Tropical medicine & international health : TM & IH
-
Trop. Med. Int. Health · Mar 2014
What happens to Palestine refugees with diabetes mellitus in a primary healthcare centre in Jordan who fail to attend a quarterly clinic appointment?
In a primary healthcare clinic in Jordan to determine: (i) treatment outcomes stratified by baseline characteristics of all patients with diabetes mellitus (DM) ever registered as of June 2012 and (ii) in those who failed to attend the clinic in the quarter (April-June 2012), the number who repeatedly did not attend in subsequent quarters up to 1 year later, again stratified by baseline characteristics. ⋯ This study endorses the value of e-health and cohort analysis for monitoring and managing patients with DM. Just over half of patients who fail to attend a scheduled quarterly appointment are declared lost to follow-up 1 year later, and systems need to be set up to identify and contact such patients so that those who are late for their appointments can be brought back to care and those who might have died or silently transferred out can be correctly recorded.
-
Trop. Med. Int. Health · Feb 2014
Estimating the costs of implementing the rotavirus vaccine in the national immunisation programme: the case of Malawi.
Worldwide, rotavirus infections cause approximately 453,000 child deaths annually. Two licensed vaccines could be life- and cost-saving in low-income countries where the disease burden is highest. The aim of our study was to estimate the total cost of implementing the rotavirus vaccine in the national immunisation programme of a low-income country. Furthermore, the aim was to examine the relative contribution of different components to the total cost. ⋯ The total cost of rotavirus vaccine implementation in Malawi is high compared with the governmental health budget of US$ 26 per capita per year. This highlights the need for new financing opportunities for low-income countries to facilitate vaccine implementation and ensure sustainable financing.
-
Trop. Med. Int. Health · Jan 2014
Measuring disparities in sanitation access: does the measure matter?
Initiatives to monitor progress in health interventions like sanitation are increasingly focused on disparities in access. We explored three methodological challenges to monitoring changes in sanitation coverage across socio-economic and demographic determinants: (i) confounding by wealth indices including water and sanitation assets, (ii) use of individual urban and rural settings versus national wealth indices and (iii) child-level versus household-level analyses. ⋯ Standard asset indices provide a reasonably robust measure of disparities in improved sanitation, although overestimation is possible. Separate setting wealth quintiles reveal important disparities in urban areas, but analysis of setting quintiles using a national index is sufficient. Estimates and disparities in household-level coverage of improved sanitation can underestimate coverage for children under five.
-
Trop. Med. Int. Health · Jan 2014
Review Meta AnalysisSystematic review of the proportion of pregnancy-related deaths attributed to HIV in population-based studies in sub-Saharan Africa.
To estimate the proportion of pregnancy-related deaths attributed to HIV in population-based studies in sub-Saharan Africa, and to document the methods used to make such attribution. ⋯ The proportion of pregnancy-related/maternal deaths attributed to HIV is substantially lower than modelled estimates, but comparisons are hampered by the absence of standard approaches. Clear guidelines on how to classify pregnancy-related deaths as attributable to HIV are urgently needed, so that the effect of the HIV epidemic on pregnancy-related mortality can be monitored and action taken accordingly.
-
Trop. Med. Int. Health · Dec 2013
The magnitude of diabetes and its association with obesity in the slums of Nairobi, Kenya: results from a cross-sectional survey.
To assess the prevalence, awareness, treatment and control of diabetes and to examine the relationship of obesity with raised blood glucose in the slums of Nairobi, Kenya. ⋯ The prevalence of diabetes in this impoverished population is moderately high, while the levels of awareness, treatment and control are quite low. In this population, obesity is an important risk factor for raised blood glucose particularly among women. Prevention and control strategies that target modifiable risk factors for diabetes and increase access to treatment and control in such disadvantaged settings are urgently needed.