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  • Ibrutinib continues to influence the therapeutic landscape of chronic lymphocytic leukemia: new data presented at ASCO 2017

    Posted 2017-08-16 00:00:00 by: The HealthFolk Team

    According to data presented at the 2017 American Society of Oncology (ASCO) Annual Meeting, with more than 4 years of follow-up, ibrutinib continues to provide clinical utility in chronic lymphocytic leukemia ...

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  • Effectiveness of a brief behavioural intervention on psychological distress among women with a history of gender-based violence in urban Kenya: A randomised clinical trial

    Posted 2017-08-15 21:00:00 by: The HealthFolk Team

    by Richard A. Bryant, Alison Schafer, Katie S. Dawson, Dorothy Anjuri, Caroline Mulili, Lincoln Ndogoni, Phiona Koyiet, Marit Sijbrandij, Jeannette Ulate, Melissa Harper Shehadeh, Dusan Hadzi-Pavlovic, Mark van Ommeren Background Gender-based violence (GBV) represents a major cause of psychological morbidity worldwide, and particularly in low- and middle-income countries (LMICs). Although there are effective treatments for common mental disorders associated with GBV, they typically require lengthy treatment programs that may limit scaling up in LMICs. The aim of this study was to test the effectiveness of a new 5-session behavioural treatment called Problem Management Plus (PM+) that lay community workers can be taught to deliver. Methods and findings In this single-blind, parallel, randomised controlled trial, adult women who had experienced GBV were identified through community screening for psychological distress and impaired functioning in Nairobi, Kenya. Participants were randomly allocated in a 1:1 ratio either to PM+ delivered in the community by lay community health workers provided with 8 days of training or to facility-based enhanced usual care (EUC) provided by community nurses. Participants were aware of treatment allocation, but research assessors were blinded. The primary outcome was psychological distress as measured by the total score on the 12-item General Health Questionnaire (GHQ-12) assessed at 3 months after treatment. Secondary outcomes were impaired functioning (measured by the WHO Disability Adjustment Schedule [WHODAS]), symptoms of posttraumatic stress (measured by the Posttraumatic Stress Disorder Checklist [PCL]), personally identified problems (measured by Psychological Outcome Profiles [PSYCHLOPS]), stressful life events (measured by the Life Events Checklist [LEC]), and health service utilisation. Between 15 April 2015 and 20 August 2015, 1,393 women were screened for eligibility on the basis of psychological distress and impaired ...

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  • Pregnant and breastfeeding women: A priority population for HIV viral load monitoring

    Posted 2017-08-15 21:00:00 by: The HealthFolk Team

    by Landon Myer, Shaffiq Essajee, Laura N. Broyles, D. Heather Watts, Maia Lesosky, Wafaa M. El-Sadr, Elaine J. Abrams Landon Myer and colleagues discuss viral load monitoring for pregnant HIV-positive women and those breastfeeding; ART treatments can suppress viral load and are key to preventing transmission to the ...

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  • Impact of fortified versus unfortified lipid-based supplements on morbidity and nutritional status: A randomised double-blind placebo-controlled trial in ill Gambian children

    Posted 2017-08-15 21:00:00 by: The HealthFolk Team

    by Stefan A. Unger, Saikou Drammeh, Jahid Hasan, Kabiru Ceesay, Edrisa Sinjanka, Sainey Beyai, Bakary Sonko, Bai Lamin Dondeh, Anthony J. Fulford, Sophie E. Moore, Andrew M. Prentice Background Multiple micronutrients (MMN) are commonly prescribed in pediatric primary healthcare in sub-Saharan Africa to improve nutritional status and appetite without evidence for their effectiveness or international clinical guidelines. Community-wide MMN supplementation has shown limited and heterogeneous impact on growth and morbidity. Short-term ready-to-use therapeutic foods in acutely sick children in a hospital setting also had limited efficacy regarding subsequent growth. The effectiveness of MMN in improving morbidity or growth in sick children presenting for primary care has not been assessed. Methods and findings We undertook a double-blind randomised controlled trial of small-quantity lipid-based nutrient supplements (SQ-LNS) fortified with 23 micronutrients in children aged 6 months (mo) to 5 years (y) presenting with an illness at a rural primary healthcare centre in The Gambia. Primary outcomes were repeat clinic presentations and growth over 24 wk. Participants were randomly assigned to receive 1 of 3 interventions: (1) supplementation with micronutrient-fortified SQ-LNS for 12 wk (MMN-12), (2) supplementation with micronutrient-fortified SQ-LNS for 6 wk followed by unfortified SQ-LNS for 6 wk (MMN-6), or (3) supplementation with unfortified SQ-LNS for 12 wk (MMN-0) to be consumed in daily portions. Treatment masking used 16 letters per 6-wk block in the randomisation process. Blinded intention-to-treat analysis based on a prespecified statistical analysis plan included all participants eligible and correctly enrolled.Between December 2009 and June 2011, 1,101 children (age 6–60 mo, mean 25.5 mo) were enrolled, and 1,085 were assessed (MMN-0 = 361, MMN-6 = 362, MMN-12 = 362). MMN supplementation was associated with a small increase in height-for-age z-scores 24 ...

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  • Lay worker-administered behavioral treatments for psychological distress in resource-limited settings: Time to move from evidence to practice?

    Posted 2017-08-15 21:00:00 by: The HealthFolk Team

    by Alexander C. Tsai In this Perspective on the study by Bryant and colleagues, Alex Tsai discusses the evidence supporting lay worker-administered, behavioral interventions for women survivors of interpersonal ...

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  • Benefits and safety of gabapentinoids in chronic low back pain: A systematic review and meta-analysis of randomized controlled trials

    Posted 2017-08-15 21:00:00 by: The HealthFolk Team

    by Harsha Shanthanna, Ian Gilron, Manikandan Rajarathinam, Rizq AlAmri, Sriganesh Kamath, Lehana Thabane, Philip J. Devereaux, Mohit Bhandari Background and objective Chronic Low Back Pain (CLBP) is very common, with a lifetime prevalence between 51% and 80%. In majority, it is nonspecific in nature and multifactorial in etiology. Pregabalin (PG) and Gabapentin (GB) are gabapentinoids that have demonstrated benefit in neuropathic pain conditions. Despite no clear rationale, they are increasingly used for nonspecific CLBP. They necessitate prolonged use and are associated with adverse effects and increased cost. Recent guidelines from the National Health Service (NHS), England, expressed concerns on their off-label use, in addition to the risk of misuse. We aimed to assess the effectiveness and safety of gabapentinoids in adult CLBP patients. Methods Electronic databases of MEDLINE, EMBASE, and Cochrane were searched from their inception until December 20th, 2016. We included randomized control trials reporting the use of gabapentinoids for the treatment of CLBP of >3 months duration, in adult patients. Study selection and data extraction was performed independently by paired reviewers. Outcomes were guided by Initiative on Methods, Measurement and Pain Assessment in Clinical Trials guidelines, with pain relief and safety as the primary outcomes. Meta-analyses were performed for outcomes reported in 3 or more studies. Outcomes were reported as mean differences (MDs) or risk ratios (RRs) with their corresponding 95% confidence intervals (CIs), and I2 in percentage representing the percentage variability in effect estimates that could be explained by heterogeneity. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) was used to assess the quality of evidence. Results Out of 1,385 citations, eight studies were included. Based on the interventions and comparators, studies were analyzed in 3 different groups. GB compared with placebo (3 studies, ...

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  • Detection and molecular identification of Cryptosporidium species in laboratory rats (Rattus norvegicus) in Ibadan, Nigeria

    Posted 2017-08-15 11:40:43 by: The HealthFolk Team

    Related Articles Detection and molecular identification of Cryptosporidium species in laboratory rats (Rattus norvegicus) in Ibadan, Nigeria Ann Parasitol. 2017;63(2):105-109 Authors: Ayinmode AB, Ogbonna NF, Widmer G Abstract To study the occurrence of Cryptosporidium infection in laboratory rats (Rattus norvegicus) raised for experimental usage, 134 faecal samples were obtained from two rearing houses in Ibadan and examined for the presence of Cryptosporidium oocyst using the modified acid fast staining technique. Cryptosporidium species in 2 samples positive for microscopy were further characterized by a nested polymerase chain reaction (PCR) amplifying the 18S rRNA gene. Two of 134 samples were positive for the Cryptosporidium oocysts. Sequencing of the small-subunit rRNA amplicons identified the species in the two PCR positive samples as Cryptosporidium andersoni and Cryptosporidium rat genotype. These findings showed that laboratory rat is a potential reservoir for diverse Cryptosporidium species and suggests that laboratory rats should be screened for Cryptosporidium infection prior to experiments, especially where pathogen free animals are not available. This the first report to identify Cryptosporidium species infecting laboratory rats in Nigeria. PMID: 28802280 [PubMed - as supplied by ...

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  • Willingness to pay for antiretroviral drugs among HIV and AIDS clients in south-east Nigeria.

    Posted 2017-08-15 11:40:42 by: The HealthFolk Team

    Willingness to pay for antiretroviral drugs among HIV and AIDS clients in south-east Nigeria. Health Expect. 2017 Aug 14;: Authors: Mbachu C, Okoli C, Onwujekwe O, Enabulele F Abstract BACKGROUND: The current trend of withdrawal of donor support for HIV/AIDS treatment in Nigeria may require that the cost of antiretroviral drugs be borne in part by infected people and their families. OBJECTIVE: This study was conducted to determine the economic value for free antiretroviral drugs (ARVs) expressed by clients receiving treatment for HIV/AIDS in a tertiary hospital. STUDY METHOD: The contingent valuation method was used to elicit the values attached to free ARVs from people living with HIV/AIDS that were receiving care in a public tertiary hospital in south-east Nigeria. Exit poll using a pre-tested questionnaire was undertaken with adult clients on treatment. The bidding game technique was used to elicit their willingness to pay (WTP) for ARVs for themselves and members of their households. Ordinary least squares (OLS) multiple regression analysis was used to test the construct validity of elicited WTP amounts. RESULTS: About a third of the respondents were willing to pay for a monthly supply of ARVs for themselves and household members. The mean WTP for monthly supply of ARVs for self was US$15.32 and for household member was US$15.26 (1US$=₦160). OLS regression analysis showed that employment status and higher socio-economic status were positively associated with higher WTP. OLS showed that age and transport cost per clinic visit were negatively related to WTP. Knowing the risks of not adhering to treatment protocol was positively related to WTP. CONCLUSION: The respondents positively valued the free ARVs. This calls for greater financial support for the sustainable provision of the treatment service. However, holistic financing mechanisms should be explored to ensure sustained ...

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  • Health Risks Awareness of Electronic Waste Workers in the Informal Sector in Nigeria.

    Posted 2017-08-15 11:40:42 by: The HealthFolk Team

    Health Risks Awareness of Electronic Waste Workers in the Informal Sector in Nigeria. Int J Environ Res Public Health. 2017 Aug 13;14(8): Authors: Ohajinwa CM, Van Bodegom PM, Vijver MG, Peijnenburg WJGM Abstract Insight into the health risk awareness levels of e-waste workers is important as it may offer opportunities for better e-waste recycling management strategies to reduce the health effects of informal e-waste recycling. Therefore, this study assessed the knowledge, attitude, and practices associated with occupational health risk awareness of e-waste workers compared with a control group (butchers) in the informal sector in Nigeria. A cross-sectional study was used to assess health risk awareness of 279 e-waste workers (repairers and dismantlers) and 221 butchers from the informal sector in three locations in Nigeria in 2015. A questionnaire was used to obtain information on socio-demographic backgrounds, occupational history, knowledge, attitude, and work practices. The data was analysed using Analysis of Variance. The three job designations had significantly different knowledge, attitude, and practice mean scores (p = 0.000), with butchers consistently having the highest mean scores. Only 43% of e-waste workers could mention one or more Personal Protective Equipment needed for their job compared with 70% of the butchers. The health risk awareness level of the e-waste workers was significantly lower compared with their counterparts in the same informal sector. A positive correlation existed between the workers' knowledge and their attitude and practice. Therefore, increasing the workers' knowledge may decrease risky practices. PMID: 28805712 [PubMed - in ...

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  • Improving Human Resources for Health means Retaining Health-Workers: Application of the WHO-Recommendations for the Retention of Health-Workers in Rural Northern-Nigeria.

    Posted 2017-08-15 11:40:42 by: The HealthFolk Team

    Related Articles Improving Human Resources for Health means Retaining Health-Workers: Application of the WHO-Recommendations for the Retention of Health-Workers in Rural Northern-Nigeria. J Health Care Poor Underserved. 2017;28(3):1066-1086 Authors: Afenyadu GY, Adegoke AA, Findley S Abstract INTRODUCTION: Nigeria is one of 57 countries with critical shortage of health workers (HWs). Strategies to increase and equitably distribute HWs are critical to the achievement of Health Millennium/Sustainable Development Goals. We describe how three Northern Nigeria states adapted World Health Organisation (WHO)-recommended incentives to attract, recruit, and retain midwives. METHODS: Secondary analysis of data from two surveys assessing midwife motivation, retention, and attrition in Northern Nigeria; and expert consultations. RESULTS: Midwives highlighted financial and non-financial incentives as key factors in their decisions to renew their contracts. Their perspectives informed the consensus positions of health managers, policymakers and heads of institutions, and led to the adaptation of the WHO recommendations into appropriate state-specific incentive packages. CONCLUSIONS: The feedback from midwives combined with an expert consultation approach allowed stakeholders to consider and use available evidence to select appropriate incentive packages that offer the greatest potential for helping to address inadequate numbers of rural midwives. PMID: 28804079 [PubMed - in ...

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