Medicine and Health Sciences Commons^™

Involving Men To Improve Maternal And Newborn Health: A Systematic Review Of The Effectiveness Of Interventions, Mariam Tokhi, Liz Comrie-Thomson, Jessica Davis, Anayda Portela, Matthew Chersich, Stanley Luchters

Population Health, East Africa

Background: Emerging evidence and program experience indicate that engaging men in maternal and newborn health can have considerable health benefits for women and children in low- and middle-income countries. Previous reviews have identified male involvement as a promising intervention, but with a complex evidence base and limited direct evidence of effectiveness for mortality and morbidity outcomes.

Objective: To determine the effect of interventions to engage men during pregnancy, childbirth and infancy on mortality and morbidity, as well as effects on mechanisms by which male involvement is hypothesised to influence mortality and morbidity outcomes: home care practices, care-seeking, and couple relationships. …

Feasibility Of Antiretroviral Treatment Monitoring In The Era Of Decentralized Hiv Care: A Systematic Review, Minh D. Pham, Lorena Romero, Bruce Parnell, David A. Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Regular monitoring of HIV patients who are receiving antiretroviral therapy (ART) is required to ensure patient benefits and the long-term effectiveness and sustainability of ART programs. Prompted by WHO recommendations for expansion and decentralization of HIV treatment and care in low and middle income countries, we conducted a systematic review to assess the feasibility of treatment monitoring in these settings.

Methods: A comprehensive search strategy was developed using a combination of MeSH and free text terms relevant to HIV treatment and care, health service delivery, health service accessibility, decentralization and other relevant terms. Five electronic databases and two conference …

Performance Of Point-Of-Care Cd4 Testing Technologies In Resource-Constrained Settings: A Systematic Review And Meta-Analysis, Minh D. Pham, Paul A. Agius, Lorena Romero, Peter Mcglynn, David Anderson, Suzanne M. Crowe, Stanley Luchters

Population Health, East Africa

Background: Point-of-care (POC) CD4 testing increases patient accessibility to assessment of antiretroviral therapy eligibility. This review evaluates field performance in low and middle-income countries (LMICs) of currently available POC CD4 technologies.

Methods: Eight electronic databases were searched for field studies published between January 2005 and January 2015 of six POC CD4 platforms: PointCare NOW™, Alere Pima™ CD4, Daktari™ CD4 Counter, CyFlow® CD4 miniPOC, BD FACSPresto™, and MyT4™ CD4. Due to limited data availability, meta-analysis was conducted only for diagnostic performance of Pima at a threshold of 350 cells/μl, applying a bivariate multi-level random-effects modelling approach. A covariate extended model was …

Attitudes And Behaviours Of Maternal Health Care Providers In Interactions With Clients: A Systematic Review, P. Mannava, K. Durrant, J. Fisher, M. Chersich, Stanley Luchters

Population Health, East Africa

Background: High maternal mortality and morbidity persist, in large part due to inadequate access to timely and quality health care. Attitudes and behaviours of maternal health care providers (MHCPs) influence health care seeking and quality of care.

Methods: Five electronic databases were searched for studies from January 1990 to December 2014. Included studies report on types or impacts of MHCP attitudes and behaviours towards their clients, or the factors influencing these attitudes and behaviours. Attitudes and behaviours mentioned in relation to HIV infection, and studies of health providers outside the formal health system, such as traditional birth attendants, were excluded. …

Priority Interventions To Reduce Hiv Transmission In Sex Work Settings In Sub-Saharan Africa And Delivery Of These Services, Matthew F. Chersich, Stanley Luchters, Innocent Ntaganira, Antonio Gerbase, Ying-Ru Lo, Fiona Scorgie, Richard Steen

Population Health, East Africa

Introduction: Virtually no African country provides HIV prevention services in sex work settings with an adequate scale and intensity. Uncertainty remains about the optimal set of interventions and mode of delivery.

Methods: We systematically reviewed studies reporting interventions for reducing HIV transmission among female sex workers in sub-Saharan Africa between January 2000 and July 2011. Medline (PubMed) and non-indexed journals were searched for studies with quantitative study outcomes.

Results: We located 26 studies, including seven randomized trials. Evidence supports implementation of the following interventions to reduce unprotected sex among female sex workers: peer-mediated condom promotion, risk-reduction counselling and skills-building for …