Objective: To evaluate the impact of Information and Communication Technology (ICT) on the implementation of Integrated Management of Childhood Illness (IMCI) and integrated Community Case Management (iCCM) through a systematic review and meta-analysis (PROSPERO registration number: CRD42024517375).
Methods: We searched MEDLINE, EMBASE, Cochrane Library, and gray literature from January 2010 to February 2024, focusing on IMCI/iCCM-related terms () and excluding non-ICT interventions. A meta-analysis synthesized the effect of ICT on clinical assessment, disease classification, therapy, and antibiotic prescription through odds ratio (OR; 95% CI) employing a random effects model for significant heterogeneity (I>50%) and conducting subgroup analyses.
Malaria remains a major public health problem in many countries in Sub Saharan Africa, including Togo, particularly among children under 5 years of age. Therefore, several mass distribution campaigns of long-lasting insecticide-treated bed nets (LLINs), which constitute an essential preventive strategy, have been conducted. The aim of this study is to assess progress in terms of equity of ownership, access and use of LLINs in a context of universal coverage among households in Togo.
View Article and Find Full Text PDFEpidemic intelligence efforts aim to predict, timely detect and assess (re-)emerging pathogens, guide and evaluate infectious disease prevention or control. We emphasise the underused potential of integrating the monitoring of risks related to exposure, disease or death, particularly in settings where limited diagnostic capacity and access to healthcare hamper timely prevention/control measures. Monitoring One Health exposures, human behaviour, immunity, comorbidities, uptake of control measures or pathogen characteristics can complement facility-based surveillance in generating signals of imminent or ongoing outbreaks, and in targeting preventive/control interventions or epidemic preparedness to high-risk areas or subpopulations.
View Article and Find Full Text PDFBackground: The clinical and public health relevance of widespread testing for asymptomatic (chlamydia) infections is under debate. To address uncertainties in screening programs, we estimate reproductive tract complication risks following asymptomatic and symptomatic chlamydia infections in a long-term prospective cohort.
Methods: A cohort of 5704 reproductive-age women recruited from a chlamydia screening study was followed for up to 14 years.
PLOS Glob Public Health
August 2024
In sub-Saharan Africa, reported COVID-19 numbers have been lower than anticipated, even when considering populations' younger age. The extent to which risk factors, established in industrialised countries, impact the risk of infection and of disease in populations in sub-Saharan Africa, remains unclear. We estimated the incidence of mild and moderate COVID-19 in urban Mozambique and analysed factors associated with infection and disease in a population-based surveillance study.
View Article and Find Full Text PDFBackground: To guide antibiotic stewardship interventions, understanding for what indications antibiotics are used is essential.
Methods: In rural Burkina Faso, we measured antibiotic dispensing across all healthcare providers. From October 2021 to February 2022, we surveyed patients in Nanoro district, Burkina Faso, following visits to health centres (3), pharmacies (2), informal medicine vendors (5) and inpatients in health centres.
Zero-dose children remain highly vulnerable to vaccine-preventable diseases and can sustain transmission even in highly vaccinated populations. The WHO Immunization Agenda 2030 has prioritised reaching out to these children. We assessed the spatial distribution of zero-dose children together with the associated risk factors in a provincial capital in the Democratic Republic of Congo.
View Article and Find Full Text PDFInvasive non-typhoidal Salmonella (iNTS) disease manifesting as bloodstream infection with high mortality is responsible for a huge public health burden in sub-Saharan Africa. Salmonella enterica serovar Typhimurium (S. Typhimurium) is the main cause of iNTS disease in Africa.
View Article and Find Full Text PDFObjective: Optimising antibiotic use is important to limit increasing antibiotic resistance. In rural Burkina Faso, over-the-counter dispensing of antibiotics in community pharmacies and non-licensed medicine retail outlets facilitates self-medication. We investigated its extent, reasons and dispensing patterns.
View Article and Find Full Text PDFBMC Public Health
November 2022
Background: Fever is one of the warning signs of poor health in children. Care-seeking in febrile children is importance in reducing child deaths and morbidity. This care-seeking by parents in children with fever is however relatively low in sub-Sahara Africa.
View Article and Find Full Text PDFIntroduction: Isoniazid preventive therapy (IPT) can reduce the risk of tuberculosis (TB) in children living with HIV (CLHIV), but data on the outcomes of the IPT cascade in CLHIV are limited.
Methods: We evaluated the IPT cascade among CLHIV aged <15 years and newly enrolled in HIV care in eight HIV clinics in western Kenya. Medical record data were abstracted from September 2015 through July 2019.
Malar J
June 2022
Background: Malaria remains a major cause of morbidity and death among children less than 5 years of age. In Togo, despite intensification of malaria control interventions, malaria remained highly prevalent, with significant heterogeneity from one region to another. The aim of this study is to explore further such regional differences in malaria prevalence and to determine associated risk factors.
View Article and Find Full Text PDFClin Microbiol Infect
September 2022
Objective: In the Democratic Republic of Congo and other low-resource countries, community-acquired pathogens are increasingly resistant to most locally available antibiotics. To guide efforts to optimize antibiotic use to limit antibiotic resistance, we quantified healthcare provider-specific and community-wide antibiotic use.
Methods: From household surveys, we estimated monthly healthcare visit rates by provider.
Antimicrob Resist Infect Control
April 2022
Background: In low- and middle-income countries, the prevalence of antimicrobial resistance (AMR) is increasing. To control AMR, WHO recommends monitoring antibiotic use, in particular Watch antibiotics. These are critically important antibiotics, with restricted use because at risk of becoming ineffective due to increasing AMR.
View Article and Find Full Text PDFBackground: Chlamydia trachomatis (CT) is the most common bacterial sexually transmitted infection (STI) worldwide. CT is mainly asymptomatic. Test-and-treat strategies are widely implemented to prevent transmission and complications.
View Article and Find Full Text PDFObjectives: Describe the causes of death among infants and children less than 5 years stratified by HIV status.
Design: Cross-sectional analysis of causes of death ascertained through minimally invasive tissue sampling (MITS) in the Kenya Child Health and Mortality Prevention Surveillance site.
Methods: We included decedents aged 28 days to less than 5 years, whose death was reported within 36 h, underwent MITS, and had HIV test results and causes of death determined.
Objectives: The widespread use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) by patients with chronic conditions raised early concerns on the potential exacerbation of COVID-19 severity and fatality. Previous studies addressing this question have used standard methods that may lead to biased estimates when analysing hospital data because of the presence of competing events and event-related dependency. We investigated the association of ACEIs/ARBs' use with COVID-19 disease outcomes using time-to-event data in a multistate setting to account for competing events and minimise bias.
View Article and Find Full Text PDFObjectives: Rising antimicrobial resistance is a major threat worldwide. WHO has developed a Global Action Plan and has urged all countries to develop and implement a National Action Plan. We analysed the implementation of the Cameroon National Action Plan by identifying the prioritised activities and assessing possible challenges which could limit implementation.
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