diseases transmitted from animals to humans) given their pandemic potential. These measures would be valuable to support strategic and operational decision making and allocation of resources. Although vulnerability is well defined for natural hazards, for public health threats the concept remains undetermined. Here, we develop new methodologies to: (i) quantify the impact of zoonotic diseases and the capacity of countries to cope with these diseases, and (ii) combine these two measures (impact and capacity) into one overall vulnerability indicator. The adaptive capacity is calculated from estimations of disease mortality, although the method can be adapted for diseases with no or low mortality but high morbidity. As an example, we focused on the vulnerability of Nigeria and Sierra Leone to Lassa Fever and Ebola. We develop a simple analytical form that can be used to estimate vulnerability scores for different spatial units of interest, e.g. countries or regions. We show how some populations can be highly vulnerable despite low impact threats. We finally outline future research to more comprehensively inform vulnerability with the incorporation of relevant factors depicting local heterogeneities (e.g. bio-physical and socio-economic factors). This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'. This theme issue is linked with the earlier issue 'Modelling infectious disease outbreaks in humans, animals ...

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  • Response to Daly-Smith et al.’s commentary on ‘The Daily Mile makes primary school children more active, less sedentary and improves their fitness and body composition: a quasi-experimental pilot study’

    Posted 2019-05-22 00:00:00 by: The HealthFolk Team

    We thank Daly-Smith et al. for taking the time to read the results of our pilot research study, describing it as an important and welcome contribution. Nonetheless, the authors argue six points against our ...

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  • Commentary on a recent article on the effects of the ‘Daily Mile’ on physical activity, fitness and body composition: addressing key limitations

    Posted 2019-05-22 00:00:00 by: The HealthFolk Team

    A recent pilot study by Chesham et al. in BMC Medicine established some initial effects of the Daily Mile™ using a quasi-experimental repeated measures design, with valid and reliable outcome assessments for ...

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  • [Corrections] Correction to Lancet Glob Health 2019; 7: e703–05

    Posted 2019-05-21 22:30:03 by: The HealthFolk Team

    Jia P, Wang Y. Global health efforts and opportunities related to the Belt and Road Initiative. Lancet Glob Health 2019; 7: e703–05—In this Comment, in the figure the title of the key has been changed to “Number of conferences attended”; the explanation of the map colour coding has been removed from the figure key; and Taiwan has been added to the figure map. The appendix has been reformatted. These corrections have been made as of May 21, ...

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  • Heart failure and healthcare informatics

    Posted 2019-05-21 21:00:00 by: The HealthFolk Team

    by Mohamed S. Anwar, Alan G. Japp, Nicholas L. ...

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  • Research to improve differentiated HIV service delivery interventions: Learning to learn as we do

    Posted 2019-05-21 21:00:00 by: The HealthFolk Team

    by Elvin H. Geng, Charles B. Holmes In a Perspective, Elvin Geng and Charles Holmes discuss research on differentiated service delivery in HIV ...

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  • The impact of community- versus clinic-based adherence clubs on loss from care and viral suppression for antiretroviral therapy patients: Findings from a pragmatic randomized controlled trial in South Africa

    Posted 2019-05-21 21:00:00 by: The HealthFolk Team

    by Colleen F. Hanrahan, Sheree R. Schwartz, Mutsa Mudavanhu, Nora S. West, Lillian Mutunga, Valerie Keyser, Jean Bassett, Annelies Van Rie Background Adherence clubs, where groups of 25–30 patients who are virally suppressed on antiretroviral therapy (ART) meet for counseling and medication pickup, represent an innovative model to retain patients in care and facilitate task-shifting. This intervention replaces traditional clinical care encounters with a 1-hour group session every 2–3 months, and can be organized at a clinic or a community venue. We performed a pragmatic randomized controlled trial to compare loss from club-based care between community- and clinic-based adherence clubs. Methods and findings Patients on ART with undetectable viral load at Witkoppen Health and Welfare Centre in Johannesburg, South Africa, were randomized 1:1 to a clinic- or community-based adherence club. Clubs were held every other month. All participants received annual viral load monitoring and medical exam at the clinic. Participants were referred back to clinic-based standard care if they missed a club visit and did not pick up ART medications within 5 days, had 2 consecutive late ART medication pickups, developed a disqualifying (excluding) comorbidity, or had viral rebound. From February 12, 2014, to May 31, 2015, we randomized 775 eligible adults into 12 pairs of clubs—376 (49%) into clinic-based clubs and 399 (51%) into community-based clubs. Characteristics were similar by arm: 65% female, median age 38 years, and median CD4 count 506 cells/mm3. Overall, 47% (95% CI 44%–51%) experienced the primary outcome of loss from club-based care. Among community-based club participants, the cumulative proportion lost from club-based care was 52% (95% CI 47%–57%), compared to 43% (95% CI 38%–48%, p = 0.002) among clinic-based club participants. The risk of loss to club-based care was higher among participants assigned to community-based clubs than among those assigned to ...

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  • Diagnostic tests, drug prescriptions, and follow-up patterns after incident heart failure: A cohort study of 93,000 UK patients

    Posted 2019-05-21 21:00:00 by: The HealthFolk Team

    by Nathalie Conrad, Andrew Judge, Dexter Canoy, Jenny Tran, Johanna O’Donnell, Milad Nazarzadeh, Gholamreza Salimi-Khorshidi, F. D. Richard Hobbs, John G. Cleland, John J. V. McMurray, Kazem Rahimi Background Effective management of heart failure is complex, and ensuring evidence-based practice presents a major challenge to health services worldwide. Over the past decade, the United Kingdom introduced a series of national initiatives to improve evidence-based heart failure management, including a landmark pay-for-performance scheme in primary care and a national audit in secondary care started in 2004 and 2007, respectively. Quality improvement efforts have been evaluated within individual clinical settings, but patterns of care across its continuum, although a critical component of chronic disease management, have not been studied. We have designed this study to investigate patients’ trajectories of care around the time of diagnosis and their variation over time by age, sex, and socioeconomic status. Methods and findings For this retrospective population-based study, we used linked primary and secondary health records from a representative sample of the UK population provided by the Clinical Practice Research Datalink (CPRD). We identified 93,074 individuals newly diagnosed with heart failure between 2002 and 2014, with a mean age of 76.7 years and of which 49% were women. We examined five indicators of care: (i) diagnosis care setting (inpatient or outpatient), (ii) posthospitalisation follow-up in primary care, (iii) diagnostic investigations, (iv) prescription of essential drugs, and (v) drug treatment dose. We used Poisson and linear regression models to calculate category-specific risk ratios (RRs) or adjusted differences and 95% confidence intervals (CIs), adjusting for year of diagnosis, age, sex, region, and socioeconomic status. From 2002 to 2014, indicators of care presented diverging trends. Outpatient diagnoses and follow-up after hospital ...

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