Digital Commons Network^™

Multilayered Stigma And Vulnerabilities For Hiv Infection And Transmission: A Qualitative Study On Male Sex Workers In Zimbabwe, Elleen Yuk-Ha Tsang, Shan Qiao Ph.D., Jeffrey S. Wilkinson, Annis Lai-Chu Fung, Freddy Lipeleke, Xiaoming Li Ph.D.

Faculty Publications

Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture (“homosexuality is un-African, introduced by the Whites”), religion …

Determinants Of Occupational Injuries Among Building Construction Workers In Kampala City, Uganda, Arthur Kiconco, Nathan Ruhinda, Abdullah Ali Halage, Stephen Watya, William Bazeyo, John C. Ssempebwa, Joseph Byonanebye

Biomedical Sciences Faculty Research and Publications

Background

Globally, about 1000 people die and close to 860,000 people sustain injury at work daily. Injury prevention and control require contextual evidence, although most studies in Uganda have focused on general causes. Factors associated with occupational injuries among building construction workers were assessed in this study.

Methods

A cross-sectional study among building construction workers was conducted in Kampala, Uganda. A standardized semi-structured questionnaire was used to collect data. Three hundred nineteen (319) participants were randomly and proportionately selected from 57 construction sites. Descriptive statistics were used to describe the variables while generalized linear modeling was used to estimate the …

Improving Access To Antenatal Care In Ngara, Tanzania Through Implementation Of The Lady Health Worker Programme, Alison L. Bailey

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Maternal mortality is one of the greatest health disparities facing the world today. A disproportionate number of women who die from pregnancy-related complications live in developing countries: the average maternal mortality in developed nations is 12/100,000, compared to 239/100,000 in developing nations; this rate is even higher in several sub-Saharan African nations. Reasons for this disparity include a lack of providers, inaccessibility to care, and poor quality of treatment in developing nations. Women living in the sub-Saharan country of Tanzania face many of these barriers, and as a result the country’s maternal mortality rate is 398/100,000. Antenatal care is an …

Barriers To Definitive Hyper-Acute Management Of Stroke At A Tertiary Facility In Nairobi, Kenya, Caroline Wangui Mithi

Master of Medicine in Internal Medicine

Background: Stroke is a sudden neurological deficit due to a vascular cause, which can be ischaemic, haemorrhagic stroke or another cause. It is a leading cause of disability and long term functional impairment in the world. The definitive management of an acute ischaemic stroke is thrombolysis and/or mechanical thrombectomy, both of which has been shown to improve functional outcome but the utilization remains quite low in most hospitals, especially in Africa. This is due to certain pre-hospital and in-hospital barriers, and these factors have been shown to differ from country to country. Objective: To determine the pre-hospital barriers that prevent …

Value Of Dedicated Research Time For Imgs In Obtaining Surgical Residency Training Positions: A 10-Year Review Of Applicants From A Medical College In Pakistan, Mohammad Raheel Jajja, Marvi Tariq, Salila Shoaib Hashmi, Thomas F. Dodson, Rashida Ahmed

Department of Pathology and Laboratory Medicine

Objective: International Medical Graduates (IMGs) secured greater than 10% of all general surgery (GS) residency positions in the US during the past decade. The Match process remains competitive, with a significant number of IMGs performing dedicated research before residency application. The impact of such research remains largely unknown. We aimed to provide an objective analysis of the impact of dedicated research time on obtaining a categorical GS residency position.
Design: Data for National Resident Matching Program Match results from 2008-2017 was compiled from annual Match lists of the Aga Khan University, Medical College (Karachi, Pakistan). Medical graduates provided this information …

The Effects Of Rurality And Cost Of Transportation On Time Of Evolution And Disease Complexity At Diagnosis For Cutaneous Leishmaniasis In Colombia, Miguel Paredes

Public Health Theses

Patients in Colombia affected by cutaneous leishmaniasis (CL) face significant geopolitical and socioeconomic barriers to accessing diagnosis and treatment. This study aimed to understand how the geosocial characteristics of a patient’s area of residence affect time to medical consultation and disease status at consultation. An observational cross-sectional study was performed of individuals with CL who consulted at a local clinical referral center (CIDEIM) in Cali and Tumaco, Colombia. Descriptive, bivariate, and multivariable simple and ordinal logistic regression analyses were done to examine how area of residence (urban or rural) and cost of transportation to the nearest urban center may influence …

Reviewing The Preclinical Curriculum In A Problem Based Learning Driven Medical Program: Challenges And Strategies, Manori Amarasekera, Paul S. Noakes, Brian D. Power

Medical Papers and Journal Articles

In order for medical curricula to remain progressive and contemporary, continuous review is critical to ensure that the learners are directed to achieve the intended goals and become workforce ready. We developed a framework for continuous curriculum review at the School of Medicine Fremantle (The University of Notre Dame Australia), taking the key aspects of a curriculum review process into consideration. In planning and implementing the review process we identified several challenges, including management of metadata, work load on staff members, and evaluation. These challenges were addressed successfully by applying necessary strategies using limited resources. The framework we have developed …

Relationship Between The Cervical Microbiome, Hiv Status, And Precancerous Lesions, Cameron Klein, Daniela Gonzalez, Kandali Samwel, Crispin Kahesa, Julius Mwaiselage, Nirosh Aluthge, Samodha Fernando, John T. West, Charles Wood, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Nearly all cervical cancers are causally associated with human papillomavirus (HPV). The burden of HPV-associated dysplasias in sub-Saharan Africa is influenced by HIV. To investigate the role of the bacterial microbiome in cervical dysplasia, cytobrush samples were collected directly from cervical lesions of 144 Tanzanian women. The V4 hypervariable region of the 16S rRNA gene was amplified and deep sequenced. Alpha diversity metrics (Chao1, PD whole tree, and operational taxonomic unit [OTU] estimates) displayed significantly higher bacterial richness in HIV-positive patients (P = 0.01) than in HIV-negative patients. In HIV-positive patients, there was higher bacterial richness in patients with …

3d Printing In Low Resource Healthcare Settings: Analysis Of Potential Implementations, Alenna Beroza

Dissertations, Master's Theses and Master's Reports

3D printing has gained significant momentum in the past ten years, and its unique advantages make it especially ideal for use in low resource healthcare settings, where many designs have already been successfully implemented. Yet, little has been studied on how 3D printing can be sustainably and functionally implemented in low resource healthcare systems as a manufacturing practice. In this report, three business models are proposed for this implementation: In-House Operator, Independent Operator, and Print Farm. These models were then tested over four months in Kisumu county, Kenya, at two workshops and seven public hospitals. I worked with local medical …

Determination Of Medication Adherence And Related Factors Among People Living With Hiv/Aids In A Turkish University Hospital, Erdal Ceylan, Ayşegül Koç, Ahmet Çağkan İnkaya, Serhat Ünal

Turkish Journal of Medical Sciences

Widespread use of antiretroviral treatment (ART) has led to decrease in the incidence of HIV/AIDS-related mortality. Besides the availability of ART, medication adherence is essential for treatment success. There is a scarcity of data reported from Turkey regarding ART adherence among people living with HIV/AIDS (PLWHA). Therefore, this study was undertaken to determine medication adherence and related factors among PLWHA in Turkey.Materials and methods: The sample consisted of 158 PLWHA, who were being followed up at Infectious Diseases Outpatient Clinic of Hacettepe University Hospital. Data were collected using an individual questionnaire and the Turkish version of the Morisky Medication Adherence …

Knowledge Of Hiv/Aids Among Older Adults (50 Years And Above) In A Peri-Urban Setting: A Descriptive Cross-Sectional Study, Reindolf Anokye, Enoch Acheampong, Amy Budu-Ainooson, Edmund Isaac Obeng, Emmanuel Tetteh, Yvonne Sabby Acheampong, Curtis Edward Nettey-Marbell

Research outputs 2014 to 2021

Background: In the absence of vaccine or cure, public knowledge about Human Immune Virus (HIV) is a central tool for curbing HIV epidemic. This study sought to assess the knowledge of HIV among older adults (50 years and above) at the Methodist Faith Healing hospital, Ankaase, Ghana. Methods: Using a descriptive study design, older adults (50 years and above) who visited the Ankaase Methodist Faith Healing hospital were randomly sampled for the study. A structured questionnaire was administered to collect data which was analyzed quantitatively using Statistical Package for Social Sciences (SPSS version 16.0). Results: A total of 100 respondents …

Acquiring Knowledge About The Use Of A Newly Developed Electronic Fetal Heart Rate Monitor: A Qualitative Study Among Birth Attendants In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hussein Kidanto, Columba Mbekenga, Hege L. Ersdal

School of Nursing & Midwifery, East Africa

In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants’ perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use. Five Focus group discussions (FGDs) were carried out with doctors and nurse-midwives, who were using the monitor in the labor …

Establishing Trust In Hiv/Hcv Research Among People Who Inject Drugs (Pwid): Insights From Empirical Research, Roberto Abadie, Shira Goldenberg, Melissa Welch-Lazoritz, Celia B. Fisher

Department of Sociology: Faculty Publications

Background — The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico.

Methods — Qualitative research was nested within a multi-year Social Network and …

Adolescent Sexual And Reproductive Health In The Gambia., Sandhya Lohani

Electronic Theses and Dissertations

Adolescence is a crucial period in human development. Knowledge and awareness about when to have children, when to have sex, and use of contraceptives impacts the chances of teenage pregnancy and risk of sexually transmitted diseases. The objective of this study is to determine the prevalence and associated risk factors related to age of sexual debut, teenage pregnancy, and use of contraceptives in the Gambia. This study also compares the data with 2014 survey research conducted in the Gambia. The total study population were 50 adolescents aged 13-21 years from Bafuluto and surrounding communities in the Gambia. Among 50 respondents, …

Predictors Of Glucose Control In Children And Adolescents With Type 1 Diabetes: Results Of A Cross-Sectional Study In Khartoum, Sudan, Zainab Taha, Zeinab Eltoum, Sidiga Washi

All Works

© 2018 Zainab Taha, Zeinab Eltoum, Sidiga Washi. BACKGROUND: Type 1 diabetes mellitus (T1DM) is a rapidly growing problem in Sudan as well as other African countries. Children and adolescents with type 1 diabetes have previously been found to have poor glycemic control. Strict glycemic control reduces the incidence and progression of chronic complications. AIM: This study aimed to identify the factors associated with glycemic control among children and adolescents. METHODS: The study was a health-centre based descriptive cross-sectional study. Data on socioeconomic, demographic, disease history, and diabetes-specific variables was obtained. Glycemic control was assessed by measuring glycosylated haemoglobin (HbA1C). …

Kawasaki Disease: Two Case Reports From The Aga Khan Hospital, Dar Es Salaam-Tanzania, Mariam Noorani, Nuruddin Lakhani

Faculty of Health Sciences, East Africa

Background

Kawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania. Case presentation We present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them …

"It's A Precious Gift, Not To Waste": Is Routine Cross Matching Necessary In Orthopedics Surgery?: Retrospective Study Of 699 Patients In 9 Different Procedures, Obada Hasan, Eraj Khurshid Khan, Moiz Ali, Sadaf Sheikh, Anum Fatima, Haroon Ur Rashid

Section of Orthopaedic Surgery

Background: Orthopedic surgeries are usually associated with excessive blood loss which leads surgeons to overestimate need for blood transfusions and over ordering of blood. The cross matched blood, when not used, leads to the wastage of blood bank resources in terms of time, money and manpower. The objective of this study was to investigate the compliance to previously proposed MSBOS and to provide updated recommendations for all orthopedic procedures.
Methods: A retrospective analysis was conducted between 1st June 2015 and 31st May 2016. Patients admitted to the orthopedic surgery service for whom blood products were requested were included. Cross Match/Transfusion …

Pseudomyxoma Pleurii And Peritonei Secondary To Sigmoid Colon Adenocarcinoma: A Rare Clinico-Pathologico-Radiological Presentation, Casmir Wambura, Ahmed Jusabani, Salim Surani

Faculty of Health Sciences, East Africa

Pseudomyxoma peritonei (PMP) is a rare condition resulting from mucin-producing tumors that have disseminated intointraperitoneal implants and mucinous ascites. The extra-abdominal spread of PMP is exceptionally rare, with few reportedcases in the medical literature. Pseudomyxoma pleurii is an infrequently encountered clinical syndrome characterized bytransdiaphragmatic pleural extension and spread of PMP. The disease is highly fatal. We hereby report a case of 58 years oldwoman who presented with an abdominal distension and shortness of breath of 2 months duration. Histopathology confirmedthe diagnosis of large mucin-producing rectosigmoid adenomatous polypoid lesion with malignant transformation and PMPthat had spread to the right pleural space. …

Maternal Experiences Of Intimate Partner Violence And C-Reactive Protein Levels In Young Children In Tanzania, Natalie Slopen, Jing Zhang, Samuel S. Urlacher, Gretchen De Silva, Mona Mittal

Publications and Research

Intimate partner violence (IPV) is a critical public health issue that impacts women and children across the globe.Prior studies have documented that maternal experiences of IPV are associated with adverse psychological and physical health outcomes in children; however, research on the underlying physiological pathways linking IPV to these conditions is limited. Drawing on data from the 2010 Tanzania Demographic and Health Survey, we examined the relationship between maternal report of IPV in the past 12 months and inflammation among children ages 6 months to 5 years. Our study included 503 children who were randomly selected to provide a blood sample …

Direct Experience With Cervical Cancer Patient, Husband Support, And Self-Perception As Determinant Factors Of Women’S Desire To Take Via Screening Test, Nur Anisah Rahmawati, Linda Dewanti

Kesmas

Kanker serviks menyebabkan 10.3% kematian pada perempuan di Indonesia. Inspeksi visual asam asetat (IVA) telah digunakan untuk program skrining sejak tahun 2014 tetapi hanya 2,45 % perempuan yang melakukan pemeriksaan pada tahun 2015. Di tempat penelitian, cakupan skrining metode IVA kurang dari 1%. Penelitian sebelumnya menyebutkan faktor psikososial sebagai satu faktor penting, tetapi sedikit penelitian yang menganalisis peran dukungan suami dan pengalaman langsung dengan penderita kanker serviks. Penelitian ini bertujuan mempelajari hubungan antara pengalaman langsung dengan penderita kanker serviks, dukungan suami, persepsi diri dan keinginan perempuan melakukan skrining IVA. Penelitian potong lintang dilakukan secara acak pada perempuan berusia 25-55 tahun …

Predictors Of Death Including Quality Of Positive Pressure Ventilation During Newborn Resuscitation And The Relationship To Outcome At Seven Days In A Rural Tanzanian Hospital, Robert Moshiro, Jeffrey M. Perlman, Hussein Kidanto, Jan Terje Kvaløy, Paschal Mdoe, Hege L. Ersdal

Faculty of Health Sciences, East Africa

Background Effective positive pressure ventilation (PPV) of non-breathing newborns is crucial in facilitating cardio-respiratory adaptation at birth. Identifying predictors of death in newborns receiving PPV is important in order to facilitate preventative strategies.

Objective The objective of this study was to determine the perinatal predictors of death including the quality of PPV administered among admitted newborns.

Methods An observational study of admitted newborns who received PPV after birth was conducted. Research assistants observed all deliveries and recorded perinatal events on data collection forms. Measured heart rate (HR) and ventilation parameters were then compared between newborns who died and survivors.

Results …

Evaluation Of A Human Papillomavirus Genotyping Assay For Cervical Cancer Screening In Tanzania, Kandali S. Kapie

School of Biological Sciences: Dissertations, Theses, and Student Research

Abstract: Mucosal high-risk Human papillomavirus (HR-HPV) has been identified as the primary factor in causing cervical cancer, the most common cancer in women of low and middle-income countries (LMICs). Cervical cancer screening, incorporating the HPV test shown to be more advantageous than screening by visual inspection with acetic acid (VIA) alone. However, due to resources constrain these countries could not afford the available HPV tests. We, therefore, validated a cost-effective Multiplex PCR HPV (mPCR) assay, a recently developed assay for detecting sixteen genital HPV, fourteen HR-HPV and 2 low-risk genotypes. We postulate that this HPV multiplex assay will be at …

One-Compound-Two-Pharmacophores: Design, Synthesis And Antimalarial Activities Of Chloroquinoline-Cassiarin, Thobias M. Kalenga, Monica M. Ndoile, Quintino A. Mgani

Tanzania Journal of Science

This paper describes the design and synthesis of a potential antimalarial compound, chloroquinoline-cassiarin (6) using 4,7-dichloroquinoline and the natural product barakol (1) extracted from the leaves of Cassia siamea as starting materials. In this paper a one compound-two-pharmacophores concept is introduced in which coupling of two known pharmacophores into one has been described. The concept is not only useful to organic synthesis but also to drug development researches. The synthesized compound 6 exhibited potent in vitro antimalarial activity at IC50 = 0.51 µM, and low toxicity where at 20 µM, 80% viability of HeLa cells was observed.

Assessing The Impact Of A Partnership‐Based Work/Study Nursing Upgrade Programme In A Low And Middle‐Income Setting, Sharon Brownie, Samwel Gatimu, Abdul Haq Wahedna, Isabel Kambo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Aim: To evaluate the 15‐years impact of the work‐study nursing upgrading programme in East Africa.

Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work‐study upgrade programme for enrolled‐ and diploma‐level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access.

Design: A mixed method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory …

Tracking Facility-Based Perinatal Deaths In Tanzania: Results From An Indicator Validation Assessment, Marya Plotkin, Dunstan Bishanga, Hussein Kidanto, Mary Carol Jennings, Jim Ricca, Amasha Mwanamsangu, Gaudiosa Tibaijuka, Ruth Lemwayi, Benny Ngereza, Mary Drake

Faculty of Health Sciences, East Africa

Background Globally, an estimated 2.7 million babies die in the neonatal period annually, and of these, about 0.7 million die from intrapartum-related events. In Tanzania 51,000 newborn deaths and 43,000 stillbirths occur every year. Approximately two-thirds of these deaths could be potentially prevented with improvements in intrapartum and neonatal care. Routine measurement of fetal intrapartum deaths and newborn deaths that occur in health facilities can help to evaluate efforts to improve the quality of intrapartum care to save lives. However, few examples exist of indicators on perinatal mortality in the facility setting that are readily available through health management information …

Complete Blood Count Reference Intervals From A Healthy Adult Urban Population In Kenya, Geoffrey Omuse, Daniel Maina, Jane Mwangi, Caroline Wambua, Kiran Radia, Alice Kanyua, Elizabeth Kagotho, Mariza Hoffman, Peter Ojwang, Zul Premji, Kiyoshi Ichihara, Rajiv Erasmus

Pathology, East Africa

Background: There are racial, ethnic and geographical differences in complete blood count (CBC) reference intervals (RIs) and therefore it is necessary to establish RIs that are population specific. Several studies have been carried out in Africa to derive CBC RIs but many were not conducted with the rigor recommended for RI studies hence limiting the adoption and generalizability of the results.

Method: By use of a Beckman Coulter ACT 5 DIFF CP analyser, we measured CBC parameters in samples collected from 528 healthy black African volunteers in a largely urban population. The latent abnormal values exclusion (LAVE) method was used …

Occurrence Of Pathogenic Vibrio Cholerae Serogroups O1 And O139 In Some Estuaries Of Tanzania, David Temba, Lucy Namkinga, Sabrina Moyo, Thomas J. Lyimo, Charles V. Lugomela

Tanzania Journal of Science

In this study, the occurrence of culturable Vibrio cholerae serogroup O1 and O139 in three selected Tanzanian Estuaries, Mzinga, Pangani and Ruvu were explored. A total of 480 water and plankton samples were collected along salinity gradients (fresh, brackish and marine waters). Samples were enriched in Alkaline Peptone Water (APW) and subsequently cultured on Thiosulfate Citrate Bile-Salt Sucrose (TCBS) agar. Resulting isolates were serially identified by oxidase test, API-20E test and monoclonal antibodies for V. cholerae serogroup O1 and O139. A total of 670 presumptive V. cholerae isolates were obtained from 416 samples (86.7%), where 137 (20.4%) were oxidase test …

Intermittent Fetal Heart Rate Monitoring Using A Fetoscope Or Hand Held Doppler In Rural Tanzania: A Randomized Controlled Trial, Paschal Francis Mdoe, Hege L. Ersdal, Estomih R. Mduma, Jeffrey M. Perlman, Robert Moshiro, Peter T. Wangwe, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

Background: Neonatal mortality is a global challenge, with an estimated 1.3 million intrapartum stillbirths in 2015. The majority of these were found in low resource settings with limited options to intrapartum fetal heart monitoring devices. This trial compared frequency of abnormal fetal heart rate (FHR) detection and adverse perinatal outcomes (i.e. fresh stillbirths, 24-h neonatal deaths, admission to neonatal care unit) among women intermittently assessed by Doppler or fetoscope in a rural low-resource setting.

Methods: This was an open-label randomized controlled trial conducted at Haydom Lutheran Hospital from March 2013 through August 2015. Inclusion criteria were; women in labor, …

A Care Bundle Including Antenatal Corticosteroids Reduces Preterm Infant Mortality In Tanzania A Low Resource Country, Augustine Massawe, Hussein Kidanto, Robert Moshiro, Edna Majaliwa, Flora Chacha, Aisa Shayo, Paschal Mdoe, Prisca Ringia, Mary Azayo, Georgina Msemo

Faculty of Health Sciences, East Africa

Background Preterm neonatal mortality (NM) has remained high and unchanged for many years in Tanzania, a resource-limited country. Major causes of mortality include birth asphyxia, respiratory insufficiency and infections. Antenatal corticosteroids (ACS) have been shown to significantly reduce mortality in developed countries. There is inconsistent use of ACS in Tanzania.

Objective To determine whether implementation of a care bundle that includes ACS, maternal antibiotics (MA), neonatal antibiotics (NA) and avoidance of moderate hypothermia (temperature < 36°C) targeting infants of estimated gestational age (EGA) 28 to 34 6/7 weeks would reduce NM (< 7 days) by 35%.

Methods A Pre (September 2014 to May 2015) and Post (June 2015 to June 2017) Implementation strategy was used and introduced at three University-affiliated and one …

Intermittent Fetal Heart Rate Monitoring Using A Fetoscope Or Hand Held Doppler In Rural Tanzania: A Randomized Controlled Trial, Paschal Francis Mdoe, Hege Ersdal, Estomih Mduma, Jeffrey M. Perlman, Robert Moshiro, Peter Wangwe, Hussein Kidanto

Faculty of Health Sciences, East Africa

Background: Neonatal mortality is a global challenge, with an estimated 1.3 million intrapartum stillbirths in 2015. The majority of these were found in low resource settings with limited options to intrapartum fetal heart monitoring devices. This trial compared frequency of abnormal fetal heart rate (FHR) detection and adverse perinatal outcomes (i.e. fresh stillbirths, 24-h neonatal deaths, admission to neonatal care unit) among women intermittently assessed by Doppler or fetoscope in a rural low-resource setting.

Methods: This was an open-label randomized controlled trial conducted at Haydom Lutheran Hospital from March 2013 through August 2015. Inclusion criteria were; women in labor, …