A Test of Accuracy and Completeness in Data Flow Value Chain Within the Context of Early Infant Diagnosis of HIV Using Mixed Methods Approaches
Leonard King’wara,
David Omondi Okeyo,
Charles Obonyo
Issue:
Volume 5, Issue 4, July 2016
Pages:
63-72
Received:
5 May 2016
Accepted:
17 May 2016
Published:
4 June 2016
Abstract: Recent changes to Kenya’s early infant diagnosis (EID) testing algorithm have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major challenge. The purpose of this study was therefore to assess data completeness, accuracy and challenges in relation to routine EID data management in Kisumu East and Kisumu West Districts within Kisumu County, Kenya. Purposive sampling was used to select 23 active health facilities across the two districts disproportionate by partners. From the selected facilities a sampling frame of 192 patients was established and a sample size of 130 patient’s data selected. Accuracy and completeness were determined by computing sensitivity, specificity, and predictive values. Infant sex, Infant prophylaxis, Breastfeeding information, Entry point, and Test results were found to have registered replication completeness not significantly different from 99% replication at (p>0.05) as oppose to Sample code, Infant Age, Date of sample collection, and PMTCT prophylaxis were found to be significantly different from the 99% replication (p<0.05). On completeness; Sample code and date of sample collection registered completeness beyond the hypothesized value, implying they were complete as required. The remaining data elements including infant sex, infant age, infant prophylaxis, PMTCT prophylaxis, breastfeeding information and entry point were significantly lower than the hypothesized completeness value (p<0.0001) except for test results that had completeness score equal to 0.99. The study, therefore, concludes that despite the shortage of staffing and other challenges, personnel working in the data management system appear to be dedicated, informed and conscientious. However, this research suggests that there is a suboptimal use of the information for local action in certain areas. This assessment thus serves to enlighten policy-makers on the current state of the EID data management system in Kisumu East and West districts.
Abstract: Recent changes to Kenya’s early infant diagnosis (EID) testing algorithm have raised hope that the national goal of reducing perinatal HIV transmission rates to less than 5% can be attained. While programmatic efforts to reach this target are underway, obtaining complete and accurate data from clinical sites to track progress presents a major chall...
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Prevalence of Crytpococcal Infection in Patients Clinically Diagnosed to Have Meningitis in Ethiopia
Adane Bitew,
Mulu Hassen,
Tigist Getachew,
Surafel Fentaw
Issue:
Volume 5, Issue 4, July 2016
Pages:
73-76
Received:
21 May 2016
Accepted:
31 May 2016
Published:
14 June 2016
Abstract: Cryptococcal meningitis is a fungal infection that causes significant morbidity and mortality worldwide. However, its incidence in Ethiopia is poorly known. The present study was undertaken to determine cryptococcal meningitis in Ethiopian patients diagnosed to have meningitis. Cerebrospinal fluid was collected from 201 patients with meningitis attending two tertiary hospitals for the isolation and characterization of major bacterial pathogens implicated in causing meningitis. Left over sample of each patient was screened for cryptococal antigen using lateral flow Assay. Of the total number of 201 patients 17 (8.5%) were positive for cryptococcal antigenemia of which 8 (47.1%) were male patients while 9 (52.9%) were female patients. In conclusion a high prevalence of cryptococcal meningitis in the present study urges detection and /or isolation and characterization of the pathogen in patients diagnosed to have meningitis regardless of the immune status. Furthermore, in view of the increasing number of cryptococcal infections, rapid, sensitive, and specific diagnosis of cryptococcal disease has become more important than ever in Ethiopian health institutions.
Abstract: Cryptococcal meningitis is a fungal infection that causes significant morbidity and mortality worldwide. However, its incidence in Ethiopia is poorly known. The present study was undertaken to determine cryptococcal meningitis in Ethiopian patients diagnosed to have meningitis. Cerebrospinal fluid was collected from 201 patients with meningitis att...
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Investigation on the Effects of Brain Retraction on Local Cerebral Metabolism Utilizing Microdialysis
Issue:
Volume 5, Issue 4, July 2016
Pages:
77-81
Received:
14 June 2016
Published:
15 June 2016
Abstract: In order to study the effect of brain retraction on local biochemical metabolism in brain tissue and to investigate the potential application of microdialysis in monitoring local cerebral metabolic and biochemical variations owing to brain retraction injury. Brain tissues were retracted based on different retraction pressures (30 mmHg, 40 mmHg, 50 mmHg) and retraction modes (intermittent and continuous tractions). Microdialysis was utilized for the dynamic collection of the dialysis fluid of extracellular fluid (ECF), and [Glu]d, [Lac]d, [Gly]d, [Gluta]d and L/P changes were observed. Different brain retraction pressures led to the changes of [Glu]d, [Lac]d, [Gly]d, [Gluta]d and L/P to various extents in ECF. Differences between the retraction group and control group before and after injury were significantly different (P<0.05). A higher retraction pressure resulted in a more significant change. Continuous retraction led to more serious brain damage than intermittent retraction. [Glu]d, [Lac]d, [Gly]d, [Gluta]d and L/P of the continuous retraction group changed more apparently, and the differences between the groups were significantly different (P<005). Microdialysis technique is ideal for the dynamic monitoring of local biochemical changed in brain tissues resulted from brain injury, which can be utilized as a valuable tool in monitoring brain retraction injury during neurosurgical operations.
Abstract: In order to study the effect of brain retraction on local biochemical metabolism in brain tissue and to investigate the potential application of microdialysis in monitoring local cerebral metabolic and biochemical variations owing to brain retraction injury. Brain tissues were retracted based on different retraction pressures (30 mmHg, 40 mmHg, 50 ...
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